Measles Can Kill

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.   Measles can kill.

 Kristen Fischer at Healthline:

Measles has taken the life of an international flight attendant five months after she first contracted the disease, prompting health officials to warn again that this seemingly childhood disease can be dangerous for adults.

 Rotem Amitai, 43, who died Tuesday, traveled from New York to Tel Aviv in March, according to The Times of Israel. A few days after landing in Israel, she developed a fever.

Authorities don’t know if the mother of three was infected on the flight or which country she was in when she contracted the disease.

Doctors said she had brain swelling (encephalitis), which is a complication of measles.
Amitai’s death has put a spotlight on the record-breaking measles outbreak in the United States and around the globeTrusted Source — as well as the dangers the virus can pose to adults.

Medical XPress:

The World Health Organization said Tuesday that measles cases had nearly tripled globally during the first seven months of the year compared to the same period in 2018.
The global body warned against "misinformation about vaccines".

The so-called anti-vax movement—driven by fraudulent claims linking the MMR vaccine against measles, mumps and rubella to a risk of autism in children—has gained traction.

So far this year, 364,808 measles cases have been reported around the world, compared to 129,239 cases during the first seven months a year earlier—the highest registered since 2006.

Amitai's death was the first related to measles in Israel this year, following two last year, according to the ministry.

The highly contagious disease can be entirely prevented through a two-dose vaccine.
Amitai had only received one dose, Israeli media reported.

Trump v. People with Disabilities

In The Politics of Autism, I discuss the issue's role in campaign politics.   In the 2016 campaign, a number of posts discussed Trump's bad record on disability issues more generally.   As his actions as president indicate, he has little use for Americans with disabilities.

From the Arc:

The Arc denounces the harmful rule that will be finalized by the U.S. Department of Homeland Security (DHS) on Wednesday, August 14. This new rule discriminates against people with intellectual and developmental disabilities (I/DD) and their families, among others. It allows the federal government to deny admission into the U.S. and unfairly restructures immigration in a way that is detrimental to individuals based on their disability and the use of vital programs like Medicaid.

The DHS final rule means the government will consider a significantly expanded list of factors to determine whether a person will be considered a “public charge.” A public charge is a person that the government thinks will (currently or in the future) be dependent on the government for support. The rule will hurt children and adults based on disabilities and chronic conditions. The use of many programs such as most Medicaid services, the Supplemental Nutrition Assistance Program (SNAP), housing assistance, and other important benefits will also be considered in the public charge test. DHS acknowledges that the new rule may have an outsized impact on people with disabilities.

“This new policy is devastating to many people with intellectual and developmental disabilities and their families. It discourages immigrant families from utilizing critical public services out of fear of harming their immigration status. The rule will increase poverty, hurt public health, and worsen housing instability. It’s the latest callous tactic in restricting access to necessary services and supports. The Arc continues our work to ensure that non-citizens with any type of disability have a fair opportunity to enter and reside legally in the U.S., without unnecessary or discriminatory restrictions based on their disability,” said Peter Berns, CEO, The Arc.

The Arc opposed the rule and submitted comments with the Consortium for Citizens with Disabilities when the rule was proposed in 2018.

For more information, see this short explainer.

Maegan Vasquez at CNN:

President Donald Trump said Thursday that the US should build more mental institutions to deal with mass shooters.

"We're going to be looking at that very closely and we're looking at the whole gun situation. I do want people to remember the words mental illness. These people are mentally ill and nobody talks about that, but these are mentally ill people. And people have to start thinking about it," Trump said ahead of his campaign rally in New Hampshire.

"I think we have to start building institutions again because you know, if you look at the '60s and the '70s, so many of these institutions were closed, and the people were just allowed to go onto the streets. And that was a terrible thing for our country. ... A lot of our conversation has to do with the fact that we have to open up institutions. We can't let these people be on the streets," he added.

Business Group Backs CA Screening Bill

In The Politics of Autism, I discuss evaluation and diagnosis of young children.  Screening is an important part of theprocess.

From the Valley Industry and Commerce Association:

Ahead of the legislative session reconvening on August 12, VICA urges legislators to support Assembly Bill 1004 (McCarty), which would require developmental screenings for children ages 0 to 3 years old to be provided as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit under Medi-Cal. The EPSDT benefit is designed to ensure that children from low-income families receive early detection and preventive care in addition to medically necessary treatment services, so that health problems are diagnosed and treated as early as possible. In California, only 36 percent of infants and toddlers in Medi-Cal receive developmental screenings despite EPSDT requirements. AB 1004 helps establish clear guidelines and oversight for developmental screenings for children ages 0 to 3 years old. Early identification and intervention can improve a child's long-term outcome.

Autistic Actors

In The Politics of Autism, I discuss depictions of ASD in popular culture.  

Jessica Blank and Wendy Lu at Huffington Post write about actor Mickey Rowe:

In 2017, he became the first autistic actor to play the role of Christopher Boone in “The Curious Incident of the Dog in the Night-Time” at the Indiana Repertory Theatre and Syracuse Stage productions. Now, he is the Co-Executive Director at National Disability Theatre and is an activist, speaking and performing at various events. Recently, he was the keynote speaker at the Arts for Autism Benefit Concert, held at the Gershwin Theater in New York City.

During job interviews or other interactions, Rowe said people often treat him like a child — a common microaggression that many disabled people experience. “It’s just hard because I’m not 14 years old,” Rowe said. “I’m a dad, and I have two kids. I need to pay the bills. I need to do all the things that an adult needs to do.”

These assumptions and other forms of ableism all contribute to the major lack of accurate representation of autism in Hollywood. Many popular films and shows that feature autistic characters, including “Rain Man,” “Atypical” and “The Good Doctor,” aren’t actually played by autistic people in real life. In fact, about 95% of all disabled characters on television are played by nondisabled actors, according to the Ruderman Foundation, a nonprofit that researches and advocates for full disability inclusion.

1,182

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.

From CDC: "From January 1 to August 8, 2019, 1,182** individual cases of measles have been confirmed in 30 states. This is an increase of 10 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000."

Another Potential Correlate: Estrogen in the Womb

In The Politics of Autism, I discuss various ideas about what causes the condition. Here is just a partial list of correlates, risk factors, and possible causes that have been the subject of serious studies:

• Pesticides;
• Air pollution and proximity to freeways;
• Maternal thyroid issues;
• Autoimmune disorders;
• Induced labor;
• Preterm birth;
• Fever;  
• Birth by cesarean section;
• Anesthesia during cesarean sections;
• Maternal and paternal obesity;
• Maternal diabetes;
• Maternal and paternal age;
• Maternal post-traumatic stress disorder;
• Smoking during pregnancy;
• Antidepressant use during pregnancy;
• Polycystic ovary syndrome.
• Infant opioid withdrawal
• Zinc deficiency
• Processed foods
• Maternal occupational exposure to solvents

A release from the University of Cambridge:

Scientists have identified a link between exposure to high levels of oestrogen sex hormones in the womb and the likelihood of developing autism. The findings are published today in the journal Molecular Psychiatry.

The discovery adds further evidence to support the prenatal sex steroid theory of autism first proposed 20 years ago.

In 2015, a team of scientists at the University of Cambridge and the State Serum Institute in Denmark measured the levels of four prenatal steroid hormones, including two known as androgens, in the amniotic fluid in the womb and discovered that they were higher in male foetuses who later developed autism. These androgens are produced in higher quantities in male than in female foetuses on average, so might also explain why autism occurs more often in boys. They are also known to masculinise parts of the brain, and to have effects on the number of connections between brain cells.

Today, the same scientists have built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank, which has collected amniotic samples from over 100,000 pregnancies, but this time looking at another set of prenatal sex steroid hormones called oestrogens. This is an important next step because some of the hormones previously studied are directly converted into oestrogens.

All four oestrogens were significantly elevated, on average, in the 98 foetuses who later developed autism, compared to the 177 foetuses who did not. High levels of prenatal oestrogens were even more predictive of likelihood of autism than were high levels of prenatal androgens (such as testosterone). Contrary to popular belief that associates oestrogens with feminisation, prenatal oestrogens have effects on brain growth and also masculinise the brain in many mammals.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at the University of Cambridge, who led this study and who first proposed the prenatal sex steroid theory of autism, said: "This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well established as another, and these hormones likely interact with genetic factors to affect the developing foetal brain."

Disparities in Diagnosis and Service Access

In The Politics of Autism, I write about the experiences of different economic, ethnic and racial groups.

At the Journal of Autism and Developmental Disorders,Waganesh A. Zeleke, Tammy L. Hughes and Natalie Drozda have an article titled "Disparities in Diagnosis and Service Access for Minority Children with ASD in the United States. The abstract:

This study examined children with an autism spectrum disorder (ASD) using data from the 2011 Survey of Pathway to Diagnosis and Services national data set (n = 1715). When comparing white and minority families, results indicate there were no differences between the child’s treatment needs based on the number and type of ASD symptoms or insurance coverage. However, minority parents were less likely to contact a doctor or health care professionals about their concerns, waiting years, rather than months as described by white families, to have the child evaluated. Although both white and minority families received similar types of care (e.g., conducting developmental tests, making a referral to a specialist, suggesting that the parent discuss the concern with the school), white families reported they were more formally engaged in the diagnostic process and subsequently visited a larger variety of service providers. White parents were more satisfied with the services that their child received from doctors and other health care providers whereas minority families indicated school services were more responsiveness to their needs. Recommended outreach efforts are suggested and described.

From the article:

Data from this study highlights the role school services are already playing for minority families. Although insurance coverage was the same for both groups, minority families indicated that the schools were the most responsive to their needs. These results may be due to the outreach that  is already required via special education law. The process,
called Child Find (20 U.S.C. 1412 a (3)) requires districts to formally notify residents that their children may be eligible for services from birth through the age of 21. Although the process for contacting the school can vary by state or district, most often the community is notifed via flyers or other written announcements, often twice a year, that families may bring their children in for a variety of screening procedures (e.g., vision, hearing, physical, social-emotional, language, motor and cognitive development) free of charge. This process allows schools to help families access early intervention services including head start and other programs. Also, it helps families identify underlying medical conditions (e.g., ADHD) and developmental disabilities (e.g., ASD).
Although the data suggest that schools have been more successful that the general health care system that does not mean that best practice standards have been achieved