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Friday, February 15, 2019

Darla Shine: Threat to Public Health

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

Lindsey Bever at WP:
Darla Shine, the outspoken wife of White House communications director Bill Shine, has been tweeting about childhood diseases, claiming that illnesses such as measles, mumps and chickenpox “keep you healthy & fight cancer.” Health experts warn that the claim is not true and adds to misinformation that could cause harm.
Darla Shine, who has been known to tweet out stories with anti-vaccination claims, wrote Wednesday on Twitter that “The entire Baby Boom population alive today had the #Measles as kids."
She added: “I had the #Measles #Mumps #ChickenPox as a child and so did every kid I knew — Sadly my kids had #MMR so they will never have the life long natural immunity I have. Come breathe on me!”
Shine’s Twitter account has not been verified, but it notes that she is the wife of Bill Shine, “assistant to #POTUS.” The White House declined to comment about the tweets.

Schiff Gets Facebook to Review Antivax Content

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.

A release from Rep. Adam Schiff (D-CA):
Today, Rep. Adam Schiff (D-CA), sent a letter to Sundar Pichai and Mark Zuckerberg, the Chief Executive Officers of Google and Facebook, respectively, to express concern that the company’s platforms including YouTube, Facebook and Instagram, are surfacing and recommending information that discourages parents from vaccinating their children, contributing to declining vaccination rates which could reverse progress made in tackling vaccine-preventable diseases.
“As a Member of Congress who is deeply concerned about declining vaccination rates, I am requesting additional information on the steps that you currently take to provide medically accurate information on vaccinations to your users, and to encourage you to consider additional steps you can take to address this growing problem,” Schiff wrote in the letter. “I was pleased to see YouTube’s recent announcement that it will no longer recommend videos that violate its community guidelines, such as conspiracy theories or medically inaccurate videos, and encourage further action to be taken related to vaccine misinformation.”
The scientific and medical communities are in overwhelming consensus that vaccines are both effective and safe. There is no evidence to suggest that vaccines cause life-threatening or disabling diseases, and the dissemination of unfounded and debunked theories about the dangers of vaccinations pose a great risk to public health.
In 2015, Rep. Schiff first introduced the bipartisan Vaccines Save Lives resolution, recognizing the importance of vaccines and immunizations in the United States. The resolution sends a message of unequivocal Congressional support for vaccines and urges parents, in consultation with their health care providers, to follow scientific evidence and the consensus of medical experts in favor of timely vaccination for the well-being of their children and surrounding communities.
Sarah Frier at Bloomberg:
In response, Facebook said it is “exploring additional measures to best combat the problem," according to a statement from the company. That might include “reducing or removing this type of content from recommendations, including Groups You Should Join, and demoting it in search results, while also ensuring that higher quality and more authoritative information is available."

Google, which did not immediately respond to a comment about Schiff’s letter, has already been taking similar measures. Last month, Google’s YouTube unfurled a change in the way it recommends videos -- an automated system that has been criticized for promoting misinformation. YouTube said it would starting cutting videos with "borderline content" that "misinform users in harmful ways" from its recommendation system. The company only offered three examples. One was videos that promote "a phony miracle cure for a serious illness."

Thursday, February 14, 2019

Not Providing ABA

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for people with intellectual and developmental disabilities

Courtney Perkes at Disability Scoop:
In 2014, the Centers for Medicaid and Medicare Services issued a bulletin telling states to pay for “medically necessary diagnostic and treatment services” for kids with autism, but stopped short of directly requiring ABA therapy.
However, advocates say that because some children on the spectrum require ABA, every state should offer coverage to those who do. Most states have since done so, but some legislatures have not allocated funding, even though they’ve passed laws that require private insurers to cover ABA therapy.
The states that do not offer ABA therapy to all children who meet medical necessity criteria are: Idaho, Illinois, Maine, New Jersey, New York, Ohio, Oklahoma and Texas. ABA therapy uses reward-based motivation to help children with autism learn new skills and reduce harmful behavior.
From Autism Speaks:
The Texas state legislative session has begun, along with our advocacy efforts to ensure autism coverage for Texas children on Medicaid!

An estimated 80,000 Medicaid-enrolled Texas children are diagnosed with autism spectrum disorder. However, most are unable to access evidence-based treatments for their diagnosis.

Timely access to medically necessary treatment, including applied behavior analysis (ABA), is critical for children diagnosed with autism.

Under the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) Medicaid benefit, children under the age of 21 are entitled to any treatment, procedure, or service that is medically necessary to address health conditions of a child.

In July 2014, the Centers for Medicare and Medicaid Services (CMS) issued a bulletin telling states to add coverage of medically necessary autism treatments for children in their Medicaid plans. Since then, more than 40 states have moved forward in the addition of this coverage.Texas is one of the few states to have NOT yet added coverage.
A solution is moving forward in the Texas legislature this session. The Texas Health and Human Services Commission has included the addition of this autism health benefit as Exceptional Item 44 in their proposed budget.

The proposed budget must be approved by the Texas state legislature.

Wednesday, February 13, 2019

Gender Differences in Employment, Services, and Family Support

In The Politics of Autism, I discuss  social services for people with intellectual and developmental disabilities.

At Autism, Julie Lounds Taylor and colleagues have an article titled "Sex Differences in Employment and Supports for Adults with Autism Spectrum Disorder."  The abstract:
This study explored sex differences in employment, reasons for unemployment, benefits, and supports among a large, international sample of adults with autism spectrum disorder. The sample included 443 adults with autism spectrum disorder (60% female; 74% residing in the United States) who consented to be part of an autism research registry and completed an Internet survey. Outcome variables included current employment status, number of hours working, number of jobs in the past 5 years, reasons for unemployment, as well as the number of benefits received and the amount of financial support currently being received from families of origin. Using multiple regression models, we found that males and females were working at similar rates. Females were more likely than males to say that their unemployment was a result of choosing to withdraw from the labor market. Similar percentages of males and females reported receiving some form of benefits or family support, but of those receiving benefits/family support, males received more than females. These results are consistent with other studies finding subtle, but potentially important sex differences in life-course outcomes of individuals with autism spectrum disorder.
From the article:
This study adds to the literature by suggesting subtle yet potentially important differences between men and women with ASD in employment, formal services, and family financial support. The pattern of findings in this sample is consistent with findings from other studies examining sex differences in employment. In the Taylor and Mailick studies (Taylor et al., 2015; Taylor & Mailick, 2014), sex differences were not observed when looking at rates of employment/PSE or independence in vocation at a single point in time, but only when digging beneath the surface to examine patterns of employment/PSE. Similarly, in the present analyses, there were no overall sex differences in rates of employment/PSE participation, but instead there were differences in attitudes toward employment (thoughts about hours working, reasons for unemployment). There were also no overall sex differences in the percentages of those receiving any benefits or family financial support, but instead in the amount of assistance received (for those receiving support/benefits). Thus, it appears that sex differences for adults with ASD might not be observed when examining broad indicators of adult outcomes, but instead when delving deeper to examine outcomes in a more fine-grained manner.

Tuesday, February 12, 2019

Measles, Vaccines, and Autism

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

From CDC:
From January 1 to February 7, 2019, 101** individual cases of measles have been confirmed in 10 states. The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington.
  • *Cases as of December 29, 2018. Case count is preliminary and subject to change.
  • **Cases as of February 7, 2019. Case count is preliminary and subject to change. Data are updated weekly.

Trends in Measles Cases, 2010-2019

Samantha Putterman at PolitiFact:
A years-old story claims courts have "quietly confirmed" the MMR vaccine causes autism.

The story relies heavily on a 2012 Italian court case, which was based on a retracted and discredited 1998 study. It also incorrectly suggests that U.S. "courts" are quietly paying off families for vaccine-linked autism cases. In fact, the well-known National Vaccine Injury Compensation Program has evaluated vaccine injury claims since 1988.

A link between autism and vaccines has been disproved by court proceedings and several scientific studies. The story misrepresents the relevance of court rulings and provides obscure examples and sparse evidence.

It is Pants on Fire!

Monday, February 11, 2019

Juvenile Justice and Autism

The objective was to delineate the prevalence of criminal behavior and school discipline in juvenile justice-involved youth (JJY) with autism. A sample of 143 JJY with autism was matched to comparison groups of JJY without a special education classification, JJY with learning disabilities, and JJY with other special educational needs (N = 572). Results showed that JJY with autism committed significantly fewer property crimes. With regard to school discipline, JJY with autism were least likely to receive policy violations, out-of-school suspensions, and in-school suspensions. Finally, regardless of special education classification, JJY who had a history of fighting in school were more likely to recidivate. Our results suggest that JJY with autism are not more likely to commit crimes compared to JJY without SEN.
From the article:
We found that JJY without SEN had significantly more school violations compared to JJY with autism during the 2010–2011 school year with the exception of incidents involving violence at school. It is important to note that because of the protections of the IDEA (2004) for SWD, including for those with autism, schools would have acted differently (e.g., possibly more cautiously) in response to disciplinary infractions because  f federal procedural safeguards. Additionally, when teachers know a student has autism, they may be more likely to attribute youth misbehavior to symptoms of the diagnosis, over which the student has no control, and therefore be less inclined to punish them (Ling et al. 2010). Therefore, it is possible that disciplinary responses were overall  lower for JJY with autism due to IDEA safeguards or to differential teacher responses.  however, it appears that IDEA safeguards and differential teacher responses may not  ave the same effect for JJY with other IDEA-eligible disability classifications since JJY with SEN and JJY with LD received more OSS and ISS compared to JJY without SEN during the 2010–2011 school year

Sunday, February 10, 2019

Measles in 2019

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

CDC reports: From January 1 to 31, 2019, 79 individual cases of measles have been confirmed in 10 states. The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington.

Rachel Frazin at The Hill:
Hundreds of anti-vaccination supporters demonstrated outside a public hearing in Washington state on Friday to protest a bill that would make it harder for families to opt out of mandatory vaccinations for children, the Associated Press reported.
The protest took place amid the state's worse measles outbreak in more than two decades. Health officials have reported at least 56 cases in Washington and Oregon.
An estimated 700 people demonstrated in Olympia, Washington, most of whom opposed stricter requirements, The Washington Post reported.
Wendy Orent at LAT:
The mystery is why they choose to believe such anecdotal “evidence” instead of the vast amount of scientific research that has found vaccines to be safe. One paper still cited by vaccine skeptics was published in 1998 by British physician Andrew Wakefield and colleagues. The article, which suggested a link between the measles vaccination and autism, has since been retracted and repeatedly disproved, and Wakefield has lost his British medical license. Yet his discredited autism hypothesis still resonates in the superheated atmosphere of anti-vaccine websites.

Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and father of an autistic daughter, has watched the anti-vaccine movement closely. What surprises him, he said, is how activists “fine-tune the appeal to the local political environment. In Texas, anti-vaxxers use terms like “medical freedom” and “personal choice,” while in the Pacific Northwest, they talk about purity and toxic ingredients, said Hotez, author of “Vaccines did not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad." 
Russian social media trolls have promoted the bogus vaccine-autism connection.   Haider Warraich at Vox:
“Taking on the misinformation campaign about vaccines has become more complex now that research is demonstrating that a large amount of the social media posts represent state-sponsored cyberwarfare, particularly from Russia,” said Robert Califf, a former commissioner of the Food and Drug Administration who now leads the Forge, Duke University’s center for health data science. The center is now mounting an effort to understand and address misinformation on the internet.