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Thursday, December 5, 2019

Autism Classifications and the Great Recession

In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence

In a letter to the Journal of Autism of Developmental Disorders. Maureen S. Durkin and Barbara L. Wolfe write about a 2007-2009  "plateau" in the number of white children in the U.S. with an autism special education classification:
Perhaps the best explanation for the plateau noted by Nevison and Zahorodny is that the recession adversely affected the ability of families of children with autism to access diagnostic services. The cost of obtaining a diagnosis of autism in the U.S., at more than $2000, would have been prohibitive during the recession for many parents who experienced lapses in insurance coverage and loss of income needed to cover out-of-pocket payments for autism diagnoses. Research has shown that parental job loss often leaves children with private health insurance uninsured, with an estimated 311 children in the U.S. losing coverage for every 1000 parents who become unemployed (Fairbrother et al. 2010). In addition, while data specific to autism testing are difficult to find, we know from research on cancer that people without health insurance are less likely than others to report use of recommended diagnostic testing (Seeff et al. 2004). During the great recession, five million Americans lost employment-based health insurance, with white Americans being disproportionately affected due to their greater reliance on this type of insurance than other groups (Holahan 2011). These findings are consistent with Nevison and Zahorodny’s (2019) observation that the plateau in autism prevalence occurred only for white children, and with the possibility that the recession could have had as big an impact as any other hypothesized environmental exposure on the number of children receiving services for autism during this period.

Tuesday, December 3, 2019

Measles in Samoa

In The Politics of Autism, I look at the discredited notion that vaccines cause autismTwitterFacebook, and other social media platforms have helped spread this dangerous myth.   Measles can kill.

Anna Ball at VOA:
The government of Samoa announced on Monday that five more children had died within the past day from measles.

That raises the number of measles deaths on the Pacific island nation to 53 since late October. Forty-eight of the victims were children.

The government has closed schools and is restricting travel before the Christmas holiday season.

The French news agency AFP reports that the government said almost 200 new measles cases had been recorded since Sunday. There was no sign of the rate of infection slowing on Samoa, even with a mass vaccination program in effect.

This is the latest outbreak of a worldwide epidemic of measles. The highly infectious virus found an at-risk population in Samoa. The World Health Organization, WHO, says only about 31% of the population was vaccinated when the outbreak started.

Now there are more than 3,700 cases of measles recorded among the 200,000 people on the islands.
 Local media reports that Samoan officials blamed low coverage rates in Samoa in part on fears caused last year when two babies died after receiving vaccinations. The country’s immunization program was temporarily suspended. The deaths were later found to have been caused by medications that were wrongly mixed.
Beth Mole at Ars Technica:
Still, news of the heartbreaking deaths shook the island nation’s confidence in the healthcare system. And anti-vaccination groups pounced on the circumstances. Most notably, the deaths were picked up by the Children’s Health Defense, run by the prominent anti-vaccine advocate Robert F. Kennedy Jr. As The Washington Post noted, Kennedy’s organization spent months highlighting the deaths on Facebook while questioning the safety of the MMR vaccines. But the organization did not correct the posts or update its audience with information regarding the nurses’ error and convictions.
Kennedy visited Samoa in June, appearing alongside local anti-vaccine advocates and even a staff member of the US embassy. In November, Kennedy’s organization sent a letter to the Samoan prime minister, encouraging officials to question the MMR vaccine. Kennedy peddles the false and dangerous claim that vaccines are linked to autism, despite the fact that numerous scientific studies have robustly debunked the baseless claim.
On Sunday, Samoan Prime Minister Tuilaepa Sailele Malielegaoi encouraged residents to fight back against misinformation. “Let us work together to encourage and convince those that do not believe that vaccinations are the only answer to the epidemic,” he said.
At the same time, he announced that all government services will be closed from Thursday, December 5, to December 6 so that public servants could carry on with the mass vaccination campaign.

Monday, December 2, 2019

Special Education Day

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

Today, December 2, is Special Education Day.

On this day in 1975, President Ford signed the Education for All Handicapped Children Act, which Congress later renamed the Individuals with Disabilities Education Act.

From the University of Minnesota:
Inclusive education provides all students, regardless of any learning difficulties, access to age-appropriate general education classes and the instruction, intervention and support to meet core standards.
University of Minnesota experts Kathy Seifert, a senior lecturer in the special education program, and Cynthia Zwicky, a lecturer in the elementary education program, train teachers working in special education and general education settings. Both are available to comment on how special education teachers, general education teachers, school support staff and parents can work together to provide inclusive classrooms settings that benefit all students.
Kathy Seifert, Ph.D., Department of Education Psychology
“Special education teachers are trained primarily as academic and behavioral interventionists. Therefore, many don’t have the subject matter expertise of, say, a math teacher. Inclusive education protects the civil rights of students with disabilities by ensuring — since all students are assessed by the same common core curriculum standards — they receive the content instruction they need to meet these standards.
“Multi-tiered systems of support is a model that helps teachers and other school support staff identify students who are at risk for educational difficulties from both an academic and behavioral standpoint. General education teachers serve as the first line of defense.
“In inclusive classrooms, students with learning, behavioral, or social/emotional difficulties participate in general education classrooms alongside their peers. Sometimes a special education teacher will teach alongside a general education teacher. Other times, students may be in a general education classroom for most of (or part of) the day but may require more specialized support in another setting such as a resource room

Teachers in inclusive classrooms use a variety of teaching methods to build flexibility into their curriculum. Offering more than one way to learn and demonstrate a concept helps all students, not just those with difficulties, learn in a way best suited to their academic strengths.”

Cynthia Zwicky, Ph.D., Department of Curriculum and Instruction
“When students are part of an inclusive classroom, they all benefit, regardless of ability. This is because differentiating instruction, a student-centered instructional approach that makes learning accessible, provides more student choice and increases engagement for all children. There are multiple ways to learn and understand a topic (e,g, movement, song, literature). Understanding this, and then offering students multiple ways to engage with a subject, helps students thrive.
“We live in an inclusive society. We don’t live in a place where, as adults, we are separated out by reading levels or math ability, so it makes sense to structure classrooms to model the society we live in. One of the key outcomes of inclusive education is helping students to be more empathetic and compassionate to others. Fostering, at a young age, an understanding that there are many ways to learn and engage in schools truly benefits us all.
“Training teachers to provide inclusive environments is key to the success of students. The U of M has a unique teacher training program, requiring elementary education students to take a practicum in special education. They spend a semester in a special education class or a general education inclusive classroom while taking courses in special education and classroom management. This ensures teachers are trained with strong foundational knowledge of how to best reach all learners regardless of abilities and learning styles.”

Saturday, November 30, 2019

Charter Schools

In The Politics of Autism, I write about special education and the Individuals with Disabilities Education Act.  Vouchers and charter schools are part of the ongoing debate.

The National Center for Special Education in Charter Schools has a report titled Key Trends
in Special Education in Charter Schools in 2015–2016: Secondary Analysis of the Civil Rights
Data Collection

Compared to traditional public schools, charter schools report a higher percentage of  enrollment of students with specific learning disability (the largest population of students with disabilities) (47.79% v. 43.98%), autism (8.08% v. 7.71%), and emotional disturbance (4.72% v. 3.89%)

Our analysis of specialized charter schools’ websites revealed that schools typically advertise that they serve students with multiple different disabilities or one specific
disability. Of the schools we identified, most (63.3%) focus on two or more disabilities. Of the schools that advertise that they specialize in serving students with a specific
disability, emotional disturbance (14.5% of the schools) and autism (14.5% of the schools) were the most common
 The most-represented disability focuses are not necessarily the same among specialized charter schools in Florida, Ohio, and Texas. In Florida, the majority of specialized
charter schools have a general focus (n = 28), followed by a focus on autism (n = 7) and developmental delay (n = 3).

Friday, November 29, 2019

Integrated Communities

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  Housing is a big one for autistic adults.

Eileen Abbott at The Hill:
Some 87 percent of autistic adults live with their parents, according to the Autism Housing Network, and almost 1,000,000 of those live with family caretakers that are older than the age of 60. But what happens when the parents die?
Integrated communities are now emerging nationally as a possible solution where both neurotypical and developmentally disabled residents share living space in an opportunity to thrive together.
A housing model that best illustrates this is the Faison Residence in Virginia’s capital city. Located off West Broad Street in Richmond, the apartment complex dedicates one-third of its 45 units for adults with autism and other developmental differences.

“The Faison Residence is designed to develop and foster natural relationships between individuals in our program and members of their community,” says Director of Adult & Residential Services Matthew Osborne, in an interview with Changing America. “Our program apartments are scattered throughout the building, so their neighbors truly are their community.”
 Adults with autism tend to fall through the cracks, according to the Autism Housing Network. Less than 3 percent of autism research funding is for adult issues — even though autistic children grow up to be autistic adults. More than 75 percent of autistic adults report their top concern in securing housing is not being able to afford it. According to the National Conference of State Legislatures, unemployment rates for people with disabilities are higher across all education levels compared to those without a disability.

Thursday, November 28, 2019

The Health of Autistic Senior Citizens

The Politics of Autism discusses health care, and explains that autism services can be complicated, creating difficulties for autistic people and their families. 

The abstract:
While there is emerging evidence on the prevalence of physical and mental health conditions among autistic adults, less is known about this population’s needs during older adulthood (aged 65+). We conducted a cross-sectional retrospective cohort study of 2016–2017 Medicare data to compare the prevalence of physical and mental health conditions in a national sample of autistic older adults (N = 4685) to a matched population comparison (N = 46,850) cohort. Autistic older adults had significantly greater odds of nearly all physical health conditions including epilepsy (odds ratio = 18.9; 95% confidence interval = 17.2–20.7), Parkinson’s disease (odds ratio = 6.1; 95% confidence interval = 5.3–7.0), and gastrointestinal conditions (odds ratio = 5.2; 95% confidence interval = 4.9–5.5). Most mental health conditions were more common among autistic older adults, including schizophrenia and psychotic disorders (odds ratio = 25.3; 95% confidence interval = 22.4–28.7), attention deficit disorders (odds ratio = 24.4; 95% confidence interval = 16.2–31.0), personality disorders (odds ratio = 24.1; 95% confidence interval = 17.8–32.5), and suicidality or self-inflicted injury (odds ratio = 11.1; 95% confidence interval = 8.9–13.8). Health conditions commonly associated with advanced age in the general population (e.g. osteoporosis, cognitive disorders, heart disease, cancer, cerebrovascular disease, osteoarthritis) were also significantly more common among autistic older adults. By highlighting the significant physical and mental health needs for which autistic older adults require care, our findings can inform healthcare systems, healthcare providers, and public health initiatives seeking to promote well-being in this growing population.

Wednesday, November 27, 2019

Couirt Case on Tax-Credit Plan

From the Autism Society:
The Autism Society signed onto a friend of the court brief developed by the National Disability Rights Network, The Arc of the United States, the Council of Parent Attorneys and Advocates (COPAA), and other advocacy organizations in the case of Espinoza v. Montana Department of Revenue asking the Court to uphold the decision made by the Montana Supreme Court invalidating Montana’s private school tax-credit scholarship program as it is harmful to students with disabilities. While families petitioning the court suggest that the program would help students with disabilities, school vouchers and tax-credit programs like Montana’s actually hurt students with disabilities by redirecting public funds to private schools that are largely unbound by the federal laws in place for over four decades that protect the rights of students with disabilities.
When students with disabilities use vouchers or tax credits to attend a private school, typically they forfeit their rights mandated by federal law —including the right to an appropriate, individualized education—because the statute’s key provisions do not apply to private schools. At least seven states have voucher programs that require parents to explicitly waive all or most of their disability rights protections under federal law to participate. In other states, parents often do not realize the rights they are forfeiting: 83% of parents of students with disabilities in such programs report that they receive inaccurate or no information on the loss of those rights, according to a federal watchdog report. The Court has scheduled to hear oral arguments on January 22, 2020.