Trump Despises People with Disabilities

In The Politics of Autism, I discuss the issue's role in presidential campaigns. In this campaign, a number of posts have discussed Trump's support for the lie that vaccines cause autism. He also has a bad record on disability issues more generally.  He told his nephew Fred that severely disabled people -- such as Fred's son -- should "just die."

He has also used the r-word, and Lordy, there are tapes.

Maegan Vazquez and Sabrina Rodriguez a WP:

Republican presidential nominee Donald Trump criticized Vice President Kamala Harris’s mental capacity Saturday, falsely claiming she was born “mentally impaired” and comparing her actions to that of “a mentally disabled person.” The remarks prompted criticism from advocates for people with disabilities.

Disparaging Harris’s actions on border security as vice president, Trump told the crowd in Prairie du Chien, Wis., “Kamala is mentally impaired. If a Republican did what she did, that Republican would be impeached and removed from office, and rightfully so, for high crimes and misdemeanors.”

He later suggested Harris “was born that way,” prompting cheers in the crowd.

“Joe Biden became mentally impaired. Kamala was born that way. She was born that way. And if you think about it, only a mentally disabled person could have allowed this to happen to our country,” he said, elaborating on a claim backed by no evidence. He called Harris “a very dumb person,” and repeatedly mispronounced her first name, an action some supporters see as demeaning and racist.

Biden’s faltering debate performance prompted criticism about his mental acuity and his eventual decision to drop out.

The comments, which were part of what Trump acknowledged was “a dark speech,” drew swift criticism. Maria Town, CEO and president of the American Association of People with Disabilities, said in a statement to The Washington Post that Trump’s comments “say far more about him and his inaccurate, hateful biases against disabled people than it does about Vice President Harris, or any person with a disability.”

“Trump holds the ableist, false belief that if a person has a disability, they are less human and less worthy of dignity,” she added. “These perceptions are incorrect, and are harmful to people with disabilities.”

New California Laws

In The Politics of Autism, I discuss services for people with disabilities.

A release from the Governor of California:

Governor Gavin Newsom signed a package of legislation today to make California more accessible and inclusive to all people with disabilities and strengthen California’s nation-leading commitment to support people with intellectual and developmental disabilities so they can live and thrive in their communities.

“When we say ‘California for ALL,’ we mean every single person in this state should be able to thrive – and that includes those with physical, intellectual, and developmental disabilities. I’m proud to continue our historic actions to protect vulnerable students, improve statewide supports, and strengthen future opportunities for the disabled community.”

Governor Gavin Newsom

Bigger picture

The bills signed by the Governor build on six years of actions to make the California dream more accessible to people with disabilities. Scores of investments and reforms will improve dyslexia detections, support special education services, and increase access to higher education, housing options, health care affordability, home care and community day services, public safety practices, civil rights protections, and more.

A priority of the Newsom administration has been supporting the 400,000 Californians with intellectual and developmental disabilities, such as Down Syndrome and autism. A Master Plan for Developmental Services was announced in January to engage the public in modernizing the system for better outcomes for all; public meetings continue in October and a framework will be released in March 2025. This week, the first Comprehensive Dashboard on people served and services provided was unveiled by the Department of Developmental Services. On January 1, 2025, rates paid to service providers will increase and the first quality incentive program will begin. This is the culmination of nearly $2 billion invested in provider rates by the Newsom administration and Legislature since 2022 in response to a landmark rate reform study in 2019.

What the new laws do

Create Historic Transparency, Accountability, and Equity in Support Services for People with Intellectual and Developmental Disabilities: The State’s regional centers that provide support services to people with intellectual and developmental disabilities will now be subject to the Public Records Act. This change will increase public transparency, accountability for outcomes, and equity of services in all communities. California’s service system is funded with approximately $15 billion annually to support 400,000 people with Down Syndrome, autism, and other developmental disabilities in their homes, schools, jobs, and communities.

The state will also begin to review and update biannually the provider rate reform study, beginning in 2025. The updated rate model will be posted on the Department of Developmental Services (DDS) website.

Max Benson’s Law to Protect Vulnerable Students’ Safety and Rights: Prone restraint is a technique that physically or mechanically restrains students in a face down position — one of the most dangerous forms of emergency interventions, which has resulted in severe injuries and even fatalities among students. This new law protects students by prohibiting its use in ALL California schools.

Jumpstarts Career Pathways for All: Students with disabilities who have an Individualized Education Program (IEP) will start planning for their post-secondary goals no later than age 16, and possibly as early as they begin high school– up to two years earlier than current law. One in 8 California students have an IEP and will have greater access to higher education and to work opportunities with planning that begins as early in the high school career as deemed appropriate by the student’s IEP team.

Additional legislation signed today to support the disability community and a more inclusive California for All:

SB 445 by Senator Anthony Portantino (D-Glendale) – Special education: standardized individualized education program template: translation.

SB 483 by Senator Dave Cortese (D-Campbell) – Pupil rights: prone restraint.

SB 939 by Senator Tom Umberg (D-Santa Ana) – Educational equity: school site and community resources: neurodivergent pupils.

SB 1001 by Senator Nancy Skinner (D-Oakland) – Death penalty: intellectually disabled persons.

SB 1197 by Senator Marie Alvarado-Gil (R-Modesto) – In-home respite services for families caring for children with an intellectual or developmental disability, including foster families.

AB 438 by Assemblymember Blanca Rubio (D-West Covina) – Pupils with exceptional needs: individualized education programs: postsecondary goals and transition services.

AB 1147 by Assemblymember Dawn Addis (D-San Luis Obispo) – Disability Equity, Transparency, and Accountability Act of 2024.

AB 1938 by Assemblymember James Gallagher (R-Chico) – Special education: inclusion and universal design for learning.

AB 2423 by Assemblymember Devon Mathis (R-Visalia) – Developmental services: rates.

AB 2821 by Assemblymember Tim Grayson (D-Concord) – Postsecondary education: students with disabilities.

More on Robert Roberson

 In The Politics of Autism, I discuss interactions between the justice system and autistic people.

An autistic Texan is on death row.

Alyxaundria Sanford at The Innocence Project:

When Robert Roberson brought his unresponsive daughter to the hospital, medical staff became suspicious of his flat affect and interpreted his response to his daughter’s condition as lacking emotion. Former Detective Brian Wharton, who later led the investigation of the child’s death, testified that Mr. Roberson seemed “not right” because he did not display the expected emotional reactions, like anger or sadness, like a “typical” parent.

In fact, Mr. Roberson’s lack of visible emotion, or his “flat affect,” is a typical trait of autism. During the 2003 trial for the death of his chronically ill two year old daughter, Nikki, his affect, along with other autism-related behaviors he displayed during the course of the investigation, was used to paint him as cold and remorseless. In fact, he was a loving, dedicated father who simply could not express emotion as neurotypical, or non-autistic, people do. It was not until 2018 — well after he was wrongly convicted — that Mr. Roberson was evaluated and officially diagnosed with autism spectrum disorder (ASD).

To date, Mr. Roberson has spent more than 20 years on death row. Convicted on the basis of a now discredited shaken baby syndrome hypothesis, he faces execution in Texas on Oct. 17, for a crime that never occurred. His case illustrates how the criminal legal system’s failure to understand autistic behavior can contribute to devastating, life-threatening consequences.

“Robert’s disability directly contributed to his wrongful conviction when investigators assumed his flat demeanor during pronounced stress (a manifestation of his Autism) was a sign of culpability,” Mr. Roberson’s attorneys wrote in their Sept. 17 clemency petition.

Drowning and Autistic Children

The Politics of Autism discusses the dangers facing autistic people, including wandering and drowning.

Jyesha Johnson at KRIV-TV in Houston:

Over the span of just a few months, recent drownings involving autistic children in the Houston area have shed light on the alarming reality that these children are at significantly greater risk of drowning.

According to the Autism Society, drowning is the leading cause of death among children with autism, with 91% of fatalities occurring in those aged 14 years or younger. Children with autism are 160 times more likely to drown than their neurotypical peers, underscoring the critical need for vigilance and safety measures.

Four tragic incidents reported between June and September underscore the urgent need for awareness and preventive measures.

Offit on RFK Jr.

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.

A number of posts discussed Trump's support for the discredited notion.

 Another leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.  He is part of the "Disinformation Dozen."

He recently ran for president as an independent and has now endorsed Trump.  If Trump wins, RFK could get a major job in the administration.

On CNN, vaccine expert Dr. Paul Offit raised alarms about RFK and Project 2025.

https://t.co/dTwstculPT

The lurking danger of RFK Jr.

— Paul Offit (@DrPaulOffit) September 25, 2024

Autism and COVID

In The Politics of Autism, I discuss evaluation, diagnosis, and the uncertainty of prevalence estimates.

From the Columbia University Irving Medical Center:

Children born during the first year of the pandemic, including those exposed to COVID in utero, were no more likely to screen positive for autism than unexposed or pre-pandemic children, found researchers from Columbia University Vagelos College of Physicians and Surgeons.


The study(link is external and opens in a new window), published in JAMA Network Open, is the first report on autism risk among pandemic-era children.

“Autism risk is known to increase with virtually any kind of insult to mom during pregnancy, including infection and stress,” says Dani Dumitriu, associate professor of pediatrics and psychiatry and senior author of the study. “The scale of the COVID pandemic had pediatricians, researchers, and developmental scientists worried that we would see an uptick in autism rates. But reassuringly, we didn’t find any indication of such an increase in our study.”

It’s important to note, Dumitriu adds, that the study did not look at autism diagnosis, only the risk of developing autism as measured by a screening questionnaire filled in by the child’s parents. “It’s too early to have definitive diagnostic numbers,” she says. “But this screener is predictive, and it’s not showing that prenatal exposure to COVID or the pandemic increases the likelihood of autism.

“There has been broad speculation about how the COVID generation is developing, and this study gives us the first glimmer of an answer with respect to autism risk.”
Investigating autism risk and COVID

Dumitriu’s team has been studying the potential effects of pandemic-related maternal stress and maternal infection on child neurodevelopment at different points since birth through the COMBO (COVID-19 Mother Baby Outcomes) Initiative. Children who were in the womb during the first phases of the pandemic are now reaching the age when early indicators of autism risk could emerge.

The current study examined nearly 2,000 children born at NewYork-Presbyterian’s Morgan Stanley Children’s Hospital and Allen Hospital between January 2018 and September 2021. Autism risk was calculated based on responses from a neurodevelopment screening questionnaire that pediatricians give to parents to evaluate toddlers’ behavior. Scores were compared for children born during and prior to the pandemic and for children with and without in utero exposure to COVID. All children were screened between 16 and 30 months of age.

Reassuring results

The researchers found no difference in positive autism screenings between children born before the pandemic and those born during the pandemic.

“COVID is still quite prevalent, so this is comforting news for pregnant individuals who are worried about getting sick and the potential impact on autism risk,” Dumitriu says.

Surprisingly, the study also found that fewer children exposed to COVID in utero screened positive for autism compared with children whose moms did not have COVID.

“We suspect that having COVID during pregnancy may have influenced parents’ assessment of their child’s behaviors,” Dumitriu says. “Parents who did not have COVID may have experienced higher stress—due to the constant worry of getting sick and the vigilance around preventing infection—and may have been more likely to report concerning child behaviors.”

Could autism show up later in childhood?

As the children age, the researchers will continue to monitor them for autism diagnoses. But based on the current results, Dumitriu thinks it unlikely that an uptick in autism related to COVID will occur.

“Children who were in the womb early in the pandemic are now reaching the age when early indicators of autism would emerge, and we’re not seeing them in this study,” Dumitriu says. “And because it’s well-known that autism is influenced by the prenatal environment, this is highly reassuring.”

But other impairments may emerge later, and the researchers will continue to study the children’s neurodevelopment as they age.

Several studies of infants who were in utero during previous pandemics, natural disasters, famines, and wartime have shown that other neurodevelopmental conditions, potentially triggered by the stressful environment, can emerge in adolescence and even early adulthood.

“We need to acknowledge the unique experience and environment of children who were born during the pandemic—including parental stress and social isolation—and continue to monitor them for potential developmental or psychiatric differences,” says Morgan Firestein, associate research scientist in psychiatry and first author of the study.

Topics
Infectious Diseases, COVID-19, Pediatrics, Research

References

More information

Dani Dumitriu, MD, is also an attending pediatrician in the Newborn Medicine Section at NewYork-Presbyterian's Morgan Stanley Children’s Hospital.

The study, titled "Positive Autism Screening Rates in Toddlers Born During the Covid-19 Pandemic(link is external and opens in a new window),” was published online Sept. 23, 2024, in JAMA Network Open.
.

Disability Stats

In The Politics of Autism, I discuss evaluation, diagnosis, and the uncertainty of prevalence estimates.

Bonnielin Swenor, Scott Landes, and Jean Hall at STAT:

Many disabled people are not included in official U.S. data. This is because there is “No Box to Check” to indicate their particular disability on surveys from the U.S. Census Bureau and other federal agencies. The questions used to identify people with disabilities are missing millions.

Two question sets are most often used to assess disability in U.S. federal surveys: the American Community Survey Six (ACS-6) or the Washington Group Short Set (WG-SS). Combined, they are used in at least 17 U.S. federal surveys, so these disability question sets have an enormous effect on people’s lives. For instance, they appear in the Census Bureau’s surveys, which provide information that “generates data that help inform how trillions of dollars in federal funds are distributed each year.” They are also used in surveys fielded by the Centers for Disease Control and Prevention that help monitor health and health care in the U.S. population.

In both sets, questions focus on respondents’ limitations on specific tasks or activities, such as difficulty seeing even while wearing glasses.

Because of this approach, both sets miss large groups of disabled people. They miss between 23% and 59% of people with mental health or psychiatric disabilities, between 13% and 33% of people with intellectual and developmental disabilities, and between 32% and 53% of people with chronic health conditions, such as long Covid.

We recently led efforts to push back against a proposal for the U.S. Census Bureau to change how disability is measured in the ACS. Had it been enacted, the Census Bureau would have changed from using the ACS-6 questions to the WG-SS questions to measure disability in the American Community Survey. This proposed change to the WG-SS questions would have underestimated the prevalence of disability in America by over 40%. Advocacy efforts from the disability community successfully halted this change. But this issue is far from being resolved.

We have been frequently asked which set of disability questions, the ACS-6 or WG-SS, is best. Which set should be used? These questions echo a long debate among researchers, advocates, and the federal statistical community about which of these measures are superior. The honest answer is that both are bad options. Both exclude many disabled people. The federal government must invest in providing something better.

The first step in moving disability measurement forward is recognizing that defining disability solely by someone’s functioning is inadequate. While measures of functioning are important to understand the limitations certain disabled people experience and could identify disabled people who may benefit from specific programs or benefits, these surveys still fail to capture many disabled people. Using this data to determine national estimates of disability is akin to using data on languages used in the home to determine the national race and ethnicity estimates.

Second, disability must be viewed as a demographic variable. As such, it should be collected everywhere we collect other demographics such as age, gender, and race-ethnicity.

Regional Center Transparency

In The Politics of Autism, I discuss services for people with disabilities.

Regional centers are private nonprofits that contract with California's Department of Developmental Services to coordinate or provide services for people with developmental disabilities. The 21 regional centers help disabled people and their families find and access a variety of services.

Regional centers have had many problems.  There are great spending disparities among them.  Access to services is very uneven.

 Chris Egusa at KQED:

http://www.autismpolicyblog.com/2022/05/inequitable-access-in-california.html allowing nearly 450,000 people with disabilities to access certain records and information related to their care for the first time.

The bill, AB 1147, passed the state Assembly and Senate without opposition at the end of August, after a 19-month fight in which many of its accountability measures were stripped out. The most impactful remaining provision would make the 21 nonprofit organizations throughout the state, called “regional centers,” subject to the California Public Records Act (PRA), a law that requires the public disclosure of government records when requested.

Proponents of the bill argue the regional centers perform a public function and are entirely funded by state dollars and should, therefore, be subject to the PRA. However, the centers that oppose the bill say that complying with it would strain an already cash-strapped system and could lead to accidental disclosures of personal information.

California’s developmental disability system operates with a budget of more than $15 billion, serving Californians with a range of conditions, including autism, cerebral palsy, intellectual disability and epilepsy. All funding and services flow through the regional centers, which connect people with disabilities to various service providers.

The governor is expected to sign or veto the bill by Sept. 26.

IDEA and a Case in Connecticut

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

The Trumpist Project 2025 would turn that law into a "no-string" block grant, thereby gutting its protections for students with autism and other disabilities. Here is an example how child advocates use IDEA, and what they would lose if the Trumpist agenda goes into effect.

Laura Tillman at Connecticut Mirror:

The Office of the Child Advocate and Disability Rights Connecticut have jointly filed a complaint with the U.S. Office of Special Education Programs against the Connecticut Department of Education, alleging that the department is not fulfilling its role of monitoring schools for children with disabilities.

The complaint, filed on Wednesday, follows a lengthy investigation by OCA and Disability Rights CT that publicly revealed alarming conditions for those children in specific Connecticut schools earlier this year.

The investigation, which took place between 2019 and 2022, looked at a private school system known as High Road Schools. These private special education schools serve students whose home districts are unable to provide appropriate services for children with special needs. But the investigation alleged that staff at the schools were often uncertified, that education was of poor quality, that students were restrained and put in seclusion at a high rate, and that most children in the programs were sent there from low-income communities of color.

Officials at OCA and Disability Rights CT earlier this summer also filed a complaint with the U.S. Department of Justice alleging disability discrimination by four school districts — Hartford, Bridgeport, Waterbury and Stratford — that send their special needs students to High Road Schools.

That complaint is trying to hold the public school districts accountable, according to Sarah Eagan, the state’s child advocate.

The new complaint is targeting the state’s role, claiming that in its alleged lack of sufficient oversight and regulation, the Connecticut Department of Education is in violation of the Individuals with Disabilities Education Act, the Americans with Disabilities Act, and the Rehabilitation Act of 1973, which together ensure that children with disabilities have access to quality education and opportunities.

Autism and Emotion

In The Politics of Autism, I look at the daily struggles of autistic people, including stereotypes and myths.

One is that autistic people lack empathy and emotion.

A release from Rutgers:

What does giddiness or joy or anger feel like?

To a group of autistic adults participating in a Rutgers study, giddiness manifests like “bees”; small moments of joy are like “a nice coffee in the morning” that yields “a sense of elevation”; anger starts with a “body-tensing” boil, then headaches.

Contrary to common perceptions and years of research that autistic people can’t describe their emotions or often have muted emotional responses, a Rutgers study published in the American Journal of Occupational Therapy concludes that  many autistic adults are in fact acutely aware of their feelings and can label them in vivid, often colorful detail.

“What if everything we know about autism is wrong?” said Aaron Dallman, an assistant professor of occupational therapy at the Rutgers School of Health Professions and the author of the study.

“We spend all this time problematizing autism, rather than doing the work to understand what it’s like to be autistic,” he said. “The popular idea that autistic people don’t have rich, emotional lives is simply not true.”

To catalog how young autistic adults describe their emotions and navigate their interactions with others as well as identify potential strategies to bridge the emotional chasm between autistic and nonautistic people, Dallman conducted a series of focus groups designed to understand individual experiences.

Twenty-four autistic adults ages 18 to 35 participated in one of six video conference focus group interviews. Discussions were facilitated by Dallman and included questions related to how emotions are manifested physically, what participants feel during therapy sessions and how participants communicate about their emotions with others.

Transcripts from the sessions were created and anonymized by a graduate research assistant. Data was then coded and analyzed using a qualitative research methodology that explores how individuals make sense of their experiences.

Participants overwhelmingly reported that typical emotion words such as “happy” or “sad” don’t adequately characterize their complex emotional experiences. Instead, descriptions of emotions included rich, dynamic language and often combined traditional emotional words with references to physical sensations, particularly in the stomach.

Participants also reported that “affective contact” – exchanges of feelings between individuals – with nonautistic people can be difficult and is particularly challenging when nonautistic people misinterpret the emotional expressions of an autistic person.

“I’ve had people say, like, ‘Wow, you look really happy right now,’ when I’m just kind of chilling out,” one participant said. “I’m not sure what about me looks extremely happy.”

Since the first descriptions of autism, difficulties with human interaction have been considered a common feature of autism spectrum disorder. Dallman said confusion arises when therapists or nonautistic people try to supplant neurotypical definitions of emotions – a smile must mean “happy,” a frown “sad” – when these labels don’t apply to autistic people.

Eye contact is a perfect example, Dallman said. For nonautistic people, locking eyes suggests social interest but is often experienced as unpleasant by autistic people. Similarly, autistic people often use stimming techniques – repetitive actions, such as hand flapping or rocking, to regulate emotions – that can be viewed negatively by nonautistic individuals.

Dallman said his findings could point the way to new autism therapy strategies. Instead of urging changes to how autistic people communicate, he said, anyone who has an autistic person in their life should work instead to improve mutual understanding between those who have diverse modes of experiencing the world.“We don't have to change everyone, but let's think about changing the classroom, or caregivers’ attitudes, so they understand what messages an autistic individual is communicating and how they express their emotions,” Dallman said. “It’s time for our communities to embrace the unique perspectives and 
contributions of autistic community members.”

 

The study was published in the American Journal of Occupational Therapy.

The Danger of RFK Jr.

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.

A number of posts discussed Trump's support for the discredited notion.

 Another leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.  He is part of the "Disinformation Dozen."

He recently ran for president as an independent and has now endorsed Trump.  If Trump wins, RFK could get a major job in the administration.

David Gilmour at Mediaite:

Newfound Trump ally and notorious anti-vaxxer Robert F Kennedy Jr. claimed that former President Donald Trump wants him to select the leaders of key public health agencies should he win the upcoming presidential election.

Kennedy Jr., who abandoned his independent bid for the presidency to join Trump’s transition team in late August, alongside fellow ex-Democrat Tulsi Gabbard, told MAGA commentator Tucker Carlson that in a future administration, he would be tasked with purging “corrupt influences” from the agencies to “drain the swamp.”

...

The crowd applauded as Carlson asked him to expand on how he would seek to achieve those goals.

Kennedy Jr. replied: “That’s unclear because there’s no… You know, at this point, like I said, I’m on the transition committee and there is no… I don’t have a post for myself that’s picked out. I know that I’m going to be deeply involved in helping to choose the people who can run FDA and NIH and CDC in a way that restores public health rather than…”

 Interrupting, the host laughed out loud and gleefully mused that those currently running the agencies “must be dying.”

W. Ian Lipkin, Larry Brilliant and Lisa Danzig at The Hill:

In a video posted on Twitter in July, former President Donald Trump and Robert F. Kennedy Jr. exchanged conspiracy theories about the toxicity of childhood vaccines. This widely viewed conversation adds fuel to an alternative reality spread by the anti-vaccination movement.

In the video, Trump talked about “A vaccination that is like 38 different vaccines and it looks like it’s meant for a horse, not a, you know, 10-pound or 20-pound baby.” He added: “Then you see the baby all of a sudden start to change radically. I’ve seen it too many times. And then you hear that it doesn’t have an impact, right?”

 In a Fox News interview from that month, Kennedy made similar false claims that vaccines are “exempt from pre-licensing controlled placebo trials.”

There is no evidence that childhood vaccines cause autism or other brain disorders in children. The original report from Andrew Wakefield that tried to link the measles vaccine to autism has been retracted.

Concerns raised by Kennedy about the vaccine preservative thimerosal have also been discredited, as its removal from vaccines in 2001 had no effect on the frequency of disease.

Furthermore, in many children with autism, studies of blood from mothers obtained during pregnancy, and from children on the day of birth, indicate that abnormalities are present before children receive a single vaccine.

Unfortunately, although the leaked video went viral, the science and public health benefits of vaccines have not.

House Passes Autism CARES

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

 A release from Rep. Chris Smith (R-NJ):

The House of Representatives today overwhelmingly passed (402-13) new comprehensive legislation (HR 7213) authored by Rep. Chris Smith (R-NJ) to provide more than $1.95 billion to reauthorize and strengthen the United States’ whole-of-government autism spectrum disorder (ASD) initiative through 2029. Smith’s bill—with Rep. Henry Cuellar (D-TX) as the Democrat lead and 61 other bipartisan cosponsors—now heads to the Senate.

Smith, who has authored four major autism laws to date, said his new legislation “will help make a huge difference in the lives of the millions of Americans with autism by providing robust funding for durable remedies as well as effective early detection and intervention services to allow them the highest quality of life possible.”

“With substantive input from advocates in the autism community, my legislation will also help advance key research priorities and ensure enhanced collaboration between federal agencies and families and individuals with autism,” Smith said. 

“This bipartisan bill will provide vital funding to expand research and care for Americans with autism,” said Dr. Cuellar, a senior member of the House Appropriations Committee. “Through this bill, we continue important work in understanding the causes of autism, the best ways to treat autism, and incorporate the voices of those previously missed by research. I would like to thank Representative Chris Smith for his leadership on this important legislation.”

Smith’s legislation—which received unanimous approval from the House Energy and Commerce Committee in a vote (42-0) to send the bill to the House Floor earlier this year—has received strong support from the nation’s leading autism advocacy groups, including Autism Speaks, the Autism Society, the Autism Science Foundation, the Arc of the United States, the Profound Autism Alliance, and the Association of University Centers on Disabilities.

Specifically, the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2024 would:

· Authorize $1.95 billion—including $306 million in annual funding for the National Institutes of Health (NIH); $28.1 million in annual funding for the Centers for Disease Control and Prevention (CDC); and $56.3 million in annual funding for the Health Resources and Services Administration (HRSA);

· Direct the NIH to ensure research reflects the entire population of individuals with autism spectrum disorder, including the full range of cognitive, communicative, behavioral, and adaptive functioning, as well as co-occurring conditions and needs for supports and services, including and especially care necessary for physical safety;

· Increase the number of NIH Centers of Excellence and ensure research reflects the entire population of individuals with autism spectrum disorder and is designed to address the full range of needs faced by individuals, including to ensure the physical safety and to promote the well being of all Americans with autism;

· Include, for the first time, a professional bypass budget to provide the autism community with a comprehensive budget highlighting priority research areas and resources needed to advance quality of life improvements for all individuals with autism;

· Promote the adoption of assistive communication technologies to improve communications outcomes for those with communication assistance needs; and

· Require a report on youth aging out of school-aged services, as well as recommendations to improve mental health outcomes and address related disparities in mental health care for individuals with autism spectrum disorder, including prevention, care coordination, and community-based services.

Smith, who has been a steadfast champion for the autism community for decades, stepped up his involvement on autism in 1997 when Bobbie and Billy Gallagher—parents of two small children with autism—from Brick walked into his Ocean County office looking for help, believing their town had a disproportionate number of students with autism.

In response, Smith brought federal agencies to Ocean County for an investigation—which found that autism prevalence rates were high not only in Brick, but in nearby communities as well—and authored the Autism Statistics, Surveillance, Research and Epidemiology Act, which was incorporated as Title I of the Children’s Health Act of 2000, authorizing grants and contracts for the collection, analysis and reporting of data on autism and pervasive developmental disabilities.

Autism and a Capital Case

In The Politics of Autism, I discuss interactions between the justice system and autistic people.

Maurice Chammah at the Marshall Project:

Robert Roberson, who faces execution in Texas on Oct. 17, is the latest death row prisoner to see a glossy campaign to save his life. He was convicted of killing his 2-year-old daughter Nikki Curtis in 2002 on a theory of “shaken baby syndrome.” A growing chorus, from the lead detective in his case to novelist John Grisham, is arguing that he is innocent and Curtis’ death, while a tragedy, was not a crime. He’d be the first person ever executed based on shaken baby syndrome, even as the diagnosis faces growing scrutiny in the courts.

But another fact about Roberson deserves more attention to make sense of his story — his diagnosis of autism spectrum disorder.

From the moment he showed up at the hospital with his daughter turning blue, his case reveals the ways the criminal justice system can fail people with diagnoses like autism. Roberson’s execution has been scheduled amid a wave of attention to this subject from researchers, journalists and support organizations, who offer guides for autistic people and their parents on how to interact with police.

My colleagues have reported on how people with autism experience prison, for example, as well as encounters with police, which can turn deadly when officers misinterpret their behavior as suspicious. Some lawmakers are trying to reduce the risk of escalation and tragedy. For example, when looking up a license plate, Texas police may now see an alert indicating that a driver may have difficulty communicating.

But Roberson’s case shows what can happen even before the police get involved. When he took his unconscious daughter to an emergency room in the small east Texas city of Palestine, in 2002, a nurse found it strange that he’d gotten her dressed before leaving their house, according to court records. Later, as he showed detectives around his kitchen, he paused to make a sandwich. Former homicide Detective Brian Wharton recalled finding Roberson’s affect disconcerting, saying, “He’s not getting mad, he’s not getting sad, he’s just not right.”

At Roberson’s 2003 trial, prosecutors used those details to portray him as callous and remorseless. But at a 2018 appeal hearing, psychologist Diane Mosnik said autism helped explain his deviations from social norms (like the sandwich), the misalignment of his feelings and expressions (the flat affect), and his reliance on scripted behavior (dressing his daughter). She found his social problem-solving skills were equivalent to those of an 11-year-old, noting his struggles to understand sarcasm and sincerity.

All of this, Roberson’s lawyers now say, led nurses, doctors, police, prosecutors and jurors to distrust Roberson’s story — that his daughter fell out of bed — possibly making them more likely to see evidence of abuse in complicated medical findings.

Measles Outbreaks

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 fought vaccine mandates and other public health measures. 

 From CDC:

As of September 12, 2024, a total of 251 measles cases were reported by 31 jurisdictions: Arizona, California, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, New York City, New York State, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont, Virginia, Washington, Wisconsin, and West Virginia.

There have been 13 outbreaks (defined as 3 or more related cases) reported in 2024, and 70% of cases (175 of 251) are outbreak-associated. For comparison, 4 outbreaks were reported during 2023 and 49% of cases (29 of 59) were outbreak-associated.