Special Education Law Blog

Autism Society Reponse to Newtown Tragedy

I am still reeling from the depth and magnitude of what happened last week with the killing of so many young children and their heroic teachers and staff. I am not sure when, if ever, I will be able to make any sense of this extreme violence. However, in the media frenzy that always follows such events there have been irresponsible statements attributing autism as a possible explanation. Below is the Autism Society's reponse on this issue.

Sleeping Difficulties Prevalent in Students with ASD

Many children have difficulty sleeping.  But a disproportionate number of children with special needs have sleep problems.  Anywhere from 49 to 89% of children with autism spectrum disorders, 25 to 50% of children with ADHD, and 34 to 86% of children with cognitive impairments are estimated to experience sleep difficulties.  Additionally children with other syndromes, such as Angelman or Down syndromes, are also reported to have sleep difficulties.  But what is not known is if the learning problems cause the sleep problems, or if the sleep problems cause the learning problems.  Dr. Bonuck and her associates from the Albert Einstein College of Medicine attempted to answer this question in a prospective study just published in Pediatrics by looking for an association between sleep difficulties in young children with a later need for special education services.

 Prospective studies follow a specific population (or cohort) over time, identify certain risk factors, and see how these factors affect outcomes over time. The Avon Longitudinal Study of Parents and Children (also known as ‘the Children of the 90s’ study) is one such cohort that had enrolled approximately 85% of pregnant women in Avon, England in 1991-1992, allowing for a large population-based study.  The initial cohort in the study, which was used by Dr. Bonuck and her associates for their research, comprised more than 13,000 infants, but children with any known condition that might lead to a disability or was associated with a disability were excluded. 

Educating Students with High Functioning ASD: Part 2- A Personal Story by Marilyn Green Rebnord

In doing research on finding appropriate placements for students with either high-functioning autism or Asperger’s syndrome, I got side tracked by a little jewel of an article that had appeared in a magazine published by the National Education Association.  Titled “Square Pegs:  Kids with Asperger Syndrome are Hoping You’ll Help Them Find a Place in the Classroom that Fits Just Fine,” the article quotes Lucas, a young man with Asperger’s who had just graduated high school.  According to Lucas, “You’ve heard people say we don’t want to be square pegs in round holes, we want to be square pegs in square holes.  To me that means we don’t need to be fixed.  We’re not broken people.  We just need to be understood.” What Lucas is asking for—understanding--is what is essential to ensure a successful placement for the child with high-functioning autism or Asperger’s.

 Teachers who are willing to go the proverbial extra mile may discover that children on the spectrum can contribute enormously to their classrooms.  These children can shine brightly with a teacher who appreciates who they are and shows classmates by example how to treat the child with autism or Asperger’s with respect.   Children who are placed with rigid, top-down disciplinarians are probably not going to do so well.  Everyone—the child, the teacher, the principal, and the family—are going to be miserable.  And some children simply cannot have their needs met in a mainstream classroom. 

Educating Students with High Functioning ASD: Part 1

The number of children being diagnosed with autism is rapidly increasing.  The incidence rate within the past few years has gone from one child in every 500, to one child in every 150, and now, according to the CDC, the incidence of kids on the autism spectrum is 1 in 88.  It’s beyond the scope of this blog to explain the reason for the escalating number of children being diagnosed, but suffice it to say that the public schools are being called upon more and more frequently to provide services for these children.  Sometimes schools can do a phenomenal job in addressing these children’s needs; sometimes not.  In particular, meeting the needs of those students with higher functioning autism or Asperger’s syndrome can be uniquely challenging because on the surface many of these children look “fine.”  Yet, these children have challenges and need help. 

 School staff can be blinded by the sometimes high intellect or seemingly strong verbal skills some children with either Asperger’s syndrome or high-functioning autism exhibit.  Yet, these kids can be exceedingly puzzling.  Seemingly competent students fall apart when their rigid adherence to routine is interrupted.  Due to sensory overload, the student in AP physics might wind up under the table during a fire drill.  Navigating gym classes, lunchrooms, and playgrounds—confusing even for some children without special needs--can be nightmares for children on the spectrum.  Homework and class work are also stressors for these children.  Some teachers will fault the child on the spectrum who fails to turn in his homework, loses it, or even more frustratingly, simply refuses to do it.  After all, these are bright children who should really “know better.”  Any and all of these scenarios can result in meltdowns for these children.  In worst case scenarios some melt downs are so very badly managed by school staff that the child exits the school in handcuffs escorted by police.  Other children will quietly slip under the radar and simply have their needs overlooked.     

Elopement Behaviors: A Real Danger

Elopement or running away behaviors are certainly at the top of the list of most serious behaviors that must be eliminated from the range of behaviors that a student with special needs experiences in school. I have had several families where elopement has been a frequent and tortuous experience. While some have been injured fortunately none have died. For students with autism there is a great propensity to elope from school supervision and put themselves in danger. According to a study just published in Pediatrics on elopement behaviors, 49% of parents reported that their child had attempted to elope at least once. Of these children, 65% had a “close call” with traffic whereas another 24% were at risk of drowning. Children who elope leave their homes (74%), stores (40%), and schools (29%). Researchers were able to compare the rate at which children with an autism spectrum disorder eloped compared with that of their typical siblings. Between ages 4 and 7 (4 being the developmental age when children can be expected to not wander off), 46% of children with an autism spectrum disorder eloped compared to 11% of their siblings. And between ages 8 and 11, 27% of children on the spectrum wandered compared with just 1% of their siblings.

The Epidemic Effects of Non-Vaccination

As an unfortunate legacy of the now discredited Wakefield “study” in many areas of the country, it has become too common that parents are opting out of vaccinating their youngsters before entering kindergarten. The negative consequences for their children is obvious, but for the school and the community as a whole the results can be quite significant. While some parents are legitimately opting out of vaccinations for medical, religious or philosophical exemptions from vaccinating their children. In the cases where parents have a sincerely held religious belief that prohibits vaccinations, those beliefs need to be respected; that is the small minority of cases. Similarly some children must not be vaccinated, either because they have medical conditions or have had adverse reactions which contraindicate their receiving vaccinations.  These children depend upon what is known as herd immunity to protect them against serious if not lethal cases of contagious but preventable diseases.  To achieve herd immunity, a critical mass of the population must be vaccinated, usually about 95% depending on the illness being vaccinated against.  At this level, disease transmission is contained because it cannot be transferred.  Outbreaks of disease, however, can occur in areas where this threshold is unmet, and those individuals who are not vaccinated; e.g., the young, the immunocompromised, the medically vulnerable, or those who are vaccinated but for whom the vaccine is not working, all become at risk.

 

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.