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Thursday, February 28, 2019

Vaccine News: The Good, the Bad, and the Ugly

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

The Good:

Carmen Forman at Arizona Capitol Times:
Gov. Doug Ducey promised today he will not sign several controversial bills moving through the Legislature that could lead to fewer children being vaccinated.
Ducey said he will not sign any legislation that goes against promoting vaccinations.

“I’m pro-vaccination and anti-measles,” he said.
Specifically, Ducey was referring to three bills proposed by Rep. Nancy Barto, R-Phoenix, although he didn’t address the measures individually.
The bills would:
  • Expand vaccination exemptions and eliminate a requirement that parents sign a state form in order for their kids to receive an exemption
  • Require doctors to offer parents a blood test to determine if their child is already immune
  • Require parents to be given extensive information about the risks of vaccines, including information that is typically reserved for doctors
Most states also allow exemptions for religious reasons, and 17 states, including Washington and Texas, allow exemptions for both religious and personal or philosophical beliefs, according to the National Conference of State Legislatures. Both Washington and Texas have seen measles outbreaks this year.
Lawmakers in Iowa, New Jersey and Vermont, which already ban personal or philosophical exemptions, are now debating proposals to eliminate religious exemptions.
Proposals in Maine and Oregon would eliminate both exemptions, while measures in Minnesota, Colorado, and Washington state, where there are 66 confirmed measles cases this year, would only eliminate personal exemptions and leave religious exemptions in place.

All of the major medical and health organizations oppose religious and personal exemptions and have for years urged state lawmakers to eliminate them.

The bad:

There are eight cases of measles in Texas so far this year. Sophie Novack at The Texas Observer:
A bill filed in the Texas Legislature this month by Representative Matt Krause, a member of the far-right House Freedom Caucus, would make it easier for parents to request vaccine exemptions. A similar version was left pending after a House Public Health Committee hearing in 2017, but Krause’s new bill would go further, explicitly preventing the state health department from tracking the number of exemptions. Even though the exemption data doesn’t include anything that could identify individual students and is only available at the school district level, Krause and [State Rep. Bill] Zedler point to fears among anti-vaxxers that they will be tracked and bullied. “We’ve seen instances in California, stuff like that, where they start hunting people down,” Zedler said.
Public health officials say the proposal would curb their ability to identify and stop disease outbreaks, and parents of immunocompromised kids would have even less information to decide where to send their children to school.
“This is the modus operandi for anti-vaxxers in Texas: to promote exemptions, obfuscate and minimize transparency,” said Peter Hotez, a leading vaccine scientist and dean for the National School for Tropical Medicine at Baylor Medical School. “To do this in the middle of a measles outbreak in Texas is especially unconscionable.”

The ugly:

CDC reports 159 cases of measles in the United States this year:

Trends in Measles Cases, 2010-2019

College Programs

According to Think College , a national organization dedicated to developing college opportunities for individuals with intellectual disabilities, more than 260 colleges across the nation now offer on-campus transition programs for this population. That’s up from just 25 such programs in 2004.

These programs often have been launched with private donations or with seed funding from the Transition Programs for Students with Intellectual Disabilities (TPSID), which was funded by the federal Higher Education Opportunity Act of 2008. TPSID also made students with intellectual disabilities eligible for Pell grants, Supplemental Educational Opportunity Grants and the Federal Work-Study program. Once in place, the programs are usually self-supporting through the tuition and fees paid for by the students, many of whom receive scholarships.
Typically, the programs are four to five semesters in length, although more mature programs, like Vanderbilt’s Next Steps and George Mason University’s LIFE have expanded to four years. After completing the program, students are awarded a graduation certificate that officially recognizes their achievement. Some may transfer to a traditional baccalaureate program.
For colleges that have not yet begun a program for students with IDD, the advice is simple: you should. Technical assistance can be found at the National Technical Assistance Center on Transition, the Association of Higher Education And Disability, the National Center for College Students with Disabilities , the Parent Advocacy Coalition for Educational Rights, and the National Collaborative on Workforce and Disability for Youth.

Tuesday, February 26, 2019

The Divorce Myth

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  One challenge consists of myths surrounding autism.

Sara Luterman at The Washington Post:
Why does the narrative that autism destroys marriages persist? Last year, at the Autism at Work conference, an otherwise wonderful gathering of business leaders from across America, autism mom and pseudo-celebrity Holly Peete Robinson gave a presentation trotting out the claim that 80 percent of marriages with an autistic child end in divorce. It felt like being stabbed. At a conference ostensibly for lifting up autistic people and our hidden value, I was confronted with the accusation that my mere existence hurts my parents. That the mere existence of people like me destroys marriages and turns love into ash. After her presentation, I confronted her at the front of the room with the data. Her response? The 80 percent number “felt real.” Feelings aren’t facts. (Robinson’s representatives declined to respond to a request for comment from The Washington Post.)

Monday, February 25, 2019

Antivax Bills Advance in Arizona

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

Stephanie Innes at the Arizona Republic:
Disregarding warnings by public health officials, an Arizona legislative panel on Thursday endorsed three bills that critics say will erode immunization coverage among Arizona schoolchildren. The House Health and Human Services Committee approved all three bills in contentious 5-4 votes that were split along party lines, with Republicans favoring the measures and Democrats voting in opposition. Several critics pointed out measles outbreaks across the country and said the three bills could make Arizona more vulnerable.
One of the measures — House Bill 2470 — not only expands vaccine exemption categories in Arizona, it gives parents additional leeway by removing the requirement that they sign a state health department form to get a vaccine exemption.
Two other bills endorsed by the committee Thursday would create more work for physicians. House Bill 2472 requires doctors to offer parents an "antibody titer" blood test to determine whether their child needs a vaccine or is already immune. House Bill 2471 is an informed-consent bill that would give parents information about vaccine ingredients and vaccine risks, including how to file a complaint for vaccine injury.
Bruce Y. Lee at Forbes:
Huh? The Grand Canyon may not be the only big gap in Arizona. Pushing these three bills through would seem like a huge gap between what is being done and what is truly needed. The state of Washington had to declare a statewide emergency and has already spent over a million dollars of taxpayer money dealing with the measles outbreak. All scientific evidence suggests that lower vaccination rates in Clark County, Washington, led to the outbreak. Therefore, the focus in Washington has been trying to increase vaccination rates.
On top of all this, Arizona may have the lowest measles-mumps-rubella (MMR) vaccination rates in the country at 84.1%, according to a Centers for Disease Control and Prevention (CDC) survey as Claire Cleveland and Jessi Schultz reported for the Cronkite News Service. Such a rate would be well below the 95% critical immunization threshold needed to prevent the measles virus from more readily spreading in a population, as I described previously for Forbes.

Sunday, February 24, 2019

Reaction to Defeat of South Dakota Autism Bill

The Politics of Autism includes an extensive discussion of insurance.

Last week, a South Dakota legislative committee defeated a bill that would have extended the state's autism insurance mandate.  At KEVN-TV in Black Hills, South Dakota, Jeff Voss reports on reaction:
Beth Zimmerman, ' And I was devastated, and to watch the other moms who have been able to have ABA coverage for their children, to watch their reaction and know there is no way they can get this coverage on their insurance, they needed this bill to essentially make their child functioning members of society.'
ABA or Applied Behavioral Analysis works on attention level and social skills. Without insurance, an hour-long ABA class can cost up to 250 dollars out of pocket, and some children require 40 hours of therapy per week. Testimony in Pierre from an autistic 10-year-old made a large impact.

Zimmerman says, ' There was a little girl there and she was 10 years old and she testified in front of this committee. I was severely autistic when I was 2 years old, I could not speak and now I'm a 10-year-old, I have friends, I can speak in full sentences. I'm not on an IEP anymore. It was so gutwrenching to listen to that, not a single dry eye in the house except for those on the legislature and those on the committee.'
While Zimmerman understands the cost concerns from insurance providers and why they opposed the bill, she encourages them to look at a broader scope.
Zimmerman, 'Think about our children. these are supposed to be our future. And we are sitting here arguing over cents. It's going to cost, what they came up with was 35 cents per person insured per month.'

KELO-TV showed testimony:

Saturday, February 23, 2019

ID Cards in New York State

The Politics of Autism includes an extensive discussion of policy initiatives in the statesNew York enacted ID legislation by Assemblyman Angelo Santabarbara.

Stephen Williams at The Daily Gazette (Schenectady, NY):
The state Office for People With Developmental Disabilities has started issuing standardized identification cards for people with intellectual and/or developmental disabilities, upon request, the agency announced on Friday.
The goal of the ID cards for individuals with disabilities is to help first responders – such as law enforcement, firefighters and emergency medical services personnel – better understand and interact with people with developmental disabilities who may not be able to communicate their situation effectively.
The program grows out of legislation sponsored by Assemblyman Angelo Santabarbara, D-Rotterdam, and state Sen. Pamela Helming, R-Canandaigua. Santabarbara said he was inspired to push for the new ID cards by his teenage son, who has autism. Governor Andrew M. Cuomo signed the legislation last year and charged the Office for People With Disabilities Disabilities with creating the ID card program.

Friday, February 22, 2019

Big Tech v. Antivax

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.

Sara Fischer and Kia Kokalitcheva at Axios:
  • YouTube: The company announced last month it will begin reducing recommendations of borderline content and content that could misinform users in harmful ways, including videos promoting a phony miracle cure for a serious illness. "This includes certain types of anti-vaccination videos," the company says.
  • Google: When it comes to Search, Google says that for queries that pertain to sensitive topics susceptible to misinformation, like health information, it has systems in place to prioritize results from authoritative sources. To help with this process, Google displays knowledge panels at the top of search results for illnesses and conditions with information from authoritative sources and have been evaluated by medical professionals.
  • Facebook: Facebook says it has "taken steps to reduce the distribution of health-related misinformation on Facebook," but says it knows it has more to do. A spokesperson says it's currently working on additional changes that Facebook will be announcing soon. Facebook is considering changes like reducing or removing this type of content from recommendations and demoting it in search results.
  • Twitter: There's no specific policy in place at Twitter to cover anti-vaccination content, but the company argues that the dynamics of its platform mean that readers are more likely to encounter balanced information.
  • Pinterest: The company is currently blocking results for searches like "vaccine" or "vaccination" altogether, saying it doesn't want to lead users down a rabbit hole of potentially harmful advice. However, Axios searches for "vaxxer" or even "autism vaccine" still returned a slew of returns, suggesting it's still fairly easy for a user to be exposed to this content.

Thursday, February 21, 2019

Autism Mandate Fails in SD Committee

The Politics of Autism includes an extensive discussion of insurance.

At KELO-TV, Angela Kennecke reports:
For parents of children with autism, coverage for Applied Behavior Analysis was anything but guaranteed. In 2015, the South Dakota legislature passed a bill requiring insurance companies cover ABA therapy. But insurance companies have now discovered a loophole in the law that's allowing them to drop the coverage for many children with autism.

Here's the loophole: the 2015 South Dakota law does require Applied Behavior Analysis be covered for children with autism in large insurance pools made up of 50 people or more. But it did not require that those who are part of small groups or hold individual policies get the same coverage.
In Sioux Falls, KSFY-TV reports:
The House State Affairs committee Wednesday killed a bill that would mandate South Dakota health insurers include autism and spectrum disorders in their coverage.
SDBA reports the committee took 90 minutes of often emotional testimony late Wednesday afternoon before calling a 7-4 vote to send the bill to the 41st day, effectively killing the bill.
Supporters from across the state packed the Capitol building’s largest committee room sharing stories of the personal and financial impacts of caring for children with autism.
Opponents, including the South Dakota Division of Insurance and Sanford Health Plans, testified that the bill is a mandate and would require the State of South Dakota pick up as much as $1.4 million or more in costs.
As the vote was called, many of the supporters in the room broke down in tears.
KSFY News earlier this month spoke with two different Sioux Falls parents who were pushing for this insurance coverage.

The Cliff and the Tsunami

Two demographic trends will influence autism politics in the coming decades. First, the identified autistic population will get bigger, particularly in the adult range. Service providers refer to this coming change as a “tsunami,” after a large ocean wave that is barely visible when it moves over deep water but packs great power when it hits land. Second, the general population will be getting older just as the autism tsunami arrives, complicating the policy response.
Noah Remnick at The Atlantic writes about "the cliff."
About half a million people on the autism spectrum will legally become adults over the next decade, a swelling tide for which the country is unprepared. When they turn 21, these people leave behind all the programming and funding they received under the Individuals With Disabilities Education Act and enter a labyrinth of government services that vary wildly from state to state. Although people with other disabilities face similar problems, the staggering rise in diagnoses of autism creates a distinctly troubling dilemma in how to ensure that these people receive proper care.
 Uncertainty is a major theme of The Politics of Autism.  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.
Remnick writes:
What happens when people with autism age into adulthood remains understudied. Researchers predominantly focus on early intervention—less than 2 percent of all autism funding is directed to the experience of adulthood and aging—even though people with autism spend a vastly greater proportion of their life as adults. The existing findings are dismaying. About half of adults with autism continue to grapple with aggressive, self-injurious behaviors as they get older, and about half are also unemployed—the lowest employment rate among disability groups. Especially for those with greater challenges, it is more difficult to attain the basics necessary to live a comfortable life: housing, job training, and social opportunities.
Inequality and complexity are also major themes of The Politics of Autism.

Remnick again:
In general, adults with disabilities are eligible for resources through Medicaid, Supplemental Security Income, and various state disability agencies. These funds are meant to be combined and configured to fit the needs and priorities of each person, going toward everything from employment opportunities and day services to long-term care. But in reality, all the layers of bureaucracy often seem to tangle together for families. Individuals have to be certified separately by a variety of different agencies, all of which require their own documentation and have their own criteria for approval. Safeguards intended to protect adults with disabilities from being exploited often stymie parents and cost them money they simply do not have.
“There’s not enough funding in the first place, but even so, a ton of money is left on the table because this system is just so difficult to navigate,” says [Julie Lounds] Taylor, the Vanderbilt professor. “It’s nearly impossible for full-time professionals with a great deal of resources. I can’t even imagine what it must be like for families who are less well resourced.”

Wednesday, February 20, 2019

More Measles

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 14, 2019, 127** individual cases of measles have been confirmed in 10 states.
The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon, Texas, and Washington.
Trends in Measles Cases, 2010-2019
*Cases as of December 29, 2018. Case count is preliminary and subject to change.
**Cases as of February 14, 2019. Case count is preliminary and subject to change. Data are updated weekly.

Tuesday, February 19, 2019

The Antivax Danger

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.

Microbiologist Paul Duprex at The Conversation:
What one of the most infectious pathogens on the planet can do to an unvaccinated person in 2019 is biologically incredible. Yes, that’s right, an unvaccinated human. But why would anyone decide not to get vaccinated or refrain from protecting their children?
That’s because forgetting the past has precipitated selective amnesia in our post-measles psyche. Ignoring scientific facts has tragically brought us to a place where some people fail to appreciate the values and utility of some of the most phenomenal tools we have created in our historical war on infectious disease. Unsubstantiated claims that vaccines like MMR were associated with autism, multiple sclerosis, Crohn’s disease, etc., etc., and ill-informed celebrities have wreaked havoc with vaccination programs. Genuine, caring parents unaware of the realities of diseases they had never seen decided that since the viruses were gone from this part of the world shots were so last millennium. Put simply, some people have given up on vaccines.
This has created the perfect storm. Since the measles virus is so infectious and Europe, Africa, South America, and South East Asia are not really that far away by jumbo jet, a case somewhere in the world can lead to an infection anywhere in the world. Failure to vaccinate large groups of people is helping measles come back. From California, to New York from Washington state to Minnesota and Georgia, measles is back with a vengeance. Now we can only live in hope that the last death from this deadly disease in the U.S. remains from 2015. Unfortunately, that is not a given.
Dr. Arthur Caplan writes at NBC:
There are stupid statements. And then there are statements so outrageous, so ridiculous and so dangerous that they standout with startling clarity. This week, just such a rare instance occurred. In the middle of a concerning measles outbreak in Washington state, and with cases being reported in many other regions, Darla Shine, the wife of former Fox News bigwig and current deputy chief of staff for communications in the Trump administration Bill Shine said that childhood diseases such as measles "keep you healthy & fight cancer."
The idea that getting infectious diseases helps one acquire “natural” immunity as opposed to the “unnatural immunity” provided by vaccines is a pernicious lie. Shine went so far as to suggest cancer can be battled by an immune system strengthened by measles. She should tell that to the thousands and thousands of people who have died from a myriad of cancers and who also had chicken pox or measles as children. As anyone even vaguely familiar with cancer knows, cancer couldn’t care less about the measles, vitamins or other mythical notions of immunity. It is nothing short of cruel to suggest that women who inherit breast cancer should have been more willing to catch chicken pox.

Monday, February 18, 2019

Russian Trolls

Ron Synovitz at Radio Free Europe/Radio Liberty:
Studies have already documented how cybercampaigns by the Internet Research Agency -- a St. Petersburg "troll farm" that has been accused of meddling in the U.S. 2016 presidential election -- artificially bolstered debate on social media about vaccines since 2014 in a way that eroded public trust in vaccinations.
Now, the World Health Organization (WHO) is warning that "vaccination hesitancy" has become one of the top threats to global health.
It notes a 30 percent rise in measles globally and a resurgence of measles in countries that had once been close to eradicating the disease.
The article quotes Rober Califf, director of Duke University's center for health data, The Forge.
He said combating misinformation campaigns about vaccines had become more complex now that research is demonstrating that a large amount of the social-media posts represent what he called "state-sponsored cyberwarfare, particularly from Russia."
Katharina Kieslich, a political scientist at the University of Vienna, has written that "vaccination hesitancy might be explained from a political-science perspective."
Kieslich says the pervasiveness of anti-vaccination arguments ensures that challenges will remain for policymakers and health workers trying to reach "citizens who are skeptical of vaccines.".
GWU management professor David Broniatowski, has explained how Russi'as Internet Research Agency has spread vaccine disinformation.
Broniatowski tells RFE/RL he hasn't seen any evidence that Russia has tried to weaken Western democracies by persuading people to stop vaccinating. Rather, known trolls masqueraded as legitimate users on social media and debated vaccines as part of their strategy to promote political polarization.
"It's a known strategy to infiltrate an interest group around a particular issue or topic and then slowly try to introduce new things into that discourse," he explains.
After "getting access to a vulnerable subgroup and getting followers from that subgroup" on social media, Broniatowski says, the Russian trolls would get their followers to retweet messages about other issues that are in line with the Kremlin's agenda.

Sunday, February 17, 2019

Autistic Lawyer

In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities.

Lulu Ramadan at The Palm Beach Post:
 When Haley Moss was diagnosed with autism at 3 years old, doctors told her parents that she would be lucky to graduate high school and get a minimum-wage job.
Two decades later, Moss is a law school graduate, a practicing attorney, a published author and an inspiring voice for children on the autism spectrum.
Moss, 24, prepared a speech for a Boca Raton gala Saturday, where she’s being honored with an award from nonprofit Unicorn Children’s Foundation, about changing the conversation surrounding autism.
“It’s about dreams and following dreams and having no limits,” said Moss, a Miami-based attorney.

Saturday, February 16, 2019

Reported Abuse of Autistic Children

In The Politics of Autism, I write:
People with disabilities are victims of violent crime three times as often as people without disabilities. The Bureau of Justice Statistics does not report separately on autistic victims, but it does note that the victimization rate is especially high among those whose disabilities are cognitive. A small-sample study of Americans and Canadians found that adults with autism face a greater risk of sexual victimization than their peers. Autistic respondents were more than twice as likely to say that had been the victim of rape and over three times as likely to report unwanted sexual contact.

A release from Vanderbilt University Medical Center:
A recent study by Vanderbilt researchers of 11 counties in Middle Tennessee revealed that children with autism spectrum disorder (ASD) were nearly 2.5 times more likely than children without ASD to be reported to the Child Abuse Hotline by the age of 8.
The study, led by researchers from Vanderbilt Kennedy Center’s Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), examined the entire population of Middle Tennessee residents born in 2008 and compared their records through 2016. Using data collected through the Centers for Disease Control and Prevention’s (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network, 387 children out of the population of 24,306 were identified as having a diagnosis of ASD.
More than 17 percent of those identified with ASD had been reported to the Child Abuse Hotline by 2016, compared to 7.4 percent of children without ASD. Additionally, females with ASD were six times more likely to have substantiated allegations of maltreatment than males with ASD.Zachary Warren, PhD

According to Warren, children with ASD may be particularly vulnerable to maltreatment due to a variety of factors, including the presence of challenging behavior and complex cognitive and language impairments, increased caregiver stress, lower levels of family social support and higher rates of caregiver isolation and dependence.
Children with autism are also more likely to regularly work with a team of providers who may be paying closer attention than they would to children without ASD, though data from this study can’t confirm or deny these hypotheses.

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.