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.

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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.

Alex Jones Is An Antivaxxer

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

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

 AJ McDougall at The Daily Beast:

Jones went so far as to take potshots at the families from afar, calling them “pawns” in an episode of his Infowars show that aired Tuesday, according to Media Matters for America. He claimed that Heslin was autistic, saying he thought the father was acting “like somebody on the spectrum.”

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 Someone in the courtroom—it was unclear from the video feed—then brought up Jones’ claim that Heslin was autistic. “Hey, I think I’m autistic too, buddy,” Jones called at the plaintiffs as they filed out of the courtroom.

Five years ago, Julia Belluz wrote at Vox:

Jones has said Oprah Winfrey is trying to reduce the African population by half, that Sesame Street’s new autistic Muppet was designed to normalize an increasingly common disease that’s caused by vaccines, and that the Atlantic and other lefty periodicals are hinting at an imminent decapitation of President Trump.

In this world, Andrew Wakefield, the discredited doctor who falsified data to suggest vaccines are linked to autism, is a “pioneer” and “trailblazer” who just wants to help keep people healthy

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Maloney Takes Hits for Her Antivax Past

In The Politics of Autism, I discuss the discredited theory that vaccines cause autism. 

In the past, Rep. Carolyn Maloney embraced that notion, though she later changed her position.

Alex Maroño Porto at West Side Rag:

The generational strife at the heart of the Democratic primary race for New York’s 12th district congressional seat (which includes the Upper West Side) resonated throughout Tuesday night’s candidate debate.

On the one hand, Democratic Reps. Carolyn Maloney and Jerry Nadler, both elected to Congress in 1992 and reelected every two years since, tried to defend their records and praise the benefits of congressional seniority. On the other hand, challenger Suraj Patel, a 38-year-old with no previous legislative experience, called for a renewal of leadership.

“It’s 2022. It’s time to turn the page on 1992,” Patel said in his opening statement, echoing the issue he’s made the heart of his campaign.

During the 90-minute debate, each of the three Democratic candidates tried to convince voters in the newly-created district, the first in more than fifty years to combine Manhattan’s Upper West and the Upper East sides, to support their platform in the August 23 primary. Issues ranged from how to deal with rising inflation, to bail reform, to the efficacy of vaccines.

As he has throughout the campaign, Patel depicted Maloney as “committedly anti-vaxxer,” citing her co-sponsorship of a 2015 Republican-led bill to study the risk of autism between the vaccinated and the unvaccinated population.

“I support vaccines,” Maloney shot back when challenged again by Patel. “I support the science behind vaccines,” Maloney said, citing a variety of actions she said she had taken to promote vaccines.

Worldwide 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.

Dr. Peter Hotez in Nature:

Many countries now face declining immunization rates as a result of anti-vaccine activism1. In the case of the USA, an anti-vaccine movement that began with false assertions linking vaccines to autism accelerated roughly a decade ago in Texas (where I live and work) around a libertarian framework known as health freedom2. At present, many conservative elected leaders in the US House of Representatives actively promote this health freedom anti-vaccine agenda, as do several US senators, sitting governors and federal judges3. Far-right extremist groups such as the Proud Boys march at anti-vaccine rallies.

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US anti-vaccine activism under the banner of health freedom (also referred to as medical freedom) has produced tragic and even deadly consequences. The loss of life has been massive. Since 1 May 2021, when President Biden’s administration announced that COVID-19 vaccines would become widely and freely available, at least 200,000 unvaccinated Americans have lost their lives potentially needlessly because they refused to have a COVID immunization. Analyses from Charles Gaba and organizations such as the Kaiser Family Foundation and the New York Times have shown that those COVID-19 deaths or low vaccination rates occurred overwhelmingly along a partisan divide and in Republican-majority states, with the highest death rates among US counties that voted heavily for the 2020 re-election of President Trump. A new phrase known as ‘red COVID’ has been invoked to report on this strong partisan divide in vaccine acceptance.

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Antivax Movement Morphs

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

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

 Sheera Frenkel at NYT:

Nearly half of Americans oppose masking and a similar share is against vaccine mandates for schoolchildren, polls show. But what is obscured in those numbers is the intensity with which some parents have embraced these views. While they once described themselves as Republicans or Democrats, they now identify as independents who plan to vote based solely on vaccine policies.

Their transformation injects an unpredictable element into November’s midterm elections. Fueled by a sense of righteousness after Covid vaccine and mask mandates ended, many of these parents have become increasingly dogmatic, convinced that unless they act, new mandates will be passed after the midterms.

To back up their beliefs, some have organized rallies and disrupted local school board meetings. Others are raising money for anti-mask and anti-vaccine candidates like J.D. Vance, the Republican nominee for Senate in Ohio; Reinette Senum, an independent running for governor in California; and Rob Astorino, a Republican gubernatorial candidate in New York.

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Renée DiResta, a research manager at the Stanford Internet Observatory who has studied anti-vaccine activism, said the movement had indoctrinated parents into feeling “like they are part of their community, and that community supports specific candidates or policies.”

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Activists posted statistics about Covid vaccines in those Facebook groups. Often that information came from the Vaccine Adverse Event Reporting System, a database maintained by the C.D.C. and the Food and Drug Administration, which allows anyone to submit data. The C.D.C. has warned that the database “cannot prove that a vaccine caused a problem.”

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Another post titled “If you want to really know what is going on, read this” linked to an article that falsely claimed vaccines could leave children sterile. The article was originally posted to a Facebook group named Children’s Health Defense, which supports an organization founded and chaired by the anti-vaccine activist Robert F. Kennedy Jr.

That tipped some parents into repudiating every vaccine, from chickenpox to hepatitis, and against vaccine mandates of any kind. A right to self-determination so that parents could decide what vaccines their children took was paramount.

Unanticipated Consequences: Insurance, Private Equity, and ABA

The Politics of Autism includes an extensive discussion of autism service providers.  Since the book's publication, a big change has consisted of a massive increase in private equity investments.

The law of unanticipated consequences is at work.

Erica Fry at Fortune:.

[State-mandated nsurance coverage] has revolutionized access to autism services in America, making early intervention affordable for families. The shift, reflected in a recent CDC-led analysis, is striking: Per-child spending by employer-sponsored health insurance plans on young children with ASD increased 51% between 2011 and 2017 (over the same period, spending increased just 8% for kids with no ASD diagnosis). Annual per-child spending on intensive behavioral therapy, i.e. ABA, increased 376% in that period, from $1,746 per child to $8,317 per child; for 14.4% of kids with ASD, spending on that therapy in 2017 exceeded $20,000.bers suggest, insurance reform turned ABA into a big business. The mandates unleashed a gold rush, with large investors working to consolidate the fragmented provider landscape and build up regional platform companies specializing in the expensive, time-consuming therapy. “It’s like vultures now,” says Michi Medley, an Oklahoma-based family advocate and autism professional. “All these companies are coming in, and there’s so many of them, families don’t know who’s who.”

Between 2012 and 2021, the Braff Group, a health care M&A Advisory firm, identified 223 deals done in this sector. Nearly 90% of transactions over the past five years have involved private equity, according to the firm’s proprietary analysis; what Braff calls the most “frenzied” period, from 2017 to 2019, was characterized by PE firms buying up ABA providers at 10 to 15 times their annual profits: Big names like Blackstone, KKR, TPG, and Cerberus have all made investments in the space. One of the Braff Group publications compared investor enthusiasm for autism services to that of “fan boys to the latest Star Wars release.”

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Lorri Unumb, the parent advocate who now serves as CEO of the Council of Autism Service Providers (CASP), remembers being dumbfounded when an industry investor boasted that his company hired a supervising therapist for every 40-50 patients (10-15 is the industry standard). Having been so involved in the advocacy that created the industry’s funding stream, Unumb now feels responsible to ensure quality in the industry. “These kids don’t get a do over,” she says. “You can’t just put a shoddy program out there and waste these children’s most important window to change the trajectory of their lives.”

Another urgent question is whether the autism-therapy workforce is trained and equipped to deliver effective care. The ABA industry heavily relies on two categories of workers: Board Certified Behavior Analysts (BCBAs)—the graduate level professionals who design and oversee a child’s ABA program—and Registered Behavior Technicians (RBTs), the industry workhorses who implement the therapy and work with autistic children many hours a day. RBTs, who are sometimes called ABA therapists, get 40 hours of training for the job, and are supposed to be supervised for 5% of their hours.

In general, the workforce is very young and inexperienced. As of July 2022, there were 57,000 BCBAs in the country, up from 20,000 in 2015, along with 120,000 RBTs, all of whom have been certified since 2014 when a professional certification program was created.

The varied readiness and competence of this workforce worries Erick Dubuque, director of the Autism Commission on Quality, a non-profit accreditation body for organizations offering ABA services. “We have a real serious issue with our training programs,” he told me, explaining that many programs get away with offering the “bare minimum,” despite the vulnerability of the population workers will be serving, because of high demand in the field. In a 2020 study, Dubuque and colleagues identified more than 20,000 additional providers that claim a BCBA credential but don’t actually have one. Individuals who work in the field and spoke with Fortune shared concerns about feeling ill-equipped for the job, which sometimes involves managing difficult situations where they might be kicked, hit, or bitten by a combative child. Others commented on a lack of professionalism among their colleagues, sharing stories in which therapists made fun of their clients’ autistic behaviors.

 

Dingell and Fitzpatrick Co-Chair Bipartisan Disabilities Caucus

In The Politics of Autism, I discuss the congressional role in the issue.

A July 26 release from Rep. Debbie Dingell (D-MI):

Today, founder and co-chair of the Bipartisan Disabilities Caucus (BDC), Rep. Jim Langevin (D-RI-02), named Rep. Debbie Dingell (D-MI-12) a new co-chair of the BDC, alongside Brian Fitzpatrick (R-PA-01). The announcement comes on the 32nd anniversary of the Americans with Disabilities Act.

Rep. Langevin, the first quadriplegic ever elected to Congress, founded the Caucus in 2001 shortly after being elected to the House of Representatives. For over 20 years, the Bipartisan Disabilities Caucus has served as a space to inform, educate, and raise awareness in Congress on the many issues that affect people with disabilities. Boasting more than 50 members, the Caucus has helped Congressmen and women on both sides of the aisle find common ground in pursuit of moving the needle on disability issues.

“It is an honor to be named a co-chair of the Bipartisan Disabilities Caucus, and I thank my friend and colleague Rep. Langevin for the opportunity to continue to build on his efforts to promote equality and remove barriers for Americans with disabilities. Rep. Langevin has made monumental progress advancing disability rights and bringing attention to these issues with graciousness and candor, and his leadership in Congress will be missed,” said Rep. Dingell. “Living with my husband who experienced mobility problems later in his life gave me a better understanding of just how far we still must go to ensure Americans with disabilities have access to the same experiences and opportunities as everyone else. I look forward to working with the Caucus to advance policies that promote equity and address barriers to inclusion in years ahead.”

“22 years ago, I founded the Bipartisan Disabilities Caucus to raise awareness among members of Congress in both parties about the challenges facing Americans with disabilities. Since then, our caucus has brought Republicans and Democrats together to deliver countless wins for the disability community,” said Rep. Jim Langevin, founder of the Bipartisan Disabilities Caucus. “As my tenure in Congress begins to wind down, I am so proud to welcome Representatives Debbie Dingell and Brian Fitzpatrick as my two, new co-chairs of the Bipartisan Disabilities Caucus. I know that they share my fierce commitment to creating a society that is fully inclusive and accessible for all Americans, and I am confident that the Caucus will be in strong, capable hands after I am no longer in Congress.”

“I am honored to be the new co-chair of the Bipartisan Disabilities Caucus and I look forward to working across the aisle to help the 61 million Americans living with a disability,” said Rep. Fitzpatrick. “During my time in Congress, I have been committed and will remain committed to ensuring those living with a disability have the access and coverage they not only need but deserve. As we celebrate the 32nd Anniversary of the ADA, we must recognize that there is more we can do to address the challenges that our disabled community is facing.”

“A sincere thanks to all the advocates and the members of Congress, including Speaker Pelosi and Leader Hoyer, and members of the Disability Caucus, led by Congressman Langevin. Jim, thank you for your 22 years of service in Congress. And I know Reps. Debbie Dingell and Brian Fitzpatrick will follow your tremendous leadership in the Caucus,” President Joseph R. Biden Jr. said in his pre-recorded remarks. “We know there’s more that needs to be done, and I’m committed getting more done with you… Together, let’s keep fulfilling ADA’s promise: building a nation that truly is for all of us.”

“It was my privilege to join the Bipartisan Disabilities Caucus to celebrate the 32nd anniversary of the Americans with Disabilities Act – a transformative legislative achievement and a pillar of civil rights,” Speaker Nancy Pelosi said. “Guided by Rep. Jim Langevin, the Congress’s support for the disability community has remained bipartisan and steadfast. Twelve years ago today, Rep. Langevin made history presiding over the House, making clear that every American deserves an equal voice in our society. Now, as he prepares for his next chapter, the Congress will proudly carry on his fight for justice – drawing strength from the leadership of Rep. Debbie Dingell and Rep. Brian Fitzpatrick, two devoted advocates for America’s disability community.”

“Without the ADA, I would not be in Congress. Today is a day to celebrate the tremendous progress that we’ve made for Americans with disabilities, while also recognizing how much further we have to go until all people with disabilities can enjoy fulfilling, independent lives,” Langevin continued. “Although this will be my last ADA anniversary celebration as a member of Congress, you can count on me to continue fighting for the disability community until my last day in office, and beyond. I want to thank President Biden, Speaker Pelosi, Leader Hoyer, Senator Casey, Representatives Dingell and Fitzpatrick, Undersecretary of Transportation Monje, and Jim Brett and for joining me tonight in commemoration of such a special day.”

Reps. Langevin, Dingell, and Fitzpatrick were joined for a celebration of the 32nd anniversary of the Americans with Disabilities Act by Majority Leader Steny Hoyer, Senator Bob Casey, White House Domestic Policy Council Disability Policy Director, Day Al-Mohamed, former Senator Tom Harkin, and Vice-Chair of the National Council on Disability, Jim Brett.

Autism and Inequality: International Perspectives

In The Politics of Autism, I discuss international perspectives.

Rosa A. Hoekstra has an editorial at Autism titled "Serving the underserved: How can we reach autism families who systemically miss out on support?"

Key factors that may make a family vulnerable and at risk of missing out on support include poverty, limited access to education, poor literacy, being subject to structural racism and other forms of discrimination and stigma. Families caring for a child with autism are more likely to be affected by poverty because the child’s needs may prevent the caregiver from generating an income (Minhas et al., 2015; Tilahun et al., 2016). In countries where (mental) healthcare is paid for out-of-pocket, seeking help may result in catastrophic payments, meaning that the costs comprise a very high portion of household income (de Leeuw et al., 2020; Gona et al., 2016). Families from lower-income households report poorer access to care (Bishop-Fitzpatrick & Kind, 2017) and poorer quality (Magaña et al., 2015) of care for their child with autism. Even when children are diagnosed and families are offered intervention, barriers linked to poverty (e.g. transportation costs) may prevent them from attending the intervention (Koerting et al., 2013) or having the time and capacity to actively engage with the intervention (Szlamka et al., 2021; Tekola, Girma, et al., 2020).

Low literacy is common in low-income countries but also affects vulnerable groups in high-income countries. Caregiver-reported screening instruments developed and tested in primarily highly educated families may not work as well in groups with limited literacy (Khowaja et al., 2015). Similarly, interventions developed and tested with highly educated caregivers may require adaptation when applied to families with low literacy and limited prior education.

Families with a cultural minority status in the country of residence may be less likely to access services and report lower satisfaction when accessing such services (Magaña et al., 2015). This is likely due to systemic factors. For example, clinicians may be less likely to recognise autism in ethnic minority children than in children from the cultural majority (Begeer et al., 2009) and in some contexts autism identification rates in ethnic or racial minority children (Begeer et al., 2009; Maenner et al., 2021) or children from Indigenous backgrounds (Bailey & Arciuli, 2020) lag behind identification in White children. Access barriers linked to racism may also be intertwined with language diversity. Latino parents living in the United States with low English language proficiency reported receiving poorer primary healthcare services than those with good English language proficiency (Pippins et al., 2007).

Stigma towards autistic people and their families occurs globally and across different cultures (de Leeuw et al., 2020; Han et al., 2022). In low-resource contexts where awareness of autism is low, stigma may be particularly strong (Tekola, Kinfe, et al., 2020). Stigma may affect how families interpret the signs and symptoms of their child, when and where they seek help (de Leeuw et al., 2020) and how they engage with intervention services (Guler et al., 2018; Koerting et al., 2013).

Early Intervention

 In The Politics of Autism, I discuss evaluation, diagnosis, and early intervention.

A release from Rutgers:

Despite a federal mandate requiring access to early intervention programs (EIP) for children with disabilities, fewer than half of autistic children in four New Jersey counties received services before 36 months of age, according to a Rutgers study.

Income and race-based disparities were significant obstacles to accessing EIP support, researchers found.

“For infants and toddlers on the autism spectrum, early intervention is important for improved later-life outcomes,” said Josephine Shenouda,an adjunct professor at the Rutgers School of Public Health and lead author of the study published in JAMA Pediatrics. “We wanted to understand the level of early intervention participation among children with autism.”

In the U.S., access to EIP for young children is mandated by law as part of the Individuals with Disabilities Education Act. However, the extent to which children with autism participate in early intervention programs had not previously been measured.

Shenouda and her colleagues analyzed data collected between 2006 and 2016 by the New Jersey Autism Study, an autism spectrum disorder (ASD) monitoring system developed and maintained by researchers at Rutgers New Jersey Medical School.

By analyzing the medical and special education records of 23,441 children in Essex, Hudson, Ocean and Union counties, the researchers identified 4,050 8-year-olds with autism spectrum disorder. Fewer than half (1,887; 47 percent) had received EIP services.

The researchers linked cases to data representing different indicators of wealth, including median household income, and found that ASD children residing in affluent areas were 80 percent more likely to receive EIP services than children residing in disadvantaged areas. Black and Hispanic children also were less likely to participate in EIP.

While the study was conducted in New Jersey metropolitan areas, Shenouda said the findings have important implications nationwide.

“New Jersey is known as an epicenter of autism, but it also has many resources for autism detection and treatment,” she said. “If only half of the children with autism in our study area are getting early interventions, chances are the disparities are even more pronounced in other communities and regions with fewer services.”

Shenouda said there may be multiple reasons why children from disadvantaged and minority areas aren’t enrolled in EIP, such as lower rates of ASD screening or less likely follow-through with recommendations. In either case, focused outreach can help increase EIP referrals and participation.

Shenouda added: “With autism prevalence estimates approaching 7 percent in some areas, we need universal autism screening between 18 and 36 months and enhanced support for the early intervention system. These actions will reduce economic and race-based disparities in autism identification and care.”

Bad Security at Antivax Dating Site

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

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

At The Daily Dot,  Mikael Thalen reports that an anti-vaccine dating website tleft its users’ personal data exposed online.

The site, Unjected, launched in May 2021 and claims to be the “largest unvaccinated platform” on the internet. Unjected initially made headlines in August after its app was removed from the Apple App Store for violating the company’s policies regarding COVID-19.

Similar in design to Twitter and often referred to as the “Tinder for anti-vaxxers,” Unjected has remained under the radar ever since, quietly adding new features for its small userbase. The site now offers what it describes as “mRNA FREE blood match & fertility directories” where unvaccinated users can donate blood, sperm, or eggs to one another.

While some of the ads for blood appear legitimate, others, such as one offering up unvaccinated semen, appear to have been made in jest. The site’s fertility section allows users the option to offer up their eggs, breastmilk, or semen. Users can also offer to be a surrogate.

Yet, according to the programmer and security researcher known online as GeopJr, the site’s administrator dashboard was openly accessible to anyone. The dashboard allows Unjected’s administrators to add, edit, or deactivate pages, such as the website’s “About Us” section, as well as users’ accounts.

Rick Scott: Abolish the Department of Education, Gut IDEA

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

The Individuals with Disabilities Education Act is not a civil rights law, although parents frequently assume that it is. Rather, it "condition of aid" law:  it sets certain requirements for receiving federal money.  If Congress abolished federal aid, it would effectively gut IDEA.

At the Center for American Progress, Will Ragland analyzes a policy agenda by Sen. Rick Scott (R-FL):

Scott’s plan includes shuttering the U.S. Department of Education, eliminating the $75 billion in federal education funding it administers, and sunsetting civil rights laws it enforces.

To be clear, efforts such as Sen. Scott’s are an attempt to rob low-income students and students with disabilities, to whom most of these investments are targeted. To make matters worse, many of these students are trying to make up for massive learning gaps two years into a global pandemic.

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Doing away with these federal education resources would defund several critical programs, including the Individuals with Disabilities Education Act (IDEA). IDEA mandates that students with disabilities receive a free and appropriate public education. Indeed, before 1975, children with disabilities were regularly turned away from public schools. Eliminating this law’s funding or the mandates would needlessly harm these children and undo decades of progress.

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Lost protections against discrimination for students with disabilities: 7.3 million children and students with disabilities, larger than the total population of Arizona, would lose $14 billion used every year to ensure that they receive a quality education.

In a 2019 Pew survey, 72 percent wanted to INCREASE federal spending on education while only 9 percent wanted to cut it.

 

Special Ed Staffing Shortages

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

Cortney O'Brien at Fox News Digital:

Staffing shortages are a major factor in the struggle to support students with special needs, special education experts told Fox News Digital.

The federal Individuals with Disabilities Education Act (IDEA), enacted in 1975, guarantees students with disabilities access to fully licensed special educators. Addie Angelov, co-founder and CEO of the Paramount Health Data Project, said that while the "spirit and intent" of the law was commendable, reality has painted a different picture.

All states except New Hampshire and New Mexico expect shortages in special education teachers for the 2021-2022 school year, according to a spokesperson from the U.S. Department of Education. While COVID-19 can account for some staffing setbacks, Angelov said the field of special education suffered from shortages long before the virus.

"There’s so much paperwork involved," she told Fox News Digital. "There’s so much of an administrative burden."

She was one of multiple experts who identified the high rate of regulations as a key factor in dissuading people from entering the field.

"It continues to be one of the most litigious federal laws on the books," said Phyllis Wolfram, who works for the Council of Administrators of Special Education (CASE), which coordinates and implements special education programs for students under the IDEA. "It also is so highly regulated that the standards and requirements that teachers have to meet from state to state really vary. And it’s up into the hundreds."

There are some states where they’ve counted the standard requirements for that process of special education is over 1,000, Wolfram told Fox News Digital.

"That equates to 1,000 points of paperwork for teachers that they’re dotting their I’s and crossing their T’s, and it’s hard to teach and do all of the paperwork," she said.

Angelov and Wolfram cited a less-than-enticing salary as another factor keeping individuals from the field.

Polio

 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.    Examples include measles, COVID, flu ... and polio.

 Dustin Jones at NPR:

Health officials in New York have discovered a case of polio in an adult — the first case in the country since 2013.

The good news is most people have nothing to worry about. "Unless you're unvaccinated," according to retired family physician and polio survivor Marny Eulberg.

The New York State Department of Health said the unvaccinated individual from Rockland County likely contracted the virus from someone outside of the country who had taken an oral polio vaccine, which hasn't been authorized for use in the U.S. since 2000.

Back in October, Aaron Blake reported at WP:

The new YouGov poll shows that fewer than half of Republicans — 46 percent — now say parents should be required to vaccinate their children against infectious diseases.

That’s both far shy of where Democrats are at — 85 percent — and also far shy of where Republicans used to be. Used to be, as in last year.

YouGov has polled this question repeatedly over the years, and up until recently Republicans were in a pretty similar place to Democrats. Back in 2015, both 81 percent of Democrats and 67 percent of Republicans believed such vaccines should be mandated for children.

And that split held pretty constant, through 2020 — until the coronavirus vaccines.

Jane Zuckerman at Ohio Capital Journal:

State politicians advanced an effort Tuesday to place anti-vaccination language onto a general election ballot, which would leave the fate of vaccine mandates in Ohio in voters’ hands.

If passed, Ohio would become the only state in the nation with an explicit ban of vaccine mandates in its constitution. It would mark a major step backward for public health, dampen an already sluggish COVID-19 vaccination effort in Ohio, and nix a practice of mandating vaccination that traces back through early American history.

The Ohio Ballot Board — a bipartisan panel controlled by Republicans — allowed organizers of the “Medical Right to Refuse” amendment to begin gathering the 443,000 voters’ signatures required to place the referendum on a ballot. Organizers said they’re hoping to put the issue to voters in May 2023.

• The proposal covers all vaccines, not just COVID-19. It contains two basic elements:“An individual’s right to refuse any medical procedure, treatment, injection, vaccine, prophylactic, pharmaceutical, or medical device shall be absolute.”
• “No law, rule, regulation, person, employer, entity, or healthcare provider shall require, mandate or coerce any person to receive or use a medical procedure, treatment, injection, vaccine, prophylactic, pharmaceutical, or medical device nor shall the aforementioned discriminate against the individual who exercises this right.”