A C-Section Study and Media Coverage

In The Politics of Autism, I write:

If the science were not confusing enough, its coverage in the mass media has added another layer of murk. News reports hype tentative findings and weak correlations as “breakthroughs” in the quest for autism answers. When the research yields mixed results, the media headlines can be comically inconsistent. Consider how various publications covered a 2013 study on the impact of in vitro fertilization:

• RARE IN VITRO TECHNIQUE RAISES AUTISM RISK, STUDY SAYS
• IVF PROCEDURES DO NOT BOOST AUTISM RISK
• SOME FORMS OF IVF LINKED TO AUTISM, MENTAL DISABILITY
• IVF, AUTISM NOT LINKED, BUT STUDY FINDS RISK OF INTELLECTUAL DISABILIT

Recent headlines suggest very different interpretations of an article about cesarean sections. 

• Study: C-Section Tied to Higher Risk of Autism
C-Section Babies 33% More Likely to Develop Autism
• Possible Link between C-section and Autism, ADHD
• Cesarean Sections Probably Don't Cause Autism or ADHD: 'Correlation Doesn't Equal Causation'

Judge the article for yourself:

Tianyang Zhang and colleagues have an article at JAMA Network titled "Association of Cesarean Delivery With Risk of Neurodevelopmental and Psychiatric Disorders in the Offspring A Systematic Review and Meta-analysis."

This systematic review and meta-analysis explored the association of cesarean delivery with a wide range of neurodevelopmental and psychiatric outcomes. Compared with vaginal delivery, cesarean delivery was associated with increased risk of several neurodevelopmental and psychiatric disorders. The estimates for ASD (33% increased odds) and ADHD (17% increased odds) were statistically significant, but other disorders, such as learning disabilities, tic disorders, OCD, and eating disorders, presented with similar or higher odds, although these were not statistically significant, possibly because of the modest number of studies.
...

The mechanisms underlying the observed associations remain unknown and require empirical investigation to examine whether cesarean delivery plays a causal role in the development of neurodevelopmental and psychiatric disorders.

Correcting Vaccine Misinformation

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 annual meeting of the American Political Science Association, Kristin Kay Lunz Trujillo and colleagues have a paper titled "Identifying Strategies to Correct Misinformation about the MMR Vaccine."  The abstract:

Many Americans endorse misinformation about vaccine safety. This is problematic because those who do are more likely to resist evidence-based policies, such as mandatory vaccination for school attendance. Given that misinformation acceptance jeopardizes public health, many scholars have attempted to correct misinformation about vaccines. But, few have been successful. In this study, we explore several understudied psychological correlates of vaccine misinformation endorsement, and use this information to develop a novel misinformation correction strategy. Our simple, yet surprisingly under-utilized, approach posits that misinformation correction attempts are most likely to be successful when they recognize why people endorse vaccine misinformation. For example, people who are driven to accept vaccine misinformation because they see vaccines as a violation of moral sanctity, due to the disgust that injections induce, may be responsive to communication attempts that portray the consequences of under-vaccination (e.g., disease spread) as even more violating of moral purity. We put this strategy to the test in a large survey experiment of American adults (N = 7,019). First, we demonstrate that two under-studied psychological dispositions, moral purity and needle sensitivity, are strongly correlated with the endorsement of vaccine misinformation. Critically, we then show that interventions designed to appeal to people high in moral purity and needle sensitivity are effective at reducing misinformation. In addition to providing a better understanding of the psychological origins of misinformed vaccine attitudes, we suggest a novel science communication strategy for combating misinformation about vaccines, ultimately boosting support for evidence-based policy.

Uncertainty about causation is a major theme of the book. The paper reinforces the point by addressing the need for cognitive closure (NCC):

Finally, although the link has not been tested previously, there is reason to think that the belief that vaccines cause autism could be related to individual-level degree of NCC. NCC is the desire for an answer to an unanswered question, and an intolerance toward ambiguity and confusion (Webster and Kruglanski, 1994). For those high in NCC, the answer need not be specific - any answer is preferable to no answer. For phenomena that have a large degree of uncertainty involved, those higher in NCC will want to latch onto an explanation and strive to uphold this explanation, even if the veracity of that explanation has yet to be proven or has been questioned. Autism is one of these uncertain phenomena, as its exact causes are not fully understood (Ratajczak, 2011). Vaccines as the cause of autism presents a seemingly simple answer to a complex question. Consequently, people high in NCC may be more likely to adopt this misinformation, as it provides a clear and definite answer.

Prevalence Among African Americans and Hispanics

In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence. 

A release from the University of Colorado at Boulder:

Autism rates among racial minorities in the United States have increased by double digits in recent years, with black rates now exceeding those of whites in most states and Hispanic rates growing faster than any other group, according to new University of Colorado Boulder research.

The study, published this month in the Journal of Autism and Developmental Disorders, also found that prevalence of autism among white youth is ticking up again, after flattening in the mid-2000s.

While some of the increase is due to more awareness and greater detection of the disorder among minority populations, other environmental factors are likely at play, the authors conclude.

"We found that rates among blacks and Hispanics are not only catching up to those of whites—which have historically been higher—but surpassing them," said lead author Cynthia Nevison, an atmospheric research scientist with the Institute of Arctic and Alpine Research. "These results suggest that additional factors beyond just catch-up may be involved."

For the study, Nevison teamed up with co-author Walter Zahorodny, an autism researcher and associate professor of pediatrics at Rutgers New Jersey Medical School, to analyze the most recent data available from the Individuals with Disabilities Education Act (IDEA) and the Autism and Developmental Disabilities Monitoring (ADDM) Network.

IDEA tracks prevalence, including information on race, among 3-to-5-year-olds across all 50 states annually. ADDM tracks prevalence among 8-year-olds in 11 states every two years.

The new study found that between birth year 2007 and 2013, autism rates among Hispanics age 3-5 rose 73%, while rates among blacks that age rose 44% and rates among whites rose 25%.

In 30 states, prevalence among blacks was higher than among whites by 2012.

In states with "high prevalence," 1 in 79 whites, 1 in 68 blacks and 1 in 83 Hispanics born in 2013 have been diagnosed with autism by age 3-5.

Other states like Colorado fell in a "low-prevalence" category, but the authors cautioned that differences between states likely reflect differences in how well cases are reported by age 3-5. They also said the real prevalence is substantially higher, as many children are not diagnosed until later in life.

"There is no doubt that autism prevalence has increased significantly over the past 10 to 20 years, and based on what we have seen from this larger, more recent dataset it will continue to increase among all race and ethnicity groups in the coming years," said Zahorodny.

In 2018, the Centers for Disease Control reported that about 1 in 59 children of all races have been diagnosed with autism and that rates had risen 15 percent overall from the previous two year period, largely due to better outreach and diagnosis among historically underdiagnosed minority populations.

"Our data contradict the assertion that these increases are mainly due to better awareness among minority children," said Zahorodny. "If the minority rates are exceeding the white rates that implies some difference in risk factor, either greater exposure to something in the environment or another trigger."

Established risk factors associated with autism include advanced parental age, challenges to the immune system during pregnancy, genetic mutations, premature birth and being a twin or multiple.

The authors said that, based on current research, they cannot pinpoint what other environmental exposures might be factoring into the increases in autism. But they would like to see more research done in the field.

1,215

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.   Measles can kill.

From CDC:

From January 1 to August 22, 2019, 1,215** individual cases of measles have been confirmed in 30 states. This is an increase of 12 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.

• Measles can cause serious complications. As of August 22, 2019, 125 of the people who got measles this year were hospitalized, and 65 reported having complications, including pneumonia and encephalitis.
• The majority of cases are among people who were not vaccinated against measles.
• More than 75% of the cases this year are linked to outbreaks in New York and New York City. Measles is more likely to spread and cause outbreaks in U.S. communities where groups of people are unvaccinated.
• All measles cases this year have been caused by measles wild-type D8 or B3.

Moai Capital

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

A release from Moai Capital:

Brian Jacobs, co-founder of Emergence Capital, today announced the launch of Moai Capital, a $10 million seed capital fund focused on consumer, IoT, cloud and impact investing. Jacobs continues to serve as a general partner at Emergence, but is now focusing his investment activity on opportunities for Moai Capital.

Jacobs founded Moai Capital as a vehicle to invest his personal capital in startup companies outside of Emergence Capital’s focus.   "After focusing exclusively on SaaS and cloud investments at Emergence, I am enjoying the opportunity to expand into consumer and hardware again. Prior to Emergence, I invested in a variety of technology sectors, including consumer electronics, mobile services, semiconductors, and many others. My network of founders extends beyond the cloud," Jacobs said.  Recent Moai Capital investments include Kristalic, which is developing a “digital memory,” and AnimalBiome, a veterinary health company.
 
Moai Capital will allocate a portion of its capital to impact investing. Jacobs has a particular focus on autism employment.  "'Autism is a social disability that is reaching significant proportions around the world. Individuals with autism are challenged by a traditional interview-based hiring process. Companies are finding that workers on the autism spectrum are model employees with intense focus, strong dedication and very low turnover," Jacobs said.  Ultranauts, a quality engineering startup employing talent on the autism spectrum and an early Moai investment, just announced their Series A round led by SustainVC.

...

Moai Capital is named after the huge stone carvings on Easter Island. Jacobs, who studies stone carving and ancient stone structures, argues that most entrepreneurs face immovable obstacles that test their willpower and determination. The moai are a testament to the force of human will and, when completed, become the source of mana, a supernatural power to overcome adversity. All of the technologies that we take for granted today evolved from ancient engineers and others since then who started with nothing but their vision and determination to change the world around them.

Jacobs is incubating Moai Capital at Emergence Capital, with plans to establish a separate office for Moai Capital in San Mateo, California within the next few months.

Autism Fitness Programs

In The Politics of Autism, I discuss the health problems of people on the spectrum.  Yesterday's post discussed the problem of obesity and physical inactivity.  Here are a couple of efforts to address the problem.

Kayla Burton reports at WGGB-TV:

The Holyoke Public School system hosting an autism fitness certification class this weekend meant to help people off all ages with the disorder.

While many autism programs address the cognitive side of autism, Founder, Eric Chessen, told Western Mass News the goal of this program is take on the physical health of those with the disorder.

"It's not just for highly motivated individuals who are below 12 years in age this is really for, everyone and what we're looking at is fitness as a gateway as optimal development to other areas," Chessen said.

The Autism Fitness Program was developed roughly 15 years ago.

FROM 2018: Dion Lim at KGO-TV in San Francisco:

Puzzle Piece Athletics is a first-of-its-kind gym in the Bay Area serving kids with autism. With hard work, determination, encouragement, and a special compassion lives are changed.

RELATED: New Bay Area gym specializes in CrossFit training for kids with autism

Join us as we introduce you to some of the wonderful people working out their muscles of happiness and hope.

For more information about Puzzle Piece Athletics, you can visit their Facebook and Instagram pages.

Obesity and Low Physical Activity are Problems for ASD Adolescents

In The Politics of Autism, I discuss the health problems of people on the spectrum.

Stephanie M McCoy and Kristen Morgan have an article at Autism titled "Obesity, Physical Activity, and Sedentary Behaviors in Adolescents with Autism Spectrum Disorder Compared with Typically Developing Peers." The abstract:

Decreased engagement in beneficial physical activity and increased levels of sedentary behavior and unhealthy weight are a continued public health concern in adolescents. Adolescents with autism spectrum disorder may be at an increased risk compared with their typically developing peers. Weekly physical activity, sedentary behavior, and body mass index classification were compared among adolescents with and without autism spectrum disorder. Analyses included 33,865 adolescents (autism spectrum disorder, n = 1036) from the 2016–2017 National Survey of Children’s Health (United States). After adjustment for covariates, adolescents with autism spectrum disorder were found to engage in less physical activity and were more likely to be overweight and obese compared with their typically developing peers (p’s < 0.05). As parent-reported autism spectrum disorder severity increased, the adjusted odds of being overweight and obese significantly increased and physical activity participation decreased (p-for-trends < 0.001). The findings suggest there is a need for targeted programs to decrease unhealthy weight status and support physical activity opportunities for adolescents with autism spectrum disorder across the severity spectrum.

Food selectivity and medication, the article suggests, may contribute to the problem.  People with ASD may have a hard time maintaining a healthy diet because of aversions to fruits and vegetables.  Medications such as reprisperidone and aripiprazole lead to weight gain. Physical activity is also a challenge:

Engaging in physical activity and team sports (e.g. football and soccer), requires a more advanced level of motor skills. However, it has been shown that both children and adolescents with ASD have deficits in motor skills ... Furthermore, team sports and physical activities become more competitive as children get older. The competitive atmosphere may be less conducive to adolescents with ASD compared with their typically developing peers (Nicholson, Kehle, Bray, & Heest, 2011). Another aspect of physical activity and sport that may contribute to decreased participation for adolescents with ASD is the social aspect. Fewer adolescents with ASD feel that sport and exercise are good ways to make friends (68% vs 97%, p<0 .001="" 2015="" adolescents="" al.="" blockquote="" comparison="" developing="" et="" in="" tanish="" typically="" with="">

FDA v. Bleach "Cure"

 In The Politics of Autism, I discuss autism quackery.  One particularly dangerous"cure" involves bleach.

From FDA:

If you’re drinking “Miracle” or “Master” Mineral Solution or other sodium chlorite products, stop now. The U.S. Food and Drug Administration (FDA) has received many reports that these products, sold online as “treatments,” have made consumers sick.

The FDA first warned consumers about the products in 2010. But they are still being promoted on social media and sold online by many independent distributors. The agency strongly urges consumers not to purchase or use these products.

The products are known by various names, including Miracle or Master Mineral Solution, Miracle Mineral Supplement, MMS, Chlorine Dioxide (CD) Protocol, and Water Purification Solution (WPS). When mixed according to package directions, they become a strong chemical that is used as bleach.

Some distributors are making false—and dangerous—claims that Miracle Mineral Supplement mixed with citric acid is an antimicrobial, antiviral, and antibacterial liquid that is a remedy for autism, cancer, HIV/AIDS, hepatitis, flu, and other conditions. But the FDA is not aware of any research showing that these products are safe or effective for treating any illness. Using these products may cause you to delay other treatments that have been shown to be safe and effective.

The bottom line: Sodium chlorite products are dangerous, and you and your family should not use them

Antivaxxer Shoves Dr. Pan

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.

Melody Gutierrez at LAT:

An anti-vaccine activist was cited on suspicion of assault by the Sacramento Police Department on Wednesday after he livestreamed a physical confrontation with state Sen. Richard Pan, author of legislation to restrict vaccine exemptions.

Pan, a Democrat from Sacramento, was pushed from behind by Kenneth Austin Bennett, who challenged the senator in the 2018 primary but did not qualify for the general election. Bennett filed a recall petition against Pan this year alleging the senator was committing treason by authoring bills to tighten vaccination requirements in the state.

A video Bennett posted to Facebook shows he confronted Pan near the state Capitol and was livestreaming when he struck him. Afterward, Bennett said on the video that “I probably shouldn’t have done that.” The Sacramento Police Department said Bennett was cited for assault and released. The Times was unable to reach Bennett for comment.

This incident is part of a broader pattern. Antivaxxers often engage in cyber-bullying. They make death threats. Dr. Pan has long been the target of such threats.

Family Leave and IEPs

In The Politics of Autism, I write about special education and laws that affect students with disabilities, such as the Individuals with Disabilities Education Act.  

Linda Jacobson at EducationDive:

• The U.S. Department of Labor (DOL) has issued an opinion letter stating parents and guardians are allowed to use the Family and Medical Leave Act (FMLA) intermittently to attend Individual Education Program (IEP) meetings with teachers, school administrators and others involved in planning education services for children with special needs.
• The letter was in response to a family’s complaint that the mother’s employer allowed her to use FLMA time for her two children’s medical appointments, but not for meetings at school. Cheryl M. Stanton, a DOL administrator, wrote that a child’s doctor does not have to be present at an IEP meeting for the parent to qualify for FMLA leave.
• IEP meetings, Stanton wrote, “help participants make medical decisions concerning your children’s medically prescribed speech, physical and occupational therapy; to discuss your children’s well-being and progress with the providers of such services, and to ensure that your children’s school environment is suitable to their medical, social and academic needs.”

1,203

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.   Measles can kill.

From CDC:

From January 1 to August 15, 2019, 1,203 individual cases of measles have been confirmed in 30 states. This is an increase of 21 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.

Kate Tillotson at WWMT Michigan:

The measles outbreak of 2019 is weighing on the minds of health care providers as college students return to campus this fall. They'll be welcomed by cramped dorm rooms and crowded classrooms, which can be breeding grounds for viruses. It's a concern because earlier in the year, between January and April, measles infected at least 700 people in 20 states in the U.S. 

"The real issue is that measles is highly contagious, it's one of the most contagious diseases that we deal with," said Dr. David Davenport, who provides internal medicine and infectious disease care at Ascension Borgess Hospital in Kalamazoo. "Crowded social events can create a nightmare situation," he said.

Davenport pointed to two examples of measles outbreaks in higher educational institutions last April. Hundreds of students, faculty, and staff at California State University-Los Angeles, and the University of California at Los Angeles, were quarantined due to possible measles exposure. Some were even instructed to stay home while the source of the infection was detected. The scare came during the nation's first measles outbreak since the disease was declared eliminated in 2000.

Attacks on Greta Thunberg

In The Politics of Autism, I write:  "Support from the general public will be an important political asset for autistic people. Another will be their sheer numbers, since a larger population of identified autistic adults will mean more autistic voters and activists"

But entering the public arena also means unfair criticism.

Lydia Wilkins at The Independent:

Like young people the world over, I was delighted to hear that Greta Thunberg, the youth climate activist, has set sail for New York on a zero-carbon boat. The 16-year-old is making her way across the Atlantic with plans to travel through the US, Canada and Mexico, culminating in an appearance at the annual UN climate changeconference in Chile in December.

And though I was shocked at the extent of the vitriol levelled at her as she started her voyage, I was not surprised to see her under attack.

From journalist Sarah Vine, who questioned whether Thunberg’s GQ cover appearance was “a bit….. weird?”, to multi-millionaire Aaron Banksmaking comments about "freak yachting accidents”, some of the responses to her latest campaigning are simply cruel.

Many have pointed out that she's facing a disproportionate amount of abuse because she's a young woman. That may be part of it, but there's a bigger issue – the fact that she is honest and open about her diagnosis of Asperger syndrome.

Scott Waldman at Scientific American:

But the success of Thunberg — who describes herself on Twitter as a "16 year old climate activist with Asperger" — remains a sore point for those who reject mainstream climate science and some who have helped shape or encourage the Trump's administration rollback of climate policy.

They frequently point to Thunberg's autism, claim she is used by her parents and compare her call to young people on climate change to "Hitler Youth." They have pointed to her "monotone voice" and framed her as a "millenarian weirdo" with the "look of apocalyptic dread in her eyes."

A recent opinion piece in The New York Times prompted an outcry among climate hawks and Thunberg's allies, who said the newspaper was validating these types of personal attacks on the teenage activist.

Experts say relying on ad hominem attacks has significant collateral damage in that they dissuade people with intellectual and developmental disabilities from speaking publicly. While the language of describing someone as a "puppet" or abused by adults may appear coded, it's clearly a dog whistle that signals her words should be discounted because her mind works differently, said Steve Silberman, author of "NeuroTribes: The Legacy of Autism and the Future of Neurodiversity."

"It's classic autism bashing," he said. "They feel at liberty to do it because autism has been framed as a pathology for decades, so they feel like they don't have to hold back, than just 'other' her, turn her into a freak when she's actually making more sense than 95% of the adults who have addressed this issue for the last 30 years."

Measles Can Kill

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.   Measles can kill.

 Kristen Fischer at Healthline:

Measles has taken the life of an international flight attendant five months after she first contracted the disease, prompting health officials to warn again that this seemingly childhood disease can be dangerous for adults.

 Rotem Amitai, 43, who died Tuesday, traveled from New York to Tel Aviv in March, according to The Times of Israel. A few days after landing in Israel, she developed a fever.

Authorities don’t know if the mother of three was infected on the flight or which country she was in when she contracted the disease.

Doctors said she had brain swelling (encephalitis), which is a complication of measles.
Amitai’s death has put a spotlight on the record-breaking measles outbreak in the United States and around the globeTrusted Source — as well as the dangers the virus can pose to adults.

Medical XPress:

The World Health Organization said Tuesday that measles cases had nearly tripled globally during the first seven months of the year compared to the same period in 2018.
The global body warned against "misinformation about vaccines".

The so-called anti-vax movement—driven by fraudulent claims linking the MMR vaccine against measles, mumps and rubella to a risk of autism in children—has gained traction.

So far this year, 364,808 measles cases have been reported around the world, compared to 129,239 cases during the first seven months a year earlier—the highest registered since 2006.

Amitai's death was the first related to measles in Israel this year, following two last year, according to the ministry.

The highly contagious disease can be entirely prevented through a two-dose vaccine.
Amitai had only received one dose, Israeli media reported.

Trump v. People with Disabilities

In The Politics of Autism, I discuss the issue's role in campaign politics.   In the 2016 campaign, a number of posts discussed Trump's bad record on disability issues more generally.   As his actions as president indicate, he has little use for Americans with disabilities.

From the Arc:

The Arc denounces the harmful rule that will be finalized by the U.S. Department of Homeland Security (DHS) on Wednesday, August 14. This new rule discriminates against people with intellectual and developmental disabilities (I/DD) and their families, among others. It allows the federal government to deny admission into the U.S. and unfairly restructures immigration in a way that is detrimental to individuals based on their disability and the use of vital programs like Medicaid.

The DHS final rule means the government will consider a significantly expanded list of factors to determine whether a person will be considered a “public charge.” A public charge is a person that the government thinks will (currently or in the future) be dependent on the government for support. The rule will hurt children and adults based on disabilities and chronic conditions. The use of many programs such as most Medicaid services, the Supplemental Nutrition Assistance Program (SNAP), housing assistance, and other important benefits will also be considered in the public charge test. DHS acknowledges that the new rule may have an outsized impact on people with disabilities.

“This new policy is devastating to many people with intellectual and developmental disabilities and their families. It discourages immigrant families from utilizing critical public services out of fear of harming their immigration status. The rule will increase poverty, hurt public health, and worsen housing instability. It’s the latest callous tactic in restricting access to necessary services and supports. The Arc continues our work to ensure that non-citizens with any type of disability have a fair opportunity to enter and reside legally in the U.S., without unnecessary or discriminatory restrictions based on their disability,” said Peter Berns, CEO, The Arc.

The Arc opposed the rule and submitted comments with the Consortium for Citizens with Disabilities when the rule was proposed in 2018.

For more information, see this short explainer.

Maegan Vasquez at CNN:

President Donald Trump said Thursday that the US should build more mental institutions to deal with mass shooters.

"We're going to be looking at that very closely and we're looking at the whole gun situation. I do want people to remember the words mental illness. These people are mentally ill and nobody talks about that, but these are mentally ill people. And people have to start thinking about it," Trump said ahead of his campaign rally in New Hampshire.

"I think we have to start building institutions again because you know, if you look at the '60s and the '70s, so many of these institutions were closed, and the people were just allowed to go onto the streets. And that was a terrible thing for our country. ... A lot of our conversation has to do with the fact that we have to open up institutions. We can't let these people be on the streets," he added.

Business Group Backs CA Screening Bill

In The Politics of Autism, I discuss evaluation and diagnosis of young children.  Screening is an important part of theprocess.

From the Valley Industry and Commerce Association:

Ahead of the legislative session reconvening on August 12, VICA urges legislators to support Assembly Bill 1004 (McCarty), which would require developmental screenings for children ages 0 to 3 years old to be provided as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit under Medi-Cal. The EPSDT benefit is designed to ensure that children from low-income families receive early detection and preventive care in addition to medically necessary treatment services, so that health problems are diagnosed and treated as early as possible. In California, only 36 percent of infants and toddlers in Medi-Cal receive developmental screenings despite EPSDT requirements. AB 1004 helps establish clear guidelines and oversight for developmental screenings for children ages 0 to 3 years old. Early identification and intervention can improve a child's long-term outcome.

Autistic Actors

In The Politics of Autism, I discuss depictions of ASD in popular culture.  

Jessica Blank and Wendy Lu at Huffington Post write about actor Mickey Rowe:

In 2017, he became the first autistic actor to play the role of Christopher Boone in “The Curious Incident of the Dog in the Night-Time” at the Indiana Repertory Theatre and Syracuse Stage productions. Now, he is the Co-Executive Director at National Disability Theatre and is an activist, speaking and performing at various events. Recently, he was the keynote speaker at the Arts for Autism Benefit Concert, held at the Gershwin Theater in New York City.

During job interviews or other interactions, Rowe said people often treat him like a child — a common microaggression that many disabled people experience. “It’s just hard because I’m not 14 years old,” Rowe said. “I’m a dad, and I have two kids. I need to pay the bills. I need to do all the things that an adult needs to do.”

These assumptions and other forms of ableism all contribute to the major lack of accurate representation of autism in Hollywood. Many popular films and shows that feature autistic characters, including “Rain Man,” “Atypical” and “The Good Doctor,” aren’t actually played by autistic people in real life. In fact, about 95% of all disabled characters on television are played by nondisabled actors, according to the Ruderman Foundation, a nonprofit that researches and advocates for full disability inclusion.

1,182

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.

From CDC: "From January 1 to August 8, 2019, 1,182** individual cases of measles have been confirmed in 30 states. This is an increase of 10 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."

Another Potential Correlate: Estrogen in the Womb

In The Politics of Autism, I discuss various ideas about what causes the condition. Here is just a partial list of correlates, risk factors, and possible causes that have been the subject of serious studies:

• Pesticides;
• Air pollution and proximity to freeways;
• Maternal thyroid issues;
• Autoimmune disorders;
• Induced labor;
• Preterm birth;
• Fever;  
• Birth by cesarean section;
• Anesthesia during cesarean sections;
• Maternal and paternal obesity;
• Maternal diabetes;
• Maternal and paternal age;
• Maternal post-traumatic stress disorder;
• Smoking during pregnancy;
• Antidepressant use during pregnancy;
• Polycystic ovary syndrome.
• Infant opioid withdrawal
• Zinc deficiency
• Processed foods
• Maternal occupational exposure to solvents

A release from the University of Cambridge:

Scientists have identified a link between exposure to high levels of oestrogen sex hormones in the womb and the likelihood of developing autism. The findings are published today in the journal Molecular Psychiatry.

The discovery adds further evidence to support the prenatal sex steroid theory of autism first proposed 20 years ago.

In 2015, a team of scientists at the University of Cambridge and the State Serum Institute in Denmark measured the levels of four prenatal steroid hormones, including two known as androgens, in the amniotic fluid in the womb and discovered that they were higher in male foetuses who later developed autism. These androgens are produced in higher quantities in male than in female foetuses on average, so might also explain why autism occurs more often in boys. They are also known to masculinise parts of the brain, and to have effects on the number of connections between brain cells.

Today, the same scientists have built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank, which has collected amniotic samples from over 100,000 pregnancies, but this time looking at another set of prenatal sex steroid hormones called oestrogens. This is an important next step because some of the hormones previously studied are directly converted into oestrogens.

All four oestrogens were significantly elevated, on average, in the 98 foetuses who later developed autism, compared to the 177 foetuses who did not. High levels of prenatal oestrogens were even more predictive of likelihood of autism than were high levels of prenatal androgens (such as testosterone). Contrary to popular belief that associates oestrogens with feminisation, prenatal oestrogens have effects on brain growth and also masculinise the brain in many mammals.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at the University of Cambridge, who led this study and who first proposed the prenatal sex steroid theory of autism, said: "This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well established as another, and these hormones likely interact with genetic factors to affect the developing foetal brain."