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Salon – Inside the vaccine scare

22 Sep

Salon redeems itself from producing what Orac at the time called biggest, steamingest, drippiest turd ever dropped on the web.

Three years ago Salon published the notoriously innacurate ramblings of RFK Jr. After uproar in the web science community and numerous fixes and amends to the original piece, what was left was still an awful piece of credulous rubbish.

It seems that Salon learnt their lesson. This time, they have ensured that the person talking about vaccines and autism is a _scientist_ as oppose to a crowd-pleasing politician.

Rahul Parikh has published a review of Paul Offit’s Autism’s False Prophets which differs so wildly from the RFK Jr debacle that its almost impossible to think of them being in the same publication.

I don’t want to do a review of a review as that would be bizarre and unnecessary but Parikh makes some key points that I want to address. The first one is the way the book starts.

Early in Dr. Paul A. Offit’s new book, “Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure,” he describes a threatening letter he received from a man in Seattle. “I will hang you by you neck until you are dead!” it read. The FBI deemed the threat credible, assigning Offit a protective officer who, for the next few months, followed him “to and from lunch, a gun hanging at his side.” He then recalls a suspicious phone call from a man who recited the names of Offit’s two children and where they went to school: “His implication was clear. He knew where my children went to school. The he hung up.” These days, the hospital he works in regularly screens his mail for suspicious packages.

Such stories usually come from pro-choice physicians on the front lines of the abortion debate. But Offit is no obstetrician. Rather, he is a baby doctor — the chief of pediatric infectious diseases at the Children’s Hospital of Philadelphia. The threats against him and his family have come not from antiabortion advocates, but rather from anti-vaccine crusaders who believe that vaccines cause autism. Offit, it turns out, has been targeted by them because he helped to develop a vaccine that prevents rotavirus, a serious gastrointestinal infection in children, and because he has been staunchly pro-vaccine in a time when there are many doubts about their safety.

It is amazing that we should be in a situation where a doctor who is actively saving lives is being targeted for that very fact. What is even more amazing is the fact that the very antivaxers who hate Offit so much simply don’t believe he _is_ being targeted. A few comments from Lisa Jo Rudy’s piece on Offit’s book illustrate this perfectly:

It’s very hard to judge the seriousness claims like Offit’s….

Mark Blaxill, Safe Minds.

I have heard Dr. Offitt make his claims of threats, etc. on more than one occasion. But I have never seen any real evidence of those alleged threats.

Wade Rankin, autism/antivax blogger

I would suggest that a reference to the possibility that some agency or company would harm one’s children in the future could be construed and repeated as a “threat” to one’s children if that threat would help to garner sympathy and label an opposing side as nuts.

Mike B

An amazing reaction. They genuinely hate Paul Offit so much that they think he is making up threats made to his children. And they think he’s doing it to ‘garner sympathy and label an opposing side as nuts’. This is the type of denial and refusal to see their own shortcomings that has led to the sorry state of autism/vaccine science in the first place.

Parikh also documents the reality of the science today and the reality of how the wider world views the autism/anti-vaccine community.

Despite what Wakefield claimed in his paper, his hospital’s ethics committee never approved his experiments to put children to sleep under general anesthesia, do spinal taps on them, take biopsies of their intestines (one of the children was hospitalized after his colon perforated in several places) and take volumes of blood from their veins. Deer also discovered serious conflicts of interest: Wakefield’s research was secretly bankrolled by a personal injury lawyer whose clients were suing MMR makers. Wakefield himself was given close to a million dollars to prove that the MMR caused autism. He had filed a patent for a new MMR vaccine at the same time he was doing his research. Upon learning this, Lancet retracted his paper, and he was charged with professional misconduct in 2005. If he is found guilty of misconduct, he will never practice medicine in the U.K. again.

The people in the autism/anti-vaccine community see Wakefield as a persecuted hero. Everyone else in the entire world who takes an interest in the matter sees him as a weak man who tried to game people – and did. Possibly he still is.

This level of disconnect between what those in the autism/antivax community see as the reality and the _actual_ reality is sometimes shocking. Even for me who has been in the front line of this debate for five years now, some of the things I read about and see from these people make my jaw drop.

I blogged about an example of this not long ago when Safe Minds Board Member Heidi Roger stated that Polio could be preferable to autism – and even that death could be better than autism.

This is a sadly far from uncommon opinion amongst a certain type of autism/antivax believer. To sum up their personality type would, I think, bring a sizeable minority of them very close to Munchausen syndrome by proxy/ Fabricated or induced illness , the indications of which seem very familiar to me from reading the Yahoo groups over the last few years:

* A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling and unexplained.
* Physical or laboratory findings that are highly unusual, discrepant with history, or physically or clinically impossible.
* A parent who appears to be medically knowledgeable and/or fascinated with medical details and hospital gossip, appears to enjoy the hospital environment, and expresses interest in the details of other patients’ problems.
* A highly attentive parent who is reluctant to leave their child’s side and who themselves seem to require constant attention.
* A parent who appears to be unusually calm in the face of serious difficulties in their child’s medical course while being highly supportive and encouraging of the physician, or one who is angry, devalues staff, and demands further intervention, more procedures, second opinions, and transfers to other, more sophisticated, facilities.
* The suspected parent may work in the health care field themselves or profess interest in a health-related job.
* The signs and symptoms of a child’s illness do not occur in the parent’s absence (hospitalization and careful monitoring may be necessary to establish this causal relationship).
* A family history of similar or unexplained illness or death in a sibling.
* A parent with symptoms similar to their child’s own medical problems or an illness history that itself is puzzling and unusual.
* A suspected emotionally distant relationship between parents; the spouse often fails to visit the patient and has little contact with physicians even when the child is hospitalized with serious illness.
* A parent who reports dramatic, negative events, such as house fires, burglaries, or car accidents, that affect them and their family while their child is undergoing treatment.
* A parent who seems to have an insatiable need for adulation or who makes self-serving efforts for public acknowledgment of their abilities.

I might catch some flak for making this comparison but whilst I am not suggesting that everyone autism/antivax adherent is MSbP or FII, I do think – as I say – a sizeable minority are. In the list above I have emboldened the characteristics I personally have seen lots of evidence of.

At any rate, whether there is genuine evidence of MSbP or FII or not, there is definitely an ongoing unreality to a certain group of peoples lives with autism. Why? To pretend to themselves they have total control over something that they do not understand? To medicalise something in order to keep alive the hope of a medical cure? To fuel their pre-existing lust for conspiracy theories? All of the above? None? Something else?

It gets to a point when it starts to not matter. When autistic children are literally being experimented on with absolutely no control in place like they are being with chelation, like they are being with Lupron and like they now are being with OSR we have to do something. When children in the UK are dying of vaccine preventable disease and children in the US are being hospitalised then we need to do something.

Paul Offit did something.

Better dead than autistic

15 Sep

This is Heidi Roger who is the Treasurer and a founding member of SafeMinds.

Heidi is a firm, firm believer that vaccines cause autism. No shock seeing as she’s a member of SafeMinds.

What is a shock though is her attitude to human life. In an online debate regarding the book Autism’s False Prophets Rogers made the following astounding claim:

…AUTISM is no joke, it is not “oh well” so their kid will work at McDonalds instead of Trump tower, it is a nightmare without end, it is post traumatic stress disorder every day, it is not better than measles, mumps or rubella and maybe even not better than polio.

That’s right, autism is worse than Polio which can leave some kids needing an iron lung is better than autism.

Measles which has left two teenagers in the UK dead in the last two years and still kills hudreds of thousands worldwide is better than autism.

I beg to differ. Its my opinion that my autistic child is in a much better place than some poor child in an iron lung.

But then, later on, Roger topped even this heartless statement with one so heartless and chilling it made me catch my breath:

Death may be better than autism in some cases….

Is that an official position of SafeMinds I wonder? That death ‘may’ be better than autism. If anyone has any doubts about why I and others feel it necessary to devote so much time blogging against these peoples beliefs you have it encapsulated right there. Death is not better than autism.

On the homepage of this site is a pink ribbon. If you click on that ribbon you will see some photos of Katie McCarron. Katie was murdered by her mother. Her mothers defence was that death was better than autism.

Katie’s family didn’t feel that way. Her Dad, her grandma and her grandpa didn’t feel that way. I have had the pleasure of meeting her dad and grandpa and I know that they loved Katie just as she was and that what was done to Katie was a violation. To even discuss the idea that death is better than autism is a violation. How someone who is parent to an autistic child can even suggest that death is better than autism is quite frankly beyond me.

Arthur Allen – vaccine skeptics vs your kids

11 Sep

Whilst, I’m not sure that the people Arthur is writing about are skeptics as I understand the term (having a scientifically valid basis for not accepting an argument or position), I know what he means. And he’s right that it is this group of people vs the health of people everywhere.

The sub-header is even more accurate ‘immune to reason’. One only has to take a look over at the recent rantings on a certain blog we all know about where the latest themes are:

1) Presidential candidate Barack Obama is now a big pharma shill because he told one of them: “I am not for selective vaccination, I believe that it will bring back deadly diseases, like polio.”.

2) The latest study in a long line of studies that show once more there is no link between MMR and autism is both flawed and exonerates one of their heroes.

3) Kathleen Seidel is wrong because….uh….well, no one knows why but she must be. Apparently.

Immune to reason indeed.

As Arthur points out, there is a great deal at stake:

…in the last trimester of her pregnancy, Helena Moran caught a cough that she couldn’t get rid of. She figured she’d picked up the germ—whatever it was—from one of her patients at a Boulder dentist’s office. But the real nightmare began after her daughter, Evelina, was born: The baby began to cough and cough, and then she’d curl up in a little ball and turn blue. At the emergency room, she was diagnosed with whooping cough. She spent the next five weeks in intensive care and suffered permanent lung damage.

Now, this isn’t *all* the fault of the so-called autism community, but as I’ve discussed before, I’m ashamed to say that a lot of it is.

….the movement got a huge boost from the controversy over the mercury-laden preservative thimerosal, which some theorized might be linked to autism. That link has been disproven—by, if nothing else, the fact that autism rates remained steady after pediatricians and public health authorities told manufacturers to stop making thimerosal-containing childhood vaccines in 1999. But the anti-vaccine movement has kept going, finding ever new reasons to distrust immunization.

The are a lot of zealots out there who have fed upon the autism community. A parent who might not believe vaccines case autism listens to horror stories and reads links sent to them from such places of quackery as whale.to who are nothing to do with the autism community but who market their own brand of ridiculousness (the owner of whale.to believes dolphins can manipulate gravity and has the pictures to prove it!) regarding vaccines and the autism parent greedily sucks it down.

Arthur discuss the practice of abusing ‘religious exemption’ by these people:

Right now, in many states, all it takes to get an exemption from vaccine requirements is signing a form. Some, including a group of doctors at Johns Hopkins University, have proposed making it harder—allowing a philosophical exemption only after parents demonstrate a good-faith effort to educate themselves.

But an article I read in yesterdays ‘Edmond Sun’ stated:

….a person “who has reached the age of majority and is mentally competent to do so may justifiably refuse immunizations for himself or herself, but may not impose this refusal on a child, who has no choice in the matter.” Courts have consistently upheld this principle.

That makes sense to me. Who would want to refuse such a simple thing that has no link of any kind to autism?

Arthur closes with the following:

But while questioning authority is healthy, facts are facts. If vaccines really were responsible for autism, it would be too much to ask parents to do the altruistic thing. But more than a dozen studies have failed to discover such a link—and not a single legitimate study has shown that one exists.

He’s spot on. All the celebs and all the money in the world cannot change that simple fact. We need to get past this. Those who believe autism is caused by vaccines need to put up or shut up. They are holding up progress on autism research and causing the health of our societies to suffer.

I urge readers to visit Arthur’s piece and read the comments. The first few demonstrate exactly the sort of mindset Arthur is talking about – the one’s who bring shame on the autism community. They truly are immune to reason.

Seeing the obvious

19 Aug

Two months ago I passed the half decade mark in running a blog about autism. I hoped when I started that I would be able to document my autistic child’s progress as xe developed and grew.

Somehow, through the efforts of others I got sidetracked. I no longer feel comfortable about blogging about xyr and that is nothing but a damn shame but it is still a reality. My wife is scared by the invective and hatred she reads in some people who disagree with me and we have an agreement now that I will not mention by gender or name any of my children.

This runs directly counter to my philosophy of trying to raise awareness of the good that can be available to parents and families of autistic people. Of the fun times – and there are many of them – as well as the heartbreaking times (and there are some of them too). I feel frustrated and angry that I have been forced by the irresponsible actions of others to not talk about the good thing I see in my life with autism. Maybe that was their reason for doing it. Who knows.

So, it was lovely this morning to see a story in my newsreader from someone who could see the good things. Who could see the obvious. Someone who chose to see the glass as half full.

The music was being performed live by two female artist of exceptional talent. Their music was sort of 70´s and 80s. They even took the risk of performing a Barry White Song, “My first , My Last, My everything” (I´m not sure that´s the real title), and they shocked me with how well they complemented his music. People were dancing. Old people and young people, but is was the “special” people who caught my eye; The down Syndrome people. They danced to the music and seemed so filled with the joy of the moment that it was contagious. I found myself dancing with them in my mind. They were laughing and moving, touching each other and their partners right at the moment when a spin or a turn was dictated by the music. As I watched I could not help but think of my own grandson, Anthony Adame, who is Autistic.

So maybe this writers choice of words wouldn’t be mine but there is no mistaking the vision of someone _who got it_ .

As I watched the crowd I noted many who looked upon these special people with sympathy and sorrow for them and their families. I know the look. I have often seen it while in the company of my own grandson Anthony. Only few ever intentionally mean to offend. Most simply do not understand the nature and condition of Down Syndrome, or Autistic people. They do not know the joy that many of these very special people have in their lives, or the wonder of living with, or being close to one of them.

Those words could’ve been lifted right out of my heart and mind. The joy is there. It exists. There is a choice that we can make as parents – do we fight a psuedo-war? A war which is simply psychological transference? Or do we see the fact that autistic (or Down Sydrome or Tourettes or Manic Depressive) people can see and experience happiness and bring joy to their families?

This isn’t a matter of religious style happiness. You don’t have to join hands with the world, hug a tree and sing Kumbya. Its really the simplest thing in the world. Its saying ‘my life is not like most peoples. I have hardship beyond what most do. My choices are limited. But look at the joy that my child/friend/grandchild/niece/nephew/cousin/child of a blogger from far away brings! Should I turn away from that? Or should I choose to participate in it?’

Its obvious isn’t it?

A Little More Left Rudder

14 Aug

I originally put together and posted this video (see end of post) at the beginning of the year at Autism street.

In the short seven months since that original posting, I’ve received several e-mails from a variety of readers expressing positive feedback about it. I’ve also had the opportunity to present it at a couple of conferences on a pretty large screen (something I enjoyed due to the increased visual impact). I’ve even received requests from others (parents and educators) to present it themselves in one form or another – simply because they were interested in presenting the idea of parenting autistic children in a more optomistic light than one might find in the mainstream media.

I’ll ask for my fellow LBRB authors’ indulgence in running a “repeat”, but I think there is a message here that bears repeating from time to time. Amidst all the media and internet coverage of autism, families need to know that their challenges are shared, and at the same time, know that expectations of success can be helpful. While specific successes are never guaranteed, I think flexibility and calm in the face of uncertainty can reduce stress – and probably improve family life overall.

I’d also like highlight something mentioned by commenter Prometheus – sage commentary if you ask me:

Ooooh!

It brought back chills from when I was first learning to do cross-wind landings.

It also brought back chills from when I was first learning to deal with a disabled child.

Good advice to all parents, especially those with an autistic child.

If I may extend your analogy a bit further, there is more than one way to do a cross-wind landing (and any landing you can walk away from is a “good” landing).

The worst thing to do is to freeze up – to say “I can’t do this”.

[Link in the comment by Prometheus was added] All this being said, please enjoy (and spread it around if you are so inclined). Here’s the video:

http://video.google.com/googleplayer.swf?docid=-2521787638543598212&hl=en&fs=true

Tags:

GFCF Double Blind Study

9 Aug

Washington, Aug 8 : In one of the first double-blind, clinical studies, scientists at The University of Texas Health Science Center at Houston will be seeking to determine if gluten and dairy products have a role to play in autistic behaviour, as has long been claimed by parents.

Source

This should be interesting.

Personally, I don’t have much of an issue with the GFCF diet, aside from the lack of evidence supporting it. Regulating someone’s diet is nowhere near as dangerous as chelation or Lupron injections or industrial cleaner being marketed as chelators. But maybe a nutritionist will correct me on that.

I am a little bit worried about a statement attributed to one of the study authors:

A lot of children with autism have gastrointestinal problems such as constipation and diarrhea.

Do they? Is there any actual evidence beyond the anecdotal that backs that statement up? I can’t recall seeing any myself. Not that I’m omniscient on the subject you understand.

We tried our autistic child on the diet shortly after xyr diagnosis and it did absolutely nothing. But then I think we misunderstood it. Xe didn’t have any diet or gastro issues to begin with. We were still in that rather naive ‘must cure at all costs’ phase and there was only a small handful of websites dedicated to autism or autism treatments. Indeed, one of the things that amazes me is how autism has become something of an industry over the five years or so.

Anyway, I’ll be interested to see how this one pans out. How ’bout you?

Britney Spears thinks son might be autistic

8 Aug

I can’t believe I’ve linked to stories about so many Hollywood stars (and Jenny McCarthy) lately but here we go again. Apparently, Britney Spears thinks her son Jayden might be autistic.

Compared to his big brother, Sean Preston, little Jayden “often seems to be in his own world,” family friends say.

“He plays alone a lot,” an In Touch Weekly snitch says. “Jayden often starts crying for no apparent reason,” a friend of K-Fed’s adds.

Um, well, apart from the first statement, I don’t see any red flags for autism. No ones mentioned a lack of eye contact or slow development (or none) of communication skills. On the other hand, it may well explain why Britney turned up at a Gen Rescue gig recently.

I’m not going to get into a Britney-bash. She’s been touted as a manic depressive and us loons have to stick together. I will mention however, that from what I’ve seen on TV, the Spears/Federline children have not had an easy ride of it lately and maybe these ‘symptoms’ might go away if mum and dad grew up a bit and stopped attacking each other publicly. Might also help if every tabloid in the entire Western hemisphere backed off and gave Spears some room to sort both herself and her kids out.

So, if Jayden does get diagnosed (who by? Lets hope its not Jay ‘Polio can be cured by not eating cheese’ Gordon) will she go down the anti-vaccine route? Has the lad even _been_ vaccinated?

I expect she will as she’s already been co-opted by McCarthy and GR. That means we have lots more celeb induced silliness to put up with and even less emphasis on science. Woo-hoo.

Socially aloof? Moi?

19 Jul

A New Scientist report discusses an intruiging new study that reports on how parents of autistic people process visual information. Turns out they do it very similarly to their autistic offspring:

The study evaluated how parents of autistic children evaluated facial expressions and found that they gauge the faces in exactly the same way as people having the disorder, despite them not being classified as autistic themselves.

And

They discovered that while those having autism had to make effort to read others’ emotions, all three groups of parents scored equally on the task, getting it right around 83 percent of the time.

But, when they paid attention to how the parents were judging the faces, it was found that the socially aloof parents with autistic children were increasingly dependent on looking at the mouths of the faces, and not the eyes.

“This bears a striking resemblance to what we have reported previously in individuals with autism,” New Scientist quoted Adolphs, as saying.

On the other hand, neurotypical people seemed to be more interested in looking at people’s eyes, in order to read how they are feeling.

This is yet another small cog in support of the genetic case for autism and a pretty interesting study in its own right.

“It definitely supports the idea that there is a genetic basis to autism,” says Angelica Ronald, an autism researcher at Kings College London.

One emerging theory is that behavioural traits such as introversion are passed down genetically, so if you have a parent who is introverted and another who is mildly obsessive, their child could be at increased risk of developing autism – although environmental factors are also likely to play a role as well.

The ‘social aloofness’ of parents of autistic people is something I’ve heard mentioned time and again, both online and amongst the parents I know locally to me. They (me too) tend to have few close friends and are quite happy with that, they are not big fans of smalltalk and are very happy with that. They have a few other features of autism too, which is again, not an unknown phenomenom.

I have heard some criticism of this study that it is tying to bring back the Bettlheim era of ‘refrigerator parents’. I don’t see how myself. That useless, unscientific idea expressley blamed parents for their children’s autism, stating it was a direct cause of bad parenting. This is is just an interesting take on how the parents of autistic kids in this study processed information in a way similar to their kids. The idea of blaming onesself for the genes you carry is faintly ridiculous anyway.

Age of Autism get annoyed at Amanda Peet

15 Jul

Remember last week when actress Amanda Peet gave a few people some home truths?

Once we had spoken, I was shocked at the amount of misinformation floating around, particularly in Hollywood,” says Peet, who quickly boned up on the hot-button controversies surrounding the topic, including the unproven link between certain vaccines and autism; the safety of preservatives like mercury-based thimerosal; and the fear that the relatively high number of shots kids receive today can overwhelm young immune systems. Her conclusion? Well, not only is Frankie up-to-date on her vaccines (with no staggering), but her mom will soon appear in public-service announcements for Every Child by Two. “I buy 99 percent organic food for Frankie, and I don’t like to give her medicine or put sunscreen on her,” says Peet. “But now that I’ve done my research, vaccines do not concern me.” What does concern her is the growing number of unvaccinated children who are benefiting from the “shield” created by the inoculated—we are protected from viruses only if everyone, or most everyone, is immunized: “Frankly, I feel that parents who don’t vaccinate their children are parasites.”

Well, today, Age of Autism posted a blog entry that gave full vent to their response:

…you have no idea who you are messing with. You have never seen the power of our numbers, our anger, our commitment, and our conviction. At present, you really have no dog in this fight.

Quite apart from the overtly threatening tone, I would like to remind these people that of _course_ Ms Peet has a ‘dog in this fight’. Everyone does. The collective health of us all clearly affects everyone. Parents who blog on Age of Autism and who blog about Gardasil have ‘no dog in that fight’ according to AoA logic.

The blog post contains one amusing little faux pas:

Ms. Peet’s decision to work with them [CDC] is analogous to the scientists in the 1950s who chose to assert that cigarettes do not cause lung cancer and work closely with Philip Morris to do so…

This is the same blog that continues to trumpet the opinion of Bernadine Healy who actually _did_ assert that cigarettes do not cause cancer and worked closely with Philip Morris to do so. Its either stupidity or a purposeful attempt to obfuscate the truth, I couldn’t possibly say.

The blog post closes with the contact details of Ms Peets advisors, along with the further threat:

…your client has chosen to align herself with him [Paul Offit]. In doing so, Ms. Peet puts herself directly in the line of fire.

If you wish to support Ms Peet’s stance, which I believe is a good one for both public health _and_ which will have a positive impact on autism in terms of moving on from this increasingly desperate and nasty campaign to convince the world vaccines cause autism, then please leave a comment in the comments section of this post, or email me (kevleitchATgmailDOTcom).

I can assure you that unlike the emails that will be sent using the details provided by the AoA blog, your comments will definitely be seen by Ms Peet.

Additional: There’s a nice piece on Amanda Peet and vaccines in Salon.com today.

Does 'autism' disrupt? And what does it disrupt?

8 Jul

Interesting post in the Seattle Times today. The title is _”Autism disrupts work and pay, article says”_ .

The article in question is a new study from Pediatrics:

<blockquote>An emerging body of work is showing the impact an autism diagnosis has on a family….<blockquote>….families with a child with ASD were 7 times more likely to report that child care problems affected employment than comparable families with typically developing children. These accommodations probably result in lower household income.</blockquote></blockquote>

Now, I’ll be upfront and say that I know those circumstances to be true. A combination of my own diagnosis (of manic depression) and my child’s diagnosis of severe autism with associated learning difficulties has made things very difficult at times. It is a simple truth that I cannot progress in my chosen career (I am a web developer) much past the stage I am at now because doing so means committing myself  (excuse the pun) to a schedule of work I cannot possibly meet, given our home circumstances. A lot of my professional friends and colleagues who are about my age and are of a similar skill level to me are now either owning their own companies or heading up teams of designers.

But…is it right to say that autism is the disrupting influence? Obviously In my own life there are my own personal medical issues but even so, I do not think it is right to say that it is _this_ which is the disruptive influence.

It is a simple truth that much more is expected of workers of this generation. People of my parents age never had the work pressures we do now. Employees are expected to work ‘above and beyond’ if they want to progress. To work hours beyond – way beyond – their contracted hours, to never be ill, to keep holidays to a time that is non disruptive to the employer. We in the West have started to live to work rather than working to live.

For a family with a special needs child (of any age) it is simply not realistic that they can meet this expectation. And so we _do_ need to expect a less financially comfortable life.

But what is the disrupting influence? Is it autism? Is it manic depression? Is it Down’s Syndrome? Is it Cerebral Palsy? Is it any other physical or mental difference?

Or is it the demands of a society that is putting less and less stock on the family and more on work?

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