EBD Blog

The U.S. Food and Drug Administration (FDA) issued a warning letter to the producer of a product that is sometimes used by people hoping to eliminate heavy metals from children’s bodies (e.g., chelate mercury from children with autism). In a letter addressed to Boyd D. Haley of CTI Science Inc., Teresa C. Thompson of the Cincinnati District Office of the FDA cited a host of problems in the classification and marketing of the product, OSR#1. Among these problems are the following:
Continue reading ‘FDA warns seller of chelation product’

Thanks to a comment by reader DrFoo (AKA ‘Rollen’), I was alerted to an interesting study about variation in the rates of Autism in different ethnic populations. The news releases say that the incidence of Autism among Hispanics is lower than it is among non-Hispanic white peers.

These news releases refer to a study entitled “Explaining Low Rates of Autism Among Hispanic Schoolchildren in Texas” by Raymond Palmer and colleagues. Here’s the abstract:

In data from the Texas Educational Agency and the Health Resources and Services Administration, we found fewer autism diagnoses in school districts with higher percentages of Hispanic children. Our results are consistent with previous reports of autism rates 2 to 3 times as high among non-Hispanic Whites as among Hispanics. Socioeconomic factors failed to explain lower autism prevalence among Hispanic schoolchildren in Texas. These findings raise questions: Is autism underdiagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?

I’ve not had time to examine the issue closely, but I have a few links:

• From US TV ABC: Texas Study Confirms Lower Autism Rate in Hispanics
• From Reuters: Texas study confirms lower autism rate in Hispanics

The full citation is close to what follows…

Palmer, R. F., Walker, T., Mandell, D., Bayles, B., Miller, C. S. (2009). Explaining low rates of autism among Hispanic schoolchildren in Texas. American Journal of Public Health, 100, pp-to-come. 10.2105/AJPH.2008.150565

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

• Down load the press release (source of the excerpt quoted here).
• Read coverage in these newspapers:
  • Lynchburg News and Advance—Coalition pushes mental-health care for children
  • Washington Examiner&mdash:Advocates start bid to expand children’s mental health services under bleak budget;
  • Richmond Times Dispatch— Coalition advocate mental-health care for children
  • Washington Post (blog)—New coalition has AG’s support for mental health reforms
• Visit (and support) the Web site of the Campaign for Children’s Mental Health.
• Download pdfs of “Survey of Community Services Board Child and Adolescent Services” and “Review of Community Services Board Child and Adolescent Services“; these are report by James W. Stewart, Inspector General for Virginia’s Mental Health, Mental Retardation & Substance Abuse Services (now called Behavioral Health and Development Services). The list of key services comes from these reports;
• Visit the < href="http://www.facebook.com/pages/The-Campaign-for-Childrens-Mental-Health/183467424796?v=wall" target="_blank">Facebook page;
• Listen to a brief (3+ min) interview with Ms. Crowe from WMRA: Pushing for Children’s Mental Health Reform.

Drawing on the data collected as a part of the US National Survey of Children’s Health, Michael Kogan and colleagues estimated that slightly greater than 1% of children have Autism. The survey asked parents whether a doctor or other health-care provider had said that a child had Autism and the child currently had the condition; the point-prevalence was 110 per 10,000 for Autism Spectrum Disorder. The survey, which is a part of the regular US Child and Adolescent Health Measurement Initiative (CAHMI), asked questions of 78,037 parents.
Continue reading ‘Autism prevalence > 1%?’

An individual who goes by the screen name C0nc0rdance posted a pair of videos to YouTube on 1 October 2009 that make a clear and compelling case for ignoring ill-reasoned arguments recommending that parents avoid vaccinating their children.

When we make risky decisions about our health, it’s always good to be in possession of all the facts, to let our brains, and not our hearts, make the decision. Your child is thousands of times more likely to die from a preventable disease you didn’t vaccinate them against than to develop autism from a vaccine you did give them. The case for autism and vaccines is solely based on weak correlations and emotional responses.

Continue reading ‘C0nc0rdance’s anti-vax takedown’

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.

The Substance Abuse and Mental Health Services Administration, which is a part of the US Department of Health and Human Services, maintains a Web site where users can search for and learn more about methods for preventing or treating some Emotional and Behavioral Disorders. It’s called the “National Registry of Evidence-based Programs and Practices” (NREPP) and, for those who are concerned about employing or recommending evidence-based practices, it’s worth reviewing.

The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of mental health and substance abuse interventions that have been reviewed and rated by independent reviewers.

The purpose of this registry is to assist the public in identifying approaches to preventing and treating mental and/or substance use disorders that have been scientifically tested and that can be readily disseminated to the field. NREPP is one way that SAMHSA is working to improve access to information on tested interventions and thereby reduce the lag time between the creation of scientific knowledge and its practical application in the field.

NREPP is a voluntary, self-nominating system in which intervention developers elect to participate. There will always be some interventions that are not submitted to NREPP, and not all that are submitted are reviewed. In addition, new intervention summaries are continually being added. The registry is expected to grow to a large number of interventions over the coming months and years. Please check back regularly to access the latest updates.

Although NREPP originally focused on substance abuse, its coverage is broader now. Look for resources about, for examples, Across Ages; Aggressors, Victims, and Bystanders: Thinking and Acting To Prevent Violence; Al’s Pals: Kids Making Healthy Choices; All Stars; Caring School Community; CASASTART; Children’s Summer Treatment Program (STP); Coping Cat; Creating Lasting Family Connections (CLFC)/Creating Lasting Connections (CLC); Early Risers “Skills for Success”; Families and Schools Together (FAST); Guiding Good Choices; Incredible Years; Keep A Clear Mind (KACM); Keepin’ it REAL; Lions Quest Skills for Adolescence; Multisystemic Therapy (MST) for Juvenile Offenders; Multisystemic Therapy With Psychiatric Supports (MST-Psychiatric); Positive Action; Primary Project; Project Northland; Project Towards No Tobacco Use; Project Venture; Promoting Alternative THinking Strategies (PATHS), PATHS Preschool; Protecting You/Protecting Me; Right Decisions, Right Now: Be Tobacco Free; SAFEChildren; Second Step; SMARTteam; Storytelling for Empowerment; Strengthening Families Program; Strengthening Families Program: For Parents and Youth 10-14; Success in Stages: Build Respect, Stop Bullying; Too Good for Drugs; and Too Good for Violence;

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

Even though many schools in the US have closed for the summer or are about to do so, I want to remind folks that this is not a good time to take a break from considering the mental health needs of children and youth. Although they are likely to wax and wane over time, mental health problems don’t take many vacations.

Learn more about US resources for individual children and youths who have emotional and behavioral disorders by surfing the rich resources assembled by the Substance Abuse and Mental Health Services Administration (SAMSHA) of the US Department of Health and Human Services. Although some of the materials may be a tad out of date (e.g., prevalence figures have been updated for some disorders such as Autism), there are still plenty of valuable materials available from SAMHSA.

Go there! Compare what you see learn there with what’s available at other trustworthy sites. Learn what to do and from whom help is available.

The spring 2009 issue of Stanford Medicine Magazine, a publication of the Stanford University School of Medicine, examines the turmoil swirling around vaccines. In “Hot Shots: Vaccines under the gun” one can read any of ten articles (not counting an introductory comment by Rosalyn Carter):

• The demonization of immunization: Shots get the once-over
• What is a vaccine? Immunization demystified
• Asking How: Vaccine Side Effects Probed
• When science gets hijacked: NBC News chief medical editor tells why she broke her silence
• Insourced to India: A vaccine for a scourge of the developing world
• Peet’s passion: The medical education of Amanda Peet
• Field yields: Can genetically engineered plants provide vaccines?
• Shoot it, don’t smoke it: An injectable tobacco-grown vaccine
• Golden needles: Vaccines for seniors
• Grow up: Can vaccines built for kids work in older immune systems too?

Few of the folks who ardently oppose vaccines will likely be swayed by the content provided here. However, this magazine provides an excellent broad-brush treatment of the topic for those who are curious, savvy, and vulnerable to reason.

Link to the issue on the Web. Flash of the electrons to Liz Ditz for alerting me to this excellent resource.

The US Interagency Committee on Disability Research (ICDR) is seeking citizens’ recommendations about a research agenda. Although this initiative aims at addressing issues for adults in the community, which differs from the focus of EBD Blog (educational issues related to children and youth and their families), I want to mention it here so that readers who may have interests in health, employment, and similar topics will get the news.

This year for the first time, the federally mandated Interagency Committee on Disability Research (ICDR) is utilizing an innovative Web-based approach to collect online disability research comments to assist in developing a federal disability and rehabilitation 2010 research agenda. This technology-driven approach gives the public a three-week timeframe from March 27th through April 17th to submit their recommendations. Additionally, registered participants will be invited to review all comments submitted and vote on their top 10 concerns in each topic area during the one-week period from April 22nd through April 29th. Public comments from stakeholders are the focal point of the disability research recommendations in the ICDR Annual Report to the President and Congress.

ICDR stakeholders page.

It will be interesting to watch what happens if Dr. Sanjay Gupta becomes US Surgeon General and a chief advisor on public health policy for the Obama administration, as many news sources are reporting is likely to happen. Of special interest to those who are concerned about Emotional and Behavioral Disorders will by how Dr. Gupta addresses issues associated with Autism. Vaccines? Facilitated communication?

As Harold Doherty noted about a year ago on Facing Autism in New Brunswick, in his public career on the news-and-information source CNN Dr. Gupta has promoted discussion of some questions from his CNN pulpit. However, there is a lot more to Autism than providing a forum for people to brandish their often-ill-informed opinions about vaccines.

CNN is one of the world’s great communication and education organizations. People around the world listen to CNN and learn about the world from CNN. Hopefully Dr Gupta means it when he says he wishes to report on ALL aspects of autism. He might start by visiting the Long Island residential care facility where a middle aged woman who could not communicate at all was repeatedly abused by staff until outed by a conscientious co-worker and video recordings. The good doctor could also interview people with knowledge of the life of Tiffany Pinckney who died in Toronto from starvation and neglect while living in “the care” of her adoptive sister. Or he could talk to parents whose autistic children wandered into traffic to be lost forever or who have been restrained physically, left in a brick walled isolation room for hours, or simply sent home from school.

The list could continue: Parents who have taken out mortgages to secure financing for the private therapy their children desperately need but that schools will not provide. Promulgation of best-evidence interventions. Coordination of services across the disparate agencies that affect the services individual children receive. Respite care so that parents can catch their breath for a weekend. Etc. And we haven’t even begun to list medical, behavioral, or educational research needs. (Add other potential foci in the comments, please.)

As the holder of one of the most influential posts in public health, Dr. Gupta will need to wade into some difficult issues. He will have to go beyond simply making statements that solicit viewer interaction while avoiding alienating them, a strategy that serves one well in promoting discussions. Discussions are nice, but US health policy—about Autism and many other issues closely connected to Emotional and Behavioral Disorders—needs bold leadership informed by the best available science. Such leadership is likely to cause dissatisfaction among those who receive their wisdom from anecdotes told on popular mass media shows, give as much credence to evidence-based presentations as to an individual’s illogical assertion of correlation, and embed ad hominem attacks in their anonymous comments on discussion boards.

How would Dr. Gupta respond to questions posed by folks representing diverse views about Autism (see, e.g., Kristina Chew’s note about the participation of the Autism Self-Advocacy Network in discussions with the Obama administration)?

Review Mr. Doherty’s comments from his post about Dr. Gupta in January of 2008. For a sample of the interactions about Autism that have been engendered by Dr. Gupta’s work on CNN, see this discussion of vaccinations. Consider saying something about Dr. Gupta’s CNN pieces on FC.

Updates (of a more general nature):

• PZ Myers of Pharyngula—I’m not so sure about this pick;
• Orac of Respectful Insolence—Dr. Sanjay Gupta Surgeon General? Yawn.;
• Matthew Nisbet of Framing Science—Quick Thoughts on Sanjay Gupta and CNN Science;

More: Huffingtonpost post: Conyers: Obama Should Not Nominate Sanjay Gupta;
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