Shortage of Special Ed Teachers in California

Previous posts have talked about shortages of special education teachers.  San Francisco's KGO-TV reports on the situation in California:

Autism Speaks TRICARE Analysis

Autism Speaks reports on a purported TRICARE policy change:

Last year Congress directed TRICARE to launch an ABA pilot program to improve and expand its coverage for non-active personnel. TRICARE published its ABA Pilot policy last month for non-active duty family members -- but along with it camesignificant and drastic changes to existing ABA coverage for all beneficiaries with autism, including active duty military families.

Last week, TRICARE stepped back, but not away, from this ill-conceived change in the policy for ABA. After a tremendous outcry from military families, service providers, and advocacy organizations, Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of the TRICARE Management Activity, assured military families that services under the TRICARE Basic program and the Enhanced Access to Autism Services Demonstration (ECHO Autism Demonstration) will not change.

As of this writing, however, the new policy itself has not been modified.Our summary here is based on Woodson’s verbal assurances that the ECHO Autism Demonstration and the TRICARE Basic Program will not change. We will update the summary as developments warrant – please check back.

Autism Speaks, meanwhile, remains concerned about the ABA Pilot for non-active duty family members. Specifically, these issues need to be addressed:

• by requiring specific psychometric testing, including the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2), as a baseline measure before services can be provided, access to treatment for children may be delayed, possibly for several months

• by using the Vineland Adaptive Behavior Scales, 2nd Edition (Vineland-II), to confirm progress in treatment – a function for which the test has not been validated – needed care could be denied to children who could benefit from ABA

• arbitrary age and duration limits

• discharge criteria

• proper coverage of Assistant Behavior Analysts

Autism Documentary Airs Monday

PBS is airing a documentary titled "Neurotypical."

Broadcast: Monday, July 29, 2013
Check local listings >>Online Streaming: July 30, 2013 – Aug. 28, 2013

Neurotypical is an unprecedented exploration of autism from the point of view of autistic people themselves. Four-year-old Violet, teenaged Nicholas and adult Paula occupy different positions on the autism spectrum, but they are all at pivotal moments in their lives. How they and the people around them work out their perceptual and behavioral differences becomes a remarkable reflection of the "neurotypical" world — the world of the non-autistic — revealing inventive adaptations on each side and an emerging critique of both what it means to be normal and what it means to be human.

 

Another Apology

The Huffington Post reports on another apology:

Just a few days after J. Cole apologized for a lyric about autism that many labeled offensive, Drake has stepped up to do the same. The two collaborated on the latter's "Jodeci Freestyle," with J. Cole rapping the verse in question.

Drake took to his site to issue the mea culpa:

J.Cole wrote a beautiful and moving apology to individuals and families affected by autism who were understandably hurt by a verse in "Jodeci Freestyle". I share responsibility and offer my sincerest apologies for the pain this has caused. Individuals with autism have brilliant and creative minds, and their gifts should not be disparaged or discounted. This was a learning lesson for both of us, and I’m grateful for the opportunity to try to right this wrong. J. Cole and I believe that it is the right, responsible, and respectful decision to remove the lyric from the song.

J. Cole's divisive lyric -- "I'm artistic, you n----s is autistic, retarded" -- prompted a petition from the Anti-Bullying Alliance prior to the rapper's apology. He is part of a slew of hip-hop stars who have recently backtracked on offensive lyrics, including Lil Wayne and Rick Ross. J. Cole said in his blog-post atonement that he doesn't agree with the trend but felt he overstepped decorum with this particular lyric.

TRICARE Rally

In Virginia, WAVY-TV reports on a rally to improve TRICARE benefits:

Families fight for TRICARE services

Autism Speaks adds detail:

The rally was in response to new policies announced by TRICARE imposing restrictions to ABA care under a pilot program for retired and non-active personnel. The policies, which take effect July 25, originally would have applied to all TRICARE coverage, including the ECHO program for active duty members, but was revised after an uproar from military families and members of Congress.

Legislation that would have required ABA coverage for all military members passed both houses of Congress last year, but was amended down to the pilot program in conference committee. Similar legislation this year has passed the House and awaits action in the Senate.

Rapper Apologizes

Previous posts have discussed demeaning comments about autism appearing in popular culture.  AP reports on the latest case:

Rapper J. Cole is apologizing to those with autism and their families for an offensive lyric.

Cole says in a blog post Sunday that he doesn’t agree with the recent trend of pressure rappers have faced to apologize when they step over a perceived line, but in this case he feels he went too far in a verse he contributed to Drake’s “Jodeci Freestyle.”

“To the parents who are fighting through the frustrations that must come with raising a child with severe autism, finding strength and patience that they never knew they had; to the college student with Asperger’s syndrome; to all those overcoming autism,” Cole wrote. “You deserve medals, not disrespect. I hope you accept my sincere apology.”
...

Cole has been in the spotlight this summer after his recent album “Born Sinner” jockeyed with Kanye West’s “Yeezus” when released last month and reached No. 1 on the Billboard 200 the following week. That album also contains moments that some might consider offensive. In Drake’s song, Cole raps that he’s “artistic” while his rivals are “autistic, retarded.”
Cole wrote that when he first heard a backlash from those who deal with the developmental disorder he immediately realized he went too far.

Utah Pilot Program -- Implementation

The Salt Lake Tribune reports on problems with a pilot program in Utah:

The Kavas had high hopes in November when Jason became one of 277 Utah children picked in a lottery to receive free applied behavior analysis (ABA) therapy through a Medicaid pilot program.

But it took four months for them to complete paperwork, for the state to link families with providers and for Utah Behavior Services to find tutors willing to travel to southeastern Utah.

Then the company quit treating J.J. three months later, after his father questioned the quality of its care.

The tutors, both formerly stay-at-home-moms with no experience and minimal training, "would drive around town and go to Maverik and buy soda to see how he behaved. That was supposed to be social time," said Jason Kava, a single, working dad.

One woman "was hauling him 30 miles to her house, sometimes without notifying us," he said.

Except for an initial assessment, none of the sessions was observed by a certified ABA therapist, the Kavas said, and the tutors frequently failed to show up for the 15 hours of weekly therapy J.J. was scheduled to receive.

The same paper, however, reports on success as well:

 Not all rural families in the program have faced delays and struggles in finding reliable, qualified providers. The Kartchners live in Monticello, a tiny town in the far southeastern corner of Utah near the Navajo Reservation.
...
A board-certified behavior analyst regularly checks in via Skype, providing feedback to his tutor and parents, and tweaking his therapy plan.

In five months he has gone from being nonverbal to saying "momma" for the first time, said Kartchner. "He’s requesting things and no longer needs the communication app on his iPod."

In rural Utah, said Kartchner, "We have to be realistic. We have this great opportunity, and I’m going to do as much as I can to make it successful."

McCarthy and Vaccine

The Newark Star-Ledger editorializes about Jenny McCarthy:

McCarthy is careful to say she is not anti-vaccine on the Generation Rescue website. But she also introduces parents who blame vaccines for causing autism. She doesn’t dispute them. It’s disingenuous at best: She gets to disavow the vaccine connection, while lending her name to a group that promotes it.

The accusation has been debunked by science. Seth Mnookin, co-director of MIT’s Graduate Program in Science Writing, recently wrote “The Panic Virus: The True Story Behind the Vaccine-Autism Controversy,” and has reprinted the chapter on Jenny McCarthy’s crusade on his blog. It’s worth reading to get the full sense of her crackpot views of medicine, and the power she wields over parents desperate for answers.

The danger in abstaining from vaccines cannot be overstated. This is how we virtually eradicated epidemics such as smallpox and polio. And refusing a vaccination isn’t just a choice for your kid. It’s a dangerous choice for everyone else.

The Wall Street Journal provides a telling example from Wales:

When the telltale rash appeared behind Aleshia Jenkins's ears, her grandmother knew exactly what caused it: a decision she'd made 15 years earlier.

Ms. Jenkins was an infant in 1998, when this region of southwest Wales was a hotbed of resistance to a vaccine for measles, mumps and rubella. Many here refused the vaccine for their children after a British doctor, Andrew Wakefield, suggested it might cause autism and a local newspaper heavily covered the fears. Resistance continued even after the autism link was disproved.

The bill has now come due.

A measles outbreak infected 1,219 people in southwest Wales between November 2012 and early July, compared with 105 cases in all of Wales in 2011.

One of the infected was Ms. Jenkins, whose grandmother, her guardian, hadn't vaccinated her as a young child. "I was afraid of the autism," says the grandmother, Margaret Mugford, 63 years old. "It was in all the papers and on TV."

The outbreak presents a cautionary tale about the limits of disease control. Wales is a modern society with access to modern medical care and scientific thought. Yet legions spurned a long-proven vaccine, putting a generation at risk even after scientists debunked Dr. Wakefield's autism research.

From  the CDC:

Before measles vaccine, nearly all children got measles by the time they were 15 years of age. Each year in the United States about 450-500 people died because of measles, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness. 

TRICARE Retreats

Following pushback from military families, the military has backed off from TRICARE eligibility restrictions. The Washington Times reports:

The Pentagon on Thursday eased some concerns among military families worried that a new pilot program would interrupt treatment for their autistic children.

Some active-duty families had feared the 12-month program, which will begin Thursday to provide special behavioral treatment for autistic children, would be unwieldy for service members who change duty assignments. The program requires testing every six months.

For “any active-duty family member currently enrolled in the [extended care program], there is no change in their requirements on July 25. They can continue to get the same care under the same rules going forward,” Dr. Jonathan Woodson, assistant defense secretary for health affairs, said during a conference call with reporters.

“For all of the existing programs, there is no plan to implement more rigorous requirements during the next year,” Dr. Woodson said. “We are apologetic to the autism community because we know there has been some controversy over the issue.”

The pilot program focuses on an intensive therapy for autism called applied behavioral analysis, or “ABA” treatment. It was mandated by the 2013 National Defense Authorization Act in order to study how ABA can be made available to military family members under Tricare, the military’s health care system.

Military family advocates say the Pentagon previously had issued eligibility restrictions for all members receiving ABA under Tricare, including active-duty family members, but buckled under pressure.

“It seems that Tricare has rethought the policy that it had announced previously,” said Karen Driscoll, associate director for government affairs and military relations for Autism Speaks, an advocacy group. “We think this is a positive step in the right direction, and we applaud their decision to rethink this.”

TRICARE Reports

KHON-TV in Hawaii reports that recent TRICARE changes could hurt some military families:

“Because of ABA therapy, we had a lot of hope and now I feel like that’s being taken away,” [autism mother Zebonee] Bongiorno said.

One of the major issues is the required waiver application if treatment exceeds two years.

“Our biggest concern is if there is going to be an interruption in services because we need the continuity,” mother Jennifer Frazier said.

TRICARE says, “Although ABA is not limited to a set number of years, additional ABA beyond two years requires approval by the regional contractor medical director.”

“We don’t know what we are going to do. Really, we don’t know,” Bongiorno said.

Some lawmakers in our nation’s Capitol have called upon TRICARE to review their new rules.

Phone calls to TRICARE officials were not returned.

WTKR in Virginia reports that some parents plan on demonstrating against the new policy:


See the Facebook page of Navigation Behavioral Consulting.

Reverberations of the Seattle Bus Ad

Previous posts discussed a now-withdrawn Seattle bus ad that spoke of wiping out autism. The Seattle Weekly reports:

... Arzu Forough of Washington Autism Alliance & Advocacy worries that the recent press coverage in Seattle could mislead the public about the nature of autism and obscure how serious the condition can be. Forough supported pulling the ad, and repeatedly calls for various autism groups to work together to advocate for support. But she says the points made by ASAN in many media over the last week are only part of the picture.

“A lot of people don’t understand what autism is, they don’t understand that it’s actually a disability,” says Forough, the Eastside mother of an autistic son. “Their perception is that these are individuals who may be quirky and they may just have some minor differences, and they really don’t understand the depth of support that some individuals with autism need.

“To that segment of the population, what played out with Seattle Children’s last week really won’t help them understand autism better.”

Back at Mary Gates Hall, the members of ASAN say they’ve heard it all before, and stick to their core message: If more thought was put toward accommodating autism rather than fixing it, autistic people would be far better off.

“People say ‘You’re too high-functioning to understand,’ ” Lyubov Steadman says. “You never met me when I was 10 years old. I was that kid.”

More on McCarthy

Several posts have dealt with "false balance" in media coverage of autism and vaccines. Brendan Nyhan writes at The Columbia Journalism Review:

ABC’s announcement yesterday that actress/comedian Jenny McCarthy will become a co-host of The View brought forth a torrent of condemnation from doctors, science journalists, opinion writers, and even entertainment commentators who oppose giving the anti-vaccine activist a high-profile platform to spread misinformation.

Unfortunately, however, the early coverage has generally failed to follow best practices for covering false or unsupported claims, giving greater reach to discredited claims that have potentially dangerous consequences for public health.

One problem was that McCarthy’s hiring was initially categorized as an entertainment story under the journalistic beat system and thus covered by reporters who don’t specialize in science or health. Predictably, some of them resorted to “he said,” “she said” style coverage that failed to make clear just how extreme and scientifically discredited McCarthy’s views are.

At The National Geographic, Susan Brink writes:

Maybe, just maybe, Jenny McCarthy won't even mention autism and vaccines from her new perch on The View. That's the hope of Paul Offit, chief of the Division of Infectious Diseases at the Children's Hospital of Philadelphia. "In a more rational world, this discussion would be un-reopenable," Offit says. "The answerable questions have all been answered." It's not the vaccine, or anything in the vaccine. It's not the number or timing of vaccinations. Scientifically, he says, we know that.

So what is causing an increase in autism? We don't know for sure, says Offit, but the best data are genetic, involving several genes required for brain development that may generate abnormalities even in the womb. Some researchers have found a connection between older fathers and an increased risk of autism in their children. Or the increase could be due to more awareness of autism and a broader definition of the disorder.

One quibble:  it is far from certain that there even has been a true increase in the prevalence of autism. Serious analysts agree that changes in diagnostic criteria and public attitudes account for much of the apparent change.

Jenny McCarthy and Barbara Walters

USA Today reports:

It's official: Barbara Walters confirmed on Monday's The View that comedic actress Jenny McCarthy will join the chatfest when its 17th season begins Sept. 9.
...
"We are delighted that Jenny will be joining us as a permanent co-host," Walters says, adding McCarthy "brings us intelligence as well as warmth and humor. She can be serious and outrageous. She has connected with our audience and offers a fresh point of view."

Not everybody shared Walters' delight. McCarthy, who has embraced the controversial claim that vaccinations cause autism, has drawn the ire of pro-immunization advocacy groups.

In her book Mother Warriors, however, McCarthy writes of meeting Walters before her first appearance on the show:

I turned the corner and walked into her dressing room. She was getting her makeup done when I said "Hi, Barbara." She whipped her chair around and sternly stared at me with cold eyes. All I could think was "uh-oh."

"People think you're crazy, you know that?" she said with words made of icicles.

"Um, no," I said softly. Then she lowered her chin and managed to lower an octave in her voice and yet raise the volume at the same time.

"MOST doctors do not agree with anything you are saying. Isn't that true?" she said in a wicked, scary tone. I was in shock. Truth be told, I never had anyone yell at me like that -- not since Scott Baio heard I called him Chachie [sic] in an interview...