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Tuesday, October 17, 2017

Review of Politics of Autism

Pitney might have addressed autism as Medical Care Politics in America: The Case of Autism. But he did not, and therein lies an interesting set of analytic issues. Isn’t autism a topic in medical care just as the politics of cancer or the politics of abortion? The short answer is no and for two good reasons.

First, cases of politics in, for example, an industry such as medical care do not add up to a politics of medical care. The stakes, contestants, and forms of policy politics vary. Conflicts over hospital closures, for example, differ greatly from the regulatory battles of the drug industry or the financing of Medicare. To repeat, the undeniably truthful assertion of politics in  an industry does not entail that there is a politics of that industry.
The variation in how one can think about policy politics is substantial in other ways. One can emphasize the institutional setting of the struggle (Congress, the courts et al.), the interest group players (the American Medical Association or unions and governmental targets of influence), the topics of intense conflict (e.g., budgets or prison treatment of racial groups), the character of the dispute (quiet or noisy), and so on.
Pitney does not follow any one of these modes. He instead selects from the options those approaches most likely to resolve puzzles about American treatment of the science of autism, the realities of programs in place or proposed, and what he regards as the extraordinary complexity of this arena of policy politics.

Monday, October 16, 2017

Improving the Employment Prospects of Autistic People: A Pilot Study

In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities. Many posts have discussed programs to provide them with training and experience

At Autism, Mary J Baker-Ericzén and colleagues have an article titled "Development of the Supported Employment, Comprehensive Cognitive Enhancement, and Social Skills Program for Adults on the Autism Spectrum: Results of Initial Study."  The abstract:
The population of adults on the autism spectrum continues to increase, and vocational outcomes are particularly poor. Longitudinal studies of adults with autism spectrum and without intellectual disability have shown consistent and persistent deficits across cognitive, social, and vocational domains, indicating a need for effective treatments of functional disabilities as each impact employment. This initial pilot study is an open trial investigation of the feasibility, acceptability, and initial estimates of outcomes for the newly developed Supported Employment, Comprehensive Cognitive Enhancement, and Social Skills intervention, a manualized “soft skills” curriculum, to enhance both cognitive and social development in adults with autism spectrum. A total of eight adults with autism spectrum, without intellectual disability (78% males), participated in the study. Results support the original hypothesis that adults with autism spectrum can improve both cognitive (i.e. executive functioning) and social cognitive (i.e. social thinking and social communication) abilities. Further Supported Employment, Comprehensive Cognitive Enhancement, and Social Skills was found to be feasible, acceptable, and highly satisfactory for participants and parents. Employment rates more than doubled post-intervention, with an increase from 22% to 56% of participants employed. Conclusion is that Supported Employment, Comprehensive Cognitive Enhancement, and Social Skills has promise as an intervention that can be easily embedded into exiting supported employment vocational training programs to improve cognitive, social, and vocational outcomes.

Sunday, October 15, 2017

Perspectives on Transition Outcomes

The Politics of Autism explains that autism services can be complicated, creating difficulties for autistic people and their families.  Uncertainty another major theme of the  book.  In the concluding section, I write:
A key question in autism policy evaluation is simple to pose, hard to answer: How do autistic people benefit? How much better off are they as a result of government action? While there are studies of the short-term impact of various therapies, there is surprisingly little research about the long term, which is really what autistic people and their families care about. As we saw in chapter 4, few studies have focused on the educational attainment of autistic youths. For instance, we do not know much about what happens to them in high school, apart from the kinds of classes that they take. One study searched the autism literature from 1950 through 2011 and found just 13 rigorous peer reviewed studies evaluating psychosocial interventions for autistic adults. The effects of were largely positive, though the main finding of the review is that there is a need for further development and evaluation of treatments for adults.
At Autism, an article titled "Parents’ and Young Adults’ Perspectives on Transition Outcomes for Young Adults with Autism," by Collette Sosnowy, Chloe Silverman, Paul Shattuck.

The abstract:
Existing research shows that young adults with autism spectrum disorder have poorer outcomes than their peers with other developmental disabilities in the key areas of independent living, postsecondary education, and employment. However, we understand little about how young adults with autism and their families understand and value outcomes and whether these indicators match their goals and aspirations. We interviewed parents (n = 21) and young adults with autism spectrum disorder (n = 20) about their experiences with the transition to adulthood to understand what they consider to be desirable outcomes and how they seek to achieve them. Understanding these perspectives will help identify areas of need as well as disconnections between service objectives and the goals of young adults and their families. Participants described outcomes as more complex and nuanced than current conceptions and measures account for. They defined and evaluated outcomes in relation to their or their child’s individual abilities, needs, and desires. These findings provide important insight into challenges to and facilitators of desired outcomes, which has implications for programming, service delivery, and policy.
Back to the cliff. From the study:
The finding that young adults and parents see services and supports as inadequate is not surprising, given the significant drop-off in services after high school. This study suggests that services that are currently available may be inadequate in part because they do not align with young adults’ and parents’ priorities and do not offer the kind of help they need to support the transition to adulthood. Overall, both parents and young adults made it clear that supports and services needed to be flexible enough to meet individual needs and be more comprehensive, continuous, and integrated in order to be most useful. However, few services and supports work this way, and it is a challenge for the field to address this need.

Saturday, October 14, 2017

Segregating Disabled Georgians

In The Politics of Autism, I discuss the civil rights of people with autism and other disabilities

On October 11, 2017, parents of children with disabilities, the Center for Public Representation, the Bazelon Center for Mental Health Law, the Georgia Advocacy Office, The Arc, DLA Piper LLP, and the Goodmark Law Firm filed a class action lawsuit in federal court alleging that the State of Georgia has discriminated against thousands of public school students with disabilities by providing them with a separate and unequal education via the State’s Georgia Network for Educational and Therapeutic Supports Program (GNETS). The complaint, filed in United States District Court for the Northern District of Georgia, alleges that the State, in denying GNETS students the opportunity to be educated with their non-disabled peers in neighborhood schools violates the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, and the Fourteenth Amendment to the United States Constitution. Read this fact sheet or press release to learn more about the lawsuit.
The state of Georgia is unique in having established a state-wide educational program—GNETS—that systematically segregates students with behavioral disabilities across the state. Over 5,000 students with disabilities, the disproportionate majority of whom are students of color, have been sent to the GNETS centers. Most of the GNETS centers are housed in completely separate schools (including some that were formerly schools for African-American students in the Jim Crow days). Other GNETS centers are inside regular schools but typically are housed in locked wings or have separate entrances, effectively operating as a separate school within the school. GNETS students are not only segregated from their non-disabled peers but also receive an inferior education.
Typically, GNETS students are not taught by certified teachers; many are primarily taught through computers. Students cannot access the basic classes they need to earn a diploma, resulting in a graduate rate of GNETS students of only 10% (compared to a statewide rate of 80%). Many GNETS centers do not provide access to basic school services like gyms, libraries, or science labs. In addition, GNETS students are deprived of important co-curricular opportunities that other students enjoy, such as playing sports or participating in the school play. Parents and students have described GNETS as similar to a prison, with no way out. Learn more about GNETS with these infographics or here.
In 2015, the U.S. Department of Justice investigated GNETS and found that it violates Title II of the ADA by (1) unnecessarily segregating students with disabilities from their peers and (2) providing opportunities to GNETS students that are unequal to those provided to other students throughout the state. The investigation eventually culminated in a 2016 lawsuit against the State, alleging that the State’s administration of the GNETS system violates the ADA by “unnecessarily segregating students with disabilities from their peers” and providing “unequal” education opportunity to GNETS students. On August 11, 2017, the DOJ’s lawsuit was put on hold pending a decision from the 11th Circuit Court of Appeals regarding DOJ’s authority to bring suit. Throughout, the State has continued to defend the GNETS program.
A broad coalition of disability, educational, mental health, child welfare, juvenile justice, civil rights and parent and youth advocacy groups from across Georgia have joined together around shared concerns about the GNETS program. Learn more about the Georgia Coalition for Equity in Education.
If you have questions about this lawsuit or need assistance related to GNETS, contact the Georgia Advocacy Office by phone at (404) 885-1234 (or toll-free in Georgia at 1-800-537-2329) or by email at info@thegao.org.

Friday, October 13, 2017

Trump's Executive Order



Kyli Rodriguez-Cayro writes at Bustle:
[On] Oct. 12, Trump signed a health care executive order meant to undermine and dismantle Obamacare. According to CNN, the executive order “would allow consumers to buy short-term policies, which don't have to comply with Obamacare's protections for those with pre-existing conditions.” Essentially, with this executive order, many disabled people, and the protections they receive through the ACA, will be seriously impacted.
Trump’s executive order is predicted to be part of a larger plan to gut Obamacare — a plan being called a “synthetic repeal.” The term was coined on Twitter by Andy Slavitt, who served as Acting Administrator for the Centers for Medicare & Medicaid Services during the last two years of Obama’s presidency. Slavitt believes following the Oct. 12 order, the Trump administration will continue to destabilize the health marketplace — without the help of Congress — until the ACA fails. In response to Trump’s executive order and the possible backdoor repeal, Bustle spoke with Stacy Stanford, a disability rights advocate and community organizer who works with Utah Health Policy Project.
Though the executive order and possible “synthetic repeal” will negatively affect many marginalized communities, it poses an especially great risk to people with disabilities. Stanford tells Bustle, “Introducing more options for healthy people to buy less-comprehensive coverage, removed from the protections of the Affordable Care Act, only increases the burden on sick and disabled people.” By effectively giving non-disabled people the choice to buy insurance plans that include less coverage, premiums for disabled people will increase dramatically.
The Autistic Self Advocacy Network (ASAN) condemns the executive order issued by President Trump today attacking critical protections for people with disabilities in the Affordable Care Act (ACA). The executive order would make it easier for insurance companies to discriminate against people with pre-existing conditions, and could allow insurers to sell junk coverage that doesn’t cover critical services and won’t protect people from soaring health care costs. The American people have clearly and repeatedly rejected this kind of proposal. As ASAN has stated in the past, any future attempts at health care reform must meet the needs of all Americans, leave the Medicaid program intact, and proactively include the disability community from the beginning of the process. ASAN calls on the Trump administration to listen to the voices of everyday Americans, stop attempting to sabotage the ACA, and support a bipartisan process in Congress. Our government must work to develop thoughtful and carefully considered proposals that make healthcare better for everyone and increase access to quality, affordable coverage rather than endangering the lives of people with disabilities.

Thursday, October 12, 2017

Study: Kids from Poor Neighborhoods Are Less Likely to Get an Autism Diagnosis

In The Politics of Autism, I write about the experiences of different economicethnic and racial groups.   Inequality is a big part of the story. Affluent school districts have more resources than poor ones.  Educated professionals are better able to protect their children's interests than poor people who never went to college.

A release from the University of Wisconsin-Madison
Children living in neighborhoods where incomes are low and fewer adults have bachelor's degrees are less likely to be diagnosed with autism spectrum disorder compared to kids from more affluent neighborhoods.

The finding is part of a new multi-institution study of autism spectrum disorder(ASD), led by Maureen Durkin of the University of Wisconsin-Madison's Waisman Center, and published recently in the American Journal of Public Health.
Durkin and her team found that the incidence of the disorder increased during the study period. In fact, during the eight years of the study, the overall prevalence of ASD in children more than doubled, increasing from 6.6 to 14.7 cases per thousand children.
"We wanted to see if part of this increase in ASD prevalence was because advances in screening techniques and medical training meant more children from disadvantaged backgrounds were gaining access to ASD diagnoses and services," says Durkin, a professor of population health sciences and pediatrics at UW-Madison. "It doesn't seem that's the case."
Her team analyzed education and health care data for 1.3 million 8-year-old children from a Centers for Disease Control and Prevention population-based surveillance program, with sites in 11 states across the U.S.: Alabama, Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, Utah and Wisconsin.
The study merged this autism surveillance data with U.S. Census measures of socioeconomic status, such as number of adults who have bachelor's degrees, poverty and median household incomes in the census tracts studied.
It found that regardless of which indicator of socioeconomic status the researchers used, children living in census tracts with lower socioeconomic development were less likely to be diagnosed with ASD than children living in areas with higher socioeconomic indicators.
While not the first study to highlight socioeconomic differences in rates of autism diagnosis, "the continued increase in prevalence of ASD makes understanding its epidemiology critical to ensure services are reaching the children who need them the most," says Durkin.The study does not prove children from lower socioeconomic backgrounds are not getting the diagnoses and support they need, Durkin says, but it does indicate that's the most likely scenario.

In support of this hypothesis, the study found that children who had intellectual disabilities were equally likely to be diagnosed with ASD irrespective of their socioeconomic backgrounds.
That could be because "children with intellectual disabilities usually have developmental delays that get noticed earlier in life," says Durkin. "They may get referred for comprehensive medical follow-ups, which could then lead to a diagnosis of their ASD as well."
In addition, studies in Sweden and France—which have universal health care and fewer barriers for citizens to access medical care—found no association between socioeconomic status and rates of autism diagnoses.
These findings collectively support the idea that children living in poorer or less well-educated areas are being diagnosed with ASD at lower rates because they have less access to health care providers who could make the diagnosis and provide needed support.

Wednesday, October 11, 2017

Effects of Insurance Mandates

The Politics of Autism includes an extensive discussion of insurance and the regulation of autism service providers.

Colleen L. Barry, Andrew J. Epstein, Steven C. Marcus, Alene Kennedy-Hendricks, Molly K. Candon, Ming Xie, and David S. Mandell have an article at Health Affairs titled "Effects Of State Insurance Mandates On Health Care Use And Spending For Autism Spectrum Disorder."

The abstract:
Forty-six states and the District of Columbia have enacted insurance mandates that require commercial insurers to cover treatment for children with autism spectrum disorder (ASD). This study examined whether implementing autism mandates altered service use or spending among commercially insured children with ASD. We compared children age twenty-one or younger who were eligible for mandates to children not subject to mandates using 2008–12 claims data from three national insurers. Increases in service use and spending attributable to state mandates were detected for all outcomes. Mandates were associated with a 3.4-percentage-point increase in monthly use and a $77 increase in monthly spending on ASD-specific services. Effects were larger for younger children and increased with the number of years since mandate implementation. These increases suggest that state mandates are an effective tool for broadening access to autism treatment under commercial insurance.
From a release by the Johns Hopkins University Bloomberg School of Public Health:
"The hope of patient advocates and policymakers was that these insurer mandates would increase care for children with autism, and they seem to have done that—in fact, the impact was even larger than we had expected," says Colleen L. Barry, PhD, MPP, the Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Bloomberg School.

The results, Barry adds, are important for states that have enacted such mandates to understand their impact, and also helpful for states considering whether to broaden mandates that are already in place. Barry is also affiliated faculty with the Johns Hopkins Wendy Klag Center for Autism and Developmental Disabilities at the Bloomberg School.
...
Recent federal laws including the Affordable Care Act have introduced nationwide coverage mandates, including "parity" mandates requiring that coverage of mental health care be equal to coverage of general health care. But how closely these regulations apply to behavioral therapies for ASDs is still being debated—even litigated—among insurers and patient advocacy groups.

"Concern that children with autism were not able to access services through private insurance even in the context of parity laws was one reason why patient advocates have pushed for these state mandates that apply specifically to autism coverage," Barry says.

Tuesday, October 10, 2017

California Governor Signs Bill to Make ABA More Available

The Politics of Autism includes an extensive discussion of insurance and the regulation of autism service providers.

A release from the Center for Autism and Releated Disorders:
California Governor Jerry Brown has signed Assembly Bill 1074, a bill authored by Assembly Member Brian Maienschein (R- San Diego) and co-sponsored by California Association for Behavior Analysis (CalABA) and the Center for Autism and Related Disorders (CARD). The bill received overwhelming support from both the California Assembly and Senate.
AB 1074 makes critical updates to California’s autism mandate, already regarded as one of the strongest in the nation. In addition to technical changes, AB 1074 removes the requirement for autism treatment professionals to be vendored with a state regional center and clarifies that evidence-based autism treatment includes clinical case management. Additionally, the bill removes a 6-month experience requirement for paraprofessionals who work one-to-one with individuals affected by autism spectrum disorder (ASD), a requirement that has limited the capacity of California’s autism treatment providers to meet the needs of California’s autism community.
“I’m gratified to have had the opportunity to increase access to treatment for individuals affected by autism. This bill clarifies California’s autism mandate to ensure behavioral health providers are not hindered by outdated requirements,” said Assembly Member Maienschein.
The bill’s co-sponsors worked together with Assembly Member Maienschein to identify how to increase access to evidence-based autism treatment without jeopardizing treatment quality or consumer safety.
“We are so thankful for Assembly Member Maienschein’s dedication to California’s autism community. AB 1074 ensures that individuals affected by autism have access to medically necessary treatment and that providers can increase their capacity to provide services without diluting treatment quality,” said Doreen Granpeesheh, Ph.D., BCBA-D, executive director and founder of CARD.
California is home to more autism treatment providers than any other state; yet, individuals diagnosed with ASD often encounter delays and waiting lists when seeking medically necessary treatment.

About California Association for Behavior Analysis (CalABA)
California Association for Behavior Analysis (CalABA) is the professional membership association representing behavior analysts in California. CalABA is dedicated to advancing, promoting, and protecting the science and practice of behavior analysis. For more information, visit http://www.calaba.org
About Center for Autism and Related Disorders (CARD)
CARD treats individuals of all ages who are diagnosed with autism spectrum disorder (ASD) at treatment centers around the globe. CARD was founded in 1990 by leading autism expert and clinical psychologist Doreen Granpeesheh, PhD, BCBA-D. CARD treats individuals with ASD using the principles of applied behavior analysis (ABA), which is empirically proven to be the most effective method for treating individuals with ASD and recommended by the American Academy of Pediatrics and the US Surgeon General. For more information, visit http://www.centerforautism.com or call (855) 345-2273.

Sunday, October 8, 2017

Language Barriers and Autism Services

In The Politics of Autism, I discuss the relationships of autism, class, race, and ethnicity.


The abstract:
Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents’ abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.
From the article:
Study results show that children whose parents spoke English as a primary language received significantly more hours of services provided by CA DDS Regional Centers than children whose parents primarily spoke a language other than English. These results are supported by previous studies showing a link between English–Spanish language barriers and reduced access to ASD-specific health care services (Liptak et al. 2008; Mandell et al. 2009) and are particularly meaningful as 53% of parents in our sample spoke Spanish as a primary language and only 34% spoke English as a primary language. It is of note that while primary language is major component and indicator of acculturation (Schumann 1986) acculturation is multi-dimensional by nature and not all components of acculturation were accounted for by this study.

Additionally, significant differences in IEP goal content were found by this study. Analyses showed that children of parents whose primary language was English were significantly more likely to have both social skills goals and communication skills goals listed in their IEP. The maintenance and continued evaluation of IEPs is dependent in large part on parent involvement [e.g. according to Disability Rights California, neither federal nor state law limits the number of IEPs a parent can request per year; parents may request initial special education service assessments (California Education Code 2001) and parents are encouraged to contribute to IEP meetings by reporting on their child’s academic, developmental and functional needs, the strengths of their child and concerns regarding education enhancement opportunities (California Education Code 2010)]. The discrepancy in the quality of IEPs found by this study may represent differences in the variable profile of ASD across primary language, but may also reflect the heightened challenge faced by parents whose primary language is not English to advocate for specific, appropriate IEP content. It is possible that the language barrier between parents whose primary language is not English and CA public school administrators and teachers plays a role in rendering the content of these IEPs less specific to the needs of a child with ASD, considering previous publications citing challenges associated with language barriers in IEP meetings (Cheatham 2010; Lian and Fontánez-Phelan 2001; Salas 2004)

Saturday, October 7, 2017

Variation in Special Education

A child’s chances of getting an autism label vary by geography as well as social class. On a broad level, state definitions of autism are consistent with the federal definition. At the practical level, there are differences, especially when it comes to assessing social and emotional development, health, vision, hearing, and motor skills. In 2011, seven percent of students receiving IDEA services nationwide had an autism determination. But the figures varied by state. The states with the highest share of IDEA students with identified autism were Minnesota (12.8 percent), Oregon (10.6 percent), and Connecticut (10.1 percent). The lowest were Iowa (1.1 percent), Puerto Rico (2.1 percent), Montana (2.8 percent), Oklahoma and West Virginia (3.7 percent each).  
Christiana Samuels at Education Week:
Despite wide variation in the percentage of students enrolled in special education, a majority of teachers, principals and special administrators in a given state feel that the classification rates are largely on target, says a new report from Frontline Learning and Research Institute.
More than 17 percent of the students who live in Maine, Massachusetts, New York, and Pennsylvania are enrolled in special education, far outstripping the classification rates in other states, according to federal data. In contrast, Colorado, Hawaii, Idaho, and Texas—the four states with the lowest percentage of students in special education—have classification rates around 10 percent or less.

Most educators and principals feel these numbers are correct, even though they deviate from the national average of special education enrollment, 12 percent.
The insititute is a division of Frontline Education, which provides administrative and human resources software products to educational organizations nationwide. The institute draws on data from more than 12,000 school districts and millions of users of its products to create data-driven research on educational topics. This report, "Crossing the Line: Exploring Equity in Special Education Classification Across the United States," is one of four reports planned on special education topics.

Friday, October 6, 2017

Bipartisan House Working Group on Employing People with Disabilities

In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities. Many posts have discussed programs to provide them with training and experience

House Republican Conference Chair Cathy McMorris Rodgers (R-WA) announced a new bipartisan Congressional working group focused on employing people with disabilities. The announcement took place at a press conference hosted by the National Down Syndrome Society (NDSS). The title of the working group is the “Bipartisan House Working Group on Employing People with Disabilities.” Its five members are: House GOP Chair Cathy McMorris Rodgers (R-WA), House Democrat Caucus Chair Rep. Joe Crowley (D-NY), Rep. Gregg Harper (R-MS), Rep. James Clyburn (D-SC), and Rep. Tony Cárdenas (D-CA).


Rep. Rodgers backed the ABLE Act.  Deborah Barfield Barry reports at USA Today:
Sara Weir, president of the National Down Syndrome Society, said the ABLE Act has generated 15,000 accounts with more than $30 million in assets in 28 programs.
“The next frontier is employment," she said.
Weir said her group is working with lawmakers to craft legislation that would eliminate or change outdated laws that have income limitations for people with disabilities. She said individuals can only earn about $16,000 a year before federal disability benefits are in jeopardy.
“There are income limitations on Medicaid and Social Security that prevent people with Down syndrome from having full-time careers," she said.

Some of the laws date back to the 1930s and 1960s when individuals with Down syndrome were often institutionalized and didn't live long, Weir said.

“We want all of our individuals with Down syndrome not to just have job opportunities, but have the right to pursue a meaningful career," she said.

Thursday, October 5, 2017

ACLU Suit

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 In the case of Buckeye, Arizona, an officer harassed a young autistic man who was merely stimming.

The Buckeye scandal is not a one-off.  Though some police departments do a good job of training officers about autism and other disabilities, many do not.  The result is needless confrontation, and sometimes death.

A release from ACLU Illinois:
Seeking to ensure that concerns about interactions between Chicago police and people with disabilities are part of any reform effort, the American Civil Liberties Union of Illinois and Equip for Equality filed a federal lawsuit today with Chicago-based organizations Community Renewal Society, Communities United, Next Steps and ONE Northside. The groups seek the participation of impacted community groups in the reform of the Chicago Police Department (“CPD”), including how force is used against people with disabilities and against Black and Latino Chicagoans.
“The Police Accountability Task Force’s 2016 report and the DOJ’s 2017 report found that the CPD does not have the training or vision to ensure safe encounters with people with disabilities. This community must be part of the discussion about how to reform policing in Chicago,” said Karen Sheley, director of police practices at the ACLU of Illinois.
Specifically, the lawsuit challenges the City’s failure to train and monitor officers to ensure they safely interact with people with disabilities— one third to one half of the victims of police violence nationwide. The suit also challenges CPD’s disproportionate use of force on Black and Latino Chicagoans. For people of color with a disability, these disparities are compounded, too often leading to injury or death at the hands of the police.
“We hear regular accounts of frightening, dangerous interactions between Chicago Police and people with disabilities,” added Barry C. Taylor, Vice President for Civil Rights at Equip for Equality. “Police need the training and preparation necessary to ensure that these interactions do not occur in the future. This must be a part of police reform in this City.”

Last January, the U.S. Department of Justice issued a scathing report on the use of force by CPD officers and the failures of CPD to appropriately train and manage its officers. The lawsuit alleges that these deficiencies are causing a pattern of excessive force, encouraging a culture of cover-up, and failing to provide Chicago with a community-based policing strategy to promote public safety.

"We have a moral imperative to ensure that law enforcement officers are accountable and responsible to the communities they serve,” said Reverend Robbie Craig, Interim Executive Director at the Community Renewal Society. “True and lasting reform can occur only with community members at the table. We must act to make this inclusion a reality and not rely on vague promises from politicians."
“We deserve a police force that can safely serve and protect all Chicagoans, including residents with disabilities. CPD does not have the training and ability to achieve this goal, meaning that routine interactions habitually escalate into violence. We are proud to join this lawsuit to demand all residents be involved in oversight and reform,” added Curtis Smith, Board President at ONE Northside.
Almost nine months after the DOJ report concluded that a consent decree with an independent monitor was necessary to address the CPD’s entrenched problems, no decree has been issued nor has a monitor been appointed. Though Mayor Rahm Emanuel held a press conference in August promising to work with the Illinois Attorney General to resolve her lawsuit filed the same day, that lawsuit does not address the harm of the City’s practices to people with disabilities.

The community groups involved today also felt compelled to file suit because the City recently announced it would work with the office of Illinois Attorney General Lisa Madigan to negotiate a consent decree, yet it continues to seek dismissal of the lawsuit filed in June by black civil rights groups. Neither the City nor the AG’s office has explained how affected communities will be able to influence their private deal-making or whether they will have a role in the enforcement and monitoring of a consent decree.

“The City of Chicago cannot negotiate this agreement behind closed doors. True oversight must involve impacted communities,” said Roxanne Smith, a member of Communities United. “Communities United is committed along side our partners to guaranteeing positive reforms in the Chicago Police Department and changing how they interact with their community for the better.”
The lawsuit filed today also aims to ensure there is a long-term commitment to enforcing a consent decree. Recently, Attorney General Madigan announced she would leave office in early 2019, raising the prospect that her office’s commitment to a decree could disappear with a new Attorney General. For many, the ACLU notes, this is reminiscent of what happened after the Trump Administration took office in January and abandoned the DOJ’s plans to negotiate a consent decree on police reform in Chicago.

“People with disabilities are not currently served well by either our mental health care system or our criminal justice system,” said Fred Friedman of Next Steps. “The results get worse when those systems intersect. It is critical that the interests and concerns of those with disabilities be fully heard and considered in police reform. This lawsuit helps insure we have a seat at the table.”
“The ACLU has long history of challenging unlawful police practices and fighting for the rights of people with disabilities,” Sheley added. “We believe that this process will take years, not months, and requires stable leadership. We are ready to work with the City, the current and future Attorney General, and community groups to design and implement specific reforms. In the meantime, we urge those with disabilities who have had a bad experiences with the Chicago Police Department to contact the ACLU of Illinois.”

Wednesday, October 4, 2017

The Need for Police Training


 As  Jim Pietrangelo writes at Healthline, the Buckeye incident illustrates the need for police training.
Healthline discussed the subject of law enforcement and autism with Elizabeth Rossiaky, a board-certified behavior analyst with the Center for Autism and Related Disorders (CARD).
Rossiaky works one-on-one with children who have autism. She has personal experience observing interactions between law enforcement and those children
“Throughout the country, you’re going to see a spectrum of officers and how they handle those situations involving individuals with autism,” said Rossiaky. “What it really comes down to is education and training.”
“The officers [in some Chicago suburbs] are required to have bachelor degrees,” she added. “They do go through more mental illness training. They go through more de-escalation training.”
However, there’s little to no standardization in levels of education and mental health training for officers throughout the country.
“Some officers have [less education] and receive maybe an eight-hour course on mental health. And that’s about it,” said Rossiaky.
Instead, “they often get way more training on how to physically manage an individual,” said Rossiaky. “That’s where you see an officer approaching a child, not knowing how to handle [them] not responding, and then the child ending up on the ground.”

Like what happened to the Arizona teenager.
“It’s because that’s where their focus lies,” said Rossiaky.

Tuesday, October 3, 2017

SCOTUS and Special Education

In The Politics of Autism, I write about IEPs and FAPE.

Mark Walsh at Education Week reports that the Supreme Court declined to hear a case on "stay-put" under IDEA.
In N.E. v. Seattle School District (Case No. 16-1285), the question was whether an educational setting constitutes a child's "then-current educational placement" simply because it is the placement listed in an individualized education program (IEP) drafted by the school district, even when the parents objected to the portion of the IEP listing that placement, and the child never actually attended that placement.
The U.S. Court of Appeals for the 9th Circuit, in San Francisco, had ruled in favor of the Seattle School District in the case. Lawyers for N.E., a student with attention deficit hyperactivity disorder, argued that the 9th Circuit's interpretation of the stay-put provision of IDEA was incorrect and inconsistent with several other federal circuit courts.

"The circuits exist in a state of perpetual confusion" about how to apply the stay-put provision, the Supreme Court appeal on behalf of the student said.
The justices declined the appeal without comment.
There was a different disposition for another special education case. The Supreme Court granted a California family's request to toss out a 9th Circuit decision that had upheld a federal district court's and administrative law judge's findings that a school district met its obligations under the IDEA for a student identified as E.F., who has autism and communicative delays.
The parents of E.F. said in court papers that he had made only minimal progress on his IEP's goals over four years in the Newport Mesa Unified School District, and that the lower court rulings had affirmed such a standard of minimal progress that was later rejected by the Supreme Court.
In its March 22 decision in case involving a Colorado student, Endrew F. v. Douglas County School District, the high court had set aside a "merely more than de minimis" standard adopted by another federal appeals court and held that an IEP typically should be "reasonably calculated to enable the child to achieve passing marks and advance from grade to grade."
In their Supreme Court appeal in E.F. v. Newport Mesa Unified School District (No. 16-1533), the family asked the justices to vacate the 9th Circuit's decision in their case and remand for further consideration in light of Endrew F.

And that is exactly what the high court did.

Monday, October 2, 2017

Health Care Problems

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

A 9/11 release from OSU Medical Center:
In a new study, researchers with The Ohio State University Wexner Medical Center's Nisonger Center found significant disparities between individuals with and without developmental disabilities in health status, health care quality, utilization, access to care and unmet healthcare needs.

A telephone survey of 42,876 adults and 10,122 proxy interviews for children found that, when comparing age groups, children and older adults with developmental disabilities experienced the greatest disparities in unmet healthcare needs.

The findings, based on an analysis of data from the 2015 Ohio Medicaid Assessment Survey, will publish online today in the Annals of Family Medicine. Among children 0-18 years of age with developmental disabilities, 14 percent reported problems receiving needed care, compared to 2 percent of children without developmental disabilities. Among adults age 65 and older, 50 percent of those with developmental disabilities reported one or more unmet health care needs, compared to 17 percent of those without such disabilities.

Key findings include that adults with developmental disabilities were less likely to have a primary care physician that spends enough time with them, and older developmentally disabled individuals were less likely to have clinicians who explained things well.

"These findings highlight the importance of disability competency for health care clinicians," said lead author Jessica A. Prokup, a third-year medical student at Ohio State's College of Medicine and a LEND fellow (Leadership Education in Neurodevelopmental Disabilities) at the Nisonger Center. "Based on our findings, we urge medical schools to incorporate specific training in developmental disabilities into their undergraduate medical curriculum to help reduce these health care disparities."