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Tuesday, April 27, 2021

About the Antivaxxers

 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.

 Tim Dickinson at Rolling Stone:

Today, new polling data from a survey of more that 5,000 Americans across all 50 states offers a remarkable picture of the populations that are either ill-at-ease or actively opposed to Covid vaccination. First the good news: The poll, conducted for the Public Religion Research Institute and the Interfaith Youth Core, finds that 58 percent of Americans are either already vaccinated or committed to getting their shots. Another 19 percent are in the “wait-and-see” camp wishing to see “how the COVID-19 vaccines are working for others” before getting their own.

But that leaves nearly a quarter of Americans who are vaccine resistant, saying they will only get a shot if they are mandated to do so (9 percent), or who will outright refuse a vaccine (14 percent).

The vaccine refusal population is mixed.

Unsurprisingly, vaccine refusal has extraordinarily high overlap with belief in the discredited QAnon conspiracy theory, which still has a grip on about 13 percent of the country. The poll found that 38 percent of refusers are “generally agreeable to QAnon theories” — including that the U.S. is controlled by a cabal of “Satan worshiping pedophiles who run a global sex-trafficking operation.” For more on the intersection between QAnon and the antivax movement, read Rolling Stone‘s deep-dive investigation: How the Anti-Vaxxers Got Red-Pilled.

Politically, Republicans lead the refuser pack: 23 percent say they won’t get vaccinated, compared to 13 percent of independents and 6 percent of Democrats. Among Republicans the highest resistance comes from watchers of far-right television like NewsMax and One America News Network (31 percent) or those who don’t get their news from TV at all (36 percent). FoxNews watchers are, counter-intuitively, a bit less resistant than average: 16 percent.

In an American health system riven by racism — black mothers die of childbirth complications at nearly three times the rate of their white counterparts — it’s no shock that people of color also comprise a significant percentage of vaccine refusers. The poll found that nearly one-in-five of both multiracial and Black Americans say they won’t get vaccinated, in contrast to 15 percent of whites and 11 percent of respondents classified as Hispanic. It’s interesting to note, however, that these differences largely disappear among college-educated Americans, dropping to less than 10 percent regardless of race, according to the poll.

Among religious groups, white evangelicals are significantly more likely to be vaccine refusers, with 26 percent declaring they won’t get a shot. Precisely this same percentage of white evangelicals also agree with the statement: “God always rewards those who have faith with good health and will protect them from being infected with COVID-19.” (Only religious Hispanics, both Catholics and Protestants, polled higher on this question, at 35 percent.)

Monday, April 26, 2021

Antivax Sentiment Was Rising Before the Pandemic

 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.

Eleanor Pace at King's Think Tank:

Several years prior to the pandemic arising, Professor Heidi Larson of the London School of Hygiene and Tropical Medicine (and founding director of The Vaccine Confidence Project) warned of the dangers of the spread of ‘viral misinformation’,the distrust in vaccinations that seemed to be worsening and the threat this poses to global health. In a similar vein, the World Health Organisation (WHO) named vaccine hesitancy in its top 10 threats to health in 2019. The rollout of Covid-19 vaccinations have demonstrated that these long-standing worries around vaccine hesitancy are not without basis- all manner of misinformation has surfaced online since the first vaccines were approved, along with more generalised and widespread concern that the vaccines have been ‘rushed’.

Although official information has been released in attempts to correct mistruths and alleviate concerns, claims about the vaccine inevitably spread faster and reach more people through social media than via official channels. Although regulating posts on social media is something sites such as Facebook have improved upon recently, there is arguably further to go with this and the problem may now lie more so with subtle posts influencing people’s opinions as opposed to blatant anti-vaxxers, which is much more difficult to police. In addition to social media sites like Facebook and Twitter, WhatsApp is another hotbed for misinformation- which can spread rapidly between different groups without regulation as encryption has now been put in place with concerns regarding safety being brought to light. This is especially problematic as individuals are arguably more likely to believe something forwarded directly to them by a friend. Importantly though, it is those actively spreading and endorsing misinformation we should be frustrated at, not those who have been taken in by it.

Increasingly, documentation is showing that those belonging to ethnic minority groups are less likely to take up the Covid-19 vaccine when offered it. In December, the Royal Society for Public Health conducted a poll which showed that willingness to have the Covid-19 vaccine amongst individuals from Black, Asian and minority ethnic backgrounds was only 57%, compared to 76% of the UK population as a whole. This is not a simple issue of ‘not wanting the vaccine’, but is understandably born from a longstanding lack of trust in officials and structural inequalities that minority groups are constantly faced with. Importantly, it has been pointed out that it is easy to blame those who are hesitant to receive the vaccine, rather than addressing the important systemic issues underlying this.

Sunday, April 25, 2021

A Beating in Vacaville

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

Minyvonne Burke at NBC:
A California father accused a police officer of being unnecessarily aggressive during an incident involving his teenage son, who has autism.

The father said a Vacaville officer threw his son, Preston, 17, to the ground and punched him in the face during a citation Wednesday afternoon.

"I am pro police, but I am not pro ABUSE," Adam Wolf wrote in a Facebook post on Thursday. "This individual and department must be held accountable for their actions. NO child, disability or not, deserves to be treated like this."

Police said an officer was dispatched to the area around 2:30 p.m. for a report of a possible stabbing or assault with either a knife or a pipe. The officer found the victim of the assault, a 16-year-old boy, who had minor injuries that did not require medical attention, the department said in a press release.

The officer then found the suspect, a 17-year-old boy, police said.

"The officer asked the suspect to sit down, which he did. When the police officer took out his handcuffs, the suspect actively began resisting arrest, trying to get up and run. In response, the officer forced the suspect to the ground and onto his stomach," the press release states.

The incident was captured on a Ring doorbell video, which Wolf shared on his Facebook page.


Saturday, April 24, 2021

MMS Indictment and Trump

In The Politics of Autism, I discuss autism quackery.  One particularly dangerous "cure" involves bleach.  Lately, the quacks hawking a bleach solution have rebranded it as a cure for coronavirus.

 From the US Department of Justice:

A federal grand jury in Miami has returned an indictment charging a Florida man -- Mark Grenon, 62 -- and his three sons -- Jonathan Grenon, 34, Jordan Grenon, 26, and Joseph Grenon, 32 -- with fraudulently marketing and selling “Miracle Mineral Solution,” a toxic industrial bleach, as a cure for COVID-19, cancer, Alzheimer’s, diabetes, autism, malaria, hepatitis, Parkinson’s, herpes, HIV/AIDS, and other serious medical conditions, and with defying federal court orders.

Jonathan and Jordan Grenon were arrested last summer on related charges based on a criminal complaint filed by Miami federal prosecutors.

One year ago today, Ed Pilkington reported at The Guardian:

The leader of the most prominent group in the US peddling potentially lethal industrial bleach as a “miracle cure” for coronavirus wrote to Donald Trump at the White House this week.

In his letter, Mark Grenon told Trump that chlorine dioxide – a powerful bleach used in industrial processes such as textile manufacturing that can have fatal side-effects when drunk – is “a wonderful detox that can kill 99% of the pathogens in the body”. He added that it “can rid the body of Covid-19”.

A few days after Grenon dispatched his letter, Trump went on national TV at his daily coronavirus briefing at the White House on Thursday and promoted the idea that disinfectant could be used as a treatment for the virus. To the astonishment of medical experts, the US president said that disinfectant “knocks it out in a minute. One minute!”

 Trump did not specify where the idea of using disinfectant as a possible remedy for Covid-19 came from, and the source for his notion remains obscure. But the Guardian has learned that peddlers of chlorine dioxide – industrial bleach – have been making direct approaches to the White House in recent days.


Friday, April 23, 2021

Weaponizing Racism

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.

Jonathan Jarry at McGill University:
Over the years, Kennedy’s misguided idée fixe has snowballed and gained impressive momentum. He has propagated numerous falsehoods about the COVID-19 pandemic. He has been a mainstay at the AutismOne conference, which attracts fake experts convinced that vaccines cause autism. In his last appearance as keynote speaker, he incited attendees to evangelize for the anti-vaccination movement, concluding that he would see them “on the barricades.” Kennedy was asked to chair a “vaccine safety task force” for the Trump administration in 2017. (The task force would end up never materializing.) He also served as executive producer for the anti-vaccination “documentary” Vaxxed II: The People’s Truth. Now, his own corporation has released an anti-vaccine movie, one which is directed toward people of colour.

The movie’s title is sensational click-bait. Medical Racism: The New Apartheid. It is a project of CHD Films, a division of Kennedy’s Children’s Health Defense (formerly known as the World Mercury Project). As NBC News reported when the movie was released a month ago, its producers include the founder of a private school that boasts of not enforcing vaccination mandates; a Nation of Islam minister who falsely claimed that childhood vaccines are genetically modified to harm children of colour; and a nonprofit CEO who promoted the misinformation campaign of America’s Frontline Doctors.

Thursday, April 22, 2021

Bills on Police Training

Several bills got the approval signature of West Virginia Gov. Jim Justice during a virtual ceremony Wednesday. One of them will require training for certain officers who are responding to those with disabilities.

“I just thought it was a step in the right direction with people with disabilities, specifically autism, that can help the communities and families have a little bit of relief as far as what might happen if they get into an emergency situation or they need assistance with their loved one,” Phenia Simmons, who has two sons that are on the autistic spectrum said.

The bill requires law enforcement and correctional officers to be trained on the best ways to interact with those with autism spectrum disorders.

The West Virginia Autism Training Center Executive Director, Dr. Marc Ellison was a strong advocate for the passage of the bill.

“Senate Bill 634 is a really significant step in helping police officers and the community in general understand autism better and hopefully will prevent some really poor outcomes,” Dr. Ellison, Executive Director of Marshall University’s Autism Training Center said. “I’m aware of only two states that require autism-specific training for police officers. So once again, West Virginia, at least in the world of autism support, is kind of a pioneer in leading the way.”

“Thank you again, Governor, for your support in improving life quality for those in West Virginia living on the autism spectrum,” Dr. Ellison said.

The training and guidelines will be developed and conducted at the West Virginia Autism Training Center at Marshall University.

State Rep. Alan Silvia wants police officers as well as teacher aides in elementary and secondary schools to be better equipped in dealing with autistic children and adults.

“It’s very important that paraprofessionals are trained to deal with autistic kids,” Silvia said referring to certified teacher aides.

The 7th Bristol state rep also says police departments everywhere owe it to themselves and the public to require that academy recruits be given in-service training in how to interact with people diagnosed as being on the autism spectrum.

“Police lack mental health disorders training,” said Silvia, who was a Fall River cop for 22 years and a major crimes detective before being forced to retire as result of an on-duty injury.

Silvia in February introduced two bills relative to individuals with autism.

One bill would allow autistic children of parents living at home to remain on their parents’ medical insurance plan past the age of 26.

Silvia says the bill, which has 17 co-sponsors including local state Reps. Carole Fiola and Patricia Haddad, to some extent is pre-emptive in nature.

“The insurance companies so far have not declined coverage, but it’s not the law,” he said.

The original version of the other bill filed by Silvia and 4th Bristol District Rep. Steven Howitt includes a requirement for autism-related training for law enforcement agencies and teacher aides.

It also calls for the installation of video cameras in classrooms and school “quiet rooms” where children with autism spectrum disabilities are taught

Wednesday, April 21, 2021

Restraint in the Wake of the Floyd Case

In The Politics of Autismdiscuss the use of restraint and seclusion.  Many posts have mentioned these techniques, both in schools and facilities for people with disabilities.

 Mark Keierleber at The 74 Million:

Now, the brutal manner of [George] Floyd’s death is highlighting how the practice of restraining children with similar techniques remains commonplace in Minnesota schools — and in districts across the country.

Even though state policymakers have worked for years to reduce the prevalence of “physical holds” in Minnesota schools — including a 2015 ban on the face-to-the-ground “prone restraint” used against Floyd — educators employ the tactic thousands of times each year to subdue students, state and federal data show. Such restraints often come with devastating consequences for children including injury and, in rare cases, death.

Even as the pandemic shuttered schools nationwide last spring, more than 2,800 students were subjected to more than 12,600 instances of physical restraint during the 2019-20 school year, according to a recent Minnesota Department of Education report. That’s a significant 25 percent drop from the year prior, which state education officials believe is due in large part to campus closures during COVID-19, but also recent statewide efforts to reduce educators’ reliance on the practice, training them instead how to de-escalate conflicts using preventative techniques, like positive behavioral interventions and supports.
Nationally, more than 74,000 students were subjected to physical or mechanical restraint in the 2017-18 school year, according to the most recent data from the U.S. Department of Education’s Office for Civil Rights. That year, more than 2,400 Minnesota students were subjected to more than 11,600 instances of physical restraint. Minnesota, along with Texas and a cluster of Midwestern states, including Illinois and Iowa, were among the most frequent users of the practice, according to a 2019 analysis by ProPublica and The Chicago Tribune. In a blockbuster 2019 investigation, the news organizations found that Illinois schools frequently put students, most of them with disabilities, in padded “seclusion rooms” for reasons that violate state law, like refusing to complete schoolwork or using profanity.

The data, which is self-reported by local school districts to federal education officials, is likely a significant undercount. A 2020 report by the U.S. Government Accountability Office, a nonpartisan watchdog agency, found that the Department of Education’s quality control procedures for data collection are “largely ineffective or do not exist.”

Tuesday, April 20, 2021

Bill to End the Subminimum Wage

In The Politics of Autism, I discuss the employment of people on the autism spectrum.

 A release from Rep. Cathy McMorris Rodgers:

Eastern Washington Congresswoman Cathy McMorris Rodgers (WA-05) and Congressman Bobby Scott (VA-03) introduced the bipartisan Transformation to Competitive Integrated Employment Act to ensure that states and employers help workers with disabilities transition into fully integrated and competitive jobs.

The Transformation to Competitive Integrated Employment Act provides states, service providers, subminimum wage certificate holders, and other agencies with the resources to create competitive integrated employment service delivery models while phasing out subminimum wages for workers with disabilities, which are currently allowed under Section 14(c) of the Fair Labor Standards Act, over a five-year period.

“Disability employment is the next policy frontier to empower people with disabilities to live full and independent lives,” said Rodgers. “A job is so much more than just a paycheck, it’s what gives us dignity, purpose, and the opportunity for a better life. I look forward to continuing to work in a bipartisan fashion to ensure more people – who are ready, willing, and able to work – find employment.”

Under Section 14(c), employers can apply for special certificates from the U.S. Department of Labor (DOL) to pay individuals with disabilities less than the federal minimum wage. There is no minimum floor for the hourly wage that an employer can pay an individual with a disability under these certificates.

“Today, federal law continues to deny access to opportunity for many workers with disabilities. It is long past time for Congress to phase out the subminimum wage for workers with disabilities and expand access to fulfilling employment and economic self-sufficiency,” said Scott. “By fostering collaboration between employers and services providers, this legislation makes clear that it is not only possible, but beneficial to invest in fully integrated and competitive jobs for people with disabilities. We must take this next step to ensure that every worker can succeed in the workplace and earn a fair wage.”

In 2020, the U.S. Commission on Civil Rights called for phasing out the 14(c) subminimum wage, finding that it has “limited people with disabilities participating in the program from realizing their full potential while allowing providers and associated businesses to profit from their labor.” Research also confirms that, when individuals with disabilities transition to competitive employment, they are better able to achieve financial independence and spend time engaging in their community.

While seven states have either phased out workshops that pay subminimum wages or are in the process of doing so, a recent GAO report underscores that many employers and workers with disabilities do not have the appropriate resources or services to transition to competitive integrated employment. The Transformation to Competitive Integrated Employment Act specifically provides states, service providers, subminimum wage certificate holders, and other agencies with resources and technical assistance to help workers with disabilities transition away from sheltered workshops and into community employment settings.

The Transformation to Competitive Integrated Employment Act:
  • Creates a competitive state grant program to assist states to transition all 14(c) certificate holders to models that support competitive, integrated employment for individuals with disabilities. States will be able to apply for these transformation grants and must establish an advisory committee of key stakeholders, including employers, organizations specializing in employment for individuals with disabilities, Medicaid agencies, AbilityOne contractors, individuals with disabilities and their families, and vocational rehabilitation agencies. States that successfully complete a grant will be eligible for a 25% increase in the allotment for supported employment for individuals with the most significant disabilities.
  • Creates a competitive grant program for current 14(c) certificate holders that are located in states that do not apply for the state grant, to transition their business models to support individuals with disabilities in competitive, integrated employment.
  • Immediately freezes the issuance of any new 14(c) certificates by DOL and phases out the use of existing 14(c) certificates over 5 years until employees are paid at least the federal minimum wage.
  • Establishes a technical assistance (TA) center to support all entities, even those not receiving the transformation grants, to transition to competitive integrated employment. The TA center, which will be funded by DOL, is tasked with disseminating information about best practices, lessons learned, and models for transition to all entities transitioning to competitive, integrated employment.
  • Requires reporting and evaluation on the progress of creating and expanding the service delivery structure to support workers with disabilities in competitive integrated settings and the inclusive wraparound services they receive when not working. States and 14(c) certificate holders will also be required to report on their grant activities, evaluate changes in employment for individuals with disabilities, report average wage information, and evaluate employer actions taken to comply with the phase out of 14(c) and transformation grants.
Click here for a fact sheet on the Transformation to Competitive Integrated Employment Act. 
Click here to read the bill text.

The Government Accountability Office has a report titled "Subminimum Wage Program:Factors Influencing the Transition of Individuals with Disabilities to Competitive Integrated Employment" GAO-21-260.

GAO identified 32 factors that can influence the transition from 14(c) employment to competitive integrated employment (CIE). Generally, CIE is employment that (1) is paid at or above the applicable minimum wage; (2) is performed in integrated settings, among people with and without disabilities; and (3) offers opportunities for advancement. GAO grouped the factors into the four categories depicted below, and experts and state officials GAO interviewed validated them.

The 17 interviewees identified the factors in each category they believed to be among the most important for influencing transition from 14(c) employment to CIE, and provided some additional detailed perspectives. Such factors included:

  • Concern for Maintaining Benefits (employee): Eight interviewees considered this factor to be among the most important. They explained that individuals or families may fear that earning higher wages in CIE would make individuals ineligible for certain benefits, but several noted that benefits counseling could mitigate these concerns.
  • Sufficiency of CIE Resources for 14(c) Certificate Holder (employer): Eight interviewees considered this factor to be among the most important. Six interviewees noted that certificate holders may be discouraged from providing CIE-focused services, such as job coaching, when funding for these services is lower than for services provided in 14(c) settings.
  • State Resources for CIE (public policy): Twelve interviewees considered this factor to be among the most important. For example, officials from one state described plans to offer specialized training to 14(c) employer staff, which two interviewees said is key to helping individuals transition to CIE.
  • Available Transportation (local economy): Eight interviewees considered this factor to be among the most important. Two interviewees noted ways to mitigate transportation-related challenges, such as 14(c) employers identifying nearby job openings for potential CIE positions.

Most interviewees said that the COVID-19 pandemic had caused disruptions to either 14(c) employment or CIE and described uncertainties about the future of transitions. For example, many interviewees noted that 14(c) employers have closed their facilities to comply with public health requirements. While some interviewees said that many individuals working in CIE have retained their jobs due to their status as essential workers, other interviewees described a general fear that people with disabilities are first to be fired and last to be rehired.

Monday, April 19, 2021

GOP Antiscience

 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 are increasingly joining up with the anti-vaxxers.  Recent examples include a member of the House COVID subcommittee and a crackpot who is seeking the party's US Senate nomination in Ohio.

Richard Luscombe at The Guardian:

Republicans who refuse the Covid-19 vaccination are actively “working against” efforts to lift the very coronavirus restrictions they insist are an infringement of their civil liberties, Dr Anthony Fauci, the US government’s leading infectious disease expert, said on Sunday.

Fauci’s comments came as the government announced that half of all adults in the US had received at least one Covid-19 shot, marking another milestone in the nation’s largest-ever vaccination campaign. Almost 130 million people 18 or older have received at least one dose of a vaccine, or 50.4% of the total adult population, the Centers for Disease Control and Prevention (CDC) reported. Almost 84 million adults, or about 32.5% of the population, have been fully vaccinated.

But Fauci, who was involved in a fiery exchange over the issue with the Republican congressman Jim Jordan on Thursday, told CNN’s State of the Union on Sunday he was frustrated by recent studies showing that up to 45% of Republicans would not take the vaccine.

“The fact that one may not want to get vaccinated, in this case a disturbingly large proportion of Republicans, only actually works against where they want to be,” he said.

Peter Hotez at Scientific American:

As both a vaccine scientist and a parent of an adult daughter with autism and intellectual disabilities, I have years of experience going up against the antivaccine lobby, which claims vaccines cause autism or other chronic conditions. This prepared me to quickly recognize the outrageous claims made by members of the Trump White House staff, and to connect the dots to label them as antiscience disinformation. Despite my best efforts to sound the alarm and call it out, the antiscience disinformation created mass havoc in the red states. During the summer of 2020, COVID-19 accelerated in states of the South as governors prematurely lifted restrictions to create a second and unnecessary wave of COVID-19 cases and deaths. Then following a large motorcycle rally in Sturgis, S.Dak., a third surge unfolded in the fall in the Upper Midwest. A hallmark of both waves were thousands of individuals who tied their identity and political allegiance on the right to defying masks and social distancing. A nadir was a highly publicized ICU nurse who wept as she recounted the dying words of one of her patients who insisted COVID-19 was a hoax.

Now, a new test of defiance and simultaneous allegiance to the Republican Party has emerged in the form of resisting COVID-19 vaccines. At least three surveys from the Kaiser Family Foundation, our study published in the journal Social Science and Medicine, and the PBS News Hour/NPR/Marist poll each point to Republicans or white Republicans as a top vaccine-resistant group in America. At least one in four Republican House members will refuse COVID-19 vaccines. Once again, we should anticipate that many of these individuals could lose their lives from COVID-19 in the coming months.

Historically, antiscience was not a major element of the Republican Party. The National Academy of Sciences was founded in the Lincoln administration; NASA in the Eisenhower administration, and PEPFAR (U.S. President’s Emergency Plan for AIDS Relief), PMI (President’s Malaria Initiative) and the NTDs (neglected tropical diseases) program were launched in the George W. Bush Administration. I was a professor and chair of microbiology at George Washington University, based in Washington, D.C., during the 2000s and worked closely with members of the Bush White House to shape these programs.

I trace the adoption of antiscience as a major platform of the GOP to the year 2015 when the antivaccine movement pivoted to political extremism on the right. It first began in Southern California when a measles epidemic erupted following widespread vaccine exemptions. The California legislature shut down these exemptions to protect the public health, but this ignited a “health freedom” rallying cry. Health freedom then gained strength and accelerated in Texas where it formed a political action committee linked to the Tea Party. Protests against vaccines became a major platform of the Tea Party; this then generalized in 2020 to defy masks and social distancing. Further accelerating these trends were right wing think tanks such as the American Institute of Economic Research that sponsored the Great Barrington Declaration, and the Hoover Institution at Stanford University, the home of physician Scott Atlas, who became a senior advisor to the Trump White House coronavirus task force.

The full antiscience agenda of the Republican Party has now gone beyond our national borders. In the summer of 2020, the language of the antiscience political right in America was front and center at antimask and antivaccine rallies in Berlin, London and Paris. In the Berlin rally, news outlets reported ties to QAnon and extremist groups. Adding to this toxic mix are emerging reports from U.S. and British intelligence that the Putin-led Russian government is working to destabilize democracies through elaborate programs of COVID-19 antivaccine and antiscience disinformation. Public refusal of COVID-19 vaccines now extends to India, Brazil, South Africa and many low- and middle-income countries.

Sunday, April 18, 2021

Zinger in Illinois Law Prevents Medicaid Coverage

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for people with intellectual and developmental disabilities.

In the Budget Implementation Act passed in 2019, legislators included coverage for behavioral therapy in the medical assistance program, which administers state and federal funds from Medicaid and similar services to qualifying residents. Any changes in how Medicaid funding is being used must be included in a State Plan Amendment that is submitted to the federal government for approval, which is where the mistake occurred.

The Illinois Medicaid plan requires that a practitioner must be a Board Certified Behavior Analyst, or BCBA, and possess a second credential as either a Licensed Clinical Social Worker or a Licensed Clinical Psychologist in order to receive Medicaid funding for behavioral therapy. That plan was submitted to and approved by the federal government.

A notice from the Illinois Department of Healthcare and Family Services released in October confirmed that dual credentials would be required to receive Medicaid funds through the department for behavioral therapy.

But the Illinois Autism Task Force, based in the Illinois Department of Human Services, warned in a February letter to Gov. JB Pritzker and the General Assembly that “the dual credential requirement will result in devastating barriers to access.” That same letter said only 26 BCBAs possessed one of the other required certifications and it was unclear whether any of the 26 provided behavioral therapy.

The Autism Task Force, in a 2020 meeting, claimed that $42 million placed in the state’s FY 2020 budget for behavioral therapy through Medicaid remained untouched due to the mistake.
HB 16, which currently sits in the House Rules Committee with about five weeks of the General Assembly’s session remaining, would amend the Illinois Public Aid Code to allow for just a BCBA certification for Medicaid coverage of behavioral therapy starting on July 1, the beginning of the 2022 fiscal year.

Saturday, April 17, 2021

HCBS Funding

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for adults with intellectual and developmental disabilitiesHome and Community-Based Services (HCBS) are particularly important.

Judith Heumann and Tom Ridge at USA Today:
A year after the pandemic began, people with disabilities finally can obtain the tools and assistance they need to earn a living and stay independent.

The American Rescue Plan, recently passed by Congress and signed by President Joe Biden, allocates $12.7 billion for what's known as home and community-based services, or HCBS, through 2021. This is truly something to celebrate — finally dedicated funding to support people with disabilities who want to get back to work.

HCBS is an important source to keep people with disabilities at home, in their communities and out of costly nursing homes or group living setting, where we now know COVID-19 thrives. And it provides a critical lifeline to employment.

Many people with disabilities have said for years that they could work if they were given the needed accommodations. Now that conversation, which largely went unaddressed, is a reality.

For example, HCBS pays for internet and assistive technology, allowing people with disabilities to work from home. It provides transportation upgrades, including adaptions to vehicles, so they can drive to work. It pays for job coaches who accompany people with more significant disabilities to their jobs to ensure they are able to fulfill their responsibilities.

Friday, April 16, 2021

Juking the Stats at DOD

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  As many posts have discussed, the challenges are especially great for military families.

Ellis Giacomelli at The Watertown Daily Times:
Health insurance for military members and their families falls under the DOD through TRICARE, and for autism, plans cover occupational therapy, physical therapy, physician services, psychological services, psychological testing, prescription drugs and speech therapy.

For ABA specifically, coverage is separately offered through TRICARE’s Comprehensive Autism Care Demonstration. Used by several federal departments, demonstrations are designed to gauge the effectiveness and direction of a program.

According to an analysis prepared by Dr. Ira L. Cohen and published earlier this year, DOD reports have been “substantively flawed and based on the incompetent interpretation and analysis of the collected data,” leading to results that suggest military children with autism were not making behavioral progress with ABA.

“What we’ve clearly seen since 2018, is that TRICARE, if you take these reports together, is building a case against ABA services,” NCAAS spokesperson David A. Fuscus said in a February interview, adding that the case is an apparent attempt to save the department money. “At the same time, the costs for ABA services have gone up dramatically.

With rising health care prices across nearly all sectors, the DOD has calculated ABA program costs have increased by 65% over four years, to $370.4 million in 2019.


Autism Services for Kids is a campaign sponsored by the National Coalition for Access to Autism Services (NCAAS) to ensure that military children with autism have access to the Applied Behavior Analysis (ABA) treatment under the Department of Defense’s (DoD) healthcare provider, TRICARE. Our campaign is designed to stop DoD from discrediting a proven and effective treatment for children with autism to save money. Military families already shoulder too many burdens – wondering if their child with autism will get the treatment they need shouldn’t be one of them.

The National Coalition for Access to Autism Services (NCAAS) is the voice of service providers and other constituents who help Americans with autism achieve their full potential. NCAAS believes Americans with autism deserve affordable coverage that ensures access to quality treatment. NCAAS members provide services to individuals across a range of private and public programs, including commercial insurance through employer-sponsored plans and the individual market, Medicaid, Medicaid managed care, and TRICARE.

Thursday, April 15, 2021

Spotting Fake Science

  In The Politics of Autism, I write:

Many articles and blog posts arguing for the vaccine-autism link have the trappings of genuine academic research: tables, graphs, citations, and scientific jargon. Some of the authors have credentials such as M.D. or Ph.D. degrees. None of these things is a guarantee of scientific value, as the history of science is full of crackpot theories (e.g., AIDS denialism) that are the heavily-footnoted products of people with letters after their names. But most people will not be able to spot the scientific weaknesses of such work. Outside of academia, few understand concepts such as peer review. Jordynn Jack describes one dubious article that appeared in a non-peer-reviewed publication: “Regardless of the scientific validity of the article, though, the writers perform the writing style quite effectively. It would be difficult for the layperson to distinguish this article from any other scientific research paper, especially if one did not investigate the nature of the journal … or of the scientific response to the article.”

Frederick Hess at AEI:

[Sam] Wineburg, Stanford’s Margaret Jacks Professor of Education, studies how people judge the credibility of digital content. A former history teacher with a PhD in education psychology, he’s perhaps the nation’s leading scholar when it comes to helping people figure out what’s actually true on the Internet. I recently had the chance to talk with him about his work and the practical lessons it holds.

Wineburg approaches his work with a simple guiding principle: “If you want to know what people do on the Internet, don’t ask them what they would do. Put them in front of a computer and watch them do it.”

He recounts a 2019 experiment studying how high school students evaluate digital sources, in which 3,000 students performed a series of web tasks. One task asked students to evaluate a website about climate change. Wineburg notes, “When you Google the group behind it, you learn that they’re funded by Exxon—a clear conflict of interest. Yet, 92 percent of students never made the link. Why? Because their eyes remained glued to the original site.” In other words, looking into the source of information is essential to judging its veracity—and yet, students didn’t make that leap.

In another study, Wineburg compared how a group of PhD students and Stanford undergraduates stacked up against fact-checkers at leading news outlets in New York and Washington when it came to assessing the credibility of unfamiliar websites. He says that fact-checkers speedily “saw through common digital ruses” while trained scholars “often spun around in circles.”

Why? Wineburg concludes, “The intelligent people we’ve studied are invested in their intelligence. That investment often gets them in trouble. Because they’re smart, they think they can outsmart the Web.” The result is that when they see a professional-looking website with scholarly references, they conclude it’s legitimate. “Basically,” he says, “they’re reading the web like a piece of static print—thinking that they can determine what something is by looking at it . . . On the Internet, hubris is your Achilles heel.”

Fact-checkers employ a different approach, one that Wineburg terms “lateral reading.” This involves only briefly looking at a website, then leaving it to search for background information on the organization or group behind the original site to determine if it is worth returning to. “In other words,” he says, “they learn about a site by leaving it to consult the broader Web.”

The problem for educators, according to Wineburg, is that this goes against the grain of how teachers usually teach students to evaluate a text. Usually, students are taught to read carefully and fully, and only then render judgment. “Yet, on the Web, where attention is scarce, expending precious minutes reading a text, before you know who produced it and why, is a colossal waste of time,” Wineburg says.

In fact, the usual methods teachers use for addressing online credibility are mostly unhelpful. Wineburg laments that we often approach the subject like a game of twenty questions. We ask, “‘Is the site a .org?’ If so, ‘It’s good.’ ‘Is it a .com?’ If so, ‘It’s bad.’ ‘Does it have contact information?’ That makes it ‘good.’ But if it has banner ads? ‘It’s bad.’” The problem, he says, “is that bad actors read these lists, too, and each of these features is ludicrously easy to game.”

To help teachers wrestling with all this, Wineburg and his collaborators have created a “digital literacy curriculum” with 65 classroom-ready lessons and assessments, a complementary set of videos, and an online course on “Online Civic Reasoning” done with MIT’s Teaching Systems Lab. Wineburg notes that all of these materials are free and can be downloaded by registering at


Wednesday, April 14, 2021

Autism at Work

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.

James Mahoney. Executive Director and Head of Autism at Work JPMorgan Chase & Co.:
A couple of years ago, I learned a startling statistic: The unemployment rate for individuals with some form of autism – often called the Autism Spectrum Disorder (ASD) – is estimated to be between 80 to 90 percent. While it’s shameful and disheartening that any subset of people would face such a challenge, what’s even more startling about that statistic is that many of these individuals are simply brilliant people–highly educated, highly capable, detail-oriented, yet unemployed.

But my employer JPMorgan Chase, like many successful organizations, looks at situations like this one and sees opportunity. Because of our size and continued growth, we have an almost constant need for talented employees – especially in technology-related fields. We thought that perhaps this could become a new untapped pool of talent.

And it has: Since rolling out our initiative, Autism at Work, a program focused on hiring employees with Autism, we have hired more than 30 individuals who have ASD and we anticipate hiring hundreds more across the globe over the coming years.

Autism manifests itself in many different forms; no two autistic individuals face the same exact challenges. To quote Melanie, a Columbus-based Chase employee whose daughter is autistic: “If you’ve met one person with autism, you’ve met one person with autism.”

These challenges may explain why unemployment for this community is so high.

Melanie explained that just getting past an interview can be difficult, especially if the interviewer is unaware of the applicant’s ASD. Her high-functioning daughter rocks back and forth and side-to-side, stutters, frequently says ‘um’ and has difficulty making eye contact. “I taught her to say, ‘Hi. I’m Billie and I have autism spectrum disorder. Just so you know I’m not weird or quirky.’”

Through partnerships with organizations that have more experience in working with individuals with ASD, we are learning to look beyond the traditional interview process to find highly qualified employees. We work closely with senior leaders across the firm to identify roles that would benefit from the talents of ASD adults and ensure we provide an inclusive work environment for these employees to thrive.

The embracement of this untapped workforce allows our company to benefit from the unique blend of talents provided by these detail-oriented, rule-bound, logical and independent-thinking individuals.

And it is paying off: Many studies show that the performance of autistic individuals in certain functions exceeds their peers without autism.

Jon, a quality assurance analyst at Chase, said his strongest attribute is to assess situations and come up with the best possible solutions in order to make them more organized and more efficient.

“I would encourage anyone on the spectrum to embrace what makes them different and see it as their greatest strength,” he said. “I firmly believe that companies could always benefit from having employees who see things in an unconventional way, which is something to remember any time an individual on the spectrum is seeking a job.” 
He said the Autism At Work program opens a door for those “who may not be the best at traditional interviews, to show off their unique skills in a workplace environment. Some people on the spectrum simply are not given a chance to shine through conventional means. This program is a great way to facilitate that.”

The success of Jon and others confirm that their skill set simply requires an environment in which to contribute and thrive. And that provides a winning solution for all of us.