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Dismay at Aspie ‘hate’

15 Feb

I read Bev’s latest blog entry bemused and increasingly dismayed. I thought (hoped) maybe she was wrong and had grasped the wrong end of the stick but not only is that unlikely coming from Bev it was wrong. She was spot on. There really were, I realised to my dawning amazement, people with an Aspergers diagnosis who were upset at the possibility of the DSM (V) placing them inside an overall category of ‘autism’. And not for any particularly legitimate reason but mostly because they didn’t want to be associated with the people who I’ve heard them describe as ‘low functioning’.

The comments I read under the story featuring Michael John Carely of GRASP for example pointed towards an internal selfishness bordering on disgust for those who _already_ share their place on the spectrum.

A stunningly nasty comment on this blog illustrates the issue even more handily:

Medical science used to have morons, idiots and imbeciles to describe people with defective brains, but those words became pejoratives, and mentally retarded was substituted. Then mentally retarded became a pejorative, and that got switched to developmentally disabled. Many parents with children born with defective brains glommed onto “autistic” because it had more cachét than retarded or fetal alcohol syndrome or brain damaged, perverting the word autistic and turning it into a new synonym for retarded.

So I don’t want to be called “autistic”. I prefer the distinction Asperger’s brings me; that I am endowed with a different brain, not suffering from a defective brain.

The only positive thing you can say about this commenter is at least they are being totally honest. I’ve read an uncomfortable amount of comments from aspies over the last few days that skirt around the exact same feeling but just don’t come out and say it quite so blatantly.

I know for a fact that not all aspies feel like this but I think those that don’t need to follow Bev’s example and come out and say so. Loudly and clearly. I don’t believe that aspies who want to disassociate themselves from their autistic comrades deserve any part in a movement like neurodiversity. I hope, I believe, that the aspies I count amongst my friends and colleagues feel that way too.

Update
Ari pointed me towards some comforting support from ASAN on the issue:

http://www.newscientist.com/article/dn18508-psychiatrys-draft-new-bible-goes-online.html?full=true
http://blogs.edweek.org/edweek/speced/

Update No.2
More blog reactions. If anyone knows of more please leave the address in the comments and I’ll add them to what I hope will be an ever growing list.

Clay – http://cometscorner-clay.blogspot.com/2010/02/true-neurodiversity-welcomes-dsm-v.html

Samantha – http://unclesamscabin.blogspot.com/2010/02/resisting-taint-of-autism.html

U.S. Government Committee recomends increased research into the needs of autistic adults

5 Feb

The Interagency Autism Coordinating Committee is a group representing government agencies that research autism and some segments of the autism community. It was reenacted as a result of the Combating Autism Act. The main product, if you will, of the IACC is the Strategic Plan, which lays out a suggested framework for the U.S. government’s autism research activities.

The main section of the Plan is divided into seven sections, framed around questions. I think it unfortunate that the questions are voiced as though they are posed by a parent. Be that as it may, here are the sections/questions:

1. When Should I Be Concerned?
2. How Can I Understand What Is Happening?
3. What Caused This To Happen And Can This Be Prevented?
4. Which Treatments And Interventions Will Help?
5. Where Can I Turn For Services?
6. What Does The Future Hold?
7. What other Infrastructure and Surveillance Needs Must be Met?

It is my belief, and that of many others, that the most important section is number 6: what does the future hold? This section covers research into understanding autistic adults. This is an area that has been woefully neglected in my opinion.

The goals below have a projected total budget of over US$50 million. I’d like to see a lot more. I’d like to see it now. But this is a good step forward.

Short-Term Objectives

1. New objective
Launch at least two studies to assess and characterize variation in the quality of life for adults on the ASD spectrum as it relates to characteristics of the service delivery system (e.g., safety, integrated employment, post-secondary educational opportunities, community inclusion, self-determination, relationships, and access to health services and community-based services) and determine best practices by 2012. IACC Recommended Budget: $5,000,000 over 3 years.
2. New objective
Evaluate at least one model, at the state and local level, in which existing programs to assist people with disabilities (e.g., Social Security Administration, Rehabilitation Services Administration) meet the needs of transitioning youth and adults with ASD by 2013. IACC Recommended Budget: $5,000,000 over 3 years.
3. New objective
Develop one method to identify adults across the ASD spectrum who may not be diagnosed, or are misdiagnosed, to support service linkage, better understand prevalence, track outcomes, with consideration of ethical issues (insurance, employment, stigma) by 2015. IACC Recommended Budget: $8,400,000 over 5 years.
4. New objective
Conduct at least one study to measure and improve the quality of life-long supports being delivered in community settings to adults across the spectrum with ASD through provision of specialized training for direct care staff, parents, and legal guardians, including assessment and development of ASD-specific training, if necessary, by 2015. IACC Recommended Budget: $7,500,000 over 5 years.

Long-Term Objectives

1. New objective
Develop at least two individualized community-based interventions that improve quality of life or health outcomes for the spectrum of adults with ASD by 2015. IACC Recommended Budget: $12,900,000 over 5 years.
2. New objective
Conduct one study that builds on carefully characterized cohorts of children and youth with ASD to determine how interventions, services, and supports delivered during childhood impact adult health and quality of life outcomes by 2015. IACC Recommended Budget: $5,000,000 over 5 years.
3. New objective
Conduct comparative effectiveness research that includes a cost-effectiveness component to examine community-based interventions, services and supports to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2018. IACC Recommended Budget: $6,000,000 over 5 years.
4. New objective
Conduct implementation research to test the results from comparative effectiveness research in real-world settings including a cost-effectiveness component to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2023. IACC Recommended Budget: $4,000,000 over 5 years.

IACC calls for $175 million in autism and the environment research

5 Feb

The Interagency Autism Coordinating Committee has posted the revised Strategic Plan. I blogged it recently here on LeftBrainRightBrain. I made a note of the large commitment to environmental causation research. I thought it worthwhile to highlight that section, since this is the cause of so much criticism of the IACC.

Strangely, the criticism doesn’t come from those who are supposedly “It’s all genetic” types. No, the “it’s all environmental” groups seem to be very loud in complaining that all the research funding is going into genetics.

The Plan is divided by a number of questions. Research into causation is listed in Question 3: “What Caused This To Happen And Can This Be Prevented?”

Under that category, there are seven projects on environmental or gene-environment research. Seven out of 10 projects. The estimated budget for all these projects? $175,900,000.

In other words, 70% of the projects and, if I did my math right, nearly 70% of the funding for causation is estimated to be going to environment and gene-environment projects.

This would seem like a great victory for those who have lobbied for more environmental research. I have yet to see anyone from that group even mention the new Strategic Plan, much less the large commitment to environmental research. Where are the statements from SafeMinds (who have a very vocal member who sits on the IACC proper and another who is on a working group)? How about Generation Rescue? The National Autism Association?

In my opinion, these groups really don’t care much about environmental causation unless it is either mercury or vaccines. Hey, I could be wrong. Let’s see if they surprise me with some acknowledgment of this effort by the US Government.

Here are the objectives if you would like to read for yourself.

Short-Term Objectives

1. Coordinate and implement the inclusion of approximately 20,000 subjects for genome-wide association studies, as well as a sample of 1,200 for sequencing studies to examine more than 50 candidate genes by 2011. Studies should investigate factors contributing to phenotypic variation across individuals that share an identified genetic variant and stratify subjects according to behavioral, cognitive, and clinical features. IACC Recommended Budget: $43,700,000 over 4 years.
2. Within the highest priority categories of exposures for ASD, identify and standardize at least three measures for identifying markers of environmental exposure in biospecimens by 2011. IACC Recommended Budget: $3,500,000 over 3 years.
3. Initiate efforts to expand existing large case-control and other studies to enhance capabilities for targeted gene – environment research by 2011. IACC Recommended Budget: $27,800,000 over 5 years.
4. Enhance existing case-control studies to enroll racially and ethnically diverse populations affected by ASD by 2011. IACC Recommended Budget: $3,300,000 over 5 years.
5. New objective
Support at least two studies to determine if there are subpopulations that are more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems) by 2012. IACC Recommended Budget: $8,000,000 over 2 years.
6. New objective
Initiate studies on at least 10 environmental factors identified in the recommendations from the 2007 IOM report “Autism and the Environment: Challenges and Opportunities for Research” as potential causes of ASD by 2012. Estimated cost $56,000,000 over 2 years.

Long-Term Objectives

1. Conduct a multi-site study of the subsequent pregnancies of 1,000 women with a child with ASD to assess the impact of environmental factors in a period most relevant to the progression of ASD by 2014. IACC Recommended Budget: $11,100,000 over 5 years.
2. Identify genetic risk factors in at least 50% of people with ASD by 2014. IACC Recommended Budget: $33,900,000 over 6 years.
3. Determine the effect of at least five environmental factors on the risk for subtypes of ASD in the pre- and early postnatal period of development by 2015. IACC Recommended Budget: $25,100,000 over 7 years.
4. Support ancillary studies within one or more large-scale, population-based surveillance and epidemiological studies, including U.S. populations, to collect data on environmental factors during preconception, and during prenatal and early postnatal development, as well as genetic data, that could be pooled (as needed), to analyze targets for potential gene/environment interactions by 2015. IACC Recommended Budget: $44,400,000 over 5 years.

Read more: https://leftbrainrightbrain.co.uk/2010/02/iacc-strategic-plan-is-up/#ixzz0edI3Pe8h

The new IACC Strategic Plan is online

4 Feb

The Interagency Autism Coordinating Committee (IACC) has posted the revised “Strategic Plan“. This is the document which is supposed to guide US Government funded autism research.

The Strategic Plan is written from a parent’s perspective. It is divided into 7 questions to be answered. Below I list the parts I think are the “meat” of the Plan–the proposed projects with estimated budgets.

In a very quick skim through the budget, I get 7 projects on environmental causes or gene-environment causes, with budgets totaling nearly $200M. Keep that in mind when people say there is no “environmental” research in the Plan.

There are a lot of new projects. My quick sum gives about $64M in projects for question 6 “What Does the Future Hold, Particularly for Adults?” I This is, to me, the most important part of the Plan.

Question 1: When Should I Be Concerned?

Short-Term Objectives

1. Develop, with existing tools, at least one efficient diagnostic instrument (e.g., briefer, less time intensive) that is valid in diverse populations for use in large-scale studies by 2011. IACC Recommended Budget: $5,300,000 over 2 years.
2. Validate and improve the sensitivity and specificity of new or existing screening and diagnostic tools, including comparison of general developmental screening versus autism-specific screening tools, in both high risk and population-based samples through studies of the following community populations that are diverse in terms of age, socio-economic status, race, ethnicity, characteristics of ASD, and general level of functioning by 2012. IACC Recommended Budget: $5,400,000 over 3 years.
3. New objective
Conduct at least three studies to identify reasons for the health disparities in accessing early screening and diagnosis services by 2012. IACC Recommended Budget: $2,000,000 over 2 years.
4. New objective
Conduct at least two studies to understand the impact of early diagnosis on choice of intervention and outcomes by 2015. IACC Recommended Budget: $6,000,000 over 5 years.

Long-Term Objectives

1. Identify behavioral and biological markers that separately, or in combination, accurately identify, before age 2, one or more subtypes of children at risk for developing ASD by 2014. IACC Recommended Budget: $33,300,000 over 5 years.
2. Develop at least five measures of behavioral and/or biological heterogeneity in children or adults with ASD, beyond variation in intellectual disability, that clearly relate to etiology and risk, treatment response and/or outcome by 2015. IACC Recommended Budget: $71,100,000 over 5 years.
3. Identify and develop measures to assess at least three “continuous dimensions” (i.e., social reciprocity, communication disorders, and repetitive/restrictive behaviors) of ASD symptoms and severity that can be used by practitioners and/or families to assess response to intervention for people with ASD across the lifespan by 2016. IACC Recommended Budget: $18,500,000 over 5 years.

Question 2: How Can I Understand What Is Happening?

Short-Term Objectives

1. Support at least four research projects to identify mechanisms of metabolic and/or immune system interactions with the central nervous system that may underlie the development of ASD during prenatal-postnatal life by 2010. IACC Recommended Budget: $9,800,000 over 4 years.
2. Launch three studies that specifically focus on the neurodevelopment of females with ASD, spanning basic to clinical research on sex differences by 2011. IACC Recommended Budget: $8,900,000 over 5 years.
3. Identify ways to increase awareness among the autism spectrum community of the potential value of brain and tissue donation to further basic research by 2011. IACC Recommended Budget: $1,400,000 over 2 years.
4. New objective
Launch three studies that target improved understanding of the underlying biological pathways of genetic conditions related to autism (e.g. Fragile X, Rett syndrome, tuberous sclerosis complex) and how these conditions inform risk assessment and individualized intervention by 2012. IACC Recommended Budget: $9,000,000 over 5 years.
5. New objective
Launch three studies that target the underlying biological mechanisms of co-occurring conditions with autism including seizures/epilepsy, sleep disorders and familial autoimmune disorders by 2012. IACC Recommended Budget: $9,000,000 over 5 years.
6. New objective
Launch two studies that focus on prospective characterization of children with reported regression, to investigate potential risk factors by 2012. IACC Recommended Budget: $4,500,000 over 5 years.
7. New objective
Support five studies that associate specific genotypes with functional or structural phenotypes, including behavioral and medical phenotypes (e.g., nonverbal individuals with ASD and those with cognitive impairments) by 2015. IACC Recommended Budget: $22,600,000 over 5 years.

Long-Term Objectives

1. Complete a large-scale, multi-disciplinary, collaborative project that longitudinally and comprehensively examines how the biological, clinical, and developmental profiles of individuals, with a special emphasis on females, youths, and adults with ASD, change over time as compared to typically developing people by 2020. IACC Recommended Budget: $126,200,000 over 12 years.
2. New objective
Launch at least three studies which evaluate the applicability of ASD phenotype and/or biological signature findings for performing diagnosis, risk assessment, or clinical intervention by 2015. IACC Recommended Budget: $7,200,000 over 5 years.

Question 3: What Caused This To Happen And Can This Be Prevented?

Short-Term Objectives

1. Coordinate and implement the inclusion of approximately 20,000 subjects for genome-wide association studies, as well as a sample of 1,200 for sequencing studies to examine more than 50 candidate genes by 2011. Studies should investigate factors contributing to phenotypic variation across individuals that share an identified genetic variant and stratify subjects according to behavioral, cognitive, and clinical features. IACC Recommended Budget: $43,700,000 over 4 years.
2. Within the highest priority categories of exposures for ASD, identify and standardize at least three measures for identifying markers of environmental exposure in biospecimens by 2011. IACC Recommended Budget: $3,500,000 over 3 years.
3. Initiate efforts to expand existing large case-control and other studies to enhance capabilities for targeted gene – environment research by 2011. IACC Recommended Budget: $27,800,000 over 5 years.
4. Enhance existing case-control studies to enroll racially and ethnically diverse populations affected by ASD by 2011. IACC Recommended Budget: $3,300,000 over 5 years.
5. New objective
Support at least two studies to determine if there are subpopulations that are more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems) by 2012. IACC Recommended Budget: $8,000,000 over 2 years.
6. New objective
Initiate studies on at least 10 environmental factors identified in the recommendations from the 2007 IOM report “Autism and the Environment: Challenges and Opportunities for Research” as potential causes of ASD by 2012. Estimated cost $56,000,000 over 2 years.

Long-Term Objectives

1. Conduct a multi-site study of the subsequent pregnancies of 1,000 women with a child with ASD to assess the impact of environmental factors in a period most relevant to the progression of ASD by 2014. IACC Recommended Budget: $11,100,000 over 5 years.
2. Identify genetic risk factors in at least 50% of people with ASD by 2014. IACC Recommended Budget: $33,900,000 over 6 years.
3. Determine the effect of at least five environmental factors on the risk for subtypes of ASD in the pre- and early postnatal period of development by 2015. IACC Recommended Budget: $25,100,000 over 7 years.
4. Support ancillary studies within one or more large-scale, population-based surveillance and epidemiological studies, including U.S. populations, to collect data on environmental factors during preconception, and during prenatal and early postnatal development, as well as genetic data, that could be pooled (as needed), to analyze targets for potential gene/environment interactions by 2015. IACC Recommended Budget: $44,400,000 over 5 years.

Question 4: Which Treatments and Interventions will Help?

Short-Term Objectives

1. Support at least three randomized controlled trials that address co-occurring medical conditions associated with ASD by 2010. IACC Recommended Budget: $13,400,000 over 3 years.
2. Standardize and validate at least 20 model systems (e.g. cellular and/or animal) that replicate features of ASD and will allow identification of specific molecular targets or neural circuits amenable to existing or new interventions by 2012. IACC Recommended Budget: $75,000,000 over 5 years.
3. Test safety and efficacy of at least five widely used interventions (e.g., nutrition, medications, assisted technologies, sensory integration, medical procedures) that have not been rigorously studied for use in ASD by 2012. IACC Recommended Budget: $27,800,000 over 5 years.
4. Complete two multi-site randomized controlled trials of comprehensive early intervention that address core symptoms, family functioning and community involvement by 2013. IACC Recommended Budget: $16,700,000 over 5 years.
5. New objective
Convene a workshop to advance the understanding of clinical subtypes and treatment personalization (i.e. what are the core symptoms to target for treatment studies) by 2011. IACC Recommended Budget: $50,000.
6. New objective
Launch five randomized controlled trials of interventions including biological signatures and other measures to predict response, and monitor quality of life and functional outcomes, in each of the following groups:

* Five trials in infants and toddlers by 2013. IACC Recommended Budget: $30,000,000 over 5 years.
* Three randomized controlled trials of interventions for school-aged children and/or adolescents by 2013. IACC Recommended Budget: $18,000,000 over 5 years.
* Three trials for adults by 2014.IACC Recommended Budget: $18,000,000 over 5 years.

Long-Term Objectives

1. Complete at least three randomized controlled trials on medications targeting core symptoms in people with ASD of all ages by 2014. IACC Recommended Budget: $22,200,000 over 5 years.
2. Develop interventions for siblings of people with ASD with the goal of reducing risk recurrence by at least 30% by 2014. IACC Recommended Budget: $6,700,000 over 5 years.
3. New objective
Conduct at least one study to evaluate the safety and effectiveness of medications commonly used in the treatment of co-occurring conditions or specific behavioral issues in people with ASD by 2015. IACC Recommended Budget: $10,000,000 over 5 years.

Question 5: Where Can I Turn for Services?

Short-Term Objectives

1. Support two studies that assess how variations and access to services affect family functioning in diverse populations, including underserved populations, by 2012. IACC Recommended Budget: $1,000,000 over 3 years.
2. New objective
Conduct one study to examine how self-directed community-based services and supports impact children, youth, and adults with ASD across the spectrum by 2014. IACC Recommended Budget: $6,000,000 over 3 years.
3. New objective
Implement and evaluate two models of policy and practice-level coordination among state and local agencies to provide integrated and comprehensive community-based supports and services that enhance access to services and supports, self-determination, economic self-sufficiency, and quality of life for people with ASD across the spectrum and their families, with at least one project aimed at the needs of transitioning youth by 2015. IACC Recommended Budget: $10,000,000 over 5 years.

Long-Term Objectives

1. Test four methods to improve dissemination, implementation, and sustainability of evidence-based interventions, services, and supports in diverse community settings by 2013. IACC Recommended Budget: $7,000,000 over 5 years.
2. Test the efficacy and cost-effectiveness of at least four evidence-based services and supports for people with ASD across the spectrum and of all ages living in community settings by 2015. IACC Recommended Budget: $16,700,000 over 5 years.
3. New objective
Evaluate new and existing pre-service and in-service training to increaseskill levels in service providers, including direct support workers, parents and legal guardians, education staff, and public service workers to benefit the spectrum of people with ASD and promote interdisciplinary practice by 2015. IACC Recommended Budget: $8,000,000 over 5 years.

Question 6: What Does the Future Hold, Particularly for Adults?

Short-Term Objectives

1. New objective
Launch at least two studies to assess and characterize variation in the quality of life for adults on the ASD spectrum as it relates to characteristics of the service delivery system (e.g., safety, integrated employment, post-secondary educational opportunities, community inclusion, self-determination, relationships, and access to health services and community-based services) and determine best practices by 2012. IACC Recommended Budget: $5,000,000 over 3 years.
2. New objective
Evaluate at least one model, at the state and local level, in which existing programs to assist people with disabilities (e.g., Social Security Administration, Rehabilitation Services Administration) meet the needs of transitioning youth and adults with ASD by 2013. IACC Recommended Budget: $5,000,000 over 3 years.
3. New objective
Develop one method to identify adults across the ASD spectrum who may not be diagnosed, or are misdiagnosed, to support service linkage, better understand prevalence, track outcomes, with consideration of ethical issues (insurance, employment, stigma) by 2015. IACC Recommended Budget: $8,400,000 over 5 years.
4. New objective
Conduct at least one study to measure and improve the quality of life-long supports being delivered in community settings to adults across the spectrum with ASD through provision of specialized training for direct care staff, parents, and legal guardians, including assessment and development of ASD-specific training, if necessary, by 2015. IACC Recommended Budget: $7,500,000 over 5 years.

Long-Term Objectives

1. New objective
Develop at least two individualized community-based interventions that improve quality of life or health outcomes for the spectrum of adults with ASD by 2015. IACC Recommended Budget: $12,900,000 over 5 years.
2. New objective
Conduct one study that builds on carefully characterized cohorts of children and youth with ASD to determine how interventions, services, and supports delivered during childhood impact adult health and quality of life outcomes by 2015. IACC Recommended Budget: $5,000,000 over 5 years.
3. New objective
Conduct comparative effectiveness research that includes a cost-effectiveness component to examine community-based interventions, services and supports to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2018. IACC Recommended Budget: $6,000,000 over 5 years.
4. New objective
Conduct implementation research to test the results from comparative effectiveness research in real-world settings including a cost-effectiveness component to improve health outcomes and quality of life for adults on the ASD spectrum over age 21 by 2023. IACC Recommended Budget: $4,000,000 over 5 years.

Question 7: What other Infrastructure and Surveillance Needs Must be Met?

Short-Term and Long-Term Objectives

1. Conduct a needs assessment to determine how to merge or link administrative and/or surveillance databases that allow for tracking the involvement of people living with ASD in healthcare, education and social services by 2009 . IACC Recommended Budget: $520,000 over 1 year.
2. Conduct an annual “State of the States” assessment of existing state programs and supports for people and families living with ASD by 2009. IACC Recommended Budget: $300,000 each year.
3. Develop and have available to the research community means by which to merge or link databases that allow for tracking the involvement of people in ASD research by 2010. IACC Recommended Budget: $1,300,000 over 2 years.
4. Establish and maintain an international network of biobanks for the collection of brain, fibroblasts for pluripotent stem cells, and other tissue or biological material, by acquisition sites that use standardized protocols for phenotyping, collection, and regulated distribution of limited samples by 2011. This includes developing fibroblast repositories to produce pluripotent stem cells. Protocols should be put into place to expand the capacities of ongoing large-scale children’s studies to collect and store additional biomaterials, promoting detection of biological signatures. IACC Recommended Budget for establishing biobanks by 2011: $10,500,000 over 2 years. IACC Recommended Budget for maintaining biobanks: $22,200,000 over 5 years.
5. New objective
Begin development of a web-based toolbox to assist researchers in effectively and responsibly disseminating their finding to the community, including people with ASD, their families, and health practitioners by 2011. IACC Recommended Budget: $400,000 over 2 years.
6. New objective
Create funding mechanisms that encourage rapid replication studies of novel or critical findings by 2011.
7. New objective
Develop a web-based tool which provides population estimates of ASD prevalence for states based on the most recent prevalence range and average identified by the ADDM Network by 2012. IACC Budget Recommendations: $200,000 over 2 years.
8. New objective
Create mechanisms to specifically support the contribution of data from 90 percent of newly initiated projects to the National Database for Autism Research (NDAR) and link NDAR with other existing data resources by 2012. IACC Recommended Budget: $6,800,000 over 2 years.
9. New objective
Supplement existing ADDM Network sites to use population-based surveillance data to conduct at least 5 hypothesis-driven analyses evaluating factors that may contribute to changes in ASD prevalence by 2012. IACC Recommended Budget: $660,000 over 2 years.
10. New objective
Develop the personnel and technical infrastructure to assist states, territories, and other countries who request assistance describing and investigating potential changes in the prevalence of ASD and other developmental disabilities by 2013. IACC Recommended Budget: $1,650,000 over 3 years.
11. New objective
Encourage programs and funding mechanisms that expand the research workforce, enhance interdisciplinary research training, and recruit early career scientists into the ASD field by 2013. IACC Recommended Budget: $5,000,000 over 3 years.
12. New objective
Expand the number of ADDM sites in order to conduct ASD surveillance in younger and older age groups; conduct complementary direct screening to inform completeness of ongoing surveillance; and expand efforts to include autism subtypes by 2015. IACC Recommended Budget: $16,200,000 over 5 years.
13. New objective
Support 10 “Promising Practices” papers that describe innovative and successful services and supports being implemented in communities that benefit the full spectrum of people with ASD, which can be replicated in other communities by 2015. IACC Recommended Budget: $75,000 over 5 years.

OK, we might as well get this over with–here are the times the Plan mentions the “V” word:

Numerous epidemiological studies have found no relationship between ASD and vaccines containing the mercury based preservative, thimerosal (Immunization Safety Review Committee, 2004). These data, as well as subsequent research, indicate that the link between autism and vaccines is unsupported by the epidemiological research literature. However, the IOM report acknowledged that the existing population-based studies were limited in their ability to detect small susceptible subpopulations that could be more genetically vulnerable to environmental exposures.

and

Of note, the Committee receives many public comments that reflect concerns about vaccines as a potential environmental factor in autism. Some members of the public are convinced that the current data are sufficient to demonstrate that vaccines do not play a causal role in autism and argue against using limited autism research funds to do additional vaccine studies when many other scientific avenues remain to be explored. At the same time, those who believe that prior studies of the possible role of vaccines in ASD have been insufficient argue that investigation of a possible vaccine/ASD link should be a high priority for research (e.g., a large-scale study comparing vaccinated and unvaccinated groups). A third view urges shifting focus away from vaccines and onto much-needed attention toward the development of effective treatments, services and supports for those with ASD.

and

To address public concerns regarding a possible vaccine/ASD link, it will be important for the IACC to continue to coordinate with the National Vaccine Advisory Committee (NVAC), a Federal advisory committee chartered to advise and make recommendations regarding the National Vaccine Program.

under research opportunities:

Monitor the scientific literature regarding possible associations of vaccines and other environmental factors (e.g., ultrasound, pesticides, pollutants) with ASD to identify emerging opportunities for research and indicated studies.

There closest thing to an actual proposed project (i.e. something with an estimated budget) is this one:

# New objective
Support at least two studies to determine if there are subpopulations that are more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems) by 2012. IACC Recommended Budget: $8,000,000 over 2 years.)

ASAN Update on Restraint & Seclusion Legislation National Call-In Day

15 Jan

I just received the following email from Meg Evans of the Autistic Self Advocacy Network (ASAN). ASAN is working on legislation to reduce seclusion and restraints within the schools. This alert calls for action next Thursday to call your representative (should you be a U.S. citizen) to support upcoming bills.

This is another ASAN Update for bloggers in the Autistic and disability rights communities. To increase support in Congress for the Preventing Harmful Restraint and Seclusion in Schools Act (H.R. 4247/S.2860), ASAN and APRAIS are asking disability rights advocates and others who favor the legislation to call members of Congress on Thursday, January 21st, and ask them to co-sponsor the bill. You can also help by reposting and distributing the announcement below.

As always, we encourage you to contact us with your comments, and please let us know if you would prefer to receive these announcements at a different address or to be removed from the list.

Best regards,

Meg Evans, Director of Community Liaison
Autistic Self Advocacy Network
mmevans@woh.rr.com

Here is the letter:

Dear Friends, Advocates and Community Members,

In one week, Congress will come back in session. The Autistic Self Advocacy Network (ASAN), in conjunction with the Alliance to Prevent Restraint, Aversive Interventions and Seclusion (APRAIS), is asking you to join us in a National Call-In Day on Thursday, January 21st to tell your members of Congress to support the Preventing Harmful Restraint and Seclusion in Schools Act (H.R. 4247/S.2860) introduced last month by Representatives George Miller (D-CA) and Cathy McMorris-Rodgers (R-WA) and Senator Chris Dodd (D-CT). This legislation would provide students with and without disabilities vital protections against abuse in schools. We are providing details on how to contact your members of Congress — please distribute this announcement widely.

WHAT YOU CAN DO:

Please call this coming Thursday and encourage your friends, family and coworkers to participate by dialing the Capitol Switchboard at 202-224-3121 and asking for your Congressional representative to Co-Sponsor H.R. 4247, and your senators to Co-Sponsor S. 2860.

To find out the names of your US Senators and Representative, click here (link to www.congress.org)
Ask for the offices of your US Senators and Representative
Ask to speak to the person working on education issues
Identify yourself as a constituent and the organization that you represent (if any)

Message: ” I am calling to urge (Senator y) to cosponsor S.2860, legislation preventing harmful use of restraint and seclusion in schools.”

Message: “I am calling to urge (Representative z) to cosponsor HR 4247, legislation preventing harmful use of restraint and seclusion in schools.”

Thanks for your advocacy. Increasing congressional support for these bills will help move them through the legislative process towards enactment. Please call on January 21, 2010 and tell your friends and family to join you. If you are interested in doing more, please e-mail us at info@autisticadvocacy.org for information about how you can arrange a meeting with your representatives to explain why this bill is essential or visit www.tash.org/aprais to learn more.

Regards,
The Autistic Self Advocacy Network and the APRAIS Coalition

National Council on Disabilities meeting next Tuesday

15 Jan

I realized a while back that I should be posting the announcements of the NCD (National Council on Disabilities) as well as the IACC announcements I post.

The NCD meeting is being held at the same time as the IACC meeting, for the first day at least. The NCD meeting starts on the 19th (the day of the IACC meeting) but goes on to the 21st. The meeting is being held in Houston, Texas.

Dear Friends and Colleagues:

On behalf of the National Council on Disability (NCD), it is my pleasure to invite you to attend NCD’s next quarterly meeting, which will take place at the JW Marriott Houston, 5150 Westheimer, Houston, TX, beginning at 8:30 a.m. on Tuesday, January 19, 2010, and ending at 11:00 a.m. on Thursday, January 21, 2010. This meeting is open to the public.

NCD’s purpose is to promote policies, programs, practices, and procedures that guarantee equal opportunity for all individuals with disabilities, and that empower individuals with disabilities to achieve economic self-sufficiency, independent living, and inclusion and integration into all aspects of society. To carry out this mandate we gather public and stakeholder input, including that received at our public meetings held around the country; review and evaluate federal programs and legislation; and provide the President, Congress, and federal agencies with advice and recommendations. NCD is an independent federal agency, composed of 15 members appointed by the President, by and with the consent of the U.S. Senate.

NCD believes it is vital to hear from communities around the country on what works and what does not for people with disabilities. This meeting will provide another opportunity for that exchange. The agenda will include, among other things, presentations by the Honorable Kathleen Martinez, Assistant Secretary of Labor for Disability Employment Policy and Lex Frieden, Professor of Health Informatics and Professor of Rehabilitation, University of Texas at Houston; presentations on emergency preparedness and youth with disabilities in transition; and two releases of NCD research projects: Workforce Infrastructure in Support of People with Disabilities and The State of Housing in America in the 21st Century: A Disability Perspective.

Specific times are also designated to receive public comment, supported by a toll-free call-in line, and input is encouraged and greatly appreciated. Individuals or organizations can also provide written comments by e-mail, fax, or mail. A public comment session will be held Wednesday, January 20, from 11:30 a.m. until Noon, CST. The toll-free call-in number is (888) 790-6568, and the pass code is “NCD Meeting.” Written comments on disability-related issues of concern or interest can also be emailed to mquigley@ncd.gov at any time.

You are also invited to join us for a reception at the hotel for meeting participants, audience members, and stakeholders from the disability community on Wednesday, January 20 from noon until 1:30 p.m. Additional details about the meeting will be posted on the NCD Web site at http://www.ncd.gov as soon as they become available. You will also find the meeting agenda posted there approximately 10 days before the meeting is scheduled, and written comments for Council consideration can be submitted at any time by writing to ncdinfo@ncd.gov.

For more information, please contact NCD’s Director of External Affairs, Mark S. Quigley, at mquigley@ncd.gov or by telephone at 202-272-2004 (V), 202-272-2074 (TTY), and please visit our Web site at http://www.ncd.gov. At that location you can also sign up to become a member of our extensive listserv, where you will get frequent updates about NCD activities, reports, and news of importance to the disability community nationwide.

We hope you will attend and participate.

Sincerely,

John R. Vaughn
Chairperson

IACC meeting next Tuesday

14 Jan

As always, you can submit comments for the meeting. You don’t have to wait for them to request comments. They will be voting on the Strategic Plan. This is a good time to submit comments.

Ms. Lina Perez
Office of Autism Research Coordination
National Institute of Mental Health, NIH
6001 Executive Boulevard, NSC
Room 8185a
Rockville, MD 20892-9669
Phone: 301-443-6040
E-mail: IACCPublicInquiries@mail.nih.gov

Here’s the announcement:

The Interagency Autism Coordinating Committee (IACC) will be holding a Full Committee Meeting on Tuesday, January 19, 2010 from 9:00 AM – 5:00 PM ET at the William H. Natcher Conference Center, NIH Campus, in Bethesda, MD.

The purpose of the IACC meeting is to discuss and vote on recommendations for the annual update of the IACC Strategic Plan for Autism Spectrum Disorders Research. The meeting will also include a presentation on epigenetics and autism by Dr. Andrew Feinberg of Johns Hopkins University School of Medicine.

The meeting will be open to the public and pre-registration is recommended. Seating will be limited to the room capacity and seats will be on a first come, first served basis, with expedited check-in for those who are pre-registered. The meeting will be remotely accessible by videocast and conference call. Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard.

To access the conference call:

USA/Canada Phone Number: 888-577-8995
Access code: 1991506

Individuals who participate using this service and who need special assistance, such as captioning of the conference call or other reasonable accommodations, should submit a request to the contact person listed above at least seven days prior to the meeting. If you experience any technical problems with the conference call, please-mail IACCTechSupport@acclaroresearch.com.

The latest information about the meeting can be found at: http://iacc.hhs.gov/events/2010/full-committee-mtg-announcement-January19.shtml

Five-percent of nothing

25 Dec

To paraphrase Mark Twain, a phony statistic will travel half way around the world before the truth can get its boots on – and even further when the phony statistic is hitched to the wagon of vaccine denialism.

A case in point: last June, blogger Amy Lutz  launched a broadside against neurodiversity with the following alleged quote:

Dr. (Lee) Wachtel estimates that “less than five percent” of diagnosed autistics have the linguistic and cognitive skills to participate in this movement. “Most are not going to grow up to be Temple Grandin,” she adds, referring to the famous autistic author and doctorate in animal science. On the contrary, Dr. Wachtel believes the average autistic will never go to college or live independently, and instead will struggle his entire life with the communication and social deficits that define the disorder…

Wachtel is a child and adolescent psychiatrist at Baltimore’s Kennedy Krieger Center. Lutz didn’t explain what it means to “participate” in neurodiversity, nor did she reflect on the fact that most kids don’t grow up to be Temple Grandin anyway. “This article by Lutz … has the appearance of journalism, and quotes a doctor in support of Lutz’s contention that neurodiversity is a bad thing, overall,” notes autism blogger Kim at CounteringAgeOfAutism, who tracked down the source of Wachtel’s alleged quote. “It doesn’t help that Lutz doesn’t seems to understand what neurodiversity is.”

Lutz’s post raised a few eyebrows. Commenter Jen Niebler wrote ND is not about “marginalizing the ‘real autistics’ – it’s about listening to all autistics and how they wish to be treated.” LBRB founder Kevin Leitch commented “A total misrepresentation of the ND viewpoint who (as I am one, and parent to a severely autistic child I am very aware of this) consider autism a disability AND a difference. Did the author talk to anyone from the ND community before writing this?”

Eventually Wachtel’s quote faded into the ether, only to be resurrected six months later in a comment at about.com, where blogger Lisa Jo Rudy worried that Ari Ne’eman’s recent nomination to the Council on Disability might not sit well with the anti-vaccine crowd. Commenter LoopyLoo wrote:

I’m frustrated and worried. High-functioning, highly verbal people with autism have just about zero in common with my severely impaired, non-verbal child. I’m glad that things have worked out so well for him, but in the general population of people with autism only about five percent will ever be able to participate in a movement like neuro-diversity. Acceptance of/for people who aren’t NT is a fine and lovely goal, but I’d rather have a cure.

When asked to source the “five percent” figure, LoopyLoo pointed to Wachtel. But a query to KK’s media relations office tells the rest of the story:

Regarding Dr. Wachtel’s quote, her comments were pulled from a conversation that she had with a parent. She wasn’t aware that they would appear on a large web site as was the result. Her comments were also made relative to the severely impaired patient population that she sees. The majority of these patients can be described as she did in her comments, but the full context of the discussion would include mention of the fact that advances are happening in the field of early intervention which may change outcomes for toddlers who are being newly diagnosed today at age two or earlier. Also – she does not have a citation or reference for the “less than 5 percent” reference. Again – it was a casual comment made to a parent, and within the context of her patient population.

In a follow up email, KK characterized Wachtel’s words as “casual comments made relative to Dr. Wachtel’s daily frame of reference – her severely affected patient population.” In other words, the five percent figure does not refer to all autism spectrum disorders.

The blogger, Amy Lutz, confirms the quote came from her private conversation with Wachtel, and she stands by it. “I asked Dr. Wachtel to approximate, based on her seven years of work in autism treatment and research, the percentage of diagnosed autistics who could actively participate in a political movement – because, as we all agree, there is (sic) no data in the scientific literature to answer this question,” said Lutz in an email. “Her answer, five percent, is, as I explicitly stated in my essay, an ‘estimate.'”

In a perfect world, a throwaway quote by a careless writer wouldn’t matter. But in our wired, interconnected world, poorly sourced quotes are sustenance for ideologues.

The premise here – that only the highest functioning autistics can “participate” in neurodiveristy –   would be news to many of the pro-ND bloggers who are significantly disabled, notes autism blogger Sullivan. “The fact of the matter is that everyone (autistic/non-autistic, all levels of disability) benefit from neurodiversity.”

As anti-vaccine activists and other line up to oppose Ari Ne’eman’s nomination, we are sure to see more inaccurate and self-serving definitions of neurodiveristy. And it’s a safe bet that the “five-percent” quote will surface yet again.

IACC full meeting this Friday

7 Dec

The announcement is below:

The Interagency Autism Coordinating Committee (IACC) will be holding a Full Committee Meeting on Friday, December 11, 2009 from 9:00 AM – 1:00 PM ET. The meeting will be conducted via telephone conference call and webinar only.

The purpose of the IACC meeting is to continue discussing recommendations for the annual update of the IACC Strategic Plan for Autism Spectrum Disorders Research.

The meeting will be conducted and available to the public via a telephone conference call phone number and a webinar conducted using a web presentation tool on the Internet. Registration is not required. Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard.

To access the conference call:

USA/Canada Phone Number: 888-455-2920
Access code: 9984461

To view the webinar:

https://www2.gotomeeting.com/register/906979171

Individuals who participate using this service and who need special assistance, such as captioning of the conference call or other reasonable accommodations, should submit a request to the contact person listed above at least seven days prior to the meeting. If you experience any technical problems with the web presentation tool or conference call, please-mail IACCTechSupport@acclaroresearch.com.

The latest information about the meeting can be found at: http://www.iacc.hhs.gov/events/2009/full-committee-mtg-announcement-December11.shtml

Another example of irresponsible blogging by David Kirby

14 Nov

Autism Speaks recently put out what I consider to be a rather irresponsible press release. The Interagency Autism Coordinating Committee (IACC) added a new objective, and Autism Speaks chose to frame it as “IACC includes vaccine research objective in strategic plan for autism research“. I’ve discussed that already, so I won’t go into more details here.

Instead, I want to take a look at how David Kirby treated this story. He blogged this as Top Federal Panel Endorses Autism Research That Includes Vaccines – Dueling Press Releases Ensue. Mr. Kirby takes on the role of (misinformed) cheerleader for the vaccine-epidemic groups that sponsor the Age of Autism blog, where the piece was posted. As you will see, he probably should have checked with his community before posting.

On Tuesday, the Interagency Autism Coordinating Committee (IACC), Washington’s leading arbiter for directing federal funds to autism research, unanimously voted to recommend studies that include investigations into possible links between autism and environmental triggers – including vaccines – in certain subsets of children.

Mr. Kirby is invited to check the actual process of federal funding of autism research and the role of the IACC. He could watch the latest video of an IACC meeting, where Dr. Insel (director of NIMH and chair of the IACC) makes it clear that the IACC is an advisory and planning committee only. They are far from the “final arbiter for directing federal funds”. That is a minor point compared to the fact that the IACC did not recommend studies into the possible links between autism and vaccines.

This fact that the IACC was not committing to vaccine-autism research was not missed by some of his readers, who are quoted in the conclusion of his recent blog post. A conclusion which is rather confused in tone:

So, just to recap: The Federal Government’s top autism panel has voted unanimously to support studies into autism and its possible environmental triggers – including vaccination. In turn, Autism Speaks has cheered “including vaccine research objectives in the IACC plan” while its supposed rival, ASF, has equally cheered that “vaccine research (is) out of the IACC autism plan.”

Some parents I spoke with grudglingly accepted ASF’s view of events, however. “IACC took out ALL proposed vaccine research studies; They specifically elimated A) a vax unvax study, B) an unvaxed or partially vaxed sibs study and C) an adjuvant study – all gone,” one mother wrote. “They only left the word “vaccine” in a along laundry list of POTENTIAL future possible (translation never) study topics.”

Whether the IACC has recommended specific vaccine-autism research, or environment-autism research, vaccines remain on the list of possible contributors to autistic regression as far as the US Government is concerned.

And that is just how Congressional leaders intended it to be.

If parents are telling Mr. Kirby that the IACC is not really committing to fund vaccine research, how can this “just how Congressional leaders intended it to be”, since Mr. Kirby is asserting that the congressional intent is to include vaccine-autism research? It reads a bit confusing to me.

Well, it’s confusing because David Kirby has once again edited his post after the fact. Take a look at this screenshot of the original post:

kirby_backpedal

Yep, it’s different. Sometime after he posted his piece, he added the entire paragraph :

Some parents I spoke with grudglingly accepted ASF’s view of events, however. “IACC took out ALL proposed vaccine research studies; They specifically elimated A) a vax unvax study, B) an unvaxed or partially vaxed sibs study and C) an adjuvant study – all gone,” one mother wrote. “They only left the word “vaccine” in a along laundry list of POTENTIAL future possible (translation never) study topics.”

Yes, David Kirby wrote a post praising the IACC’s actions as funding vaccine research and then backpedaled when autism parents emailed him with the reality of the situation: the IACC did not commit to funding vaccine research.

He also edited out a comment where he refers to a statment by Alison Singer of the Autism Science Foundation as “And there was this, almost Orwellian statement: ”

I guess it was Orwellian until his own readers agreed with it?

Can you find where Mr. Kirby notes his change in that piece? Neither can I. A major change like this should be noted in the piece.

I’ll take a side-trip here into discussing Mr. Kirby’s mistakes and the way he handles them. Unfortunately, Mr. Kirby has a history of changing blog posts after the fact, even to the point of leaving clearly erroneous posts online without a comment.

A few examples:

He wrote a post, “CDC: Vaccine Study Design “Uninformative and Potentially Misleading“”. After Blogger (and epidemiologist) epiwonk showed the mistakes in that post, Mr Kirby rewrote the post, complete with a note about the error. In an odd move, he left first the erroneous post online. As epiwonk showed, even the second post was seriously flawed, but Mr. Kirby chose to leave it online.

Mr. Kirby made a serious misquote in his presentation to congressional staffers. No mention of the error was made in the power point slides he posted online.

He made a factor of 10 error in reading a graph for a blog post. He copied the blog post from the Age of Autism blog to the Huffington Post, and corrected the error in his Huffington Post piece without correcting the Age of Autism piece.

He made the rather simple error of mistaking the Obama transition teams Change.gov website for the change.gov website. Again, he posted to both the Age of Autism blog and to the Huffington Post. Mr. Kirby added a comment to the Huffington Post piece, but just deleted the erroneous post on the Age of Autism blog.

I make mistakes. Sometimes pretty spectacular mistakes. But I think it shows a certain level of disrespect from Mr. Kirby in how he handles his mistakes.

But, I’ve digressed from the main topic here: how Mr. Kirby handled the press releases from Autism Speaks and the Autism Science Foundation about the IACC’s new objective. Even without the confusing conclusion and the changes made after the fact, Mr. Kirby’s post is irresponsible.

It is one thing to take on the role of cheerleader/journalist as Mr. Kirby has done. But he gets to walk away from this community. He’s tried to walk away once, and he is now about to embark on a new career path taking on factory farming. In a few years when parents are complaining that the government hasn’t funded vaccine-autism research like David Kirby told us the government would…in a few years when the bitterness comes to the surface…where will David Kirby be? Will he be here to take responsibility for the mess he has created?

I admit, this is minor compared to the mess he made with convincing parents that autism was caused by thimerosal. How many children have been “treated” with chelation who wouldn’t have if Mr. Kirby hadn’t taken on this cause? How many of them regressed or were otherwise harmed? We will never know.

And he will never accept his role in this and his responsibility.

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