Special Education Law Blog

Restraint and Seclusion, Opposing Viewpoints

The Department of Education recently released the new Civil Rights Data Collection that analyzed equities and disparities in educational opportunities in our nation’s schools during the 2009-2010 school year.  Data were gathered from 72,000 schools, or roughly 85% of students.  Among the data examined was the frequency with which students were secluded or restrained.  Almost 70% of the 38,792 students who were restrained during the past calendar year had disabilities, although students with disabilities comprise only about 12% of the student population.  African-American males, who make up only 21% of the student population with disabilities, represented 44% of those students restrained.  And finally, although approximately half of students with disabilities are male, 70% of students with disabilities who were restrained were male.  According to TASH and other disability groups, the data are sobering.  TASH characterizes the use of restraint and seclusion as an issue of “national significance,” which leads to “traumatic physical and emotional harm, and even death.”  In a press release, Barb Trader, the executive director of TASH, states, “Our students need equitable access to education and protection for their personal safety under the law, and clearly that’s not happening for students with disabilities or those from diverse backgrounds.  It is a national tragedy that any child, especially the most vulnerable, is not safe in school.”  

Changes to the DSM V- A Personal Perspective by: Marilyn Green-Rebnord

Like many parents with a child diagnosed on the autistic spectrum, I’ve been following the controversy over the proposed revisions for the new Diagnostic and Statistical Manual of Mental Disorders (DSM) 5.  Under the proposed new revisions, the categories of autism, PDD-NOS, and Asperger’s syndrome would all be collapsed into the label “Autism Spectrum Disorder.” Criteria for this new diagnosis, which are much more stringent than those used in the previous DSM IV, are causing the autism world to buzz with concern that many higher functioning individuals could “lose” their diagnoses.   Dr. Fred Volkmar of the Yale Child Study Center, who had been a member of the panel involved in the rewriting of the DSM before his resignation, recently reported his results of a study in which he claimed that up to 45% of individuals on the higher ends of the spectrum would no longer be diagnosed with a spectrum disorder. Somewhat speciously, Dr. Volkmar in a New York Times article heralded the “end of the autism epidemic.”

Specifically, Dr. Volkmar and colleagues examined the case records of 1000 children diagnosed with autism in 1993, identified 372 of the highest functioning children, and then applied the proposed DSM 5 criteria to them.  Of these children, about a quarter of those who had been diagnosed with autism, about three quarters who had been diagnosed with Asperger’s, and 85% of those diagnosed with PDD-NOS would not be diagnosed with an autism spectrum disorder under the proposed new criteria.  But members of the American Psychiatric Association (APA) who are involved in the DSM diagnostic changes are crying, “Not so fast” to Dr. Volkmar’s report, which is scheduled to be published this spring.  Dr. Volkmar’s critics, including Dr. Catherine Lord who serves on the DSM panel, are saying that the data are inadequate to re-diagnose the 1993 cohort using the new criteria.  The study is simply not valid.

The iPad and Its Many Uses for Students with Autism

The advent of the iPad and iPod with the proliferation of their accompanying applications offers extraordinary opportunities for students with special needs, including those with autism.  In an Education Week article, Matthew S. Goodwin, the director of clinical research at the Massachusetts Institute of Technology Media Lab, states, “A lot of this [new technology] is preliminary and promising, but it’s not a silver bullet.”  Mr. Goodwin continues to say, “It’s not going to cure autism, but we’re at the precipice of a revolution.” 

Most Schools Not Properly Implementing and Tracking Autism Interventions

Although the Individuals with Disabilities Education Act and No Child Left Behind both mandate that schools must provide research-based interventions for students, it appears that schools are often failing to provide such evidence-based methodologies.  Results from an August 3, 2011 study from Michigan State University of more than 200 school professionals indicate that teachers are failing to use some of the most effective strategies for teaching children with autism.  This is news?  Parents already know that teachers may not be correctly applying the different treatment interventions to their children.  And researchers have also known that there is a research-to-practice gap in autism interventions. 

Autism Series is Another Compelling Reason to Support Public Television

With all the talk about cutting funding and especially for public television and radio, the recent series that Robin McNeil has been hosting on autism is reason enough to support this programming with political support.  He tells part of the story from a first person point of view as the grandfather of a grandson with autism, which makes the series more compelling and poignant. However,  not everyone is thrilled with the coverage and Mr. McNeil's portrayal of people with autism.

For me Sesame Street and all the arts programming should be enough of a justification, but as a special education attorney and parent of a child with special needs, I felt truly affirmed and gratified to see the quality and scope of the discussions on public television.

We live in a sound-bite society but unfortunately autism and issues surrounding special education do not lend themselves to 20 second clips, if the greater society is going to have any real understanding of the issues affecting families, people with autism and with disabilities generally. This series of programs are worth it and should be shown to Congress the next time there is thought of cutting special education funding, funding for autism research and public television which creates a unique forum to delve into comlicated topics. Here is  the link to this programming.

Systematic Study of Autism Treatments shows Minimal Support for the use of Drugs as Treatment

A new study from the journal Pediatrics, the official journal of the American Academy of Pediatrics, indicated that while medication is often used to treat children with autism, “strikingly little evidence” exists to support the approach. That conclusion stems from an analysis of 10 years worth of studies on the use of antipsychotics and other drugs in treating children with autism.“Most of the medical interventions that are currently being applied for children with ASDs have insufficient strength of evidence to evaluate either their potential benefit or adverse effects,” wrote researchers from Vanderbilt University.

The strongest evidence in support of the use of medication for kids who have autism comes from studies funded by pharmaceutical companies who stand to profit, the review found. However, two drugs did stand out in the analysis. Studies suggest that risperidone and aripiprazole, both help to counteract challenging behaviors. But, it must also be noted that the drugs carried significant side effects — such as weight gain and drowsiness — making them useful to only those with the most extreme symptoms. Also, a look at the the use of secretin to treat autism-related gastrointestinal issues suggests the approach is ineffective and does not warrant further research.

This study sheds more light on the companies and medical personnel who are trying to sell a simple solution for the complex problem that is autism. As has been mentioned in prior posts much like the autism spectrum with its many facets and caveats, the treatments that work for any individual child and the ways in which they work are always different. 

Autism Rates Triple in California Since 2002

A just released study shows that from 2002 to the present the rate of autism being diagnosed has tripled in the last 8 years in California. That is a simply shocking statistic that should be on the front page of every newspaper in this country. In a time when many cancer rates have declined, there is stubborn and decided increase in the numbers of children with autism.

We can no longer accept outdated explanations like the now discredited report from Andrew Wakefield that MMR vaccines are causing autism, especially since the vaccines have been reformulated and the rates keep going up. These numbers are real and are not simply a matter of better identification (although some disagree) or labeling children autistic who once were labeled intellectually challenged.  The data shows, and frankly my personal experience over the last 16+ years of practice in the area of special education confirms, an absolute increase in the numbers.  I have asked many OTs and SLPs, who have been treating children for years, and their anecdotal accounts are all the same; the numbers in real terms are way up and at an accelerated rate over the last decade. My anecdotal data, although not scientific, is consistent with the information coming out of California. 

We need to vote our interests and spend even more public funds on autism research. We need to stop wasting time money and energy on nonsense like Wakefield. Subscribing to nonsense, divides parents and only discredits all parents no matter the dissability.

Candidates for office, especially at the top of the ticket, must have well developed and affirmative position papers on autism, special education and other disabilities, if they intend to receive support. My review of the various presidential candidates websites, a few years ago showed that only candidate Hilary Clinton had position papers on autism. We must make decisions based upon data not hype from people like Jenny McCarthy and Andrew Wakefield. We all want a magic bullet to cure and remediate the issues affecting our children, but there is no such thing and no single boogie man (e.g. vaccines) to heap scorn and blame. We need sound and early diagnosics, treatment, planning, teaching and training for school personnel based upon hard data not fraud or conjecture. The work ahead involves heavy lifting that does not lend itself to easy or magic answers like Wakefield.

The British Medical Journal calls Dr. Wakefield's Autism Study an "Elaborate Fraud"

Dr. Andrew Wakefield, the doctor who originally published a study that linked MMR to autism, was called to task by the British Medical Journal. The Journal is set to publish a series of articles by an investigative journalist who spent seven years uncovering the nature of Dr. Wakefield’s research. The BMJ called the study and Dr. Wakefield’s research “an elaborate fraud that has done long lasting damage to public health.” That proclamation goes one step further then the retractions and denouncements that have come before.

CNN reporter Anderson Cooper had Dr. Wakefield on his show last night. Mr. Cooper aggressively questioned  Dr. Wakefield and called out others, such as Jenny McCarthy, who have supported him and his findings.

Some might say that the efforts spent researching the findings in Dr. Wakefield’s study could have been spent focusing on new advances in autism research and trying to uncover innovative treatments and therapies, instead the public is still spending time on his discredited study. Hopefully, the focus on interventions and research for autism can now move past Dr. Wakefield onto real and data-driven research that will make meaningful differences in the lives of people with autism.

 

US Air Force Adopts Behavior Imaging To Treat Behavioral Disorders

Caring Technologies announced earlier this year that the United States Air Force has started a program to look into using their technology Behavior Imaging®, a video-based telemedicine application to treat autism and other behavior disabilities. 

Behavior Imaging® uses video technology to capture behaviors as they occur in their natural environment, which improves the accuracy of diagnoses and treatments. In the same way that x-rays and MRIs are important tools to visualize physical conditions, Behavior Imaging® provides first-hand, contextual information for better diagnosis and treatment of behavioral disorders. This technology is useful to all, but is particularly so for military families as they are often stationed remotely without specialists and the support required.

Behavior Imaging® can benefit military families by providing care that more effectively meets their needs and is otherwise unavailable at their location. Additionally, the technology can benefit Autism Centers all over the country by lowering the amount of time needed with each patient, allowing more patients to be seen overall while providing a more cost effective use of time and resources. One of the biggest issues that parents of students with disabilities face is behaviors. This new technology will assist parents in identifying behaviors, triggers and ultimately help in creating strategies to alter the behaviors identified. 

 

Guide to Autism Insurance Laws Now Available by Nicole T. Jorwic

Most sections of the Autism Insurance Act in Illinois went into effect in December of 2008. Implementing and understanding this act is an ongoing process. Autism Speaks through its Autism Votes initiative with the help of George Washington University Law School, has created fact sheets for each state. There are 28 states that currently have autism insurance laws. The Illinois fact sheet includes the purposes of the act, what is covered and the limitations of the act. This is useful information for any parent seeking help from their insurance companies to cover the exorbitant medical costs associated with autism. Here is a fact sheet from Pennsylvania
Download Pennsylvania--s-autism-insurance-act---a-factsheet