EBD Blog

Over on Science-Based Medicine, John Snyder has an extended post that systematically analyzes the assertions of Robert Sears about vaccinating children. The title is “Cashing In On Fear: The Danger of Dr. Sears.” Highly recommended.

For those who are familiar with the Association of Professional Behavior Analysts (APBA), this is old hat, but for others this is news: APBA has a task force devoted to services for individuals with Autism. Here’re a few words about the task force from Gina Green (Executive Director of APBA):

To help us address the many needs of our constituents who are concerned about services for people with autism spectrum disorders (ASD), APBA has established an ASD Task Force. For the initial membership of the Task Force, we recruited people with distinguished track records in designing and providing intervention programs, training practitioners and parents, conducting applied research, working with professional and consumer organizations, advocating for scientifically validated interventions, and working with policymakers. Collectively, Task Force members have a wealth of knowledge and experience that they will bring to bear on such burning issues as professional credentialing, funding for ABA services, and public policies affecting practitioners and consumers.

APBA has been working for some time to collect and create resources for those who are developing laws and regulations affecting ABA services for people with ASD. So far we have provided materials and consultation to individuals or groups in eight states. One of the principal functions of the ASD Task Force will be to help APBA build its capacity to meet the demands for assistance in this arena

For all of us, this is good news. Link to the article describing the the APBA task force on Autism.

According to Mary Ann Roser of the Austin (TX, US) Statesman, a clinic that provided chelation therapy for Autism is apparently under investigation by federal authorities. Ms. Roser did not report the nature or cause of the investigation of the CARE Clinics.

CARE Clinics, an autism clinic on Bee Cave Road that was being investigated by insurance companies over insurance claims, was raided by the FBI and IRS agents today.

The clinic has been closed, perhaps permanently.

Agents are removing dozens of boxes of documents, but they declined to say what they are looking for. They directed inquiries to Special IRS Agent Mike Lemoine, who did not immediately return a call.

In an article in May of 2009, Ms. Roser reported that the clinic was having financial trouble.

The owner of an Austin-area clinic that treats children with autism — using techniques that are controversial in mainstream medicine — says investigations by three major insurers have left it with a pile of unpaid claims and a crisis: She’s had to lay off most of her staff and drastically reduce the clinic’s hours.

In addition, Kazuko Grace Curtin said the Texas Medical Board is investigating her medical director. She and the doctor — Jesus Caquias — say the investigation is a way of harassing them because they offer nontraditional care for autism patients.

Link to Ms. Roser’s post entitled “Autism clinic raided by federal authorities” and to the earlier article, “Insurance companies question autism clinic’s charges” Check the discussion following the blog post (the first link).

In the US state of Michigan, a major health insurance provider will now reimburse families for the cost of providing therapy for children with autism. The case, Johns v. Blue Cross Blue Shield of Michigan, arose because Blue-Cross-Blue-Shield denied payment for behavioral treatment often called “ABA” to the family of a child with Autism. The case was settled in favor of the family last week.

Represented by Gerard Mantese, Mr. Christopher Johns alleged that the insurer should pay for the therapy for his son under the provisions of the policy. The insurance company refused and Mr. Johns sued. During depositions, Mr. Mantese and others on the Mr. Johns’ legal team learned of a draft memorandum identifying the behavioral therapy as effective and that a representative of the insurer would probably elect the behavioral therapy if that representative had a child with Autism.

Because Mr. Johns’ complaint was part of a class action suit, many other families will also benefit from the settlement. In an independent analysis of the case, Tresa Baldas discussed the implications.

The $1 million class action settlement from Blue Cross Blue Shield of Michigan comes amid a legislative wave in which a growing number of a states are passing laws that require insurance companies to pay for autism treatments and screenings. To date, 13 states have such laws, the most recent being Connecticut, Colorado and Nevada. New Jersey is currently considering an autism bill, and Pennsylvania’s law goes into effect July 1.

The June 17 Michigan settlement, meanwhile, has autism advocates hopeful that insurance companies will stop claiming that behavioral therapy for autistic children is experimental, and start paying for it.

“It is a significant victory for the families, obviously, and it marks a trend, hopefully, that insurance companies will start to look at autism treatment differently,” said Areva Martin, an attorney at Los Angeles-based Martin & Martin who is currently handling about 30 autism cases. She believes the labeling of autism treatments as experimental is “absurd.”

I wonder what this will mean for the California rules that do not expressly exclude behavioral therapies, but set requirements for deciding whether they are reimbursable (see my earlier post on that story).

Link for a quasi-news article about the settlement. Read another of the law firm’s press releases. Here’s link to Ms. Baldas’ analysis of the case.

Over on Autism Street, Dad Of Cameron (“Do’C”) has assembled a list of sources that have questioned the strength of the evidence about hyperbaric oxygen therapy for Autism. I’m flattered that he included the entry from EBD Blog.

The US television broadcast company NBC ran a series of segments about Autism during the week ending 17 April 2009 on the program Today. Dr. Nancy Snyderman, a medical editor for NBC, introduces the segments. Sadly, some of the content trends toward the woo-woo—replete with fantastic explanations offered by well-intentioned but ill-informed adults—but there is one (the third in the following list) that stresses the benefits of systematic, behaviorally based instruction.

• Can robots help treat Austim?
• Making sense of children’s senses
• Can kids ‘recover’ from Autism?

There is also a “Web only” segment about a school in New York dedicated to serving students with Autism. According the executive director Julie Fisher, the school’s programming is based on applied behavior analysis.

Follow this link to review them on MSNBC Website. There are also links to older segments on Autism.

Happy anniversary

Four years ago today, I published the first entry on EBD Blog, so we’re starting our fifth spin around the blogosphere.

If you have your own sparkle (and yes, the contents of that glass are from Champagne), raise a glass. If you have recommendations for coverage for the next year, please pass ‘em along in the comments. Thanks!

If you are a person who might have thought “facilitated communication” was too far out, think again. This one will probably make you shake your head in disbelief.

School officials called Colleen Leduc and asked that she go to the school of her daughter Victoria, an 11-year old who has Autism. When she got there, they told Ms. Leduc that they had allegations that Victoria was being sexually abused. Of course, the school officials had performed their legal duty and notified child protective services.

How did they come by such startling knowledge? Leduc was incredulous as they poured out their story.

“The teacher looked and me and said: ‘We have to tell you something. The educational assistant who works with Victoria went to see a psychic last night, and the psychic asked the educational assistant at that particular time if she works with a little girl by the name of “V.” And she said ‘yes, I do.’ And she said, ‘well, you need to know that that child is being sexually abused by a man between the ages of 23 and 26.’”

What’ll folks come up with next?

Of course, you should read the entire story here or here (thanks, Mark), or track the coverage here. Flashes of the electrons to PZ Myers (Pharyngula), Janice Liedl, and BoingBoing.

I’m pleased to add a link to the Web Resources section of EBD Blog that points to the Web site for Mental Disability Rights International (MDRI). MDRI is devoted to ensuring that people with disabilities can participate in society, regardless of the country in which they live. Among other things, MDRI has influenced laws and governmental agencies to promote the human rights of individuals with disabilities.

MDRI documents conditions, publishes reports on human rights enforcement, and promotes international oversight of the rights of people with mental disabilities. Drawing on the skills and experience of attorneys, mental health professionals, human rights advocates, people with mental disabilities and their family members, MDRI trains and supports advocates seeking legal and service system reform and assists governments to develop laws and policies to promote community integration and human rights enforcement for people with mental disabilities. The organization is forging new alliances throughout the world to challenge the discrimination and abuse faced by people with mental disabilities, as well as working with locally based advocates to create new advocacy projects and to promote citizen participation and human rights for children and adults.

Individuals with Emotional and Behavioral Disorders should enjoy the same basic human rights as anyone else. From this perspective, it is easy to see why EBD Blog endorses the efforts of MDRI. To save readers the need to locate the link in the side bar, here’s a jump to MDRI’s home page.

It’s true. I must update the look of the blog. Changes in the underlying software that controls the general system (killer good WordPress) and the related software (as of this writing, I’m still using the wonderful K2 theme) that controls the look of the site (layout, colors, etc.) made some of my settings fail even worse than they were failing before I updated the software. I’m working on it, honest. Now that I have a little more air in my calendar, that’ll get easier.

“Are we too quick to medicate children?” Melissa Healy asks this question in the headline of an article in the Los Angeles Times. She also weaves the related question—”Are we able to discriminate between normal and atypical behavior?”—into her article.

These are generally sensible questions. They reflect issues of real concern in the scientific community. But, when the headline asks whether we presrcibe medications too quickly, one can guess the answer pretty readily. Unless I’m way off base, would many readers expect the answer to be “no?”

Indeed, the article is nearly chockfull of critical concern about diagnoses, labeling, and treatment. Ms. Healy cites research results (without revealing some of the sources) and quotes at least a half dozen experts. Some of these experts would probably be consider advocates by some of the other experts.

As is de rigeur in contemporary journalism, Ms. Healy leads (and closes) with a case example. She tells the story of a 38-year-old mother who takes her 11-year-old daughter to a psychiatrist, because the girl’s “behavior and performance in school were exemplary, but an ill-tempered outburst had gotten the preteen kicked out of a Girl Scout troop she had joined at age 5. The girl was confused and heartbroken over her ejection.”

Katie’s maternal instincts tell her she must protect her child. But from what, she asks — a disease that threatens health, happiness and future? A bogus label applied to an admittedly challenging kid? Or drugs with potentially harmful and little-studied side effects?

And protect her exactly how — by resisting or by medicating?

In general, this is not a dispassionate examination of the question under which Ms. Healy’s article appears. I say this not because I disagree with her slant, but because the treatment is sensational and poorly informed. Had she gone more deeply into the topic, she would have learned about effective behavioral treatments that provide viable alternatives to medicaiton for many child behavior problems. Instead, she stuck with the hidden-mysteries view of Emotional and Behavioral Disorders of children.

Link to Ms. Healy’s article.

Prepare to open your browser window wide: The Autism Calendar for August 2007 is available here.