Identity-First or Person-First?

 From the preface to The Politics of Autism.

A major theme of this book is that just about everything concerning autism is subject to argument. There is not even any consensus on what one should call people who have autism and other disabilities. “In the autism community, many self-advocates and their allies prefer terms such as `Autistic,’ `Autistic person,’ or `Autistic individual’ because we understand autism as an inherent part of an individual’s identity,” writes blogger Lydia Brown.[i] Other writers prefer “people-first” language (e.g., “persons with autism”) since it puts the persons ahead of the disability and describes what they have, not who they are.[ii] For the sake of stylistic variety, this book uses both kinds of language, even though this approach will satisfy neither side. I can only say that I mean no offense.

Amanda Taboas and colleagues have a short report in Autism titled "Preferences for identity-first versus person-first language in a US sample of autism stakeholders."  Lay abstract:

 There is currently disagreement among professionals (such as teachers, therapists, researchers, and clinicians) about the most appropriate and respectful way to refer to individuals with disabilities in general, and those with autism, in particular. Supporters of person-first language feel that it is important to emphasize the person rather than the disorder or disability, and promote the use of terms such as, “person with autism” or “a person with ASD.” The goal is to reduce stereotypes and discrimination and emphasize the person’s individuality rather than their disability. However, some people within the autism community have questioned the use of person-first terms because they are awkward and use an unconventional style of language that draws attention to the disability. Moreover, autistic individuals and their families are beginning to support the use of identity-first language that embraces all aspects of one’s identity. Surveys in the United Kingdom and Australia support the idea that both types of language are preferred by different groups of autism stakeholder groups. In our study, we surveyed autism stakeholders in the United States. Overwhelmingly, autistic adults (n = 299) preferred identity-first language terms to refer to themselves or others with autism. Professionals who work in the autism community (n = 207) were more likely to support and use person-first language. Language is dynamic and our findings support the need for open communication among autism professionals about how we communicate with and about autistic individuals and their families.

Campaigns and Prejudice Against People with Disabilities

In The Politics of Autism, I write about the everyday struggles facing autistic people and their families -- including casual prejudice against disabled people.

Mehmet Oz is a doctor who peddles dubious supplements and hosts antivaxxers on TV.  His Trumpist campaign for a Senate seat from Pennsylvania has attacked opponent John Fetterman for his speech problems following a stroke.  Alex Samuels at FiveThirtyEight:

The lines of attack used against Fetterman, many of which are ableist (meaning they convey prejudice, either overt or subtle, against people with disabilities), tap into long-standing stereotypes about people with disabilities and could affect voters’ perceptions of him. That’s because there continues to be stigma against people with disabilities, according to Lisa Schur, a co-director of the Rutgers Program for Disability Research. As a result, she said, political “candidates with disabilities have to work extra hard to ensure voters that, yes, I’m competent and capable of doing the job.” This stigma can be particularly intense for candidates with mental or cognitive disabilities — or even for candidates where questions are raised about their cognitive function.

To be sure, we don’t have enough evidence to say for certain whether candidates with disabilities have a lower chance of winning elections. We do know, however, that people with disabilities are dramatically underrepresented in government. That’s especially true at the federal level where just over 6 percent of elected officials reported having a disability compared with 12 percent at the local level, according to a study from Schur and her co-director Douglas Kruse.

It figures Oz is positively canine in his devotion to Trump.  In 2020, I wrote a piece for USA Today on Trump's contempt for people with disabilities:

He displayed that attitude long before he became president. As his niece Mary Trump recounts in her new book, “Too Much and Never Enough,” Trump cut off his nephew’s medical coverage after he challenged the will of family patriarch Fred Trump. The nephew had a baby son with a severe neurological disorder. A reporter for the New York Daily News asked Trump how he felt about coldly stopping health insurance for a disabled infant. “I can’t help that. It’s cold when someone sues my father.” The nephew and his wife eventually settled with Trump. Their son now lives with cerebral palsy.

Barbara Res, who ran construction at the Trump Organization, recalled Trump talking to an architect in a Trump Tower elevator. He asked the architect about the raised dots next to the floor numbers. When the architect explained that they were Braille, Trump shouted, “Get rid of the (expletive) braille. No blind people are going to live in Trump Tower.’

His contempt for disabilities spilled into national view when he mocked New York Times investigative reporter Serge Kovaleski. Trump made fun of Kovaleski’s arthrogryposis, a condition that limits the use of 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 thrashed his arms. Trump later denied that he was ridiculing Kovaleski’s disability, claiming that he did not remember the reporter. He lied.

Workplace "Hidden Curriculum"

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

Karla L. Miller at WP:

While the topic of disabilities often brings to mind visible markers — wheelchairs, guide dogs, sign language — many health conditions aren’t as readily apparent. It’s especially difficult to detect the barriers that prevent neurodivergent adults — those with attention deficit, autism, dyslexia, or other neurological differences — from accessing fulfilling full-time employment.

The Centers for Disease Control and Prevention estimates that 2.2 percent of adults are on the autism spectrum, although the condition often goes undiagnosed, particularly in women. Joseph Riddle, director of Neurodiversity in the Workplace, estimates that “fewer than 1 in 6 neurodivergent job seekers are employed full-time at the level they should be.”

When people do land full-time jobs, they often encounter internal barriers that make it difficult to keep those jobs. “Every workplace has what’s called a ‘hidden curriculum,’ ” says Riddle — an implicit set of assumptions and expectations about how people behave and communicate that can be difficult for neurodivergent thinkers to navigate.

Oz and the Antivax Movement

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

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

David Corn at Mother Jones:

In February 2021, as the new vaccines that would tame the Covid pandemic were being released to the general public, an article sourced to an osteopath in Cape Coral, Florida, claimed that the vaccines were “a medical fraud” and did not counter the disease. The shots, it said, “alter your genetic coding, turning you into a viral protein factory that has no off-switch.”

The man pushing these false statements was Joseph Mercola, a pioneer of the anti-vaccination movement, who had a history of Covid denialism, having asserted that there was no pandemic and that Covid was a “scam.

...

Yet a few years earlier, Dr. Mehmet Oz, now the Republican candidate for US Senate in Pennsylvania, had validated Mercola and boosted his audience, helping this anti-vaxx crusader expand his ability to disseminate false and possibly dangerous information.

In 2009, after Oz had appeared on Oprah Winfrey’s talk show dozens of times, Winfrey set him up with a syndicated television show of his own on which he covered assorted health issues. It was a success. But four years later, in a lengthy profile of Oz, New Yorker reporter Michael Specter noted that Oz had “consistently” booked “guests with dubious authority” to challenge conventional medicine. That included Mercola, who had quit practicing as a doctor to run a highly profitable business selling alternative health products and dietary supplements.

...In 2014, Steven Salzberg, a professor of biomedical engineering and computer science at Johns Hopkins University and a columnist for Forbes, penned a similar critique of Oz’s promotion of Mercola:

Why has Dr. Oz repeatedly had Joe Mercola on his show? This is a tough one. Does Oz believe that autism is caused by vaccines, something Mercola has claimed repeatedly over the years? Does he understand that Mercola’s anti-vaccination campaign leads to genuine harm? Does he know that the FDA has repeatedly issued warnings to Mercola to demand that he stop making false claims about his vitamins and supplements, as Chicago Magazine reported?

Or does Dr. Oz keep inviting Mercola back because he knows Mercola has a big audience that will increase his own viewership?

In 2016, Julia Belluz reported on Trump's appearance on Oz's show:

Oz — a cardiothoracic surgeon — isn’t known for being a tough interviewer, particularly when it comes to vaccine deniers. In the past, he’s been criticized for lending his giant platform to anti-vaxxers, including the alternative medicine doctor Joe Mercola and Robert F. Kennedy. (Oz has already said he won't ask Trump things that he wouldn't want to answer.)

 

Florida Surgeon General and Vaccine Misinformation

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.

David Gorski at Science-Based Medicine:

We here at Science-Based Medicine (SBM) have been combatting antivaccine misinformation and disinformation for nearly 15 years. In our early days—and even our not-so-early days—such pseudoscientific misinformation was disseminated primarily by antivax quacks and the people who believed them. Think Andrew Wakefield, Robert “Dr. Bob” Sears, Paul Thomas, Sherri Tenpenny, Kelly Brogan, and the like, as well as propagandists like Del Bigtree, Mike Adams, and Robert F. Kennedy, Jr. Unsurprisingly, when the COVID-19 pandemic hit, it didn’t take long for these antivax propagandists to pivot first to COVID-19 minimization and then, when COVID-19 vaccines were introduced, to repurposing old antivax tropes to spread fear, uncertainty, and doubt (FUD) about the new COVID vaccines. They were also soon joined by a new generation of antivax physicians and propagandists, as evidenced by the rise of the hydroxychloroquine-promoting America’s Frontline Doctors in 2020 during the first summer of the pandemic. Among that group of disinformation-peddling (now grifting) physicians was a man named Dr. Joseph Ladapo.

Unfortunately for the people of Florida—and, to a somewhat lesser extent, the people of the US in general—about a year ago Dr. Lapado and his rejection of public health interventions such as masking and vaccines caught the eye of Florida’s COVID-19 minimizing and antivax Governor Ron DeSantis, who appointed him as Florida’s Surgeon General, the official in charge of the Florida Department of Health, in essence the entire medical and public health bureaucracy of the state. Unsurprisingly, Dr. Ladapo immediately started doing Gov. DeSantis’ bidding with respect to the pandemic—it is, after all, what he was hired to do—and promoting the message of “rejecting fear” as a public health strategy, while implementing the Great Barrington Declaration-like policies preferred by Gov. DeSantis that basically stopped trying to slow or mitigate the spread of COVID-19 and let children be infected in schools, even hosting a widely publicized “Urgency of Normal” roundtable with Gov. DeSantis and outright antivaxxers like Dr. Robert “inventor of mRNA vaccines” Malone, to promote “don’t worry, be happy” COVID-19 minimizing and denying policies.

Vax Misinformation and Vax Uptake

 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.

Daniel Romer and colleagues have an article at Vaccine titled "Misinformation about vaccine safety and uptake of COVID-19 vaccines among adults and 5–11-year-olds in the United States." Abstract:

Despite increasing rates of vaccination for COVID-19 in the US, hesitancy continues to be a barrier to the full immunization of the eligible population. Hesitancy appears to be particularly pronounced among adults deciding whether to recommend that children be vaccinated against COVID-19. In this research, we tested whether embrace of misinformation about the safety of vaccination is associated with hesitancy to vaccinate oneself and to recommend vaccination of a 5–11-year-old child for COVID-19. In a national probability panel created in April 2021, we assessed belief in both general vaccination misinformation and misinformation about COVID-19 vaccines, in particular. As hypothesized, belief in general vaccination misinformation predicted the uptake in reported vaccination among adults through September 2021, and likelihood to recommend COVID-19 vaccination of children aged 5–11 in January 2022, three months after the approval of that vaccine. In addition, misinformation about COVID-19 vaccines that arose over time correlated highly with more general vaccination misinformation. For both outcomes, general vaccine misinformation predicted vaccination hesitancy beyond concerns about the health risks of contracting COVID-19 for one’s family and children ages 5–11. The findings indicate that continued efforts are needed to bolster beliefs about the safety of authorized and approved vaccines of many types and not just those for COVID-19. Some strategies to achieve this objective are suggested.

Acetaminophen Mass Tort Litigation

In The Politics of Autism, I discuss various ideas about what causes the condition. 

If you listen to Sirius XM, you may have heard radio ads about a class action lawsuit alleging that acetaminophen causes it.

But there is a very long and growing list of other correlates, risk factors, and possible causes that have been the subject of serious studies.

Brendan Pierson at Reuters:

A federal judicial panel has created a new mass tort litigation for claims accusing Costco Wholesale Corp, Walmart Inc and other major retailers of failing to warn that using acetaminophen, a popular pain and fever-reduction medication, during pregnancy can cause autism spectrum disorder and attention deficit hyperactivity disorder in children.

The Judicial Panel on Multidistrict Litigation in St. Louis on Wednesday consolidated 18 lawsuits for pretrial proceedings before U.S. District Judge Denise Cote in Manhattan. The panel sent an additional 48 cases to the newly created multidistrict litigation on Thursday, saying the same scientific and legal questions underlie all of the cases.

The lawsuits target retailers that sell the over-the-counter drug, also sold by Johnson & Johnson under the brand name Tylenol.

They also name CVS Pharmacy Inc, Rite Aid Corp, Safeway Inc, Target Corp and Walgreens Boots Alliance Inc as defendants, but not manufacturers of the drug.

Physician Reluctance to Treat People with Disabilities

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

Tara Lagu and colleagues have an article in Health Affairs titled "‘I Am Not The Doctor For You’: Physicians’ Attitudes About Caring For People With Disabilities."  The abstract:

People with disabilities face barriers when attempting to gain access to health care settings. Using qualitative analysis of three physician focus groups, we identified physical, communication, knowledge, structural, and attitudinal barriers to care for people with disabilities. Physicians reported feeling overwhelmed by the demands of practicing medicine in general and the requirements of the Americans with Disabilities Act of 1990 specifically; in particular, they felt that they were inadequately reimbursed for accommodations. Some physicians reported that because of these concerns, they attempted to discharge people with disabilities from their practices. Increasing health care access for people with disabilities will require increasing the accessibility of space and the availability of proper equipment, improving the education of clinicians about the care of people with disabilities, and removing structural barriers in the health care delivery system. Our findings also suggest that physicians’ bias and general reluctance to care for people with disabilities play a role in perpetuating the health care disparities they experience.

Study Suggest Antidepressants Do NOT Increase Chances of Autism

 In The Politics of Autism, I discuss various ideas about what causes the condition. 

There is a very long and growing list of other correlates, risk factors, and possible causes that have been the subject of serious studies.

Occasionally, a study finds that the correlation washes out then researchers take other variables into account.

Elizabeth A. Suarez and colleagues have an article at JAMA Internal Medicine titled "Association of Antidepressant Use During Pregnancy With Risk of Neurodevelopmental Disorders in Children

Question  Is antidepressant exposure during pregnancy associated with an increased risk of specific neurodevelopmental disorders in children?

Findings  In this cohort study including 145 702 antidepressant-exposed pregnancies, antidepressant exposure during pregnancy was not associated with autism spectrum disorder, attention-deficit/hyperactivity disorder, specific learning disorders, developmental speech/language disorders, developmental coordination disorders, intellectual disabilities, or behavioral disorders after accounting for confounding through various design and analytic approaches. Results were generally consistent across antidepressant medication classes, commonly used individual drugs, and gestational exposure windows.

Meaning  These findings suggest that antidepressant use in pregnancy does not increase the risk of neurodevelopmental disorders in children.

...

 In this study of 2 large cohorts of publicly and privately insured parent-child pairs, individuals using antidepressants during pregnancy had a higher risk of having a child with an NDD than individuals not using antidepressants. After adjustment for an extensive list of measured potential confounders, elevated crude HRs shifted substantially toward the null. Comparing with antidepressant discontinuers further shifted estimates to the null, and comparison with unexposed siblings resulted in null estimates for all outcomes. These results point to an increased risk of NDDs owing to factors associated with antidepressant use during pregnancy, but not the medication itself.

Evaluating Transition Research

Uncertainty is a major theme of The Politics of Autism.  In the concluding section, I write:

A key question in autism policy evaluation is simple to pose, hard to answer: How do autistic people benefit? How much better off are they as a result of government action? While there are studies of the short-term impact of various therapies, there is surprisingly little research about the long term, which is really what autistic people and their families care about. As we saw in chapter 4, few studies have focused on the educational attainment of autistic youths. For instance, we do not know much about what happens to them in high school, apart from the kinds of classes that they take. One study searched the autism literature from 1950 through 2011 and found just 13 rigorous peer reviewed studies evaluating psychosocial interventions for autistic adults. The effects of were largely positive, though the main finding of the review is that there is a need for further development and evaluation of treatments for adults.

Kristen Bottema-Beutel and colleagues have an article at Autism titled  "An evaluation of intervention research for transition-age autistic youth."  The lay abstract:

In this study, we assess the quality of intervention research that focuses on autistic youth who are 14–22 years old. We found 193 different studies on this topic, and carefully reviewed them. Most of these studies tested strategies that were behavioral. This means that they used procedures like prompting and rewards to change participants’ behavior. We found that the majority of studies had problems that make it hard to determine whether or not the intervention worked. The problems related to how researchers designed their studies, and how they measured the study outcomes. We also found that researchers rarely tried to find out if the strategies they studied had unintended negative effects for participants. Because of these issues, we make suggestions for how researchers might design better studies that will let people know how well the strategies worked.

Vaccine Polarization

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

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

A decade ago, there was significant vaccine resistance in liberal enclaves. California's wealthy Marin County was once an example of left-wing antivax sentiment.At NYT, Soumya Karlamangla reports that things have changed.

In the pandemic age, getting a Covid-19 shot has become the defining “vax” or “anti-vax” litmus test, and on that account, Marin County has embraced vaccines at rates that surpass the vast majority of communities in the nation. It comes after public health efforts to change parents’ opinions, as well as a strict state mandate that students get vaccinated for childhood diseases.

And as the nation has grown more polarized, Marin residents are less comfortable wearing the “anti-vax” label increasingly associated with conservatives. Americans who identify as Democrats are more than twice as likely to be vaccinated and boosted against Covid — and Marin County is one of the bluest enclaves in America.

...

Dr. [Matt] Willis left the C.D.C. and in 2013 took over as Marin County’s health officer, and he was intent on figuring out why relatively few parents were vaccinating their children.

He surveyed the parents of thousands of kindergartners to understand what their vaccine concerns were. On the list were autism, ingredients in vaccines and the speed at which babies are administered dozens of shots. A 1998 study that purported to connect the measles, mumps and rubella vaccine with autism was debunked and retracted — but only after propelling the anti-vaccine movement, particularly among parents skeptical of traditional medicine and pharmaceutical companies.

Dr. Willis began public health campaigns to specifically address those fears and primed local pediatricians to have those conversations too. His efforts got a boost when, in late 2014, a measles outbreak erupted at Disneyland, drawing greater attention to unvaccinated children. When cases spread to Marin County, its low vaccination rates became a glaring example in California.

...

The anti-vaccine movement used to be a place where the left met the right, but increased polarization during the pandemic has made such a combination difficult to sustain, said Jennifer Reich, sociology professor at the University of Colorado Denver and the author of “Calling the Shots: Why Parents Reject Vaccines.”

“When we start to see such vastly different sources of information about what the risks of infection of Covid are, you start to see people making wildly different decisions in their life,” Ms. Reich said. “The vaccine and scientific expertise has become politicized.”

Jacob Wallace, Paul Goldsmith-Pinkham & Jason L. Schwartz, "Excess Death Rates for Republicans and Democrats During the COVID-19 Pandemic," NBER Working Paper 30512 ttp://www.nber.org/papers/w30512

Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat- leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post- vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.

Traffic-Stop Practice in Connecticut

In The Politics of Autism, I discuss interactions between police and autistic people.  Sometimes they occur on the road.  A number of ASD people drive cars.

In New London, CT, Erica Moser at The Day:

First in a line of several cars in the Fitch High School parking lot on a rainy morning, a driver was in what would otherwise be an odd circumstance: He was waiting for a cop to pull him over.

But he and about a dozen others showed up Saturday specifically for that reason.

Southern Connecticut State University’s Center of Excellence on Autism Spectrum Disorders teamed up with police departments to hold mock traffic stops for autistic people.

“We know our individuals with autism benefit not just to see something happen but to actually practice, and of course traffic stops make us all nervous,” said Kari Sassu, director of strategic initiatives for the center. But on top of that, she noted that people on the spectrum may have sensory issues associated with lights or sirens, or fear having broken a rule.

Southern held this kind of event on campus last fall and this spring, but Saturday was the first time the center held it elsewhere in Connecticut.

After going through a mock stop and pulling over again to complete a brief survey, Derek Regenauer, 25, said he thought it went well, and that he came because he wanted to have a better understanding of what to do if he got pulled over. His mother, Kara Regenauer, said they had gone to one of the events at Southern but “repetition is good.”

Disability Employment Awareness Month

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

From President Biden:

During National Disability Employment Awareness Month, we celebrate the essential contributions to our workplaces, economy, and Nation made by disabled Americans and recommit to promoting equal opportunity for all people.

For far too long in this country, employers could refuse to hire you if you were disabled. Stores could turn you away. If you used a wheelchair, there was no real way to take a bus or train to work or school. America simply was not built for all Americans. In 1945, President Truman established National Disability Employment Awareness Month and issued the first national call for disabled people to access all the opportunities and rewards of work. Forty-five years later, in 1990, the Congress came together to pass the Americans with Disabilities Act (ADA), which helps to ensure our workforce is more productive, prosperous, and inclusive by banning disability discrimination, including in the workplace. Courageous activists of all backgrounds had fought for decades to lay the groundwork and change public consciousness, and I was proud to cosponsor this groundbreaking civil rights law. Since then, the ADA has not only transformed lives, but it has also inspired over 180 other countries to pass similar laws and brought us closer to realizing the full promise of our Nation.

Still, we have a long way to go. Studies have found that Americans with disabilities are especially productive and motivated workers — but they still have a harder time getting jobs, promotions, and fair pay. They are three times less likely than others to be employed and often earn sub-minimum wages for their work. That is wrong. We have an obligation to change that, and as the Nation’s largest employer, the Federal Government has a responsibility to set an example as a model workplace where everyone is valued and treated with respect. Last year, I issued an Executive Order putting diversity, equity, inclusion, and accessibility front and center across the entire Federal Government. To ensure our Federal workforce actually looks like America, the Executive Order directs agencies to find and remove barriers to hiring and promotion and to recruit more recent graduates with disabilities.

Meanwhile, my Administration’s Labor Department is protecting the rights of workers with disabilities in the private sector, cracking down on employers who discriminate, and ending the unfair use of sub-minimum wages. The Departments of Education, Labor, Health and Human Services, and the Social Security Administration, are helping State and local governments, employers, and nonprofits that hire people with disabilities to access funding for competitive integrated employment opportunities. My Administration’s Bipartisan Infrastructure Law is expanding access to transit, updating old train stations and airports so more people with disabilities can travel and work. We are working to ease the added threat the pandemic has posed to the disabled community and its support networks. Where long COVID has now risen to the level of a disability, we are helping people understand their rights and get the workplace accommodations they need.

This month, let us acknowledge workers with disabilities who make our communities, our economy, and our Nation stronger. Let us continue the legacy of generations of disability rights activists who have fought for equal employment opportunities, integrated workplaces, and equal pay for equal work. Let us deliver the promise of America to all Americans.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim October 2022 as National Disability Employment Awareness Month. I urge all Americans to embrace the talents and skills that workers with disabilities bring and to promote the right to equal employment opportunity for all.

IN WITNESS WHEREOF, I have hereunto set my hand this
thirtieth day of September, in the year of our Lord two thousand twenty-two, and of the Independence of the United States of America the two hundred and forty-seventh.