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Saturday, February 27, 2021

Antivaxxers Threaten Black Doctors

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong.

Kaylin Dodson at Vice:

Earlier this month, Bloomberg reported that Black doctors are often working double duty, treating patients during the day and combatting misinformation on Clubhouse at night. Some of the doctors that have done this tell Motherboard that they have been harassed and threatened by vaccine skeptics and their followers.

Much of this has centered around Chakabars Clarke, an entrepreneur, wellness influencer, and anti-vaxxer with a million Instagram followers moderated a room on Clubhouse where he questioned the validity of vaccine information being presented by “mainly Europeans.” Clarke has 15,600 followers on Clubhouse and his rooms regularly reach upwards of a thousand audience members.

Like most viral rooms on Clubhouse, the conversation spilled over to Twitter, where users have condemned Clarke.
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Black doctors who have spent time debunking antivax conspiracy theories say they have been threatened by some of Clarke's followers, which has become a major topic of conversation among people in these rooms and became a broader discussion on Twitter, with comedian Tiffany Haddish defending Clarke.

Clarke did not respond to a request for comment from Motherboard, but told Insider that he denied "spreading information about the vaccine." At one point, Clarke was temporarily suspended from Clubhouse.

Friday, February 26, 2021

Ending Discrimination in Organ Transplantation


A release from Rep. Jaime Herrera Beutler:
U.S. Representatives Jaime Herrera Beutler (WA-03) and Katie Porter (CA-45) today reintroduced the Charlotte Woodward Organ Transplant Discrimination Prevention Act, which will prohibit using an individual’s mental or physical disability as the sole basis of determining their eligibility for an organ transplant.

The bill, named after Charlotte Woodward, an advocate fighting against discrimination who has Down syndrome and received a heart transplant in 2012, clarifies that doctors, hospitals, transplant centers and other health care providers are prohibited from denying access to organ transplants solely based on a qualified individual’s disability.

“If an individual needs access to a life-saving organ transplant, they shouldn’t be denied based on their disability – either physical or mental,” Herrera Beutler said. “I’m proud to reintroduce this important legislation today named after Charlotte Woodward, a relentless advocate against discrimination who has Down syndrome, to help ensure people with disabilities receive the same treatment and access to life-saving organ transplants.”

“A patient’s disability status shouldn’t stop them from getting the care they need, including a lifesaving organ transplant,” Porter said. “I’m proud to renew my push with Congresswoman Herrera Beutler to prevent discrimination against Americans with disabilities in getting necessary transplants. Discrimination has no place in our healthcare system.”

“As one of the very few people in the world with Down syndrome who has had the opportunity to receive a lifesaving heart transplant, I am so very, very grateful that people with disabilities will have the same opportunity as I in the future,” Charlotte Woodward said. “In the past, too many precious lives were lost due to discrimination in organ transplantation. I am so very, very thankful for the generosity of my heart donor and that of her loving family. Her gift has allowed me to live my life to the fullest and to go on to advocate for others to be able to do the same. The passage of this bill will be a monumental step towards a more just world, and I am proud to play a part in it.”

Herrera Beutler and Porter previously introduced this legislation in the 116th Congress.

Thursday, February 25, 2021

Diagnosing and Measuring Autism Across Countries

In The Politics of Autism, I discuss international perspectives.  Diagnosis depends on observation of behavior.  There are multiple problems with this approach, including cultural differences.
Moreover, the definition of behavioral symptoms rests on Western – and specifically American – expectations about the behavior of children and adults. But what is “autistic” in this context may be “normal” in another. In rural South Africa, for instance, young children avoid direct eye contact with adults because their culture considers it disrespectful.
At The Journal of Autism and Developmental Disorders, Nicole E. Rosen, Catherine Lord & Fred R. Volkmar have an article titled "The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond."
Cultural context is a crucial consideration in the diagnostic process, both in accurately assessing for ASD and in understanding the implications of a diagnosis (Freeth et al. 2014). While standardized instruments allow for reliable diagnoses of ASD across countries (Marlow et al. 2019) and diverse populations (Harrison et al. 2017), clinicians must conduct assessments and interpret results within the cultural framework of the individuals they assess. Within some Asian cultures, for example, index finger pointing to express interest is not a common overture, and thus an absence of this skill during an autism assessment may not be coded by a clinician as a behavioral symptom common to ASD (Zhang et al. 2006). Additionally, in South Africa, for example, some children are taught to avoid playing with amphibians and reptiles as safety precautions. Thus, when administering the Afrikaans ADOS or other versions of the ADOS to children who are uncomfortable playing with frogs (which happens in many places), clinicians may elect to use a toy car in place of the toy frog during the “functional and symbolic imitation task” as a culturally sensitive adaptation (Smith et al. 2017).

Similarly, as Freeth et al. (2014) note, issues such as regulation of eye contact and language differences across cultures might impact usual Western-oriented assessments. For example, in one study of Spanish-speaking families in the U.S. (Vanegas et al. 2016), potential issues were noted in the sensitivity and specificity of diagnostic instruments when parents and children experienced language discordance resulting in Spanish-speaking parents underreporting communication impairment in their English-speaking children. Issues relative to the use of screening instruments in various cultures and across multiple countries have also been noted (Dai et al. 2020; Havdahl et al. 2017; Khowaja et al. 2015; Kimple et al. 2014; Rea et al. 2019; Surén et al. 2019; Windham et al. 2014), and, together with the considerations in assessment, highlight the importance of the clinician’s interpretation of behaviors in the context of what would be socially appropriate relative to culture.

The cultural context in which an individual receives an ASD diagnosis is also important, as it may foster acceptance and access to services (common in the U.S.), or it may be associated with stigma for the individual and the family as a whole. In some African cultures, for example, individuals with ASD and their families are stigmatized because of the belief that ASD results from witchcraft (Gona et al. 2015). Furthermore, among cultures that stigmatize disabilities more generally, an ASD diagnosis in the family can also negatively affect the marriage prospects of siblings and the future of the family given the genetic liability (Divan et al. 2012). Across East Asia, the Middle East, and Western societies, a recent review suggested a strong negative impact of ASD stigma on some caregivers resulting in attempts to hide their circumstances (sometimes the child with ASD as well) to avoid rejection from the community (Papadopoulos et al. 2019). Taken together, while little variation in ASD prevalence between cultures has been reported (Elsabbagh et al. 2012), the above studies highlight the importance of navigating the diagnostic process through a cultural lens.
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While a recent global burden study reported that 95% of all young children with developmental disabilities live in low and middle income countries (Olusanya et al. 2018), the majority remain undiagnosed (Sun et al. 2019). Furthermore, relatively little research originates from these countries, which results in their underrepresentation in the broader ASD literature (Franz et al. 2017). The low diagnostic rates in poor countries likely stem from the lack of dedicated infrastructure to assist people with ASD (Minhas et al. 2015; Tekola et al. 2016), difficulty obtaining referrals to meet with the limited number of specialists (de Vries 2016; Elsabbagh et al. 2012), and low levels of parental literacy that limit a parent’s ability to understand the disorder and to locate services (de Vries 2016; Samadi and McConkey 2011). Families are often forced to manage the care of an individual with ASD on their own, which often involves enlisting the help of extended family and community members (Divan et al. 2012). Among the lucky families who find an available and appropriate assessment center, the target children may be brought to the clinic by non-parent adults, which limits the quality and quantity of relevant developmental information that can be shared with the specialist. Thus, given the numerous barriers to assessment, the children who ultimately receive ASD diagnoses are often the children with the most significant impairments and complex phenotypic profiles (Kommu et al. 2017).

Wednesday, February 24, 2021

Pandemic Litigation


Bianca Quilantan at Politico Education:
Special education is the most active area of litigation for school districts, according to education groups. About 29 percent of schools were “worried that special education litigation would consume much of their time and resources in the 2020-21 school year,” a survey from the Association of Educational Service Agencies found.

— But the number of complaints filed is actually down during the pandemic, said Lehigh University professor emeritus Perry Zirkel, who has been analyzing the complaints.

— State complaint decisions and due process hearing decisions have been increasingly rolling out. In his summary of the decisions, Zirkel found that parents are largely looking for two forms of relief: compensatory education and fixing the problem for the future. But “we find that overall, districts win about twice as many cases as parents,” he said.

— So far, the majority of cases have resulted in corrective action, Zirkel said, and many due process hearing decisions have ordered specific and direct compensatory education or reimbursement to cover in-person private arrangements. The general pattern is that “both complaint investigators and hearing officers say [free appropriate public education] does apply, but they vary in their strictness,” he said.

Tuesday, February 23, 2021

IDEA Data

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

The Department of Education has released the 42nd Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2020.

  • Between fall 2009 and fall 2018, the share of students ages 6 through 21 served under IDEA, Part B, who were reported under the category of autism increased from 5.7 percent to 10.5 percent.  (p. 138).  
  • The 2018 percentages ranged from 1.1 to 15.1 percent in the individual States. In the following nine States, 12 percent or more of the students served were reported under the category of autism: Minnesota (15.1 percent), California (13.9 percent), Virginia (13.2 percent), Nevada (13.1 percent), Texas (13.0 percent), Oregon (12.6 percent), Connecticut (12.4 percent), Maryland (12.0 percent), and Massachusetts (12.0 percent). In contrast, less than 6 percent of the students served in the following four States were reported under the category of autism: Puerto Rico (5.5 percent), Montana (5.1 percent), Bureau of Indian Education schools (4.4 percent), and Iowa (1.1 percent). (p. 139)

Monday, February 22, 2021

Autism, Vaccines, and the Pope

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.  

Antivax sentiment is strong in Italy -- but not the Vatican.


Nicole Winfield reports at AP:
The Vatican is taking Pope Francis’ pro-vaccine stance very seriously: Any Vatican employee who refuses to get a coronavirus shot without a valid medical reason risks being fired.

A Feb. 8 decree signed by the governor of the Vatican city-state says that employees who opt out of vaccination without a proven medical reason could be subject to a sanction up to and including “the interruption of the relationship of employment.”

The directive cited the need to protect Vatican employees in the workplace, as well as guidelines issued by Francis’ advisory COVID-19 commission, which said individuals have a moral responsibility to get vaccinated “given that refusing a vaccine can constitute a risk for others.”

In September, AP reported:

 Pope Francis told a group of children with autism and spectrum disorders Monday that they are beautiful, unique flowers in the eyes of God.

Francis met with members of an Austrian center for autism, Sonnenschein (“Sunshine”), in an audience at the Vatican. He told them that the center’s name evoked a flower-filled lawn in the sun “and the flowers of this house are you!”

Speaking to the children, their parents and caregivers from the center, Francis said: “God created the world with a great variety of flowers of all different colors. Each flower has its unique beauty. And each one of us is beautiful in the eyes of God, who loves us.”

Pope Francis is unusual among pontiffs in having a scientific background. He studied chemistry and worked as a chemist before entering the seminary.

Sunday, February 21, 2021

Autism, Education, and the Pandemic

 In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters.  And coronavirus is proving to be the biggest disaster of all. Providing education, social services, and therapies is proving to be very difficult.

Mary Beth Gilliland at South Jersey Times:
I work as a family advocate for a nonprofit agency in South Jersey. Of the dozens of families on my caseload, those with children on the autism spectrum have been impacted by the virus most acutely. By a landslide.

You see, the children with autism who I’m most concerned about, simply cannot access their education virtually. Let me say it louder for the people in the back: THESE CHILDREN CAN NOT LEARN THROUGH A COMPUTER SCREEN. Period.

Further, the assault of virtual learning has caused such extreme agitation that it’s leading to aggression. There are children banging their heads against keyboards. Others are attacking their parents-turned-teachers, leaving bruises and bald spots behind. These families are in crisis. The inability of schools to keep their doors open is to blame.

Sadly, regression in academic and functional skills has been just as catastrophic. For autism families, even tiny educational victories are hard-earned. Watching skills that took years to acquire vanish in a puff of pandemic smoke is the tragic reality.
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The critical distinction here is that other children can learn virtually. Children with much higher levels of need, including many of those on the autism spectrum, cannot. These children are not receiving an appropriate education as mandated by the Individuals with Disabilities Education Act (IDEA), the federal special education law of the land.

Saturday, February 20, 2021

Detroit Gives Autistic People Priority for COVID Vaccination


In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters.  And coronavirus is proving to be the biggest disaster of all. 

On February 11, Detroit Mayor Mike Duggan expanded eligibility for COVID vaccination to include several additional groups, including adults with autism. Sarah Rahal of the Detroit News quoted him: "Individuals with autism have behavioral issues that are going to make it very difficult to socially distance and wear a mask... and so we believe that it makes sense to move forward with this group."

Erin Einhorn at NBC reports:
People with disabilities are being left out of Covid vaccine rollouts and being left out of data collection when somebody contracts Covid, and that leads to disparities,” said Dessa Cosma, the executive director of Detroit Disability Power, a social justice organization that led the letter-writing campaign.
When Cosma heard that Duggan planned to announce, on Feb. 11, that adults with intellectual or developmental disabilities, along with their caregivers, would be added to the city’s vaccination list, she thought perhaps the mayor would narrow eligibility to people with conditions such as Down syndrome and cerebral palsy. Those disorders have been more conclusively linked to higher Covid-19 rates or deaths.

Instead, she was thrilled — and proud — to see that [Detroit mayor Mike] Duggan went broad, including all intellectual and developmental disabilities and specifically naming six conditions, in addition to Down syndrome and cerebral palsy. Among them were autism, Tourette syndrome, hearing and vision impairment, and ADHD, a neurological condition that affects nearly 5 percent of U.S. adults, causing impulsivity, hyperactivity and difficulty focusing.


Thursday, February 18, 2021

Republican Antivaxxers in Connecticut

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

UnfortunatelyRepublican politicians have been pushing this dangerous myth.

Daniela Altimari at The Hartford Courant:

In Connecticut and around the country, the debate over childhood immunizations is now a proxy war for Republicans concerned about religious freedom, parents’ rights, and the government’s role in enforcing public health rules such as masks to reduce the spread of the coronavirus.

That shift was evident Tuesday, during a marathon legislative hearing on a pair of bills that would make it harder for parents to opt out of vaccinating their children.

“Progressive, Republican ... whatever, it’s not even about that,’' said Rep. Lezlye Zupkus, R-Prospect. “It’s about our children.”
Zupkus said she’s not “an anti-vaxxer,’' adding that her own children have received their required immunizations. “But I, like you, have the right to say what my children get vaccinated with or not,’' she said. “This is not a partisan issue in my opinion. It is about our children and we are their parents.”

...

 Peter Hotez, a pediatrician and global health expert at the Baylor College of Medicine, has studied the anti-vaccination movement. Social media and e-commerce platforms such as Amazon have helped spread the growth of vaccine conspiracy theories and the COVID-19 pandemic has further fueled the skepticism about the government’s public health initiatives.

“What was an anti-vaccine movement became an anti-science movement,’' said Hotez, who was interviewed by phone. “It’s tied to the political extremism of the far-right.’'

Hotez, who grew up in West Hartford, said he’s seen similar anti-vaccine activism among Republicans in Texas and other states. “I’m really disappointed it’s reached Connecticut,’' he said.


Wednesday, February 17, 2021

Iowa State Senator Pushes Bogus Notion on Autism and Vaccines

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Unfortunately, Republican politicians have been pushing this dangerous myth.

Senate File 193, sponsored by five Senate Republicans, would also prohibit discrimination based on vaccine status. The Senate Human Resources subcommittee voted on a 2-1 party-line to move the bill to a full committee Thursday, as Iowa continues its COVID-19 vaccination efforts.


The subcommittee's two Republicans, Sen. Jim Carlin, R-Sioux City and Sen. Mark Costello, R-Imogene, voted in favor; its sole Democrat, Sen. Pam Jochum, D-Dubuque, voted against advancing the bill to the full Human Resources committee.
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After Carlin posed questions to an anti-vaccination speaker, Jochum asked Dr. Caitlin Pedati, Iowa's state epidemiologist, to speak to the subcommittee. Pedati echoed a concern brought up by public health advocates.

"There's good data to show that when you increase things like exemptions, people do take advantage of them," Pedati said. "It creates pockets of under-vaccinated or unvaccinated populations, which can lead to the spread of infectious diseases like measles, which is exactly what we saw in 2019."

Carlin, who recently announced a run for U.S. Senate, quizzed Pedati about the increase in the number of vaccines and the increase in the incidence of autism, alluding to the debunked theory that vaccines cause autism.

"When I was a kid, I think I don't think we had any autistic kids in my entire class," Carlin said. "Now, it's, I don't know what the actual numbers are, 1 in 10, 1 in 9. The autism numbers have exploded. You know, I know that's a classic argument."

"There is absolutely no correlation between vaccination and autism and I can tell you that with confidence as a pediatrician," Pedati replied. "I appreciate what you're reflecting on, which is that there's been an increase and I think there are reasons for that. I think in the past, we weren't as good at recognizing some of these conditions and providing supports and keeping track of them. I think that, you know, there are also things to consider, like genetic and environmental factors."

Tuesday, February 16, 2021

Inequality in Special Education

In The Politics of Autism, I write about the experiences of different economicethnic and racial groups.   Inequality is a big part of the story. 

Todd E. Elder, David N. Figlio, Scott A. Imberman. and Claudia L. Persico at Education Next:
Research has consistently found that minority students are identified with disabilities at higher rates than white students, based on straightforward comparisons of classification rates across racial groups. Such comparisons are how federal special education law defines and regulates “disproportionality” in the share of students identified with a disability within schools and districts, which triggers increased monitoring and intervention by states.

But recent research has shown that the story becomes more complex when minority students are compared not to all white students, but to white students of similar socioeconomic status. These studies find that minority students are less likely than otherwise similar white students to be identified for special education. This finding raises the possibility that Black and Hispanic students may be less likely to receive the specialized services they need. Is “disproportionality,” as it is typically understood and measured, the real problem? What role does school segregation play in special education rates?

We explore these questions by examining the birth records and eventual special education status of every child born in Florida between 1992 and 2002. The birth records capture both infant and maternal health, as well as demographics and economic circumstances, allowing us to compare students born into similar circumstances whose observable characteristics differ only by race and the racial compositions of their local schools.

Our results show that, by 4th grade, the disability rate among Black students is 13 percent lower than it would have been if they were identified at the same rate as white students born into similar economic and health circumstances. For Hispanics, the overall identification rate is 8 percent lower than what we would predict for similarly situated white students.

These gaps play out differently based on the racial composition of schools. Black and Hispanic students are placed in special education more often than their peers when they are in majority-white schools. But in predominately minority schools, when surrounded by other non-white students, Black and Hispanic students are less likely to be placed in special education. In 4th grade, a Black student attending school where more than 90 percent of students are minorities is roughly 9 percentage points less likely to be identified as disabled than an observationally identical Black student in a school with fewer than 10 percent minorities.

Our estimates suggest that minority students in heavily-minority school groups are underrepresented in special education relative to their underlying incidence of disability. While public debate has fixated on the harmful effects of too many Black and Hispanic students being identified as having special needs, our results echo the recent research suggesting that, in fact, too few minority students are being provided the educational services they need to thrive. Given ongoing public focus on equity and disproportionality, and the longstanding goal of closing gaps in educational achievement between white and non-white students, such widespread underrepresentation has substantial implications.

Monday, February 15, 2021

Pro-Vaccine Forces

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Antivaxxers have been active on social media. Pro-vaccine people are pushing back.

Mohana Ravindranath at Politico:
One group, Shots Heard Round The World, has 900 vetted global volunteers — including many doctors — who it taps to post supportive messages when vaccine advocates’ posts are targeted, said co-founder Todd Wolynn. Health care workers can report anti-vaccine activity through a link on the group’s homepage, which is monitored at all hours.

The group, part of a nonprofit that’s helping Kaiser Permanente and other health systems encourage Covid-19 shots, has shared a detailed playbook for handling anti-vaccination activists that it’s developed after years of promoting vaccines for HPV, flu and diseases. Among their top guidelines for someone facing an online attack: Don’t engage with the trolls.

The core group of doctors who thought up the #ThisIsOurShot campaign has maintained a 100-member Slack channel and weekly Zoom calls where they share intel about posts targeted by anti-vaccine forces. The group, which began as a grassroots social media campaign among members of the California Medical Association, has hired a full-time staffer to raise awareness.

A release from the AMA:

Together, the American Hospital Association (AHA), American Medical Association (AMA), and American Nurses Association (ANA) released a public service announcement today urging the American public to get the COVID-19 vaccination when it is their turn. The PSA stresses that COVID-19 vaccines are safe, effective and help us all as we work together to defeat COVID-19. Today’s effort continues the work the three associations have done over the past year to increase public acceptance of the essential actions to curb the spread of COVID-19, which also include: wearing a mask, practicing physical distancing and washing hands frequently. The organizations have released several previous PSAs encouraging the public to adhere to these critical public health measures, which will be increasingly important as more communicable COVID-19 variants appear and spread in the U.S.

 

Sunday, February 14, 2021

Antivaxxers and Social Media

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.


Imran Ahmed, CEO of the nonprofit Center for Countering Digital Hate (CCDH) said the takedown was overdue and showed an inadequate approach to tackling vaccine misinformation.

Ahmed said Facebook is failing to join the dots and take down the networks that figures like Kennedy operate. Although Kennedy's personal Instagram account is gone, his Facebook profile remains untouched, with upwards of 306,000 followers at time of writing. Simultaneously, his organisation, the Children's Health Defense, is still active on Instagram where it has more than 177,000 followers.

"Facebook must now remove all accounts linked to Kennedy [...] as well as those of the other superspreaders of dangerous anti-vaccine misinformation," said Ahmed.

He added: "One in every 30 followers of anti-vaxx accounts across social media are following RFK Jr and his organisations, so his comprehensive deplatforming would represent a significant victory in the fight against harmful misinformation."

Many of the posts on the Children's Health Defense come with warning labels applied by Instagram. One example, an image of COVID-19 vaccine vials which carried the text: "California man dies several hours after receiving COVID vaccine, cause of death unclear," had been tagged with a label saying "missing context: Independent fact-checkers say information in this post could mislead people."

Ahmed told Insider in December he believes the most effective way for Facebook to take action against vaccine misinformation is by comprehensively deplatforming key figures in the anti-vaxx community, such as Kennedy.

Saturday, February 13, 2021

RFK Jr. Complains A Business Enforcing Its Terms of Service

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.


Julie Mazziotta at People:
Multiple large-scale studies have found that vaccines are safe. There is no scientific link between vaccines and autism, according to the Centers for Disease Control.

Instagram has banned Robert F. Kennedy Jr., the son of the late Robert F. Kennedy and a controversial anti-vaccine activist, from their platform for repeatedly sharing false claims about COVID-19 and vaccines.

"We removed this account for repeatedly sharing debunked claims about the coronavirus or vaccines," Facebook, which owns Instagram, said in a statement.

Kennedy, a former environmental lawyer, has spent the last few years vehemently fighting against vaccines. He has lobbied Congress to allow parents to opt out of state requirements for vaccinating their children, and a 2019 study found that his nonprofit, called Children's Health Defense, had paid for more than half of the ads on Facebook that promoted false claims about vaccines, according to The New York Times.

During the pandemic, Kennedy has used his Instagram and Facebook pages to put out misinformation about the safety of the COVID-19 vaccines to his combined 11,000 followers. Facebook said that they do not have plans to remove his page on that platform "at this time."

Despite his efforts to discredit vaccines, Kennedy has said that he is not against safe vaccines and has vaccinated his children. His Facebook page, though, is filled with posts with vaccine misinformation. He also spoke at an August protest in Berlin to rally against Germany's coronavirus restrictions, which he said was a form of "totalitarianism."

In a statement to PEOPLE, Kennedy defended the content he shares online and doubled down on his false assertion that vaccines are being "hastily" created. In fact, all vaccines currently available for use, including the COVID-19 vaccines, have undergone large clinical trials and extensive analysis to ensure that they are safe.

Kennedy claims in his statement that his removal from Instagram is "a formula for catastrophe and a coup d'état against the First Amendment."

Friday, February 12, 2021

ER

In The Politics of Autism, I discuss health care issues and state Medicaid services for people with intellectual and developmental disabilities.

Judith Beverly, Theodoros Giannouchos, and Timothy Callaghan have an article at Autism titled "Examining Frequent Emergency Department Use Among Children and Adolescents With Autism Spectrum Disorder." The lay abstract:

 This study used data for 5.9 million individuals with 9.1 million emergency department visits from all hospitals in the state of New York to explore frequent emergency department use between children and adolescents with autism spectrum disorders and those without autism spectrum disorders. We found that children and adolescents with autism spectrum disorders had larger shares of comorbidities and diagnoses related to attention-deficit/hyperactivity disorder, intellectual disability, and epilepsy. Children and adolescents with autism spectrum disorders were also more likely to utilize emergency departments and to exhibit frequent use. These results emphasize the need for using family-centered care to improve the care experiences of children and youth with autism spectrum disorders and their families. In addition, the education of emergency department staff of processes and practices as it relates to delivery of care and the care experience.