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Wednesday, July 31, 2019

English Learners

In The Politics of Autism, I discuss the relationships of autism, class, race, and ethnicity.

At New America, Janie Tankard Carnock and Elena Silva have a report titled "English Learners with Disabilities: Shining a Light on Dual-Identified Students."
Most notably, school systems over- and under-identify students based on the type of disability. For instance, the most common category for all students with IEPs is specific learning disability (SLD), which covers 34 percent of students who qualify for special education services. Speech/language impairment is second at 19 percent.SLD is defined under IDEA as “a disorder in one or more of the basic psychological processes involved in understanding or in using language that is spoken or written, that maymanifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations.” The category includes a range of “perceptual disabilities,” including dyslexia, dyscalculia, and dysgraphia.
National research indicates that the categories of SLD and hearing impairment have higher proportions of students also identified as ELs [English Learners], while other disability categories such as autism and emotional disability have lower proportions of students who are also identified as ELs. According to the U.S. Department of Education, "Among ELs with disabilities, nearly 50 percent had a specific learning disability, compared to nearly 38 percent of students with disabilities who are not ELs. Similarly, 21 percent of ELs with a disability, compared to 17 percent of non-ELs with a disability, were identified as having a speech or language impairment."
For dual-identified students, one of the biggest questions revolves around whether to integrate home language supports. Similar to debates in EL education, some educators fear that using the home language will confuse students and delay progress. However, in an academic review of over 60 studies spanning 30 years, no research supported this conclusion. Rather, compared to English-only approaches, researchers found that interventions that used both home language and English result in similar or even greater rates of growth in English abilities. In New York, leaders have acted aggressively in light of this research base, promoting bilingual education for all children—including ELs with disabilities—and launching the nation’s first dual language program for students with autism.
Janie Tankard Carnock, From Blueprint To Building: Lifting the Torch for Multilingual Students in New York State (Washington, DC: New America, November 2016); and Michael Vaughn, “Angelica Infante-Green on Creating the Nation’s First Dual Language Program for Children With Autism,” Education Post, January 11, 2017

Tuesday, July 30, 2019

VR and Police Interactions

In The Politics of Autism, I discuss interactions between police and autistic people.   Things can get out of hand 

Rita Giordano at the Philadelphia Inquirer:
Skylar [Armstrong, 17], who is on the autism spectrum, is learning how to interact with police officers through the use of virtual reality. The Children’s Hospital of Philadelphia’s Center for Autism Research (CAR) and the creator of Floreo, an immersive viewing/education system, are examining whether virtual reality can be an effective tool to teach people with autism how to respond to law enforcement officers they may encounter in the real world.

A 2016 Florida case that almost ended in tragedy was the inspiration for the Floreo system. In an incident that drew national outrage, a North Miami police officer fired three times at an autistic man holding a silver toy truck, which the officer said he mistook for a weapon. The shots missed the autistic man, but struck and wounded his caretaker, who was on the ground with his hands raised, shouting at the officer not to shoot.
...
Virtual reality training, researchers hope, can help people with autism learn to handle difficult encounters. A virtual encounter with an officer has the person with autism getting experience being questioned — What are you doing here? What is your name? — and give appropriate verbal responses. (Some programs go so far as to advise people with autism to come out and say it to an officer.)

“A virtual interaction is a really useful tool because people on the spectrum need more practice than other people, and police officers are not readily available to handle that,” said Joseph McCleery, a lead researcher with the study and executive director for academic programs in the Kinney Center for Autism Education and Support at St. Joseph’s University.

Monday, July 29, 2019

1,164

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  TwitterFacebook, and other social media platforms have helped spread this dangerous myth.

From CDC: "From January 1 to July 25, 2019, 1,164 individual cases of measles have been confirmed in 30 states. This is an increase of 16 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000."


Sunday, July 28, 2019

Antivaxxers

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.

At The Daily Beast, Jordan Julian writes about antivaxx celebrity Rob Schneider:
On Thursday he wrote on Twitter, “Dear @LorenaSGonzalez respectfully, either accept my offer to debate you on the merits of sb276 or refuse and kill this awful piece of Government OverReach and admit that the PEOPLE HAVE SPOKEN and want to KEEP MEDICAL DECISIONS MADE BY PARENTS NOT FACELESS BUREAUCRATS.”
Based on the comedian’s liberal use of Caps Lock, I can’t say I blame Gonzalez for not taking him up on his offer.
As it turns out, Schneider and Gonzalez have a years-long history of feuding. In response to Schneider’s pushback against her 2015 bill, Gonzalez tweeted a photo of herself on the phone with the caption, “I’m calling back @RobSchneider to discuss the FACTS around #measles #immunizations and our #CAleg bill.” This isn’t even the first time he has challenged her to a debate. As highlighted in a 2017 John Oliver segment, she once responded to the actor’s foolish request on Facebook, writing, “Let’s be honest…that is 20 minutes of my life I’ll never get back arguing that vaccines don’t cause autism with Deuce Bigalow, male gigolo.”
Schneider says that's he is not anti-vaxx.

Marianne Williamson says that she is not anti-vaxx.

Bonkers Florida  Congressman Bill Posey says that he is not anti-vaxx.

Jenny McCarthy says that she is not anti-vaxx.

RFK Jr. says that he is not anti-vaxx.

And even Trump says that he is not anti-vaxx.

In fact, most antivaxxers say that they aren't anti-vaxx.

Saturday, July 27, 2019

Home-Schooled and Unvaccinated in California

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  TwitterFacebook, and other social media platforms have helped spread this dangerous myth.

Soumya Karlamangla at LAT:
California is one of only three states that does not allow parents to opt out of vaccines due to their beliefs.
Public health advocates have lauded the law’s success. In the first year the law was in place, the state’s kindergarten vaccination rate shot up above 95% for the first time in a decade.
But the law’s implementation has also coincided with an increase in parents choosing to home-school their kids — and not vaccinating them.
In the school year that ended in June, there were 6,741 home-schooled kindergartners without their shots in California, compared with 1,880 in the 2016-17 school year, according to state data. Overall, 1.2% of the state’s kindergartners were home-schooled and unvaccinated in the last school year, according to state data. (The state health department collects vaccination data only on kindergartners and seventh graders.)

And then the antivaxxers went after the reporter:

Friday, July 26, 2019

"Health" Sites That Promote Antivaxx Myths and Conspiracy Theories


John Gregory at STAT:
According to analysis by my employer, NewsGuard, NaturalNews.com articles have declared the measles outbreak a “false flag” that originated with “infected migrants.” Similarly, Adams’ network has reported that an outbreak in New Hampshire was caused by the vaccine itself (a false claim based on state officials having mistakensomeone’s reaction to the vaccine as a confirmed measles case). And the network has been relying on an old “Brady Bunch” episode as evidence that a measles infection is “typically very mild, much like getting chickenpox,” overlooking the serious complications such as pneumonia and encephalitis that typically accompany the disease.
...
NewsGuard was co-founded last year by journalist and entrepreneur Steven Brill (known in part for his health care reporting) and former Wall Street Journal publisher Gordon Crovitz. In rating news and information sites in the U.S., Italy, U.K., France, and Germany, it has discovered a diverse spectrum of health sites. These range from green-rated peer-reviewed medical journals such as the New England Journal of Medicine to hundreds of red-rated conspiracy-minded sites such as NaturalNews.com and Collective-Evolution.com, where vaccine-autism stories can be found next to articles claiming the 9/11 terrorist attacks were staged.

Americans who search symptoms or diseases online may come across well-sourced health information on sites such as WebMD or Healthline. But also high up in search results and social shares are sites with names such as GreenMedInfo and Healthy Holistic Living, which present themselves as authoritative reference guides on health topics while relying on false claims and misrepresented sources to promote alternative medical treatments.

While both of those sites promote a disproven link between vaccines and autism, their deceptive practices go beyond questioning vaccine safety.

Thursday, July 25, 2019

Least Restrictive Environment

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

A July 18 release from COPAA:
Today, a diverse coalition of professional, legal and advocacy organizations met with Department of Education Chief of Staff Nate Bailey, Acting General Counsel Reed Rubenstein and OSERS Assistant Secretary Johnny Collett to discuss what we considered to be an imminent threat of a policy reinterpretation of the Least RestrictiveEnvironment (LRE) provisions, which is a cornerstone of the Individuals with Disabilities Education Act (IDEA). Our concern was generated by credible information that the Department of Education was planning to alter or reinterpret the law’s  presumption -- that all children with disabilities will be educated in the general education classroom; except in the rare circumstance that the student cannot get a satisfactory education in that environment even with supplementary aids and services. Any reinterpretation of LRE would alter or weaken IDEA’s clear requirement that general education must be the first consideration for placement for every student.
At today’s meeting, we were assured by Mr. Bailey that there would be no such reinterpretation of LRE in the immediate future, and that the Department of Education (Department) would uphold the law. However, they noted that nothing was off the table as part of the Department’s Rethink Framework. They provided assurances to us that they would collaborate with stakeholder groups and experts in the field, though we made it clear to them that we would oppose any and all reinterpretations of LRE – a basic tenet of IDEA - that could infringe upon the civil rights of children with disabilities.
The following is a statement that reflects the position of a broader coalition of stakeholders.
“Our coalition, which represents the diverse community of individuals and organizations  that care about, educate and protect the rights of children with disabilities, will vehemently oppose any effort put forward by the Department of Education that alters or re-interprets the law’s presumption. We are shocked that the Department even considered pursuing this course. However, with millions of children, families, teachers and school leaders behind us, we will work together to vigorously protect current law and fight any interpretation of LRE that alters or weakens IDEA’s clear requirement that schools and districts must consider general education first, for every child. We must protect IDEA’s presumption of general education because without it, we can expect to see increases in the inappropriate placement of children with disabilities in more segregated settings which contradicts the clear language, intent, and established legal precedent of the
IDEA.”

Read COPAA's Full LRE Letter to DeVos.

Read CCD LRE Principles.

Wednesday, July 24, 2019

House Passes Autism CARES Act

In The Politics of Autism, I write:
No government agency has exclusive jurisdiction over all of these areas. The federal government takes the lead with some, while states and localities may be the main arenas for others. At each level, different bureaucracies deal with different aspects of autism. Courts and private organizations also play important roles in autism policymaking. Each place on the autism policy map has its own jargon and rules, hence the “alphabet soup” that bedevils parents.

From Representative Mike Doyle (D-PA):
U.S. Representative Mike Doyle (D-PA) announced today that bipartisan legislation to reauthorize federal programs and activities that help individuals with autism spectrum disorder (ASD) and their families has been approved by the U.S. House of Representatives.
This bill, the Autism CARES Act of 2019 (H.R. 1058), is supported by a broad coalition of autism and disability advocate organizations, including Autism Speaks, the Autism Society of America, the Association of University Centers on Disabilities, and the American Academy of Pediatrics. A companion bill (S. 427) was introduced in the Senate by Sens. Bob Menendez (D-NJ) and Mike Enzi (R-WY).
...
The Autism CARES Act of 2019 would reauthorize the Autism CARES Act of 2014 (P.L. 113-157). It would authorize over $1 billion in funding for programs at the National Institutes of Health (NIH), Centers for Disease Control (CDC), and the Health Resources and Services Administration (HRSA) over five years. At CDC, the funding would go to developmental disability surveillance and research; at HRSA, the funding would cover education, early detection and intervention; at NIH, the funding would cover the expansion and coordination of autism-related activities.
Among other actions, the legislation: 
• Requires HHS to report to Congress on the progress of activities related to autism and other developmental disabilities, and the health and well-being of individuals on the autism spectrum.

• Directs NIH to conduct research targeted at improving outcomes and detection for persons with autism of all ages.

• Directs HRSA to prioritize grants for developmental-behavioral pediatricians in medically-underserved areas.

• Amends sections of the Public Health Service Act (PHSA) to reflect the need for research, surveillance, education, detection, and intervention for individuals with autism spectrum disorder of all ages, not just children.

Click here to see Congressman Doyle’s statement today in support of the Autism CARES Act.

Autism and Suspension Rates


The US Commission on Civil Rights has a report titled BEYOND SUSPENSIONS Examining School Discipline Policies and Connections to the School-to-Prison Pipeline for Students of Color with Disabilities
According to national data, the type or category of disability a student is identified with may be another contributing factor to the disparate discipline rates of students of color with disabilities.  For instance, studies have shown that black students with emotional disturbance have received less and lower quality care than their white peers. For the 2009–2010 school year and across all grade levels, Losen, et al. found that as the percentage of black students identified as having emotional disturbance increased, so did their suspension rates. Further, they found that for black students—regardless of disability status—in elementary school, a 1-point increase in black students’ being identified as having an emotional disturbance predicted a 2.3 percent increase in the suspension rate for all black students at the elementary school level. It is important to note that a similar association was found in the suspension rates for white students that year. Moreover, this association (for both black and white students) was also found when comparing specific learning disability (SLD) with suspension rates. These findings suggest that on a school-wide level, there may be potential bias against students with disabilities that is driving these disparities. However, unlike with emotional disturbance and SLD, researchers found a negative association with autism identification and suspension rates, as there was a decrease in the association between the risk for suspension and autism for both black and white students. This is significant because black students (regardless of gender) are more likely to be over-identified in the two disability categories that are related to a higher risk of suspension, and more likely to be under-identified for autism—the category that consistently predicts lower risks for suspension. Thus, it may be this combination of over- and under-identification that partially explains why black students with disabilities have higher suspension rates than their white student counterparts.

Tuesday, July 23, 2019

Ad Council Promotes Autism Screening

Though autism can be reliably diagnosed as early as age 18 months, most children aren’t diagnosed until between 4 and 5 years old—and studies indicate that age is even higher for low-income and minority children. The new bilingual awareness campaign featuring Julia, a four-year-old Sesame Street Muppet with autism, promotes early screening and diagnosis, which can open a world of possibilities for the estimated 1 in 59 children with autism.
The multimedia campaign, including new video public service announcements, grew out of a partnership between the Ad Council, Autism Speaks and Sesame Workshop. The campaign stars Julia and her Sesame Street friends and family, helping parents to learn the signs of autism and understand the importance of early screening and diagnosis, ultimately making a meaningful difference in the lives of children with autism.

Monday, July 22, 2019

1,148

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing disease to spread.


From CDC: "From January 1 to July 18, 2019, 1,148** individual cases of measles have been confirmed in 30 states. This is an increase of 25 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000."

Sunday, July 21, 2019

Hill Tactics

The Politics of Autism includes a discussion of major interest groups such as Autism Speaks and ASAN.  The groups often come into conflict over strategy, tactics, and goals.  ADAPT has used very aggressive tactics in support of the Disability Integration Act.

Parents Who Sue

In The Politics of Autism, I write about the experiences of different economicethnic and racial groups.   Inequality is a big part of the story. Affluent school districts have more resources than poor ones.  Educated professionals are better able to protect their children's interests than poor people who never went to college.
Attorneys have become major figures in the world of autism, because people often need legal counsel to get services from school districts and other government agencies. Soon after a diagnosis of autism, parents seek advice from those who have already been on the path. And soon they will hear, “Get a lawyer.”
The rights approach puts a great burden on parents to serve as advocates for their children.  Highly-educated, affluent parents are in a better position to do so than the poor and uneducated:  for one thing, their social networks are more likely to include lawyers and expert witnesses.  
When classes resume at Portland Public Schools this fall, three students with autism will receive more personal care than another 15 of their classmates with the same disorder.

One of those children will have a district-employed therapist dedicated to him full time, and will also have his personal therapist in the classroom for four hours a week.

Another roughly 15 students with autism who used to receive daily help from their personal therapists won't get the same care. Their therapists—paid for by their parents' insurance—may only observe from the back of the class for a maximum of two hours a week. Instead, they will receive help from therapists paid for by the district, who will split their time among the kids.

The difference? Three families had the money to sue the school district. The others didn't.

"Only the families who could spend tens of thousands of dollars on legal services were able to get their services restored," says Paul Terdal, a parent who sued the district in 2017 and eventually settled, obtaining extra care for his son.

The families who sued the district are among those who have insurance plans that cover "applied behavior analysis," a well-regarded form of autism therapy. But not all families have such health care.

Friday, July 19, 2019

HCBS: The Need to Hear from Autistic Adults

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

Lindsay Shea, Whitney Schott, Julia Bascom, Amy R. Pettit at Health Affairs:
The US spends more than $80 billion per year on Medicaid-funded home and community-based services (HCBS). This investment provides vital support to adults with disabilities, who typically do not have access to these resources through private insurance. Over the next several years, states will be mandated to implement new federal requirements that will, for the first time, establish a federal minimum standard for HCBS and modernize and shape delivery of these services for years to come. As part of this process, the Centers for Medicare and Medicaid Services (CMS) called for states to offer meaningful and repeated opportunities for stakeholders to provide input into their transition plan and processes. Autistic adults make up a growing portion of these stakeholders, as a result of an increase in autism spectrum disorder (ASD) diagnoses and an aging population of autistic people diagnosed in childhood who will need services through adolescence and adulthood. Autistic voices and perspectives will be critical to shape a service system that can effectively meet their needs, but it remains unclear whether states’ public comment periods and feedback processes have included effective mechanisms for this group to be heard.

Thursday, July 18, 2019

Mostly Genetic


Key Points
Question  What are the etiological origins of autism spectrum disorder?
Findings  In a large population-based multinational cohort study including more than 2 million individuals, 22 156 of whom were diagnosed with ASD, the heritability of autism spectrum disorder was estimated to be approximately 80%, with possible modest differences in the sources of autism spectrum disorder risk replicated across countries.
Meaning  The variation in the occurrence of autism spectrum disorder in the population is mostly owing to inherited genetic influences, with no support for contribution from maternal effects.
Abstract
Importance  The origins and development of autism spectrum disorder (ASD) remain unresolved. No individual-level study has provided estimates of additive genetic, maternal, and environmental effects in ASD across several countries.
Objective  To estimate the additive genetic, maternal, and environmental effects in ASD.
Design, Setting, and Participants  Population-based, multinational cohort study including full birth cohorts of children from Denmark, Finland, Sweden, Israel, and Western Australia born between January 1, 1998, and December 31, 2011, and followed up to age 16 years. Data were analyzed from September 23, 2016 through February 4, 2018.
Main Outcomes and Measures  Across 5 countries, models were fitted to estimate variance components describing the total variance in risk for ASD occurrence owing to additive genetics, maternal, and shared and nonshared environmental effects.
Results  The analytic sample included 2 001 631 individuals, of whom 1 027 546 (51.3%) were male. Among the entire sample, 22 156 were diagnosed with ASD. The median (95% CI) ASD heritability was 80.8% (73.2%-85.5%) for country-specific point estimates, ranging from 50.9% (25.1%-75.6%) (Finland) to 86.8% (69.8%-100.0%) (Israel). For the Nordic countries combined, heritability estimates ranged from 81.2% (73.9%-85.3%) to 82.7% (79.1%-86.0%). Maternal effect was estimated to range from 0.4% to 1.6%. Estimates of genetic, maternal, and environmental effects for autistic disorder were similar with ASD.
Conclusions and Relevance  Based on population data from 5 countries, the heritability of ASD was estimated to be approximately 80%, indicating that the variation in ASD occurrence in the population is mostly owing to inherited genetic influences, with no support for contribution from maternal effects. The results suggest possible modest differences in the sources of ASD risk between countries.

Wednesday, July 17, 2019

Disability Voter Turnout

In The Politics of Autism, I discuss the political participation of people with autism and other disabilities.

Lisa Schur and Douglas Kruse of Rutgers: Fact sheet: Disability and Voter Turnout in the 2018 Elections
Key points:
  • Voter turnout surged by 8.5 points in 2018 among citizens with disabilities relative to the 2014 midterm elections. The surge, though, was slightly larger among citizens without disabilities (11.9 points), resulting in a 4.7 point gap in voter turnout between citizens with and without disabilities in 2018.
  • The increased turnout among people with disabilities occurred across all disability types and demographic categories—gender, race/ethnicity, age group, and region.
  • 14.3 million citizens with disabilities reported voting in the November 2018 elections.
  • Employed people with disabilities were just as likely as employed people without
  • disabilities to vote, suggesting that employment helps bring people with disabilities into mainstream political life.
  • If people with disabilities voted at the same rate as people without disabilities who have the same demographic characteristics, there would be about 2.35 million more voters. 
These figures are based on analysis of data from the federal government’s Current
Population Survey Voting Supplement for November 2018, which has a sample size of 88,749. The computations were made using six disability questions introduced on the Current Population Survey in 2008.

Tuesday, July 16, 2019

Bullying of Students with Disabilities

In The Politics of Autism, I discuss challenges facing autistic adults and children One is bullying.

The National Center on Education Statistics has a new report on bullying.

Among students who reported being bullied: Perceived relationship of bullying to

Race .........................9.5%
Religion ..................  4.5
Ethnic origin .............7.3
Disability ............7.3
Gender ......................7.5
Sexual orientation ... 3.6
Appearance ...........   29.7

Monday, July 15, 2019

1,123

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing disease to spread.

From CDC: "From January 1 to July 11, 2019, 1,123** individual cases of measles have been confirmed in 28 states. This is an increase of 14 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000."

From WHO: "20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines such as measles, diphtheria and tetanus in 2018, according to new data from WHO and UNICEF. Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86 percent. While high, this is not sufficient. 95 percent coverage is needed – globally, across countries, and communities - to protect against outbreaks of vaccine-preventable diseases."

Sunday, July 14, 2019

Transformational Advocacy Project

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

Sarah Wood in Diverse Issues in Higher Education:
MERISTEM is a day and residential program in Sacramento that helps young adults with Autism and other developmental difficulties transition into independent living and employment. The program has 50 students from the ages of 18 to 28.
After California Assembly Bill 2840 was signed by the governor, funding an Autism employment pilot program, 12 MERISTEM students were invited to become part of a leadership lab. The group was eventually named Transformational Advocacy Project (TAP), and members interview employers and individuals with ASD to gather data for their manual and trainings.
TAP also partnered with the California Workforce Development Board, the Sacramento Employment and Training Agency and the California Workforce Association to help with the process and meets weekly with peer collaborators from Los Angeles County.
...
 TAP established two pilot programs in Sacramento and Los Angeles to test ideas for the employer manual and training sessions. Eventually, the manual will consist of visual supports, presentation materials, webinar series and video series.
In contrast to other manuals, TAP’s will be written from the voice of an autistic individual.

Saturday, July 13, 2019

Antivaxxers Fail to Block NY Law

In The Politics of Autism, I look at the discredited notion that vaccines cause autism. Twitter, Facebook, and other social media platforms have helped spread this dangerous myth.

Jon Campbell at LoHud:
A state judge on Friday declined to block New York's new law removing the religious exemption for required vaccinations, pointing to previous court decisions that seem to uphold the state's right to mandate certain vaccines to attend public school.
In his ruling, Supreme Court Justice L. Michael Mackey in Albany denied a request for a temporary restraining order by the plaintiffs, a series of families being represented by vaccine critic Robert F. Kennedy Jr. and fellow attorney Michael Sussman of Rockland County.
The order would have blocked the state from implementing the law, which Gov. Andrew Cuomo and lawmakers approved last month, as the lawsuit continues through the courts.
"Plaintiffs have not shown a likelihood of success on the merits sufficient to sustain their heavy burden at this stage of the newly-filed action," Mackey wrote Friday.

Friday, July 12, 2019

Autism, Vaccines, Measles, and Distrust of Government

In The Politics of Autism, I look at the discredited notion that vaccines cause autism. Twitter, Facebook, and other social media platforms have helped spread this dangerous myth.


At The Atlantic, Peter Beinart writes that distrust of vaccines has grown in tandem with distrust of government.
.In 2002, Representative Dan Burton, who in the 1990s had repeatedly implied that the Clintons were involved in the death of Deputy White House Counsel Vince Foster, invited the disgraced doctor to testify before his committee. Burton—whose grandson has autism—went on to hold at least 20 hearings, suggesting that government scientists were covering up a link between vaccines and autism.
Burton was a harbinger. After a Republican presidential debate in 2011, one of the candidates, Michele Bachmann, claimed that the HPV vaccine, which protects against cervical cancer, causes mental retardation. While running for president in 2015, Senator Rand Paul—a physician—argued against mandatory vaccinations by asserting that there are “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.” And from 2012 to 2014, while Donald Trump was claiming that President Barack Obama hadn’t been born in the United States, he also tweeted more than 30 times about the supposed dangers of vaccines.

Yet it’s not only conservatives who translate their suspicion of government into suspicion of vaccines. Many liberals distrust the large drug companies that both produce vaccines and help fund the Food and Drug Administration, which is supposed to regulate them. The former Green Party presidential candidate Jill Stein has suggested that “widespread distrust” of what she describes as the medical-industrial complex is understandable because “regulatory agencies are routinely packed with corporate lobbyists and CEOs.” The environmental activist Robert F. Kennedy Jr. claims that thimerosal, a preservative formerly used in some vaccines, harms children. Bright-blue counties in Northern California, Washington State, and Oregon have some of the lowest vaccination rates in the country.
Although polls suggest that conservatives are slightly less accepting of vaccines than liberals are, a 2014 study found that distrust of government was correlated with distrust of vaccines among both Republicans and Democrats. Indeed, the best predictor of someone’s view of vaccines is not their political ideology, but their trust in government and their openness to conspiracy theories.

Thursday, July 11, 2019

Death and Measles

In The Politics of Autism, I look at the discredited notion that vaccines cause autism. Twitter, Facebook, and other social media platforms have helped spread this dangerous myth.

Catherine Montantes was a 28-year-old college student, training to become a border patrol agent, and recently diagnosed with an autoimmune disorder.

When she stepped into the Lower Elwha tribal health clinic in Port Angeles, Washington, she had no idea she arrived just an hour after a 52-year-old infected with measles. The virus is one of the most contagious and can live on infected surfaces for up to two hours.

Despite being vaccinated against measles, Montantes was killed less than three months later by the disease, because her immune system was suppressed by medication to control the autoimmune disorder dermatomyositis.

Her death, on 15 April 2015, became the last recorded death from measles in the United States. At the time, no one had perished from measles in 12 years. Now, as a record-setting measles outbreak spreads in 28 states, with the majority of cases in New York, her death shows how preventable diseases can devastate families far outside the communities which choose to delay or decline vaccines.

Monday, July 8, 2019

1109

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  TwitterFacebook, and other social media platforms have helped spread this dangerous myth.

From CDC: "From January 1 to July 3, 2019, 1,109 individual cases of measles have been confirmed in 28 states. This is an increase of 14 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000."

At CNN, Jacqueline Howard quotes Dr. Peter Hotez:

"Measles historically is seasonal. We know it peaks in the spring and then declines in the summer. So there is a seasonality to the virus, just like there's a seasonality to influenza," Hotez said, adding that another factor is that children are currently out of school.
"A couple of questions that I'm looking at is: One, what happens when kids come back to school in the fall? Because although measles cases have declined, they haven't disappeared," he said. "I am concerned that we're going to see the uptick again as we move into the fall months -- and then the other question: What happens in 2020? Will we see a big jump in the spring of 2020? In other words, is this peak in the spring of 2019 just the beginning of frequent peaks?"

Generosity of Insurance Mandates

The Politics of Autism includes an extensive discussion of insurance and explains the limits of insurance mandates:
There are no exact figures available, but suppose that we take the total number of autistic people and subtract the following:
Those in states without mandates;
Those who live in states with mandates but are under exempt, self-funded plans;
Those with individual and small group policies to which post-2011 mandates do not apply, and
Those who have already gone over the various limits and caps.
The remainder surely makes up a minority of the autistic population.  
At PLOS ONE, Timothy Callaghan and Steven Sylvester have an article titled "Autism Spectrum Disorder, Politics, and the Generosity of Insurance Mandates in the United States."  The abstract:
The study of Autism Spectrum Disorder (ASD) in the United States has identified a growing prevalence of the disorder across the country, a high economic burden for necessary treatment, and important gaps in insurance for individuals with autism. Confronting these facts, states have moved quickly in recent years to introduce mandates that insurers provide coverage for autism care. This study analyzes these autism insurance mandates and demonstrates that while states have moved swiftly to introduce them, the generosity of the benefits they mandate insurers provide varies dramatically across states. Furthermore, our research finds that controlling for policy need, interest group activity, economic circumstances, the insurance environment, and other factors, the passage of these mandates and differences in their generosity are driven by the ideology of state residents and politicians–with more generous benefits in states with more liberal citizens and increased Democratic control of state government. We conclude by discussing the implications of these findings for the study of health policy, politics, and autism in America.
From the article:
Even as forty-six states took action from 2001–2017 to enact an insurance mandate, the scope of these benefits varies dramatically. A select number of states have mandated generous benefits, but we show that this is far from the norm. Instead, most states limit benefits by either restricting eligibility to individuals under a certain age or by capping the amount that insurance companies must spend to pay for needed behavioral treatments. Thus, our findings suggest that even as states have moved quickly to reform their policies, the number of individuals who are eligible for generous benefits varies dramatically.