The Graham Incident

In The Politics of Autism, I discuss interactions between police and autistic people.   Police officers need training to respond appropriately.  When they do not, things get out of hand.  

Nichole Manna at The Fort Worth Star-Telegram:

If Graham police had proper training on how to approach people with autism and if all information given to dispatch had been relayed to officers, it’s likely that 19-year-old Michael Moore would have never been cuffed, wrestled to the ground and stunned twice by officers on June 26, according to experts.

That day, a neighbor in the 900 block of Texas Street called 911 to report that someone was throwing rocks into her yard and at her dogs. It wasn’t the first time he had done it, she said. She told dispatchers that Moore seemed to be “not all there.” She also asked dispatch to tell the officers to talk to her before they approached Moore. She said she had asked Moore not to throw rocks before, and just wanted officers to talk to him, reports say.

However, records show that dispatch didn’t tell police that the caller described Moore as “not all there” — which she meant as “mentally,” she wrote in an account to police.

California Vax Law and Bogus Medical Exemptions

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

Soumya Karlamangla at the Los Angeles Times:

California lawmakers took action after a measles outbreak that began in Disneyland in 2014 was linked to children whose parents had refused vaccines.

Despite parents’ fears, vaccines are largely safe, experts say. The most common side effects are soreness at the injection site or developing a fever or rash, according to the U.S. Centers for Disease Control and Prevention.

“Everything else people are worried about doesn’t happen, like autism or developmental delays,” said Dr. Paul Offit, an infectious diseases expert at Children’s Hospital of Philadelphia.

With the personal belief exemption banned in California, the only way to skip the required shots is by homeschooling kids or having a doctor state that a child can’t tolerate vaccines because of a health reason.

The law, known as SB 277, has largely been effective. The vaccination rate among kindergartners is up to 95%, from 93% before the law took effect in 2016.

But doctors say that preventing outbreaks requires high vaccination rates not just statewide, but also in each neighborhood or school. Otherwise, diseases can spread in pockets with low immunity.

But at 785 of the roughly 6,500 elementary schools in the state, 90% or fewer kindergartners had all of their required shots. Some of those students were planning to get their shots later in the school year and they hadn’t come due yet. But many had notes from their doctors saying they shouldn’t be vaccinated for the rest of their childhood.

Doctors say that at most, 3% of people could have a medical reason for not tolerating vaccines, such as a gelatin allergy or because they’re undergoing chemotherapy. But at 20 schools, more than a quarter of students had a medical exemption, according to state data.

“One can only conclude that children are getting bogus medical exemptions and the doctors are willing to give them,” Offit said. “It’s unconscionable — suddenly, 25% of children can’t get vaccines? Really? It doesn’t make any sense.”

The Antivax Movement and the Dunning-Kruger Effect

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

At Social Science and Medicine, Matthew Motta,Timothy Callaghan, and Steven Sylvester have article title:: "Knowing less but Presuming More: Dunning-Kruger Effects and the Endorsement of Anti-vaccine Policy Attitudes.

Highlights

• Low knowledge about autism is associated with thinking one knows more than experts.
• “Overconfidence” is associated with anti-vaccine policy attitudes.
• Overconfidence is also associated with support for non-experts’ role in policymaking.

Abstract

Objective

Although the benefits of vaccines are widely recognized by medical experts, public opinion about vaccination policies is mixed. We analyze public opinion about vaccination policies to assess whether Dunning-Kruger effects can help to explain anti-vaccination policy attitudes.

Rationale

People low in autism awareness – that is, the knowledge of basic facts and dismissal of misinformation about autism – should be the most likely to think that they are better informed than medical experts about the causes of autism (a Dunning-Kruger effect). This “overconfidence” should be associated with decreased support for mandatory vaccination policies and skepticism about the role that medical professionals play in the policymaking process.

Method

In an original survey of U.S. adults (N = 1310), we modeled self-reported overconfidence as a function of responses to a knowledge test about the causes of autism, and the endorsement of misinformation about a link between vaccines and autism. We then modeled anti-vaccination policy support and attitudes toward the role that experts play in the policymaking process as a function of overconfidence and the autism awareness indicators while controlling for potential confounding factors.

Results

More than a third of respondents in our sample thought that they knew as much or more than doctors (36%) and scientists (34%) about the causes of autism. Our analysis indicates that this overconfidence is highest among those with low levels of knowledge about the causes of autism and those with high levels of misinformation endorsement. Further, our results suggest that this overconfidence is associated with opposition to mandatory vaccination policy. Overconfidence is also associated with increased support for the role that non-experts (e.g., celebrities) play in the policymaking process.

Conclusion

Dunning-Kruger effects can help to explain public opposition to vaccination policies and should be carefully considered in future research on anti-vaccine policy attitudes.

Suing The Education Department Over IDEA

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

A press release from the Council of Parent Attorneys and Advocates (COPAA):

The Council of Parent Attorneys and Advocates (COPAA) filed a lawsuit today against the U.S. Department of Education (USDOE) for abdicating its responsibility to protect the civil rights of students. The suit alleges that the Department has taken actions that interfere with USDOE’s obligation under the Individuals with Disabilities Education Act (IDEA) to ensure children with disabilities get the education services they need in the most appropriate setting without regard to their race.

COPAA filed the suit against the U.S. Department of Education, Secretary Betsy DeVos and Johnny W. Collett, Assistant Secretary for Special Education and Rehabilitation Services, to challenge the Department’s notice delaying the implementation of regulations on significant disproportionality, known as the Equity in IDEA regulations. The Department's actions are legally flawed and bad policy that stall much needed reform.

It is just the second time in its 20-year history that COPAA has sued a federal agency. The decision to delay the regulation is an assault on children and the Department’s action sends mixed messages to the states regarding implementation of a key tool for civil rights enforcement. “The delay harms children and we can't afford a delay. We have real stories of kindergartners suspended 60 times; older boys and girls pushed out and criminalized for behaviors that are related to their disability. The state is not doing what it should to properly identify and serve students. We need the federal government to implement the regulations now,” said Shenikwa Medlock, a parent and advocate COPAA member in Texas. COPAA’s Executive Director, Denise Marshall said “the regulations respond to the reality that, despite being a requirement under IDEA for almost 15 years, many school districts have not taken the steps to correctly identify whether students of color need special education, sometimes under-identifying, sometime over-identifying, but rarely just right.”

According to the complaint, the significant disproportionality provision was intended to serve as an early-warning system for possible problems, analogous to a “check engine” light. When a State identifies racially significant disproportionality in a school district’s identification, placement, or discipline of students with disabilities, the State must review the school district’s policies, practices, and procedures to ensure they comply with the IDEA; engage in an analysis that identifies the factors contributing to the significant disproportionality, i.e., a root–cause analysis; and spend a percentage of their IDEA funds on comprehensive coordinated intervention services. There is no requirement that a school district eliminate a significant disproportionality if the disproportionality is not a result of violations of the IDEA but instead reflects differences among different student populations in that community.

COPAA is represented in the lawsuit by the National Center for Youth Law (NCYL) and Sidley Austin LLP. According to Seth Galanter, Senior Director of Legal Advocacy at NCYL “It's well documented that students of color who are wrongly identified as needing special education are improperly placed in restrictive classrooms, lose access to challenging academics, and are subjected to unfair disciplinary measures.” Galanter says a delay in implementing the Equity in IDEA regulations will prevent COPAA from bringing these and other harms to the attention of USDOE and the public.###

Read COPAA's Complaint

Darla Shine Spread Antivax Nonsense on Talk Radio

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

Andrew Kaczynski, Nathan McDermott and Chris Massie at CNN report that Darla Shine had a radio show where she said that vaccines cause autism:

"When we come back, I want to ask you about this, what I believe is an obvious link to autism and mercury, the preservatives and the shots," Shine said on a May 2008 show. "But guys, we have a constitutional right to take care of her own family. This is ridiculous. You know what, instead of mandating the flu shot, the government should be worrying about creating jobs in America."

Insurance in North Dakota

The Politics of Autism includes an extensive discussion of insurance.

Helmut Schmidt at The West Fargo Pioneer:

All insurance companies doing business in North Dakota will soon be required to provide coverage for autism spectrum disorders, the state insurance commissioner announced Wednesday, July 11.

A bulletin was issued Wednesday to insurers telling them that treatments for autism can’t be excluded from their policies, Commissioner Jon Godfread said in a news conference at the North Dakota Autism Center.

Coverage must be in place by Oct. 1 for policies “grandfathered in” under the Affordable Care Act, Godfread said. Coverage for policies purchased on the open market must be available by Jan. 1.

“Today’s a great day!” Godfread said, adding that insurance carriers “are being very cooperative.”North Dakota is the 48th state to require insurance coverage for autism spectrum disorders, said Lorri Unumb, vice president for state government affairs for the national group, Autism Speaks. Only Wyoming and Tennessee don’t require such coverage, she said.

From Autism Speaks:

The insurance bulletin also carries national precedence in clarifying that state-regulated insurance companies should be covering autism treatments under existing federal mental health parity law. Autism Speaks Vice President of State Government Affairs, Lorri Unumb, praised Insurance Commissioner Jon Godfread, noting that "laws are in place to prohibit the kinds of exclusions autism families routinely face; Commissioner Godfread had the guts to issue a bulletin and insist on compliance with the existing law."

 KFGO-AM reports:

In addition, Godfread notified insurance carriers in the Bulletin that they will no longer be allowed to exclude Applied Behavior Analysis (ABA) therapy to treat children with autism on the basis that ABA therapy is experimental or investigative treatment.

“Working with our partners at the federal level and with health insurers operating in North Dakota, we can now say that ABA therapies are no longer experimental or investigational and are widely recognized as a leading treatment for children with autism. Therefore, North Dakota families should have access to ABA therapies through their insurance plan” Godfread said.

All grandfathered and transitional health insurance policies regulated by the Department, including the individual, small group, and large group insured markets, must follow the guidance set forth by the Bulletin beginning no later than Oct. 1, 2018. All non-grandfathered health insurance policies and self-funded Multiple Employer Welfare Arrangement health benefit plans regulated by the Department must follow the guidance of the Bulletin beginning no later than Jan. 1, 2019.

For more information or to read the Bulletin in its entirety, visit www.nd.gov/ndins/.

BUT NOTE MY PREVIOUS POST ON THE LIMITS OF STATE INSURANCE MANDATES 

Congressional Voting Scorecards

The Politics of Autism discusses legislation before Congress.

Scott Badesch at The Autism Society:

When the Autism Society is asked to take a position on a particular bill in Congress or action by the United States Government, we engage in a review process and assess how it matches with our policy positions, our strategic plan, and our mission and vision developed by our Board of Directors.

Our review process starts with the simple questions as to how the proposed policy might impact autistic individuals and families we represent. We then assess the impact of the planned or proposed action. We also know that we represent a diverse community that often reflects the differences in the politics of our nation. In spite of these challenges, we strive to ensure our actions match up with our mission and vision and are supported by data and evidence-based research.

I mention this because this November, elections will be held in all 50 states and the District of Columbia. In all 50 states, voters will have the opportunity to vote for who will represent them in the House of Representatives and in some states, who will represent them in the Senate. As we advocate for a comprehensive and effective Federal government response to helping individuals impacted by autism, we also know that election time is a good time for each person to assess how well their current elected officials running for re-election, as well as candidates running against such individuals, share our mission and values. We do not (and can not) endorse any candidate, but we can and should educate voters on the policy positions of these candidates related to autism services and supports. To provide this information, we will be developing “Scorecards” based on votes or positions taken by incumbents running for the Senate or House of Representatives. We expect this “Scorecard” will be available in early October 2018.

Advocacy has to be more than letting your elected officials know what you think or what you want regarding a particular piece of legislation. It has to also be about holding them accountable when they wish to represent us and our constituency.