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EBD Blog is joining Sheryl’s promotion of National De-lurking Week on Paper Napkin. I’m looking for a place to put this image in the navigation elements at the right. Suggestions welcome; leave them [ahem] in the comments on this post.

Sometimes when police officers interact with children and youths with Emotional and Behavioral Disorders, the results concern me, as noted previously in my posts Letter to editors, Law enforcement protection, and Police training recommended (also see mollyg’s comment on the last of these posts). I came across another instance recently and want to report it here with links for further study.

According to a report from the Oregon Advocacy Center (OAC), an independent and not-for-profit organization that provides advocates for people with disabilities in Oregon (US), the story is about an 11-year-old boy (4′4″ or 1.3 meters tall and 65 lbs or 30 kilograms in weight) who had a long history of Emotional and Behavioral Disorders. The boy, referred to as “J” in the report, lived in a residential facility that had a school on the premises. One day, in an apparent rage, he destroyed items in his special education classroom and a teacher aide suffered scrapes and bruises when unsuccessfully restraining him. The teacher and aide took the other children out of the room and sought assistance. Someone called the police, who apparently arrived promptly. Meanwhile, the boy barricaded himself in the room.

On October 4, 2004, four armed police officers wearing riot gear and pre-authorized by a police captain to use a taser gathered in an Oregon elementary school hallway outside of a special education classroom. From behind the barricaded doorway, they could hear the screaming and swearing of a single fifth-grader. He had been trashing the room’s contents for thirty minutes or more and throwing them through the hole where the door’s window had been. Eventually, the police got behind a table and entered the room by pushing aside the furniture piled against the door.

As the four officers entered, one with a drawn taser and the other three “capable of providing lethal cover if the need arose,” the boy held a five-inch long metal drawing compass with a pointed end over his head as if to throw it. The officer who carried the taser fired his darts. The boy dropped on his back, twitching as a 5-second cycle of 50,000 volts went through his body. When he stopped moving, he was lifted to his feet and handcuffed.

In my view, this situation represents several failings, many of which the OAC reported noted. It’s easy to express concern about use of a taser on a small child; the police officers needed to know and employ other ways of handling the situation, to be sure. However, the situation should never have been allowed to escalate to the point that someone at the school called police; there are both preventative measures and means of responding to violent outbursts that can be employed. Here’s more from the OAC report:

The injection of police into situations where special education students have emotional outbursts is a short-sighted remedy that has not been shown to be effective in our state or elsewhere. More importantly, calling police as a method to control children like J is, in our view, almost never necessary and almost always traumatic. In all but the truly dangerous circumstance where a student poses an imminent threat to another person, we believe that the introduction of police into the mix should be viewed as an indication of poor educational practice and planning.

To their credit, it appears that many people involved did good things. Teachers had received (apprently ineffective) training in restraint. Teachers took other students out of harm’s way. School personnel were apparently concerned about risks to the boy himself.

I am in no position to second guess the people involved in this situation. The realists among we special educators know that sometimes these students have outbursts. However, I see it as a good example of how people in my position and other similar positions—those charged with preparing teachers and other public servants to do their jobs—need to anticipate the possibility that our students will have to address such volitile situations. We need to make sure that special educators, not just the police, know how to handle problems such as those that this boy apparently presented.

Please add to the list by commenting: Schools need policies and procedures for handling emergencies. Teachers need to provide environments that reduce the probability of outbursts. Teachers need real practice (not just idle theorizing) about calm restraint. Administrators need the same. Etc.

Link to the OAC report. Link to an advertisement for a book by Dennis Debbaudt entitled Autism, Advocates, and Law Enforcement Professionals. A friend told me that developmental disabilities councils in US states have created or are creating guidelines on interactions; if you know of such documents in your area (US or not), please pass them along to me.

Writing in OpEdNews.com, Evelyn Pringle has published another version of an editorial claiming that Autism is caused by exposure to mercury in childhood vaccines, and that US government agencies—the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA)—have conspired to suppress the causal information. As in other reports, in this editorial, she depends almost exclusively on Dan Burton’s US Congress report.

On May 21, 2003, after a three year investigation, “The Mercury in Medicine Report” was released by the House Committee on Government Reform, and stated in part:

“Thimerosal used as a preservative in vaccines is likely related to the autism epidemic. This epidemic in all probability may have been prevented or curtailed had the FDA not been asleep at the switch regarding a lack of safety data regarding injected thimerosal and the sharper eyes of infant exposure to this known neurotoxin. The public health agencies’ failure to act is indicative of institutional malfeasance for self protection and misplaced protectionism of the pharmaceutical industry.”

The Congressional report also said that the CDC, due to its “biases against theories regarding vaccine-induced autism,” had chosen to fund researchers “who also worked for vaccine manufacturers to conduct population-based immunologic studies. . .” and stated:

“The CDC in general and the National Immunization Program are particularly conflicted in their duty to monitor the safety of vaccines, while also charged with the responsibility of purchasing vaccines for resale as well as promoting increased immunization rates.”

Ms. Pringle’s indictment dwells on the least trustworthy evidence on this topic and ignores the legitimate scientific research about the hypothesized connection. Assessments of the evidence of the mercury-autism link have pretty consistently shown that there is no connection. Here’s the first paragraph from the National Academy of Sciences report on the topic:

This eighth and final report of the Immunization Safety Review Committee examines the hypothesis that vaccines, specifically the measles-mumps-rubella (MMR) vaccine and thimerosal-containing vaccines, are causally associated with autism. The committee reviewed the extant published and unpublished epidemiological studies regarding causality and studies of potential biologic mechanisms by which these immunizations might cause autism. The committee concludes that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism. The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism. The committee further finds that potential biological mechanisms for vaccine-induced autism that have been generated to date are theoretical only.

Ms. Pringle also depends on arguments and data advanced by David and Mark Geier. As readers of EBD Blog know, Judge James A. Beaty, Jr., issued a Memorandum Opinion about Dr. Mark Geier’s credibility as an expert witness in a legal suit that contended that a child’s autism was caused by Thimerosal injections given to the mother during her pregnancy with the child. Judge Beaty explained that “Dr. Geier did not have the expertise to perform a differential diagnosis nor did his diganostic study sufficiently rule out other possible causes of the child’s autism” (quoted from EBD Blog, “Autism-thimerosal expert not.

So, the hypothesis doesn’t hold up to scientific scrutiny nor are the putative advocates able to secure legal standing as expert witnesses. Still, I suspect that the defenders of the hypothesis will not admit that it is wrong. It is very difficult to say, “I was mistaken.” Indeed, there is probably no evidence that will deter them. I’d like to ask the advocates, “What evidence would convince you that the mercury in vaccines does not cause autism?”

One can download the full text of the NAS report, Immunization Safety Review: Vaccines and Autism, from he NAS site. This report was developed and reviewed by some eminent scientistists, but it’s straight-forward reading.

Some of Ms. Pringle’s treatments of this topic:

• Government Investigation Finds Autism Vaccine Related from OpEdNews.com
• Autism – Cut The Crap from SierraTimes.com (reprinted in Scoop);
• FDA Knew Of Thimerosal Dangers 60 Years Ago from DadsAgainstMercury.org (also available in slightly different form via Prairie Collaborative Homepage);

To see a list of links to some of the Internet-available articles promoting the theory, check PutChildrenFirst. On EBD Blog, see here and here for other coverage of this topic.

Temple Grandin contributed a statement to “This I Believe,” the series of statements of personal opinion that airs on National Public Radio in the US. It’s available as print or, if one uses Real or Windows Media, as an audio file here.

Michael Boll and Nicole Sparapani provide AutismPodcast in support of parents of children with autism and related disorders. Mr. Boll has been a teacher and Ms. Sparapani is a practicing speech-language therapist; they also collaborate on “Moving Your Child Up the Spectrum” on Austism One Radio. In addition to the full podcasts, they offer briefer audio segments (“Tips”) that some may find interesting as well as related links for each show.

Kirsten, blogging as kirstencan on Typepad, is the mother of a young child with autism. She blogs about lots of other matters in addition to autism, and I haven’t reviewed the material on yardsales (for example), but her observations may be of interest to one or more of the two or three readers of EBD Blog. Read kirstencan posts on autism.

Here’s the text of my letter to the editors of the Charlottesville Daily Progress regarding the editorial to which I referred yesterday:

The Daily Progress got a lot right with its editorial entitled “Protecting mentally ill” (8 August 2006). As the editorial noted, this is a complex problem that is exacerbated by deinstitutionalization, the behavior of individuals with disabilities, and the legitimate need of officers to protect the public. Efforts by the task force convened by the Public Defender Office and other law enforcement officials to provide training for local police officers in handling difficult encounters with individuals with Emotional and Behavioral Disorders certainly deserve praise, and I am glad that the Progress recognized the merits of the effort.

However, the Progress editorial writer overlooked an important aspect of this issue: Law enforcement interactions with children and youths with Emotional and Behavioral Disorders. Sad news reports from Boise, ID, Denver, CO, and other areas describe terrible incidents—including the death of children with autism—as a consequence of confrontations between officers and children.

Fortunately, around the country law enforcement officials, public-interest groups, and researchers have worked together to develop curricula to help law enforcement personnel resolve untoward encounters between police officers and children with disabilities. I hope our local officials do not overlook the need to include training for officers in use of effective methods when they encounter problems with children and youth who have Emotional and Behavioral Disorders.

Under the title “Protecting mentally ill,” the Charlottesville (VA, US) Daily Progress (my local newspaper), published an editorial discussing the problem of interactions between law enforcement officers and indivdiduals with mental illness. The editorial writer lauded efforts by local law enforcement officials to address the issue of untoward interactions between officers and individuals with Emotional and Behavioral Disorders, including securing grant funds to advance training for officers.

It’s nice to have a newspaper focus on this issue. EBD Blog readers know that it’s one that concerns me, as noted in the following quote from the entry here entitled Police training recommended:

There are curricula available and in use for helping officers of the law to handle individuals with disabilities. Examples are here, here, and here; there are many others. Do you think your community should promote use of these curricula? Would using them reduce the chances of another child being killed? I hope so.

Sadly, the Daily Progress editorial did not note the critical need for attention to how police and other public-service officials might interact with children and youths who have Emotional and Behavioral Disorders. Look’s like it’s time for me to write a tradtional letter to the editor.

Link to the editorial.

Individuals with Tourette Syndrome and comorbid Learning Disabilities differ from those who have Tourette Syndrome alone in eight specific ways, according to research by Lawrence Burd and colleague that was published in 2005.

BMC Pediatr. 2005 Sep 1;5:34.

Tourette Syndrome and learning disabilities.

Burd L, Freeman RD, Klug MG, Kerbeshian J.

Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. laburd@medicine.nodak.edu

BACKGROUND: Tourette Syndrome (TS) is a neurodevelopmental disorder of childhood. Learning disabilities are frequently comorbid with TS. Using the largest sample of TS patients ever reported, we sought to identify differences between subjects with TS only and subjects with TS and a comorbid learning disability. METHODS: We used the Tourette Syndrome International Consortium database (TIC) to compare subjects with comorbid Tourette Syndrome and learning disabilities (TS + LD) to subjects who did not have a comorbid learning disability (TS-LD). The TIC database contained 5,500 subjects. We had usable data on 5,450 subjects. RESULTS: We found 1,235 subjects with TS + LD. Significant differences between the TS + LD group and the TS-LD group were found for gender (.001), age onset (.030), age first seen (.001), age at diagnosis (.001), prenatal problems (.001), sibling or other family member with tics (.024), two or more affected family members (.009), and severe tics (.046). We used logistic modeling to identify the optimal prediction model of group membership. This resulted in a five variable model with the epidemiologic performance characteristics of accuracy 65.2% (model correctly classified 4,406 of 5,450 subjects), sensitivity 66.1%, and specificity 62.2%. CONCLUSION: Subjects with TS have high prevalence rates of comorbid learning disabilities. We identified phenotype differences between the TS-LD group compared to TS + LD group. In the evaluation of subjects with TS, the presence of a learning disability should always be a consideration. ADHD may be an important comorbid condition in the diagnosis of LD or may also be a potential confounder. Further research on etiology, course and response to intervention for subjects with TS only and TS with learning disabilities is needed.

Link to PUBMED abstract.

CNN television has a five-item series of articles about autism. The Web site offers a text-based introduction with links to each of the five video segments (which require Windows Media Player). Link to the CNN index page.

Flash of the electrons to Henry D. Schlinger, Ph.D., (Department of Psychology, California State University, Los Angeles) for alerting EBD Blog to these sources.