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Up, Up and Away: Autism in Boston Schools

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F Edward Yazbak MD

The title of a report in the “Metro” section of the Boston Globe on May 29, 2013 was hard to miss:     

                                    "Boston schools seek $6m more for special ed
                                Rise in students with autism helps prompt increase"                    

An increase in students being diagnosed with autism or other disabilities is driving up special education spending in Boston, prompting the School Department to request $6 million in ­supplemental funding.

The additional money is needed so the School Department can end the fiscal year in June with a balanced budget. The School Committee is scheduled to vote on the request at its June 5 meeting… 

By April, 747 students with disabilities, including 158 on the autism spectrum, were enrolled in preschool, compared with 482 four years ago. …

Educating students with ­autism can be an intensive and ­expensive endeavor. The School ­Department limits preschool class sizes to no more than eight ­students with autism, and many of them also require working one-on-one with a ­behavioral specialist.

Nearly $5 million of the ­additional funding request would pay for behavioral specialists, most of whom are provided by private contractors. Over the next few years, in an effort to reduce costs, the School Department is planning to expand its staff of ­behavioral specialists.

Overall, 489 students across all grade levels this year are working with behavioral ­specialists, up from 205 last year…

School officials presented the spending request at last Wednesday’s School Committee meeting. None of the committee members raised concerns about approving the addi­tional funding, an indication that passage is likely…”   http://tinyurl.com/nk3eeou 

***

The proposed 2014 Boston Public School (BPS) Budget will also contain a request for increased funding for several reasons that included: 

  • The highest projected enrollment since 2005 of nearly 1,200 new students, “nearly half of whom have high-severity disabilities, reflecting a national trend.”
  • The allocation of “$30 million new dollars directly to schools through Weighted Student Funding.” http://www.bostonpublicschools.org/budget 

The budget proposal includes the following under “Special Education”: “The FY14 budget increases the overall allocation for special education services by approximately $30 million. This allows us to serve an increasing number of students with disabilities in early grades while expanding high-quality programs in other grades – including two new inclusion schools and the planned future creation of an inclusion high school to create a K-12 pathway. We continue to closely examine our core spending obligations to better direct resources to serve students." 

Boston is obviously not alone. The same proportion of students with autism and ASD is most likely evident nationwide and an equal strain on school budgets is undoubtedly being felt everywhere. The arrival of nearly half the new enrollees to US schools with “high-severity disabilities”, many of which are related to the autistic spectrum, is a tidal wave unlike any other. 

Having served as a school physician in two school systems for 34 years, I can safely attest that we never had such a proportion of arriving special education (SPED) students in the past, many of whom requiring one-to-one attention. 

An excellent discussion of Special Education Inclusion and the Federal Laws dealing with education of the disabled can be found at http://tinyurl.com/22m3dr7 

For a general review of the “Weighted Student Funding” mentioned above, please see http://reason.org/files/wsf/overview.pdf 

For a more focused and detailed review and analysis of “Weighted Student Funding” in the Boston Public Schools 2014 Budget, please see http://tinyurl.com/p5m85gf 

*** 

In 1999, I published my first report on the increase of autism and ASD in US schools, calling the situation then a national emergency. 
/dailynews/December2001/Autism1999NatEmerg.htm 

The following table from that 1999 report reflected what happened in Rhode Island, very close to Boston in the four years that preceded my report [June 1995 - June 1998]. 

School Year & Survey Date

Students K-12

Students in       

SPED

# of cases

of Autism

% of

SPED St.

% of All Students

94-95 6/30/95

146,512

25,143

86

0.34

0.05

95-96 6/30/96

148,524

26,427

120

0.45

0.08

96-97 6/30/97

151,470

27,583

142

0.51

0.09

97-98 6/10/98

152,374

28,558

197

0.69

0.128

 The table clearly shows that the number of cases of Autism and ASD increased from year to year but more importantly that the percentage of those cases increased at a faster rate when compared to the increases in the total number of students and to the number of students in special education.    

Comparing columns 2 and 3, the number of students in SPED in school year 1994-95 was 17.2% of the total student body. By June 1998, that percentage was up to 18.7% of the student body. During the same period of time, as demonstrated in the last two columns, the percentage of children with autism doubled when compared to children in SPED and almost tripled in proportion to the total student body. 

Other states I reviewed at the time had similar alarming increases in the number of children with autism attending school as reported yearly by the US Department of Education to the United States Congress, in accordance with IDEA, the Individuals with Disability Education Act.  

On 12/1/1997, The Pennsylvania Department of Education identified 2243 students as autistic among a total school population of 1,1814,081.This prevalence was 102% higher than it was four years earlier, on 12/1/1993, when there were 1,072 autistic students in the system. The student population in Pennsylvania did not obviously increase so drastically between 1993 and 1997.

Similarly in 97-98, Colorado schools had 223 students included in the Autism / PDD category, 699,135 students in all (K-12), and 66,979 in special education classes, an autism incidence of 0.03% of the total and 0.33% of the special education population. In 1992, only 16 students in Colorado were carrying a diagnosis of Autism/PDD

In the four years preceding my report, the total student population of the State of Missouri, increased by 3.8% while the number of children with autism rose by 123%.

The following graph illustrates the increase in autism and ASD among students ages 6 to 21 attending US schools from 1991, when those statistics were first reported up until June 30, 2007.

US Department of Education Annual Reports to Congress [50 States and D.C.]

*****

The CDC Autism Prevalence Study

In a press release on February 8, 2007  the CDC reported in a much advertised Press Release, what it called its “first and largest summary of prevalence data” of autism and ASD in several communities. These data were in fact the results of a 2002 study of eight year- old children with the disorder among whom ASD rates ranged from one in 303 to one in 94, with an average finding of 6.6 and 6.7 per 1,000, or approximately one in 150 children in the studied communities.  http://www.cdc.gov/media/pressrel/2007/r070208.htm

The whole 2002 study population “included approximately 10 percent of U.S. eight-year-old children born in 1994 from 14 states - Alabama, Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah, West Virginia and Wisconsin. A total of 2,685 eight-year-olds were identified as having an ASD.” 

To this day, I have no idea why the CDC ever chose to go through all this trouble to examine such a small sample of children when they had excellent and accurate school statistics in every city and every state reported yearly by the US Department of Education to the US Congress, the same figures I had used quite extensively since 1999. 

Interestingly, Dr. Marshalyn Yeargin-Allsopp, Chief of the CDC's Autism Program alluded to that specific point in the February 8, 2007 Press Release when she stated that it was extremely difficult to accurately estimate the number of children who have an Autistic Spectrum Disorder “because medical records often do not provide such information, and identification is often made by schools or education specialists.” 

Dr. Yeargin-Allsop’ just as accurately stated: 

“We don't know the causes of ASDs”. 

I will respectfully submit that Dr. Yeargin-Allsop, now the Chief of the Developmental Disabilities Branch at the CDC, still does not know what causes autism, because indeed no one does, possibly because some specific areas of environmental research have been deemed a “No Trespass” zone by a committee of the Institute of Medicine in 2004.                  

On October 5, 2007, my dear friend Ray Gallup and I responded to the CDC study with our own report titled: “When 1 in 150 is really 1 in 67”.

/when-1-150-really-1-67 

While most people (and the press) were under the impression that the just reported ASD prevalence rate of 1 in 150 was current, we showed that indeed it was not and that in fact, the US Department of Education figures had documented a 1 in 150 prevalence rate among U.S. school children born in 1994, thirteen years before the CDC report. 

At the time, I described the situation as “a catastrophe of unprecedented proportions.” 

I have no words to adequately describe the present situation in Boston and elsewhere. 

After a flurry of Congressional Hearings that focused on vaccines and autism under the chairmanship of Congressman Dan Burton of Indiana, the whole subject seemed to have died a slow death. Evidently, other Members of Congress were spared the tragedy of having a son or a grandson with autism to get them interested enough in the subject. 

At a recent Congressional Hearing on Autism, a distinguished researcher/ father who had been scheduled to testify was suddenly not allowed to do so. Instead a parade of well chosen “experts” repeated the same old refrains and avoided to ruffle any feathers. 

Although no one invited me to present or asked for my opinion, I would like to respectfully tell the distinguished members of that committee that in view of what is happening in Boston schools and in schools elsewhere in our Nation, it is time for them to listen to parents first and to allow an open discussion of all possible environmental factors potentially related to the ongoing Autism Epidemic – without exception. 

I will also call on our distinguished Senior Senator from Massachusetts, our soon to be elected Junior Senator and all our Congressional Delegation to support the creation of a large independent Vaccinated vs. Unvaccinated study, in spite of orchestrated objections by the CDC, the Vaccine Lobby or anyone who is not caring for a child or a young adult with autism. 

On April 15, the good people of Boston reacted to the Marathon tragedy in an exemplary fashion and greatly appreciated the Nation’s support. 

The present tragedy in the Boston schools deserves a similar outcry, locally and nationally.

 

 F. Edward Yazbak MD, Falmouth, Masschusetts

 

June 3, 2013