Retraction Update

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

 Judy George at MedPage Today:

A 2010 paper that linked hepatitis B vaccines in infant boys to an increased risk of autism diagnosis was retracted and another study by the same authors is under investigation.

The study, published in the Journal of Toxicology and Environmental Health, Part A, claimed that boys vaccinated as neonates had a three times higher odds of an autism diagnosis compared with boys vaccinated after their first month of life or not at all.

The paper was included in a safety review of hepatitis B birth vaccination alongside work from David Geier and presented to the CDC's Advisory Committee on Immunization Practices at their meeting on December 4, the day before the committee voted to drop the agency's long-standing recommendation that every newborn receive a hepatitis B vaccine at birth.
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The neonate paper was retracted because "concerns were raised regarding the methodology of the study and the reported conclusions," according to a notice from the journal's editor and publisher.

The journal contacted Gallagher and Goodman for an explanation and engaged an independent reviewer for a post-publication statistical review. The reviewer concluded that the study's conclusions were unsound "due to fundamental methodological flaws," leading the journal to retract the article. Gallagher and Goodman did not agree with the retraction.

The study had multiple flaws, noted David Mandell, ScD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, who was not involved in either the research or the journal's retraction decision.

These shortcomings led to "spurious findings based on a tiny group of children," said Mandell, a member of the Coalition of Autism Scientists, a group of autism researchers. "They speak to the need to radically reform the peer review process so that all science is reviewed with a keener eye."

RFK and Stem Cell "Therapy"

In The Politics of Autism, I write:

The conventional wisdom is that any kind of treatment is likely to be less effective as the child gets older, so parents of autistic children usually believe that they are working against the clock. They will not be satisfied with the ambiguities surrounding ABA, nor will they want to wait for some future research finding that might slightly increase its effectiveness. They want results now. Because there are no scientifically-validated drugs for the core symptoms of autism, they look outside the boundaries of mainstream medicine and FDA approval. Studies have found that anywhere from 28 to 54 percent of autistic children receive “complementary and alternative medicine” (CAM), and these numbers probably understate CAM usage.

A lot of people in RFK Jr's MAHA orbit are making a lot of money from dubious "treatments."

Ed Pilkington at The Guardian:

Autistic children as young as 18 months old are being injected with human stem cells derived from umbilical cords in unapproved, unproven and potentially harmful “treatments” that scientists warn are proliferating across the US under the active encouragement of the US health secretary, Robert F Kennedy Jr.

Clinics in Florida, Texas and other states are selling what they bill as “regenerative medicine” to families with autistic children who have intensive care needs. Parents who have taken their children through the process talked about their hopes and fears for a therapy that appears to be gaining ground in the US.

The procedure, which can involve the child being sedated with ketamine before receiving intravenous doses of millions of stem cells, costs up to $20,000 for each treatment. Families are often advised to return for regular top-ups.

Profoundly stressed parents are being wooed to the clinics with promises that a high-dose infusion of umbilical cord stem cells can lead to dramatic improvements in their children’s ability to speak, socialise, or avoid aggressive or self-harming behaviour. Yet there is no scientific evidence that the procedure works – the most comprehensive clinical trial staged so far, a placebo experiment conducted by Duke University, found insignificant benefits for most of the 180 children tested.

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In his 16 months as the secretary of the Department of Health and Human Services within the Trump administration, Kennedy has undercut established scientific endeavors. He has fired thousands of federal health officials, dismissed longstanding scientific advisers, defunded $31m in autism-related research and attempted to shrink the recommended list of childhood vaccinations.

At the same time, largely unnoticed, he has given his backing to alternative health providers moving to fill the gap. Kennedy appeared by video link at the first two annual summits held in San Diego by Autism Health, a leading advocate of stem cell infusions for autistic kids.


At the summit last year, he told the audience that “your issue is no longer on the fringe”. At this year’s gathering in April, he promised to “create opportunities that extend across a lifetime” and to work with the stem cell providers “to drive solutions together”.

Measles and the World Cup

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

From CDC:

As of June 11, 2026, 2,073 confirmed* measles cases were reported in the United States in 2026. Among these, 2,063 measles cases were reported by 40 jurisdictions: Alaska, Arizona, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. A total of 10 measles cases were reported among international visitors to the United States.

There have been 30 new outbreaks** reported in 2026, and 93% of confirmed cases (1,929 of 2,073) are outbreak-associated (593 from outbreaks starting in 2026 and 1,336 from outbreaks that started in 2025

Meghan Holohan at CIDRAP:

“Disease surveillance is disease surveillance every day of the week,” Garrow, Philadelphia deputy health commissioner, told CIDRAP News. “What is changing in terms of the World Cup is how intense that disease surveillance is going to look.”

While Garrow worries about heat-related illnesses and air quality, there’s one infectious disease he’s most concerned about. “Measles is probably our top worry,” he said. “We’ve already put out communications to our regional healthcare providers about what to look for.”

With recent outbreaks in the United States, lower vaccination rates, and people traveling, it seems more likely than ever that a fan with measles could be in the stands at the World Cup. This year, stadiums and Fan Festivals packed with cheering people could make it easy for measles to thrive.

“Measles tends to hang around in the air. It’s very small particles and it just floats there for up to two hours after someone with measles has been in the space,” Garrow said. “How many people could potentially have gone through that particular site in two hours after the person left?”

AMA v. RFK

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

 Simon J. Levien at POLITICO:

American doctors want their leading lobby to drop its nice guy routine with Robert F. Kennedy Jr.

At the American Medical Association’s annual meeting this week, members of the group’s House of Delegates are sending a clear message to their leaders: Call out Kennedy, even if it costs us in the pocketbook.

That message was stated most clearly in the election of Sandra Fryhofer, an internist from Atlanta and uncompromising Kennedy critic, as AMA president-elect. She beat Michael Suk, who as AMA board chair in 2024 and 2025 prioritized doctors’ Medicare fees and promised continued pragmatism in dealing with Kennedy.


Fryhofer, who advised the vaccine committee whose members Kennedy fired last year, suggested that would be an abdication of doctors’ moral duty.

“Measles running rampant, public health destroyed, a trillion dollars ripped from Medicaid, inadequate physician payment, stupid immigration rules,” Fryhofer told AMA members in promising to call out Kennedy and the Trump administration on all of it.

In two dozen interviews this week, AMA doctors described an advocacy organization at its wit’s end with Kennedy. POLITICO granted them anonymity to describe internal dynamics. Long a Republican-leaning constituency, doctors began shifting left during the battles over managed care three decades ago. President Donald Trump’s alliance with Kennedy, a longtime skeptic of vaccine safety and critic of the medical establishment, was the last straw for many.

RFK Jr. is Checked Out

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa

Sheryl Gay Stolberg at NYT:

The secretary’s detachment from much of the work of the agency, along with the administration’s deep staff cuts and his attacks on career staff, have driven down morale, they say. It’s a dynamic that could threaten the department’s ability to protect Americans in a crisis, according to public health experts and former secretaries.

Critics say one of the most urgent problems is Mr. Kennedy’s failure to act more swiftly to address a leadership vacuum. There is no surgeon general. Around half of the 27 institutes and centers at N.I.H. are run by acting directors. The acting chief of the National Institute for Allergy and Infectious Diseases was recently fired, as was the nation’s top drug regulator.

The leader of the Food and Drug Administration quit last month under pressure over tobacco policy. Mr. Kennedy fired the C.D.C. director last August; it is now run on an acting basis by Dr. Jay Bhattacharya, who already has another huge job as director of the National Institutes of Health.

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Every Tuesday at 10:30 a.m., the chiefs of the department’s 13 operating divisions gather in the secretary’s suite to update leadership on their activities. At the outset of his tenure, Mr. Kennedy was rarely there, either virtually or in person, according to three people familiar with his schedule. Since Mr. Klomp’s elevation, he now shows up once a month. But when he does attend, he often appears disengaged and spends the time scrolling on his phone, according to people in attendance. Several described him as “checked out.”

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The Administration for Strategic Preparedness and Response, responsible for pandemic preparedness and for standing up field hospitals and quarantine facilities in Kenya, is currently run on an acting basis by John Knox, a former Los Angeles firefighter who founded the group Firefighters4Freedom during the pandemic to fight vaccine mandates.

It's Not Just Measles

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa

Washington Post editorial:

And it’s not just measles. Cases of other vaccine-preventable illnesses such as whooping cough, rotavirus and Hemophilus influenza Type B are all rising as parents decline to give their kids shots. That’s not only dangerous for those children but also those who are too young to get immunizations, as well as immunocompromised people whose bodies are unable to mount a response to surging pathogens.

The decline in vaccination predates this administration, but rhetoric from officials, especially Health and Human Services Secretary Robert F. Kennedy Jr., supercharged skepticism toward vital public health tools. That’s prompted enormous backlash, including among Senate Republicans — so much so that the White House reportedly felt compelled to sideline Kennedy on the issue. The administration has also needed to withdraw multiple nominees for health agencies because of previous anti-vaccine comments.

Whether this shift is permanent remains to be seen. Last week, President Donald Trump issued an executive order directing agencies to pare back recommended childhood vaccines, even though similar changes announced in March by the Centers for Disease Control and Prevention were blocked in federal court.

At the same time, Kennedy is still reportedly pushing to craft new “research” to support his long-debunked claims that vaccines are unsafe.

The ultimate outcome of such efforts would be to make it harder for parents to access these medical innovations to keep kids safe. It would be like lining your house with kindling as wildfires spread nearby. Someone’s bound to get burned.

US on Track to Lose Measles Elimination Status

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa

Nat Lash and Patricia Callahan at ProPublica:

To have any chance of keeping the [measles elimination] designation, the U.S. will need to make a strong case that measles didn’t spread endemically — from person to person in a continuous chain within the country for more than a year. If the Texas virus, for example, made its way across the Southwest to Utah and continued infecting people there, that would be a problem. But if cases in Utah were instead sparked by a patient who caught measles abroad, that would be a new chain, restarting the clock.

For clues, the Centers for Disease Control and Prevention is analyzing the full genetic code of measles viruses that infected patients. Last November, the CDC’s leader at the time said preliminary genomic analysis suggested the Utah cases were not directly linked to those in Texas. A spokesperson for the Department of Health and Human Services told ProPublica that the work was done by the state laboratories and the CDC is conducting a more comprehensive investigation.

ProPublica embarked on its own analysis, reviewing over 1,800 whole genome sequences, including those released as recently as last month, to compare the genetic fingerprints of measles viruses circulating in the U.S. and Canada. This showed that the measles virus still spreading in Utah as of this May is very closely related to the one that sickened Texans over a year ago.

ProPublica’s analysis isn’t a smoking gun that proves endemic spread. It’s impossible to tell from this information whether the virus spread from state to state or if it at some point left the country and was brought back by a sick traveler.

But given how similar the viruses are in the sequences ProPublica identified, it’s going to be difficult for the U.S. to prove measles isn’t endemic — “unless CDC has something up their sleeves,” said Dr. Alberto Severini, a retired molecular virologist and measles expert who spent two decades at Canada’s Public Health Agency.

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During prior U.S. outbreaks, health and political leaders, with unwavering language, urged Americans to vaccinate their children and assured them the shots were safe.

Trump and HHS Secretary Robert F. Kennedy Jr. haven’t followed that playbook. Both have fueled doubts about the safety of the MMR shot, which guards against measles, mumps and rubella.

Researchers around the world have found the vaccine does not cause autism. Nevertheless, at a press conference on autism last fall, Trump said he had heard for years that there was a problem with the combination vaccine and urged parents to insist on separate shots for their kids — even though standalone shots don’t exist in the U.S.

Kennedy has said the vaccine offers protection from measles, but he also has repeatedly made the shot sound scarier than the disease.

Assisted Spelling

  Autism parents are highly vulnerable to quacks.

Arthur Allen at WP:

Assisted spelling is used to help nonverbal people communicate by pointing to letters on boards or using keyboards with physical help from another person.

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But leading professional groups for autism science, as well as those representing psychologists and speech pathologists, point to research showing that these methods — premised on the idea that people with autism have the normal range of cognitive powers but are imprisoned in malfunctioning bodies — are flawed or fraudulent.

Other, validated methods enable nonspeakers to communicate through digital and analog pictures and letter boards. But assisted spelling isn’t autonomous communication, critics say: Consciously or not, the board holder may be influencing or responsible for the typed or pointed-at words — as with a Ouija board.

For many parents in Kennedy’s Make America Healthy Again community, the spelling controversy is angrily ringing the bells as the notion that vaccines cause autism — which they refuse to consider debunked. As some people see it: Established medicine damaged them with vaccines and now refuses to accept a helpful treatment.

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“In this underfunded disability environment, I don’t want a single penny diverted to debunked interventions like spelling,” said Amy Lutz, a senior lecturer in history at the University of Pennsylvania and an autism support advocate who described her 27-year-old son as “profoundly autistic.”

It’s not only a waste of time, she said later in an interview, but “people subjected to spelling are not given access to evidence-based education. Every interaction turns someone like my son into a puppet, and I find that very objectionable.”

See a review of the literature from the Association for Science in Autism Treatment. 

Antivax Papers Under Fire

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Michelle R. Smith at The Guardian:

Three scientific papers that raised questions about vaccine safety and were used by the Trump administration to justify controversial changes to US vaccine policies have over the last two months been removed, retracted or placed under investigation by the journals that published them.

In some cases, the actions occurred years after scientists first raised alarms about the studies’ scientific merits.

Robert F Kennedy Jr, the US health secretary who has been a leader in the anti-vaccine movement for decades, relied on two of the studies that are now facing scrutiny for a 2023 book he co-wrote that argued unvaccinated children were healthier than children who had been vaccinated. The US Centers for Disease Control and Prevention (CDC) cited one of the papers when it changed its long-held position that vaccines do not cause autism, cutting against the scientific consensus. And all three papers were cited by a lawyer, Aaron Siri, who called for changes to the childhood immunization schedule before an influential federal vaccine advisory panel. Siri is the managing partner of Siri & Glimstad and has served as a lawyer for a prominent anti-vaccine group.

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[A paper] by Carolyn M Gallagher and Melody S Goodman, was published in 2010 in the Journal of Toxicology and Environmental Health, Part A, and found boys vaccinated for hepatitis B in their first four weeks of life were more likely to be diagnosed with autism.

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The CDC cited the hepatitis B paper in November when it changed its stance on a possible link between vaccines and autism at Kennedy’s direction. The reworked page now states at the top that “Studies supporting a link have been ignored by health authorities” and later cites the paper.

HHS did not respond to the Guardian’s questions about whether the CDC would update its page.

Morgan McSweeney, a scientist who posts on social media as Dr.Noc, was moved to make a six-minute video debunking the paper after seeing the CDC’s changes. The authors, relying on a small number of cases, said their findings suggested male newborns vaccinated with the hepatitis B vaccine had a higher risk of autism diagnosis.

“This was a low-quality, very small study that was not replicated. So yeah, the CDC page now says that some studies supporting a link have been ignored by health authorities,” McSweeney said in the video, which now has more than 5m views between Instagram and TikTok. “And maybe that’s a little bit true, because the studies they’re showing here are worth less than a fart in the summer breeze.”

Measles and Vitamin A Poisoning

  In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

From CDC:

As of June 4, 2026, 2,030 confirmed* measles cases were reported in the United States in 2026. Among these, 2,020 measles cases were reported by 40 jurisdictions: Alaska, Arizona, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. A total of 10 measles cases were reported among international visitors to the United States.

There have been 30 new outbreaks** reported in 2026, and 93% of confirmed cases (1,890 of 2,030) are outbreak-associated (558 from outbreaks starting in 2026 and 1,332 from outbreaks that started in 2025).

RFK has advocated vitamin A as an alternative treatment for measles.

Bischops AC, Nagorsen M, Madsen E, Majumder MS. Internet Searches for Vitamin A and Related Media Statements During the 2025 US Measles Outbreak. JAMA Netw Open. 2026;9(6):e2615013. doi:10.1001/jamanetworkopen.2026.15013.

The US is experiencing its largest measles outbreak since the disease’s elimination in 2000.1 Although vaccination remains the only proven prophylactic, vaccine hesitancy is rising.2 Within this climate of doubt, alternative medicines like vitamin A and cod liver oil have gained attention.3 Vitamin A may be administered under medical supervision to support measles recovery, but it does not prevent measles and can be toxic if dosed incorrectly.3 The same applies to cod liver oil, which contains high levels of vitamin A.4 Between January and March 2025, America’s Poison Centers reported a 38.7% increase in vitamin A exposures.3 This trend may have been influenced by public figures who have increasingly promoted vitamin A to treat measles.4

RFK Wants to Pry into Our Medical Records

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

 Amanda Seitz and Darius Tahir at KFF Health News:

U.S. health secretary Robert F. Kennedy Jr. is pursuing federal government access to most Americans’ medical records, in a quest to research a link between vaccines and autism — a connection the medical establishment studied for decades and flatly rejects.

The Department of Health and Human Services is seeking data from little-known state systems that allow hospitals and clinics to exchange detailed, identifiable patient information, KFF Health News has learned.

In private meetings, some public health leaders have objected to giving Kennedy’s team access to such data, raising doubts that it’s legal or that the information would even be useful.

They have also expressed concerns about allowing the federal government to peer into the minutiae of Americans’ medical records, which could mean viewing anything from doctors’ notes to prescription history. HHS has offered no insight into how it will protect or handle the personal health information it obtains.

But Kennedy told KFF Health News that medical records are key to investigating the cause of autism, vaccine safety, and chronic diseases. And millions of dollars in grant money has poured into a Nebraska nonprofit that has assisted Kennedy’s effort, according to state records.

IDEA Challenges

In The Politics of Autism, I write about social services, special education, and the Individuals with Disabilities Education Act. 

Project 2025 proposed to turn IDEA into a "no strings" block grant, effectively gutting the law and destroying protections that disability families have long relied upon. During the 2024 race, Trump denied any connection to the project, but now he proclaims it, praising OMB director Russ Vought "of Project 2025 fame."

Trump and Vought are now accomplishing their goal of ravaging the law. Instead of shifting it to a block grant, they have tried firing most of the staff who enforce it. 

Ashley White at The Hill:

​​​A clear pathway for addressing these challenges can be seen in the Science of Reading Act, which seeks to align federal literacy funding with evidence-based practices “to ensure state literacy plans reflect these evidence-based approaches.” However, there is no “Science of Special Education” movement generating bipartisan legislation. There is no House committee unanimously passing a bill to strengthen IDEA’s core protections. Instead, there is silence — or worse, erosion.

States, meanwhile, are left holding the bag. Some have stepped up, investing state dollars to fill the federal gap. Others have not. The result is a patchwork of protections that varies wildly depending on where a child with a disability happens to live. This is precisely the inequity IDEA was designed to prevent. The staffing crisis compounds the challenge. Across the country, districts report critical shortages of special education teachers, school psychologists, speech-language pathologists, and related service providers. Caseloads have ballooned. Timelines for evaluations are missed. Individualized Education Programs are written but not implemented with fidelity. And in too many cases, the procedural protections that remain on paper have become aspirational rather than operational.

For families, the lived experience of special education in 2026 often feels like navigating a system designed to say no. Due process remains available in theory, but in practice, it is expensive, adversarial, and inaccessible to the families who need it most. The asymmetry of power between school districts and individual families has only grown as federal oversight has receded.

Predatory Providers

 The Politics of Autism includes an extensive discussion of autism service providers.  Private equity firms now own many of them.   Insurance mandates and Medicaid spending have contributed to the growth trend.

Christopher Weaver and Anna Wilde Mathews at WSJ:

The autism-therapy industry, once a tiny corner of pediatric care, has exploded into a multibillion-dollar business, fueled by rising diagnoses, new providers entering the market and laws requiring insurers to cover more services. It has also attracted predatory providers who bill for phantom services, pad hours and charge steep fees for care delivered by low-wage workers with minimal training.

The billing abuses run wide. Aetna said the number of investigations that found likely fraud or abusive billing by autism-therapy providers in its private-plan business shot up by 300% between 2024 and 2025—and is on track to rise by another 50% this year.

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Autism-therapy spending has become one of the fastest-growing healthcare expenses for many private insurance plans, insurers, employers and auditors say. The boom has also made the therapy one of Medicaid’s fastest growing segments, according to a Journal investigation published in March. Medicaid claims data showed providers billed as much as $340,000 per patient a year, the Journal reported.

In the private insurance sector, annual spending on hands-on autism therapy for about 40 large employers covering 3.5 million people doubled to $108 million from 2021 to 2025, according to claims data analyzed by the Health Transformation Alliance. The coalition, which helps companies including Walgreens and American Express track and manage medical spending, said that reflects more patients, more hours of service and higher prices.

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Most of the therapy is delivered by behavior technicians, who in many states need little more than a high-school degree and often earn as little as $20 an hour. By the end of 2025, about 535,000 people were registered as behavior technicians in a federal database of healthcare providers, an increase of 457% from 2019, an analysis by the Journal found.

The front-line workers are overseen by behavior analysts, more highly trained professionals who often have master’s degrees and licenses and can supervise multiple technicians.