TRICARE and ABA

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.

 Berkeley Lovelace Jr., Jason Kane and Erin McLaughlin at NBC:

ABA helps children with autism to develop important life skills, said Alycia Halladay, chief science officer at the Autism Science Foundation, a nonprofit advocacy group.

“It’s all about breaking things down into smaller steps, and then also providing the appropriate reinforcement for things,” Halladay said.

“This is how we all learn, by the way,” she added. “We all learn to go to the potty by somebody reinforcing us by going to the bathroom on the potty. We learned to be on time by people reinforcing us and giving us positive accolades for being on time. Kids with autism, they get it more intensely and they get it more directed based on the skill they need help with.”

Most states have mandates requiring private insurers to cover ABA or other behavioral interventions for children with autism, Halladay said.

Those mandates, however, don’t apply to the federal government, including federal programs such as TRICARE, she said. (Some federal programs do cover the therapy for children, including Medicaid and the Federal Employees Health Benefit, the government’s health insurance program for federal employees, retirees and their families.)

In 2021, Kristi Cabiao started a nonprofit called Mission Alpha aimed at pressuring both TRICARE and members of Congress to restore broad coverage of ABA. She lobbied Congress for an independent study reviewing the effectiveness of the therapy, which was launched that same year and conducted by the National Academies of Sciences, Engineering, and Medicine. Last September, the group published a 336-page report affirming that ABA should be included as a basic benefit under TRICARE, without the excessive administrative barriers that have disrupted treatment for children in military families.

The report stated the evidence to support ABA therapy “is robust” and meets “the Department of Defense’s own criteria of reliable evidence.”

The Antivaxxers Leave Their Mark

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

From CDC:

As of June 18, 2026, 2,104 confirmed* measles cases were reported in the United States in 2026. Among these, 2,093 measles cases were reported by 41 jurisdictions: Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. A total of 11 measles cases were reported among international visitors to the United States.

After polls showed the political downsides of antivax policy, the administration took a lower profile on the issue.  But at WP,  Rachel Roubein  and Lena H, Sun report:

But outside the public eye, a small circle of Kennedy’s allies has kept working to reshape the federal apparatus that guides vaccines. This account of the behind-the-scenes effort is based on interviews with more than 15 people familiar with the matter, in addition to medical experts and Kennedy allies, many of whom spoke on the condition of anonymity to detail private conversations or internal deliberations, or out of fear of retaliation.

Federal health officials are exploring re-creating an influential vaccine advisory panel that was blocked by a federal judge, including discussions around adding new members, according to two people familiar with the matter who spoke on the condition of anonymity.

There is also an effort to create a new Office of Science at the Centers for Disease Control and Prevention that reports to the office of CDC’s chief of staff, even though the agency already has a science office.

Earlier this month, the National Institutes of Health urged scientists to take part in vaccine injury research and encouraged new research into vaccine schedules, vaccines’ long-term health effects and other issues that Kennedy has long wanted reexamined.

These moves, the extent of which have not been previously reported, suggest that political warnings and legal challenges from medical groups have not fully stopped Kennedy’s vaccine agenda, but shifted it largely out of public view. Kennedy’s allies are embedding his agenda in institutions that decide what gets studied, who does vaccine research and how these findings are translated into policy. This could keep the Trump administration’s questioning of vaccines’ safety alive for years to come.

Greg Jaffe and Maggie Haberman at NYT:

A major flu outbreak has sickened nearly 160 troops at Lackland Air Force Base in Texas less than two months after Defense Secretary Pete Hegseth announced that U.S. troops would no longer be required to be vaccinated for the flu, defense officials said.

The outbreak at the base in San Antonio raced through an Air Force Basic Military Training wing, where new recruits sleep on bunk beds in open bays and share meals at large communal tables.

A trainee in his sixth week of basic training died after falling ill on Friday and being taken to Brooke Army Medical Center, the Air Force said in a news release. It was not immediately clear whether the death of the trainee, Keon McDaniel, was related to the flu outbreak.

A comprehensive medical review into his death is underway to determine the cause, according to the Air Force.

In the weeks since Mr. Hegseth’s vaccine policy took effect on April 21, only about 40 percent of Air Force trainees have opted to take the vaccine, which had long been mandatory, an Air Force official said.

In the aftermath of the outbreak, the Air Force issued an exception to the voluntary vaccine policy, requiring that all recruits at Lackland get flu shots — part of a broader effort to stem the virus’s spread.

 

Report Supports Tricare Funding for ABA

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.

 Karen Jowers at Military Times:

Defense Health Agency officials should formally authorize Applied Behavior Analysis, a widely recognized intervention to help children with autism, as a basic Tricare benefit, according to a report on the findings of a congressionally mandated independent study.

The report, conducted by the National Academies of Sciences, Engineering and Medicine, debunks DHA officials’ repeated assertion that ABA services don’t meet their standards for reliable medical evidence.

The researchers lay out their analysis of why ABA meets Tricare’s own standards, defined in law.

Researchers recommend this major shift in Tricare’s policies for military family members diagnosed with autism spectrum disorder, citing problems with an 11-year-old demonstration project that in effect limits the care available for these children.

“It’s time for ABA to be a basic benefit in the Defense Health Agency,” said Dr. Eric Flake, a retired Air Force colonel who is a member of the committee that conducted the study, during a webinar Tuesday.

Roim Rachok

In The Politics of Autism, I discuss military personnel and military families.  The IDF recruits autistic soldiers.

Policy entrepreneurs and policy change when politicians are absent: The inclusion of autistic individuals in the Israel Defense Forces Ben Kizel & Nissim Cohen The University of Haifa, paper for the International Public Policy Association.

Abstract 

How do policy entrepreneurs achieve policy change in the absence of the direct involvement of politicians? While the public policy literature has examined the conditions under which politicians refrain from direct engagement in policy design, less attention has been paid to the strategies policy entrepreneurs employ when political actors are absent from the policy arena. We address this gap by examining how policy entrepreneurs independently advance policy change. Drawing on 30 in-depth interviews and textual analysis, and using the “Roim Rachok” (“Looking Ahead”) program, which facilitates the inclusion of individuals on the autism spectrum in the Israel Defense Forces as a case study, we have several indications of the strategies of policy entrepreneurs in the absence of political involvement. First, the policy entrepreneurs operated through institutionalized collaborative networks for funding. Second, they leveraged Israel's security challenges as a structured framework to advance change. Third, the policy entrepreneurs created an organizational infrastructure. Fourth, they used trust building as a strategy when collaborating with security organizations.

From the article:

The "Roim Rachok" program was founded in 2012 by two former employees of the Israeli Defense Ministry. It was not a project undertaken by the Israeli government. Its goal is to include those on the autism spectrum in the IDF, specifically in military professions where the distinctive abilities of this population can address personnel shortages. Thus, the program regards integrating individuals on the autism spectrum as an operational imperative for the military rather than a charitable endeavor aimed at supporting a disadvantaged population (Greenbank et al., 2024). 

 

IDF and Autism

In The Politics of Autism, I discuss military personnel and military families.  The IDF recruits autistic soldiers.  The US military is lagging.

Hana Levi Julian at JewishPress.com:

The Israel Defense Forces (IDF) is implementing significant changes to its recruitment and integration strategies for individuals on the autism spectrum, according to Udi Heller, an autistic IDF officer and founder of the “Titkadmu” (“Move Forward”) program, and the “Shavim” association, which works to provide vocational rehabilitation for the disabled.

The reforms aim to address manpower shortages and diversify service options for autistic individuals.

The move will see changes to “Move Forward”, with the IDF shifting toward recruiting some autistic personnel through standard channels, with possible integration into operational units.

Previously, young people on the autism spectrum could volunteer for service with medical profiles of 25 or higher, primarily in predefined roles, or enlist via the specialized “Move Forward” program, which allowed them to serve under Profile 45 with accommodations that suited their needs.

According to a document from the IDF’s “Meitav” Command, new policies permit certain autistic individuals to be recruited under Profile 64 without adjustments, enabling placements in combat support units or even combat units, aligning with the IDF’s war-driven recruitment needs.

DOD and Special Ed

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

Special Education: Improved Allocation of Resources Could Help DOD Education Activity Better Meet Students' Needs GAO-25-107053.

The Department of Defense Education Activity (DODEA) operates DOD's school system and provides special education and related services for about 15 percent of its students worldwide. However, GAO found that related services provided by the military branches for students in overseas locations—such as physical therapy—were often limited or unavailable, resulting in service delays or disruptions. These services are required by students' individualized education programs—legally binding written plans describing the services students are to receive. GAO found delays in service delivery for students in 44 of DODEA's 114 overseas schools for 2022–2023 (see figure). Further, from school years 2018–2019 through 2022–2023, at least six cases took more than a year to resolve. Service delays and disruptions can negatively affect students' academic progress, according to related service providers and parents GAO interviewed.

From NEA:

The Federal Education Association, an NEA affiliate, represents 6,000 educators in 161 schools stateside and overseas for military-connected students—the children of active duty and civilian Department of Defense employees. The schools are administered by the Department of Defense Education Activity (DoDEA).

As part of his “Workforce Acceleration & Recapitalization Initiative,” Secretary of Defense Pete Hegseth has proposed eliminating hundreds of positions in DoDEA schools for educators with specialized skills: educational technologists, speech-language assessors, special education assessors, and automation clerks.

The plan shortchanges military-connected students and stretches educators to the breaking point. Tell your members of Congress to take action and stop it!

 

Trump Despises People With Disabilities, continued

 In The Politics of Autism, I discuss the issue's role in campaign politics.   In the 2016 campaign, a number of posts discussed Trump's bad record on disability issues more generally.   As his words and actions have shown, he despises Americans with disabilities.   He told his nephew Fred that severely disabled people -- such as Fred's son -- should "just die."

 Jeffrey Goldberg at The Atlantic:

Kelly and others have taken special note of the revulsion Trump feels in the presence of wounded veterans. After Trump attended a Bastille Day parade in France, he told Kelly and others that he would like to stage his own parade in Washington, but without the presence of wounded veterans. “I don’t want them,” Trump said. “It doesn’t look good for me.”

Milley also witnessed Trump’s disdain for the wounded. Milley had chosen a severely wounded Army captain, Luis Avila, to sing “God Bless America” at his installation ceremony in 2019. Avila, who had completed five combat tours, had lost a leg in an improvised-explosive-device attack in Afghanistan, and had suffered two heart attacks, two strokes, and brain damage as a result of his injuries. Avila is considered a hero up and down the ranks of the Army.

It had rained earlier on the day of the ceremony, and the ground was soft; at one point Avila’s wheelchair almost toppled over. Milley’s wife, Holly­anne, ran to help Avila, as did then–Vice President Mike Pence. After Avila’s performance, Trump walked over to congratulate him, but then said to Milley, within earshot of several witnesses, “Why do you bring people like that here? No one wants to see that, the wounded.” Never let Avila appear in public again, Trump told Milley.

Reupping other examples:

Jonathan Swan, Maggie Haberman, and Shane Goldmacher at NYT:

Donald J. Trump took his seat at the dining table in his triplex penthouse apartment atop Trump Tower on the last Sunday in September, alongside some of the most sought-after and wealthiest figures in the Republican Party.

...

He disparaged Vice President Kamala Harris as “retarded.” He complained about the number of Jews still backing Ms. Harris, saying they needed their heads examined for not supporting him despite everything he had done for the state of Israel.

He has also used the r-word before, and Lordy, there are tapes.

In welcoming the US Olympic team to the White House , Trump said:

So today, on behalf of the United States, I want to thank every Olympian and Paralympian. And what as just incredible. And what happened with the Paralympics was so incredible and so inspiring to me. And I watched — it’s a little tough to watch too much, but I watched as much as I could.

Trump thinks it's "tough to watch" disabled people play sports.  This comment is the latest sign of his aversion to people with disabilities.

On November 26, 2015, Jose A. DelReal at The Washington Post:

On stage Tuesday, Trump berated Times investigative reporter Serge Kovaleski for his recent recollection of an article he had written a few days after the [9/11] attacks. Trump appeared to mock Kovaleski's physical condition; the reporter has arthrogryposis, which visibly limits flexibility in his arms.

“Now, the poor guy — you've got to see this guy, ‘Ah, I don't know what I said! I don't remember!' " Trump said as he jerked his arms in front of his body.

On August 3, 2015, Celeste Katz wrote at The New York Daily News:

"While disabled veterans should be given every opportunity to earn a living, is it fair to do so to the detriment of the city as a whole or its tax paying citizens and businesses?" Trump wrote in a 1991 letter to John Dearie, then-chairman of the state Assembly's Committee on Cities.

"Do we allow Fifth Ave., one of the world's finest and most luxurious shopping districts, to be turned into an outdoor flea market, clogging and seriously downgrading the area?" Trump demanded.

New York's original peddling exceptions for veterans date back to 1894 — created to give those disabled during the Civil War a chance to support themselves.

In 2004, when the regulations had come up for renewal, Trump piped up again.

John Hendrickson at The Atlantic:

Former president Donald Trump, perhaps threatened by President Joe Biden’s well-received State of the Union address, mocked his opponent’s lifelong stutter at a rally in Georgia yesterday. “Wasn’t it—didn’t it bring us together?” Trump asked sarcastically. He kept the bit going, slipping into a Biden caricature. “‘I’m gonna bring the country tuh-tuh-tuh-together,’” Trump said, straining and narrowing his mouth for comedic effect.

Trump has made a new habit of this. “‘He’s a threat to d-d-democracy,’” Trump said in his vaudeville Biden character at a January rally in Iowa. That jibe was also a response to a big Biden speech—one tied to the anniversary of the January 6 insurrection. (Guess who the he was in that sentence.)

...

Stuttering is one of many disabilities to have entered Trump’s crosshairs. In 2015, he infamously made fun of a New York Times reporter’s disabled upper-body movements. Three years later, as president, when planning a White House event for military veterans, he asked his staff not to include amputees wounded in combat, saying, “Nobody wants to see that.” Stuttering is a neurological disorder that affects roughly 3 million Americans. Biden has stuttered since childhood. He has worked to manage his disfluent speech for decades, but, contrary to the story he tells about his life, he has never fully “beat” it.

 

Autism in the US Military

In The Politics of Autism, I discuss military personnel and military families.  The IDF recruits autistic soldiers.  The US military is lagging.

John Donvan, Marjorie McAfee, Katy Sheward, Justin Green, and Aria Young at ABC:

For people on the autism spectrum, finding their place in the American military can be an arduous process. The U.S. Department of Defense considers having autism spectrum disorder (ASD) to be a “disqualifying condition” to join the military. Many candidates are turned away because of their diagnosis.

...

“National security problems are some of the hardest problems we have in this country,” said Cortney Weinbaum, Sr., national security researcher at RAND Corporation. “It makes no sense to not want all brain types working on it.”

Having authored one of the few studies attempting to assess the military’s handling of neurodivergence, Weinbaum found a community of military members hiding their symptoms to avoid being medically discharged.

...

“With ASD in particular, we've seen about 1,800 applicants come through the process with that diagnosis,” said Miller. “And we've seen about 500 applicants actually approved for a waiver with a history of ASD.”

Miller admits that the waiver process can be opaque and lengthy.

“We do not necessarily put out a lot of information about the waiver process itself, because every review is individualized and depends on those individual circumstances,” Miller told “Nightline.” “But we do believe that we need to do more to make the waiver process understood and known.”

Stephanie Miller, Deputy Assistant Secretary of Defense for Military Personnel Policy at the Department of Defense, says the military is beginning to take a more individualized approach to autism in the waiver process, reflecting a more nuanced understanding of the diagnosis.

IDF Recruits

In The Politics of Autism, I note that we need more study of how autistic people fare in other countries.

 From The Jerusalem Post:

The IDF achieved an inclusivity milestone recently as the first round of autistic military recruits finished their army service, the IDF reported on Monday.

The announcement comes the day before World Autism Awareness Day.

The IDF’s “Advance” program started in July of 2021 and was designed to integrate people like Ori Weiss, a young man with autism, into the military.

"I was excited to join the army like everyone else, that they wouldn't treat me like I was made of glass,” the IDF quoted Weiss as saying. “ I wanted to do something significant and contribute as much as possible."

Because of the “Advance” program two years and eight months ago, he, along with 52 other young men and women on the autism spectrum, were able to arrive at the IDF induction center and commence their training.

...

Since the program started in 2021, eight recruitment rounds have taken place.

The IDF went on to note that, with the first batch of recruits completing their mandatory service just one week ago, the recruitment of young men and women with autism into the military has become a fait accompli.

Special in Uniform

In The Politics of Autism, I note that we need more study of how autistic people fare in other countries.

Pesach Benson at the Jewish News Service:

At the heart of the Emergency Logistics Warehouses in the Israel Defense Forces Home Front Command base in Ramla, an extraordinary scene unfolds daily. Young soldiers, dealing with various disabilities and neurodiversity, are actively contributing to Israel’s war effort through their dedicated service in the Special in Uniform (SIU) program.

...

Soldiers such as Ilai, who is on the autism spectrum, exemplify the program’s ethos.

“Me and my friends, we’ve all got different special needs,” he explains without pausing from his meticulous work. “We know how critical things are at the front, and we responded to the nation’s call, no questions asked. We’re here to give to Israel, to contribute all we can to our country and fellow citizens.”

...

The SIU program is a collaborative initiative of the IDF and Jewish National Fund-USA, which focuses on integrating young people with physical and mental disabilities into the Israeli military and society.

Around 1,000 Special in Uniform soldiers, from communities across Israel, serve in 45 bases in all branches of the IDF.

The US Military Discriminates Against Autistic People Who Want to Serve

In The Politics of Autism, I discuss military personnel and military families.  

Jennifer Barnhill at The War Horse:

Autism is one of hundreds of conditions—from asthma to attention-deficit/hyperactivity disorder to a history of anxiety—the Defense Department says disqualifies people from serving in the military.

The average American doesn’t meet the basic qualifications to serve, and the pool of eligible Americans has dropped from 29% in 2013 to 23% in 2023. About 4% of eligible applicants would be ruled out for psychological and developmental diagnoses, such as autism, depression or attention-deficit/hyperactivity disorder, according to the Defense Department, which works out to thousands of potential recruits a year.

More than five million Americans have been diagnosed with autism spectrum disorder, according to a U.S. Centers for Disease Control study in 2020.(iStock/Getty Images)

As the military faces a recruiting crisis, with the Army, Navy, and Air Force expected to miss their goals this year, the military medical waiver process may no longer be serving the services. Qualified candidates may not bother to apply because the process is so opaque—enough so that Congress has enacted legislation to ensure medical waivers do not “inappropriately” disqualify candidates. And how each service processes medical waivers varies, frustrating recruiters and recruits alike. This affects a generation of potential recruits—including young adults diagnosed with ADHD or people with a diagnosis on the autism spectrum who may be more inclined to choose careers in cybersecurity or coding—who often have the focus on detail and ability to see patterns the military needs to protect the United States.

However, the Defense Department has launched a pilot program to try to streamline the issue, and it looks as if recent changes may have affected the number of potential recruits being turned away.

National Security and Autism

In The Politics of Autism, I discuss military personnel and military families.  

Cortney Weinbaum at Military Times:

At conference of intelligence community professionals, I briefly stood up to describe a study my team was embarking on — the first ever conducted in the United States about neurodiversity and national security. Anyone who wanted to discuss it, I said, could find me later by the coffee table.

Two women introduced themselves as autistic senior intelligence officers. One was a leader at her agency; the other a highly seasoned intelligence officer. Both said their wish is for their autistic colleagues to be able to serve out of the closet, “like the LGBTQ community can.”

My team set out to examine whether neurodiversity — the diversity of all cognitive functions — would offer benefits to U.S. national security, as it has for Israel, the UK, and Australia. But we found that archaic U.S. military and federal policies, combined with decades-old understandings about autism spectrum disorder, create an environment where people hide their autism and other cognitive diagnoses.

...

The official Department of Defense policy is to exclude all autistic candidates from military service — with no exceptions. The reality is much more complicated.

The people we spoke to were often diagnosed after they joined the military. They described going outside of the military health system to pursue a diagnosis in secret during adulthood. A widely held perception among the service members we spoke to is that their 10 or 20 years of successful military promotions could be erased if an autism diagnosis becomes known — even though that condition would have existed since early childhood.

Cortney Weinbaum is a senior national security researcher at the nonprofit, nonpartisan, Rand Corp. She is the author of the study “Neurodiversity and National Security: How to Tackle National Security Challenges with a Wider Range of Cognitive Talents.” She is a former intelligence officer.

Autism and the Army

In The Politics of Autism, I discuss military personnel and military families.  

Courtney Weinbaum at the Modern War Institute:

Autistic soldiers, and soldiers with other neurodivergent diagnoses, are already serving on active duty, in many cases in secret—hiding their diagnoses from the Army—and I know this because they called to tell me. My team at the RAND Corporation published the first study ever conducted in the United States about neurodiversity and national security, and as word spread that we were conducting this research, my phone started ringing. Based on my conversations, this is what I think the autistic and neurodivergent soldiers in your unit want you to know.

They are intelligence officers, cyber operations officers, company commanders, and in other jobs. They likely entered the military before they were diagnosed, and they went outside the military health system—and dug into their own pockets—to get assessed during adulthood. Or they are waiting until after retirement to seek official diagnoses, though they already have a deep sense of what the results will be. They fear losing the careers they love if their diagnoses were to become known, they described being bullied in the past by classmates or coworkers because of their conditions, and they described the mental cost and exhaustion of hiding their symptoms to pass as “normal” at work.

While neurodivergent diagnoses are not automatically disqualifying from Army service, any new recruit who reveals a diagnosis jumps through hoops to serve. Some described having to prove that their diagnoses do not impede their ability to serve, which puts the burden on an eighteen-year-old to prove a negative for which the Army has no assessment criteria.

...

Our research found peer-reviewed studies reporting that neurodivergent people outperform neurotypical people at recognizing patterns in a distracted environment, on intelligence tests using nonverbal testing methods, and at achieving states of hyperfocus. The one study we found about ethics and neurodivergence found that autistic research subjects were more likely to behave ethically even when it was at a personal cost than neurotypical subjects. If this research holds true, then the implications for people with security clearances is enormous.

Israel, the UK, and Australia already have autism programs in their national security organizations. Multibillion-dollar companies EY and Google proactively recruit neurodivergent candidates, because of the value both companies have reaped from these cadres of employees.

Autistic Members of the IDF

In The Politics of Autism, I note that we need more study of how autistic people fare in other countries.

Joshua Zitser at Business Insider:

Each day, Sgt. I. scours the internet to find elusive intelligence that could help Israel fight its enemies.

He is a web specialist for an elite unit of the Israel Defense Forces, focused on open-source research that informs high-level decision-making and can even reach the prime minister's desk.

He is also autistic.

Sgt. I., like some 150 others, isn't in the IDF by chance. He signed up to serve through Ro'im Rachok, a first-of-its-kind program that places autistic people in the military to utilize their valuable skills.

Speaking to Insider from inside HaKirya, the sprawling headquarters of the IDF, he said he was able to cope with long, exhausting intelligence work better than many others and that he was most productive when given to-do lists.

He couldn't elaborate on the specifics of what he does. The IDF and Ro'im Rachok members spoke on the condition that Insider use initials or only their first names, citing the secrecy of their work.

A typical IDF open-source project might involve trawling social media and obscure sites for intel on everything from the effect of sanctions on the Iranian economy to the size of Hezbollah's arsenal.

An IDF minder sat in the meeting room throughout, ready to intervene if Sgt. I. accidentally divulged anything classified.

On occasion, Sgt. I. said, his daily work routine is interrupted by "stimming" — a behavior often associated with autism that can involve repeating words, sounds, or movements to cope with stress.

Sgt. I. tends to flap his hands when he's excited or overwhelmed. "It's an urge, like blinking," he said.

He'd always been taught in special-education settings, so he wasn't self-conscious about doing this before he joined the IDF and started working in an office alongside neurotypical soldiers. "So, yes, I've had to adapt," he said.

Highly Mobile Students with Disabilities

 

In The Politics of Autism, I write about special education and the Individuals with Disabilities Education Act. II also discuss the day-to-day challenges facing autistic people and their families. 

Kara Arundel at K-12Dive:

• In a letter to state special education leaders focused on the needs of “highly mobile children” the U.S. Office of Special Education and Rehabilitative Services on Thursday said school systems need to provide “timely and expedited evaluations and eligibility determinations” for any of these students suspected of having a disability that impacts their learning. The letter defines highly mobile children as those who are connected with military families, or are migratory, homeless or in the foster care system.
• The 11-page letter, which came in response to concerns from stakeholders, includes resources on response to intervention approaches before an evaluation is complete and the use of comparable special education services for students new to a district.
• Students who move frequently, particularly those with disabilities, can face challenges such as difficulty communicating their needs to an unfamiliar school and district. OSERS said the intent of its letter is to ensure the educational stability of highly mobile students with disabilities.

DOD Extends Tricare Autism Program

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.

Patricia Kime at Military.com:

The Defense Department will extend its program meant to help provide care for military dependents diagnosed with an autism spectrum disorder through 2028 to evaluate its effectiveness, the agency announced Thursday.

In a Federal Register notice, DoD officials said research at the University of Rochester, as well as a newly required review by the National Academies of Sciences, Engineering, and Medicine, need additional time, and they have decided to extend the program past its current Dec. 31, 2023, sunset date to support the studies.

The program, formally known as Tricare Comprehensive Autism Care Demonstration, was started in 2014.

...
In March 2021, the program underwent significant changes, with the DoD combining several benefits under one umbrella and broadening services beyond ABA. Under the revised program, Tricare began covering group treatment for autism, if deemed appropriate, and families were assigned a care coordinator to develop care plans and coordinate therapy and treatment.

From its inception, the demonstration project has drawn both support and criticism, with proponents pressing for broad access to early, intense intervention they say contributes significantly to improved quality of life for patients and their families, and the DoD raising concerns about the effectiveness of ABA therapy.

A 2020 DoD report to Congress noted that the current demonstration project "and the delivery of ABA services, is not working for most Tricare beneficiaries."

But a year later, the 2021 report found that 57% of participants in the program made "statistically significant improvements," while 43% showed no improvement or worsening symptoms.

Autistic Soldier Exhibits Iron Dome to POTUS

In The Politics of Autism, I note that we need more study of how autistic people fare in other countries.

From the Jerusalem Post:

An IDF soldier on the autism spectrum presented the Iron Dome to US President Joe Biden at Ben-Gurion Airport on Wednesday, representing the "Special in Uniform" program as well.

Akiva Parsoff, the IDF soldier, is a member of the Jewish National Fund-USA's (JNF-USA) affiliate program Special in Uniform and was inducted into the IDF several years ago as part of the military's inclusion program.

Today, Parsoff serves as a technician on the Iron Dome batteries at the Palmachim Airbase.

“Autism is a gift, a gift to the world, and people on the spectrum can offer a lot to the world. That’s why I’m here—to spread this word. I was ecstatic when my commander chose me to represent the unit and exhibit Iron Dome to President Biden, who is a great friend of Israel,” said Parsoff.

The Special in Uniform program integrates young people with disabilities into the IDF, focusing on the unique talents of each participant to help them find a job within the IDF that is a perfect fit for them.

Military-Base Internship

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

At the Journal of Autism and Developmental Disorders, Paul Wehman and colleagues have an article titled "Effects of a 9-Month Military-Base Internship on the Competitive Integrated Employment of Military Dependent and Connected Youth with ASD."  The abstract:

This waitlist-controlled cluster randomized clinical trial presents the results of PS + ASD [Project SEARCH Plus ASD Supports] for military dependent and connected youth with ASD. Following earlier findings regarding PS + ASD, this study expands upon that previous work by including a new population, military dependent and connected transition aged youth with ASD. Findings indicate that military dependent and connected youth who participated in PS + ASD gained competitive integrated employment at 60% despite the impact of the COVID-19 pandemic and economic downturn. In addition, these youth worked a mean of 24.42 h weekly and earned an average hourly wage of $9.38 at one year post baseline while the waitlist control group participants did not gain CIE. In addition, by 18 months, 58.3% of participants gained positions in federal employment. Implications of the study are discussed.

Sources of Autism Research Funding

 In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

Portfolio Analysis Report IACC Autism Spectrum Disorder Research 2017-2018

(IACC published the data last year.)

The federal government provides most of the research funding:

Most of the federal money comes from NIH:

The Army is one of these sources:

The Office of the Congressionally Directed Medical Research Programs (CDMRP) was created in 1992 from a powerful grassroots effort led by the breast cancer advocacy community that resulted in a Congressional appropriation of funds for breast cancer research. This initiated a unique partnership among the public, Congress, and the military. Since that time, Congress has added additional research programs and topics. Funds for the CDMRP are added to the Department of Defense (DoD) budget, in which support for individual programs such as the Autism Research Program (ARP) is allocated via specific guidance from Congress. Since its inception in fiscal year 2007 (FY07) and on through FY20, appropriations totaling $104.4 Million have been directed to the ARP by the Peer-Reviewed Autism Research Congressional appropriation.

Why the Army?

Strategies to Leverage Research Funding Guiding DOD's Peer Reviewed Medical Research Program Institute of Medicine (US) Committee on Alternative Funding Strategies for DOD's Peer Reviewed Medical Research Programs; Editors: Michael McGeary and Kathi E. Hanna

CDMRP was initiated in 1992 in response to several forces. One was the emergence of women's health as an urgent public policy issue. In July 1991, for example, the New England Journal of Medicine published several studies showing that there was sex bias in the management of coronary heart disease. In addition, the National Institutes of Health (NIH) had recently launched a women's health initiative and was requiring the inclusion of women in clinical trials.






...

One attractive source of funding at that time was DOD, which had approximately $29 billion in unobligated funds from prior years for the development of weapons systems planned before collapse of the Soviet Union in 1991.1 Those funds were put off limits by the Budget Enforcement Act of 1990, which established “firewalls” between the budgets for defense, foreign affairs, and domestic programs and imposed strict caps on funding increases in each of the three categories. A number of attempts were made to breach the firewalls by transferring defense funding to domestic programs, including two attempts in September 1992 that would have increased funding for breast cancer research specifically, but they all failed.2 Ultimately, Senator Tom Harkin put forward an amendment to the FY 1993 defense budget to increase funding for breast cancer research within DOD (rather than at NIH) by $185 million, to bring the total breast cancer research program within DOD to $210 million (Watson, 1992). As a transfer within DOD's research and development (R&D) budget, the amendment did not violate the budget agreement's firewalls. The funds were to be taken from the Strategic Defense Initiative and thus would be above and beyond the battlefield medicine-oriented core program of the U.S. Army Medical Research and Materiel Command (USAMRMC),3 which was funded at $410 million in the Senate bill. The “Harkin Amendment for Breast Cancer” which passed in the Senate by a vote of 89 to 4, also stipulated that all projects funded by the resulting Breast Cancer Research Program (BCRP) would have to undergo peer review (Mervis, 1993).

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Autism Families Take Offense at TRICARE

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.

A previous post noted that TRICARE has been touting Autism Acceptance Month.  Military families are not buying it.

Maggie BenZvi at Coffee or Die:

On April 8, the Facebook page for TRICARE, the government health care program that provides medical insurance for military service members and retirees, posted a message regarding April’s status as a month for awareness and acceptance of autistic people.

“April is #AutismAcceptanceMonth!” the post read. “We can all work to make room for more inclusivity and tolerance with just a little patience, understanding, and education.”

For Holly Duncan, the post was a stab in the heart.

“I don’t ‘tolerate’ my kids,” Duncan told Coffee or Die Magazine in the days after the post went up. “I don’t ‘tolerate’ their autism. I learned to live in their world.”

...

TRICARE is not just some corporate PR department looking for clicks. Rather, as demonstrated by the hundreds of responses to the post and according to parents who spoke to Coffee or Die, TRICARE has failed to deliver needed help to their families.

The reaction to TRICARE’s Facebook post was instant and outraged: scores of military parents who say they have spent hours or even years fighting with TRICARE to get appropriate therapy services covered for their children.

Hundreds of comments quickly piled up on the post.

“Oh, look, useless virtue signaling as they cover less for families. Thanks, TriCare,” wrote a user named Rachel Dawn.

“What a slap in the face #TRICARE with this post!” Kira Barrett-Voelker commented.

“Whoever marketed this mess is an embarrassment,” wrote Kristin Borg.

Duncan, along with Jennifer Bittner, co-chairs the Autism Family Advocacy Committee for Exceptional Families of the Military.

Both women are military spouses, both have two children on the autism spectrum, and both are dismayed by recent TRICARE changes that make receiving those therapies even more difficult.