NEWS
Routine Screening for Autism Not Needed, Researchers Say
Immigration Says Son With Asperger’s ‘Inadmissible’ To Canada
Korean Family's Deportation Order May Be Lifted
PUBLIC HEALTH
Flacking for Big Pharma
Measles Returns As Parents Refuse Vaccines
EDUCATION
Judge Rules In Favor Of Letting Autistic Boy Take Service Dog To School
TREATMENT
Family's Life Unravels With Claims Dad Raped Daughter
COMMENTARY
Autism Doctor: My Therapy Is Unconventional, But It Works
NEWS
Routine Screening for Autism Not Needed, Researchers Say
ScienceDaily
— Proposals recommending routine screening of all children for autism
gets a thumbs down from researchers at McMaster University.
In a study in the online edition of the
journal Pediatrics, the researchers say there is "not enough sound
evidence to support the implementation of a routine population-based
screening program for autism."
Not only are there no good screening
tools or effective treatments but there is no evidence yet that routine
screening does more good than harm, said Dr. Jan Willem Gorter, a
researcher in McMaster's CanChild Centre for Childhood Disability
Research and associate professor of pediatrics.
Contrary to the McMaster researchers'
findings, the American Academy of Pediatrics recently recommended that
screening for autism be incorporated into routine practice, such as a
child's regular physician check-up, regardless of whether a concern has
been raised by the parents.
Autism, or the autism spectrum disorders
(ASDs), is a group of serious neurodevelopmental disorder with major,
life-altering implications. Its symptoms include differences and
disabilities in many areas, including social, communication skills,
fine and gross motor skills, and sometimes intellectual skills.
During the past three decades, the
prevalence of autism has risen dramatically to 11 cases per 1,000
school-aged children from 0.8 cases per 1,000. Reasons for this
increase vary: improved detection, changes in diagnosing the disorder
or an actual increase. The disorder is more common in males with a 4:1
male-to-female ratio.
For the study, McMaster researchers
conducted a literature search to assess the effectiveness of community
screening programs for autism.
"None of the autism screening tests
currently available has been shown to be able to fulfill the properties
of accuracy, namely high sensitivity, high specificity, and high
predictive value (proportion of patients with positive test results who
are diagnosed correctly) in a population-wide screening program,"
researchers said.
Gorter said that unlike breast cancer
screening, no autism screening programs have been studied in randomized
controlled trials. "There is no solid evidence on which to base the
recommendations of the American Academy of Pediatrics."
"None of the autism screening tests for
the general population that we have today have proven accuracy," said
Gorter. "That is, they aren't good enough to accurately detect children
who have autism or to accurately detect those who don't."
Gorter said the study is a "call for
action."
+ Read more.
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• •
Immigration Says Son With Asperger’s
‘Inadmissible’ To Canada
By thestar.com.
University of Toronto
professor Thomas Reynolds, middle, and his sons Chris, left, and Evan,
right have applied to become permanent residents. But Chris, who has
Asperger Syndrome, a mild form of autism, is deemed medically
inadmissible.
By Vince Talotta/Toronto Star Nicholas Keung
Immigration Reporter
Chris Reynolds wants to stay in Canada
with his dad and brother. But the only way his family’s application for
permanent residency will be approved is if he’s not on it.
Immigration officials say Reynolds, 20,
will be too big a drain on the health care system because he has
Asperger and Tourette syndromes. He has been deemed “inadmissible."
His family is torn: Should they leave
Canada or leave Chris off their application?
“The end verdict is a judgment of
worthlessness,” says his father, Tom Reynolds, who is a professor at
the University of Toronto. “Chris has a lot of potential to contribute
many gifts to Canada."
Chris, like other youth his age, is
tethered to his PlayStation 3 and wired to the Internet 24/7.
“I am a homebody,” he said with a
sheepish smile. “I am not good at starting a conversation and I get bad
anxiety sitting in a car for too long."
Asperger’s is a high functioning form of
autism, and Tourette’s syndrome is a condition associated with motor
and verbal ticks.
Born in Nashville, Tenn., Chris, an
American citizen, has lived in Toronto since 2007, with his expatriate
father, a tenured theology professor at the University of Toronto’s
Emmanuel College, and younger brother, Evan, 17, who is still in high
school — both here on their father’s work permit. Shortly after
arriving in Toronto, the family applied to immigrate from within Canada.
An early medical assessment by
Citizenship and Immigration Canada concluded that Chris would place an
“excessive demand” on health and social services, and hinder the
family’s chances of being accepted.
Officials never met with Chris but
deemed him “medically inadmissible” and estimated his care could cost
Canadians $7,000 a year.
The Reynolds’ story comes on the heel of
immigration’s threat to deport a South Korean family from New Brunswick
last week. That story attracted national attention and ultimately
forced the government to issue a reprieve. The Maeng family arrived
Moncton in 2003 on a work permits and was asked to leave because their
14-year-old son has autism and epilepsy.
Both families are among the 0.2 per cent
of permanent residency applicants a year who are deemed inadmissible to
Canada for fear they would pose an excessive demand on the country’s
health care system.
Mark MacLean, minister of Toronto’s St.
Andrew’s United Church, has known the Reynoldses since their arrival
and was surprised when Chris revealed his medical conditions.
+ Read more.
• • •
Korean Family's Deportation Order May Be Lifted
By ca.news.
The immigration ordeal of a South Korean
family facing deportation because their youngest son is autistic and
epileptic may be almost over, the Conservative MP for
Moncton-Riverview-Dieppe said Thursday.
Robert Goguen said the federal
government needed a more detailed letter from the province about the
family, and once that's dealt with the deportation order will be lifted.
On Wednesday, the federal government
received a letter from the province promising to provide health,
education and social services for the Maeng family as long as they're
granted permanent or temporary resident status.
"There's been a real show of support for
the family and for all the right reasons. They're very productive and
look they're an integral part of our society in Moncton and that's
exactly where we want to keep them," Goguen said Thursday.
"So I'm very pleased for them and,
listen, if we would have had to put 10 times as much effort, we'd have
done the same thing. I'm just glad it's coming to a halt before even
close to this deadline that was looming on June 30."
Last week, the federal Department of
Citizenship and Immigration told the Maeng family, which has been
living in Moncton since 2003, they must leave Canada by the end of the
month.
The federal government argued that
because Sung-Joo Maeng, 15, is epileptic and autistic the costs of his
care would be too expensive.
Social Development Minister Sue Stultz
presented a letter to the Maeng family Wednesday with a guarantee the
provincial government will cover the health-care costs for their son.
Nicole Druckman, the family's lawyer,
said the provincial government's support will help the family's bid to
stay in the country.
"Knowing that that's the case and
knowing there's just been an oversight tells me that once the federal
government reads this letter, we are very hopeful that they will grant
our clients the ability to stay," Druckman said.
Druckman said she hopes to have news on
the Maeng family's future by the weekend.
But she said they are ready to take the
case to court if immigration officials don't change their minds.
Meanwhile, a Moncton woman who has been
heading up the community support for the Maeng family said she is
thrilled to hear the provincial government has promised to pay health
care costs for the family.
Mary Sullivan said the rally she's
planned for this weekend to support the family will go ahead hopefully
as a celebration.
"I think this means that it will be a
short fight. I think it shows the federal government that the whole
province of New Brunswick is behind this family and I think it means
that they're going to be able to stay, I hope so at least," Sullivan
said.
Sullivan said she is proud the
provincial government came together so quickly to make a decision to
support the Maeng family.
Sung-Joo Maeng was diagnosed with autism
and epilepsy at age five.
His father, Tae-Shik Maeng, and his
mother, Hee-Eun Jang, moved the family to Canada with the hope of
getting help to treat their son's illnesses. They have another son,
Jung-Joo Maeng, who is studying science at Dalhousie University in
Halifax.
The family has owned and operated
Moncton's Main Stop Oriental Market on West Main Street since 2003.
+ Read more.
• • •
PUBLIC HEALTH
Flacking for Big Pharma
Drugmakers don’t just compromise doctors; they also undermine top
medical journals and skew medical research
By Harriet Washington theamericanscholar.org.
“Drug Makers Cut Out Goodies for Doctors” and “Drugmakers Pulling Plug
on Free Pens, Mugs & Pads” read headlines in The New York Times and
The Wall Street Journal Health Blog at the end of 2008 after, in a very
public act of contrition, 38 members of the pharmaceutical industry
vowed to cease bestowing on prescribing physicians goodies such as
pens, mugs, and other tchotchkes branded with their names. Some
physicians and ethicists had long expressed concern about the
“relationship of reciprocity” that even a pizza or cheap mug can
establish between doctors and drugmakers, and branded trinkets also
send a message to the patient, who might reason that Gardasil must be a
good drug if her doctor wields a reflex hammer inscribed with its name.
But while the popular press celebrated this sudden attack of
nanoconscience and while we still gravely debate whether physicians’
loyalties can really be bought for a disposable pen or a free lunch,
the $310 billion pharmaceutical industry quietly buys something far
more influential: the contents of medical journals and, all too often,
the trajectory of medical research itself.
How can this be? Flimsy plastic pens
that scream the virtues of Vioxx and articles published in the pages of
The New England Journal of Medicine would seem to mark the two poles of
medical influence. Scarcely any doctor admits to being influenced by
the former; every doctor boasts of being guided by the latter. In fact,
medical-journal articles are widely embraced as irreproachable bastions
of disinterested scientific evaluation and as antidotes to the long
fiscal arm of pharmaceutical-industry influence.
And yet, “All journals are bought—or at
least cleverly used—by the pharmaceutical industry,” says Richard
Smith, former editor of the British Medical Journal, who now sits on
the board of Public Library of Science (PLoS), a nonprofit open-access
group publishing scientific journals that eschew corporate financing
and are freely available online to the public.
Big Pharma, as the top tier of the
industry is known, starts modestly, inserting the thin edge of its
wedge by advertising copiously—and often inaccurately—in medical
journals. In 1981, concerned officials at the Food and Drug
Administration recognized the educational nature of pharmaceutical
advertising by establishing explicit standards for medical-journal ads
that mandate “true statements relating to side effects,
contraindications, and effectiveness,” and a “fair balance” of
statements about medication risks and benefits.
In 1992, the editors of the esteemed
Annals of Internal Medicine decided to gauge how well their own
advertisements met that standard. They tested 109 advertisements along
with the references cited by those ads, sending each ad to three expert
reviewers who evaluated them in light of the FDA standards. Fifty-seven
percent of the ads were judged to have no educational value, 40 percent
failed the fair-balance test, and 44 percent, the reviewers believed,
would result in improper prescribing. Overall, reviewers would have
recommended against publication of 28 percent of the advertisements, as
the Annals revealed in its published report.
+ Read more.
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•
• •
Measles Returns As Parents Refuse Vaccines
By Liz Szabo, USA
Today News
Landon Lewis, 4, was living in a
Minneapolis homeless shelter when he fell ill, first with a fever of
104 degrees, then with a red rash on his forehead.
It took two visits to a doctor to
diagnose a disease clinic staff hadn’t seen in years: measles.
The rash spread into his mouth and
throat, so swallowing was torture. He began vomiting and developed a
cough that nearly choked him. He was rushed to the emergency room and
hospitalized for five days.
“Seeing a child in that predicament
really hurt,” says his mother, Katrina Lewis, 27. “He can’t eat, he
can’t sleep, he’s bad all around, and you can’t do anything about it."
Landon is one of at least 152 cases of
measles diagnosed in the USA so far this year — twice the number seen
in a typical year, and the biggest outbreak in 15 years, says the
Centers for Disease Control and Prevention. Half of patients have had
to be hospitalized.
For the doctors and nurses caring for
patients like Landon, the return of vaccine-preventable diseases such
as measles a viral illness that once killed 3,000 to 5,000 Americans a
year is both frightening and all too predictable.
“Measles can be like a canary in a coal
mine,” says the CDC’s Gregory Wallace. “If there are any issues with
vaccine coverage, it can first be apparent with measles."
In the past three years, doctors also
have seen outbreaks of other vaccine-preventable diseases such as
mumps, whooping cough and a life-threatening bacterial infection called
Hib. All can be deadly.
Although overall vaccine coverage
remains high, 40% of parents say they have deliberately skipped or
delayed a shot for their children.
In some ways, vaccines are a victim of
their own success. Today’s parents have never seen the diseases that
terrified their grandparents, says Paul Offit, chief of infectious
disease at Children’s Hospital of Philadelphia. “We’ve not only
eliminated these diseases; we’ve eliminated the memory of these
diseases,” Offit says.
Parents who decline vaccines may not
realize that they’re gambling with the lives of not just their kids but
all the children around them, says Patsy Stinchfield, director of
pediatric infectious disease at Children’s Hospitals and Clinics of
Minnesota, where Landon was treated. Measles can kill by causing
pneumonia, brain inflammation and other complications, Stinchfield
says. Babies too young to be vaccinated and people with compromised
immune systems, such as those with cancer, are especially vulnerable.
They rely on others around them to keep the virus out of circulation, a
phenomenon known as “herd immunity,” which protects even those who
can’t be vaccinated, she says.
And Offit notes that measles — which
killed 3,000 to 5,000 Americans a year in in the pre-vaccine days
—continues to kill. More than 164,000 people died of the disease in
2008, says the World Health Organization.
+ Read more.
• • •
EDUCATION
Judge Rules In Favor Of Letting Autistic Boy Take Service Dog To School
Autistic boy's parents sued after the Cypress School District tried to
keep the animal out. They've won a preliminary injunction, but a trial
is expected next year.
Caleb Ciriacks, 7, who is severely
autistic, with his service dog Eddy, who kept Caleb from running off
and knows to intervene when the boy is getting anxious. – LA Times.
By Victoria Kim, Los
Angeles Times.
By the time summer school starts in
early July, Caleb will probably walk into class with a golden retriever
at his side.
Caleb Ciriacks is a 7-year-old severely
autistic boy who for the most part doesn't speak. He shrieks and paces
when he gets anxious, and on occasion he pinches and scratches others.
Eddy is Caleb's service dog, tethered to the boy by a red strap. The
dog keeps Caleb from running off into crowds or darting into traffic,
and he knows to intervene when the boy starts to feel anxious.
When Caleb entered first grade
last year, school officials in Cypress refused to let him take Eddy to
school. Caleb's parents sued in federal court, alleging that the
district was discriminating against their son based on his disability.
On Tuesday, a federal judge in Santa Ana
ruled that Frank Vessels Elementary School must let Caleb take Eddy to
school and that the boy was probably a victim of discrimination. U.S.
Department of Justice attorneys filed a "statement of interest" in the
case, saying the school district was violating the boy's civil rights
and misinterpreting the Americans With Disabilities Act.
The district had argued in court papers
that Eddy does not qualify as a service dog under federal statutes, and
that his presence could disrupt school activities and be burdensome for
staff. Attorneys for the school district also said the dog could
undermine Caleb's independence and self-control.
U.S. District Judge Andrew Guilford
granted a preliminary injunction in favor of the student, finding that
keeping the boy and the dog apart during school hours could diminish
their bond and disrupt their relationship. Not allowing the dog to
accompany Caleb to school "could cause [Caleb] serious harm in his
ability to enjoy any of the benefits that Eddy was meant to provide,"
he wrote.
+ Read more.
• • •
TREATMENT
Family's Life Unravels With Claims Dad Raped Daughter
Six part series by the Detroit
Free Press.
Julian Wendrow paced in his cell.
Three steps one way. Turn. Three steps
the other way.
Four to eight hours a day, he walked
back and forth in his windowless cell in the Oakland County Jail, a
first-time prisoner accused of raping his autistic daughter.
Wendrow spent 74 of his 80 days in jail
in the one-man cell. He saw almost none of the winter of 2008, the
season that would change the West Bloomfield father's life.
He and his wife, Thal Wendrow, were
seemingly ordinary middle-class parents deeply involved in their
children's lives -- until the accusations prompted a prosecution that a
federal judge later described as a "runaway train."
Thal spent five days in jail, accused of
ignoring the abuse. Their children -- a severely disabled teen girl and
a mildly autistic boy -- were put in separate juvenile homes and kept
apart from their parents for 106 days.
Beginning today, Free Press staff
writers L.L. Brasier and John Wisely go behind the scenes of the case.
The parents who wanted to believe in miracles after a school aide was
assigned to help their mute, autistic daughter communicate. The
prosecutors who set out to protect a child. The nightmare that engulfed
the Wendrow family.
The ordeal didn't end when it was clear
that the girl wasn't communicating, after all. It didn't end when a
sexual assault exam found no proof of abuse. And it didn't end when a
prosecution witness insisted the abuse never happened.
Through hours of interviews and
thousands of pages of never-disclosed testimony, the Free Press over
the next six days examines how the case developed -- and how it
collapsed.
Chapter 1: The allegations
The ordeal that would devastate the
lives of Julian and Thal Wendrow began in a most mundane way: The
message light on their home phone was blinking.
Julian Wendrow, who owned a painting
business, had been out running errands. His wife, Thal Wendrow, a
research attorney for a local judge, was at work. Their children were
at school.
It was a cold November afternoon in 2007.
The voice mail was from a state social
worker, who had an urgent message for them.
Julian Wendrow called back.
Disturbing allegations had been made,
the social worker told him: Your disabled daughter, who was at Walled
Lake Central High School, claims you raped her over the weekend. That
you've been raping her for years.
Wendrow was stunned. His 14-year-old
daughter -- mute and autistic -- communicated only through a technique
called facilitated communication (FC), a typing method in which an aide
guided her hand.
Surely, he thought, there had been some
terrible mistake. The typing went awry. It could all be easily
corrected, he figured.
The family had airline tickets for South
Africa, his native country, and was set to leave in 12 days. His
daughter came home on the school bus that afternoon, along with her
13-year-old brother. Wendrow said nothing to them, but called his wife
at work. She came home.
With the children out of the room, the
parents talked quietly.
They came up with a plan -- one they
hoped would end the ordeal the next day.
+ Read more.
• • •
COMMENTARY
Autism Doctor: My Therapy Is Unconventional, But It Works
Dr. Mark Geier, who is fighting the state's suspension of his license,
says his practice should be judged on the results
By Mark Geier baltimoresun.com
If there's a single statement that everyone who works in the field of
autism can agree on, it's that there is so much that we still don't
know.
Medical professionals can't even
definitively say why more children are being diagnosed as having autism
or similar developmental delays, much less agree on the best courses of
treatment and therapy. Yet all of us who work with families of children
with autism can't help but be affected by the emotions of desperate
parents.
This month, I go before an
administrative law judge to appeal a decision by the Maryland Board of
Physicians to summarily suspend my medical license related to the
treatment of children with autism. I wish that I was permitted to
respond to the various allegations in detail, but the board's privacy
restrictions make that impossible. (For the record, I have tried to
waive my privacy rights and asked that my appeal be opened to the
public, but have thus far been denied.)
In my more than 30 years of practice,
since completing my medical training at the Johns Hopkins Hospital, I
have spent thousands of hours talking to the families of children with
autism — evaluating their condition, publishing research in
peer-reviewed journals and trying to add to the medical profession's
broad base of knowledge about autism. I understand that not everyone
agrees with some of what our research has concluded, just as I don't
necessarily agree with what other physicians have written. In the end,
finding answers through continued research is how science moves forward.
Over the years, our work has helped to
uncover that a significant number of children with autism have
remarkably high levels of male hormones in their blood. We have found
that many of these children with high male hormone levels display
behaviors that are among the most challenging to deal with in autism,
such as unprovoked and extreme violence, to themselves and the people
around them, and an inability to sit still for beyond a few seconds.
These behaviors make it all-but-impossible to engage children in the
more well-known forms of behavioral therapy.
In young children without autism, these
levels of hormones prompt a diagnosis of precocious puberty, and
physicians often use medication to reduce the hormone levels to those
that are more appropriate for the age group. We have begun using a
similar approach for children with autism who display high levels of
male hormones, prescribing a drug called Lupron. The drug — supported
for use in children by the American Academy of Pediatrics — suppresses
the male hormone levels without leaving any lasting changes to the
body's ability to manufacture those hormones in the future.
For a large percentage of the hundreds
of children we have treated using this therapy, the results have been
tremendous. Countless parents have told us that their families' lives
have been transformed by the use of Lupron — particularly because the
alternative for many of these children has been either the off-label
use of dangerous anti-psychotic medications or institutionalization.
+ Read more.
Note: The opinions expressed in COMMENTARY are those of the author and
do not necessarily represent the views of the Schafer Autism Report.