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Showing posts with label IACC. Show all posts
Showing posts with label IACC. Show all posts

Saturday, March 21, 2026

I-ACC Meets

 In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

Allison Parshall at Scientific American:

A “shadow committee” of autism researchers and science advocates met in the nation’s capital for the first time on Thursday.

Called the Independent Autism Coordinating Committee (I-ACC), the group rapidly came together as a response to Secretary of Health and Human Services Robert F. Kennedy, Jr., overhauling of the federal government’s Interagency Autism Coordinating Committee (IACC), which provides guidance on autism research. Kennedy’s 21 new appointees to the committee include several who have promoted a disproved connection between vaccines and autism and who have promoted non-evidence-based and potentially dangerous therapies for the condition.

...

The federal autism committee now has a “striking absence of scientific expertise,” said Craig Snyder, policy lead at the Autism Science Foundation, during the rival group’s meeting on Thursday. “It disproportionately represents the small subset of families who believe, contrary to scientific consensus, that vaccines cause autism while excluding the overwhelming majority of autistic individuals, families and advocates who support evidence-based science.”

The independent group plans to review autism science and recommend research priorities to improve the lives of autistic people—something that many of its members worry the federal committee will no longer prioritize.

 ...

.In 2019 the federal committee began to include a larger number of autistic people as members. Now the federal group has less representation from autistic people than before, and the independent group has only one autistic member. Neither group includes representatives of autism self-advocacy organizations.

“At present autistic people are losing ground on political representation,” says Ari Ne’eman, co-founder of the Autistic Self Advocacy Network and a health policy researcher at Harvard University. “I don’t think either [group] can be meaningfully said to represent our community at this moment.”

Tuesday, March 10, 2026

IACC Cancels Meeting

In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

 Allison Parshall at Scientific American:

The government’s advisory board on autism research has cancelled a public meeting scheduled for March 19. This would have been the first public meeting of the Interagency Autism Coordinating Committee (IACC), a group that guides federally funded autism research, since health secretary Robert F. Kennedy, Jr., entirely overhauled the group’s membership in January. He appointed 21 new members, some of whom are vaccine skeptics.
The news of the cancellation broke on March 7, the same week that a group of autism experts formed an independent group to counter misinformation. This outside group, which calls itself the Independent Autism Coordinating Committee (I-ACC), scheduled a meeting on the same day as the federal IACC meeting. The rival group includes several former members of the federal advisory board.

Wednesday, March 4, 2026

Shadow IACC

In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

Lena H. Sun at WP:

A group of prominent scientists launched an independent autism advisory panel Tuesday over fears that Health Secretary Robert F. Kennedy Jr. has politicized the key federal autism advisory board he oversees.

The shadow committee will focus on developing a coordinated scientific agenda for autism research and will function as a counterweight to the advisory board Kennedy reshaped in January by appointing new members. Many of those members have echoed his controversial views, including promoting debunked claims linking vaccines to autism and advocating for unproven treatments.

The new independent group will do more than speak out against misinformation, Alison Singer, president of the Autism Science Foundation and member of the group, said in a statement Tuesday. The group will create a research agenda that reflects the progress and promise of autism science and report annually on key research advances, including basic research on genes and cells, environmental causes, early detection, therapeutics and services.

The new panel, to be called the Independent Autism Coordinating Committee, includes experienced scientists and advocates who have funded and conducted autism research for many decades, including two past directors of the National Institute of Mental Health, Joshua Gordon and Tom Insel. It is set to hold its first meeting on March 19, the same day as the federal panel.

Sunday, February 8, 2026

RFK Jr's IACC Appointees

In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

RFK Jr. has stacked it with his own type of people.

 David Gilbert at Wired:

Among those appointed last week was Daniel Rossignol, a doctor who was sued for alleged fraud after prescribing a 7-year-old autistic child a debunked and dangerous treatment. Tracy Slepcevic, an appointee who Kennedy calls a “dear friend,” offers exposure to a wide range of bogus autism cures at her annual Autism Health Summit, including one that involves the injection of animal stem cells into children. Another appointee, Toby Rogers, has claimed that “no thinking person vaccinates” and that vaccine makers are “poisoning children.” Rogers is a fellow at the Brownstone Institute for Social and Economic Research and has also called vaccines “one of the greatest crimes in human history.” He has written articles for Children’s Health Defense (CHD), the anti-vaccine group founded by Kennedy that has linked autism to vaccines.

Other appointees are no different: John Gilmore founded the Autism Action Network and has said that his autistic son is “vaccine injured.” Gilmore is also the founder of the New York chapter of Kennedy’s Children’s Health Defense group. Ginger Taylor, the former director of the Maine Coalition for Vaccine Choice, has publicly claimed that many autism cases involve “vaccine causation.” Elizabeth Mumper has written for Children’s Health Defense and is a senior fellow with the Independent Medical Alliance, a group formerly known as the Front Line Covid-19 Critical Care Alliance that has promoted ivermectin as a treatment for Covid.


Thursday, January 29, 2026

RFK Jr Stacks IACC

  In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

 From the Autism Science Foundation:

Today, the U.S. Department of Health and Human Services (HHS) announced a complete reconstitution of the Interagency Autism Coordinating Committee (IACC), appointing 21 new members while excluding the scientific and advocacy leadership that has historically guided the committee.

The IACC, created through the efforts of the broad autism community’s work with Congress and sustained for more than two decades by the dedicated service of leading scientists, advocates, and public servants, has been fundamentally compromised. The current committee has been hijacked by a narrow ideological agenda that does not reflect either the autism community or the state of autism science. By sidelining rigorous, evidence-based inquiry, this shift will stall scientific progress, distort research priorities, and ultimately harm people with autism and all who love and support them.

“The newly constituted IACC represents a complete and unprecedented overhaul, with no continuity from prior committees and a striking absence of scientific expertise,” said Autism Science Foundation President Alison Singer, who served three terms as an IACC public member. “Consistent with other federal advisory committees under Secretary Kennedy’s leadership, like the Advisory Committee on Immunization Practices (ACIP), committee members have been cherry-picked to reach a predetermined conclusion, not to seek broad, good-faith input from qualified experts and stakeholders.”

This committee does not reflect the breadth of the autism community. It disproportionately represents a very small subset of families who believe vaccines cause autism, while excluding the overwhelming majority of autistic individuals, families, and advocates who support evidence-based science. Notably, none of the advocacy organizations represented on the committee fund autism research. Past IACCs included a wide range of viewpoints and expertise, enabling meaningful discussion of scientific advances and policy priorities. That balance is now gone.

Beyond concerns about expertise and representation, there are serious questions about whether the current committee complies with the law. Federal statute requires representation by leading research, advocacy, and service organizations for individuals with autism spectrum disorder, as well as the capacity to summarize advances in autism research on causes, prevention, treatment, screening, diagnosis, interventions, and access to services and supports across the lifespan. We have little confidence that the current IACC can fulfill these responsibilities or reflect current scientific understanding.

As constituted, this committee neither represents the autism community nor advances its interests. It undermines decades of progress toward evidence-based policymaking and risks reversing hard-won gains in autism research, services, and public trust in science.
O. Rose Broderick at STAT:
“Much like the vaccine advisory panels, which [promote] improper false information, the American people are going to be lied to by the IACC under the wrong leadership,” said Joshua Gordon, the former director of the National Institute of Mental Health and chair of IACC for eight years between 2016 and 2024.

Six people have publicly announced their selection onto the autism committee in recent weeks, including John Gilmore, executive director of the Autism Action Network; Honey Rinicella, executive director of the Medical Academy of Pediatric and Special Needs; Jennifer Philips, founder of Make a Stand 4 Autism; Ginger Taylor, former director of the Maine Center for Vaccine Choice; Tracy Slepcevic, organizer of the Autism Health Summit and host of a fundraiser for Kennedy during his failed presidential bid; and Caden Larson, a nonspeaking autistic man from Minnesota.

 


Wednesday, November 12, 2025

Nature Medicine: Autistic People Deserve Science-Based Policy

 number oposts discussed Trump's support for discredited notions about autism. The Sept 22 White House news conference was a firehose of lies. Last month, he posted an unfounded warning about Tylenol RFK then tiptoed away from the idea that it definitely causes autism.

Recent public discourse in the USA has been marred by the propagation of claims about the causes of autism that do not reflect current scientific consensus and disregard an extensive research body indicating that there is no single root cause of autism. US Secretary of Health and Human Services Robert F. Kennedy Jr. has made identifying the causes of autism a focal point1 of his tenure. While understanding the origins of autism is important, the approach must be grounded in rigorous, unbiased science and informed by the lived experiences of people with autism and their families. So far, this standard does not seem to have been met.

Within the first 10 months of the current administration, senior officials have advanced a series of assertions linking autism to childhood vaccines, prenatal acetaminophen2 (Tylenol) use, and even circumcision3. These claims reflect a broader pattern of science communication that prioritizes ideology over evidence, often relying on selective data interpretation4 while disregarding the broader scientific literature. This approach marginalizes experts, advocacy organizations, and — most importantly — people with autism and their families.

The consequences of such rhetoric were immediate and far-reaching. A national poll conducted shortly after a press conference in which Secretary Kennedy and President Trump alleged a causal link between prenatal Tylenol use and autism found that 77% of respondents had been exposed to the claim5. Alarmingly, 60% expressed uncertainty about its validity. This confusion is not benign. Acetaminophen is considered the safest choice of analgesic and antipyretic for use during pregnancy; systematically discouraging its use could endanger maternal and fetal health.

Moreover, the language employed in these public statements risks perpetuating stigma. Framing autism as a condition to be ‘cured’ or attributing blame to parents6 reinforces harmful stereotypes and undermines the dignity of people with autism. It is imperative that public communication about autism be accurate, respectful and reflective of neurodevelopmental diversity.

While understanding autism’s causes remains a legitimate scientific goal, it must not eclipse the urgent need to improve the quality of life for people with autism across their lifespan. The US National Institutes of Health’s Autism Data Science Initiative, launched earlier this year with over $50 million in funding across 13 projects, focuses mainly on early-life exposures and the perceived rise in autism prevalence. Although such efforts are valuable, they must be complemented by research into aging, comorbidities and service delivery. Notably, the 2020 Interagency Autism Coordinating Committee report found that less than 13% of autism research funding was allocated to lifespan issues, services and support — an imbalance that must be urgently addressed.

Equally important is the inclusion of people with autism in shaping the research agenda. Participatory research models that prioritize co-creation and community engagement are more likely to yield findings that translate into meaningful improvements in care and policy. Yet, as of this writing, the Interagency Autism Coordinating Committee — the only federal advisory body with representation from the autism community — has not publicly announced a convening since the start of the current administration. This absence raises concerns about the inclusivity and legitimacy of recent policy and funding decisions.

Responsibility for restoring scientific integrity in autism research and policy must be shared. Advocacy organizations such as the Autistic Self Advocacy Network, the Autism Society and the Academic Autism Spectrum Partnership in Research and Education have taken commendable steps to counter misinformation and promote community-engaged research. 
References
  1. Seitz, A. PBS News https://go.nature.com/49E5GKv (10 April 2025).
  2. Hamilton, J. Noguchi, Y. & Greenfieldboyce, N. NPR https://go.nature.com/4qJlEch (22 September 2025).
  3. Beaumont, T. & Ungar, L. PBS News https://go.nature.com/3LAfWcE (10 October 2025).
  4. FactCheck.org. Annenberg Public Policy Center https://go.nature.com/47nNCTu (3 February 2025).
  5. Shutt, J. The Highland County Press https://go.nature.com/4oGeTGn (23 October 2025).
  6. Kim, J. NPR https://go.nature.com/4nGKZRB (26 September 2025).



 

Monday, September 29, 2025

IACC Nominations

  In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

ACTION: Notice.

SUMMARY: The Office of the Secretary of the Department of Health and Human Services (HHS) is seeking nominations of individuals to serve as non-federal public members on the Interagency Autism Coordinating Committee (IACC).

DATES: Nominations will be accepted through Monday, November 10, 2025.

ADDRESSESNominations are due by Monday, November 10, 2025 and may be sent to Dr. Susan Daniels, Director, Office of National Autism Coordination/NIMH/NIH, 6001 Executive Boulevard, Room 6119, Bethesda, Maryland 20892 by standard or express mail, or via email to . Please include full contact information (address, phone number, and email). Electronic confirmation of receipt will be provided. More information about the IACC is available at https://iacc.hhs.gov/​.

FOR FURTHER INFORMATION CONTACT: Susan Daniels/Office of National Autism Coordination via email at .

SUPPLEMENTARY INFORMATION:

As specified in the Combating Autism Act of 2006 (Pub. L. 109-416) and reauthorized by the Autism Collaboration, Accountability, Research, Education and Support Act of 2024 (Pub. L. 118-180).

The Office of National Autism Coordination (ONAC) of the National Institute of Mental Health, National Institutes of Health is assisting the Department in conducting an open nomination process. Appointments of non-federal public members to the committee shall be made by the Secretary of Health and Human Services.

Eligibility Requirements

Nominations of new non-federal public members are encouraged, and previous non-federal public members may also be re-nominated to serve if they have served only one term previously, in accordance with 42 U.S.C. 280i-2(c)(3). Self-nominations and nominations of other individuals are both permitted. Only one nomination per individual is required. Multiple nominations of the same individual will not increase likelihood of selection. The Secretary may select non-federal public members from the pool of submitted nominations and other sources as needed to meet statutory requirements and to form a balanced committee that represents a broad range of expertise and perspectives within the autism community in the United States and its territories.

Those eligible for nomination include individuals on the autism spectrum; parents, guardians, or family members of individuals on the autism spectrum; leaders or representatives of major autism research, advocacy, and service organizations; healthcare and service providers; educators; researchers; and other individuals with professional or personal experience with autism. Nominations of individuals from all U.S. states and territories, and individuals representing a range of lived experience, community service perspectives, and/or professional expertise within the autism community are encouraged. Nominations of individuals with a variety of disability and support needs are encouraged; requests for reasonable accommodation to enable participation on the Committee should be indicated in the nomination submission.

IACC non-federal public members are appointed as special government employees (SGEs) and are required to be at least 18 years old and U.S. citizens. Male non-federal public members must have signed up for the U.S. Selective Service in order to be eligible. To serve, SGEs must submit an annual confidential financial disclosure report used to determine conflicts of interest as well as a foreign activities questionnaire. Prohibited foreign activities include holding a position or title with a foreign governmental entity (including certain universities), and from receiving compensation and certain gifts from a foreign government. In accordance with White House Office of Management and Budget guidelines ( https://www.federalregister.gov/​articles/​2014/​08/​13/​2014-19140/​revised-guidance-on-appointment-of-lobbyists-to-federal-advisory-committees-boards-and-commissions), federally-registered lobbyists are not eligible. Federal employees may not serve as non-federal public members. IACC non-federal public members may be restricted from serving on other federal advisory committees while serving on the IACC and are subject to standard background checks associated with federal employment.

Responsibilities of Appointed Non-Federal Public Members

As specified in the Committee's authorizing statute (section 399CC of the Public Health Service Act, 42 U.S.C. 280i-2, as amended), the Committee will carry out the following responsibilities: (1) on a regular basis, monitor autism spectrum disorder research, and to the extent practicable, services and support activities, across all relevant Federal departments and agencies, including coordination of Federal activities with respect to autism spectrum disorder; (2) summarize advances in autism spectrum disorder research related to causes, prevention, treatment, early screening, diagnosis or ruling out a diagnosis; interventions, including school and community-based interventions, and access to services and supports for individuals with autism spectrum disorder across the lifespan of such individuals; (3) make recommendations to the Secretary regarding any appropriate changes to such activities, including with respect to the strategic plan; (4) make recommendations to the Secretary regarding public participation in decisions relating to autism spectrum disorder, and the process by which public feedback can be better integrated into such decisions; (5) develop a strategic plan for the conduct of, and support for, autism spectrum disorder research, which shall include (A) proposed budgetary requirements; and (B) recommendations to ensure that autism spectrum disorder research, and services and support activities to the extent practicable, of the Department of Health and Human Services and of other Federal departments and agencies are not unnecessarily duplicative; and (6) submit to Congress and the President: (A) an annual update on the summary of advances; and (B) a biennial update to the strategic plan, including progress made in achieving the goals outlined in such strategic plan and any specific measures taken pursuant to such strategic plan.

Committee Composition

In accordance with the Committee's authorizing statute, “Not more than 1/2 , but not fewer than 1/3 , of the total membership of the Committee shall be composed of non-Federal public members appointed by the Secretary.”

All non-Federal public members are appointed as Special Government Employees for their service on the IACC, of which:

  • At least three such members shall be individuals with a diagnosis of autism spectrum disorder; and
  • At least three such members shall be parents or legal guardians of an individual with an autism spectrum disorder; and
  • At least three such members shall be representatives of leading research, advocacy, and service organizations for individuals with autism spectrum disorder.

The Department strives to ensure that the membership of HHS Federal advisory committees is balanced in terms of points of view represented and the committee's function. Every effort is made to ensure that a range of perspectives and expertise are represented on HHS Federal advisory committees and, therefore, the Department encourages nominations of qualified candidates, including individuals with disabilities, from across the United States and its territories. Appointment to this Committee shall be made free from all forms of discrimination on the basis of race, religion, color, national origin, age, disability, or sex.

Member Terms

Non-Federal public members of the Committee “shall serve for a term of 4 years and may be reappointed for one additional 4-year term. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member [with a valid appointment] may serve after the expiration of the member's term until a successor has been appointed.”

Meetings and Travel

“The Committee shall meet at the call of the chairperson or upon the request of the Secretary. The Committee shall meet not fewer than 2 times each year.” In the years 2021-2024, the IACC typically held 3-4 meetings per year, including full committee, subcommittee, working and planning group meetings, and workshops. Meetings were held as either hybrid meetings with both in-person and videoconference accessibility, or as videoconference only. Travel expenses are provided for non-federal public Committee members to facilitate in-person attendance at hybrid meetings. Members are expected to be committed to making every effort to attend, either in-person or by video conference, all IACC full committee meetings and workshops and relevant subcommittee, working and planning group meetings. Accessible meeting design is employed, and reasonable accommodations are provided to facilitate full participation of individuals with disabilities.

Submission Instructions and Deadline

Nominations should include a cover letter of no longer than 3 pages describing the candidate's interest in seeking appointment to the IACC, including relevant personal/lived, professional, and/or community service experience with autism; indication of any membership eligibility requirements met; disability accommodation requests; and an indication of commitment to attend IACC meetings if selected; as well as full contact information and a current resume or curriculum vitae. Up to 2 letters of support are permitted in addition to the nomination, with a page limit of 3 pages per letter. Please do not include other materials unless requested.

Nominations are due by Monday, November 10, 2025. Nominations may be sent to Dr. Susan Daniels, Director, Office of National Autism Coordination/NIMH/NIH, 6001 Executive Boulevard, Room 6119, Bethesda, Maryland 20892 by standard or express mail, or via email to . Please include full contact information (address, phone number, and email). Electronic confirmation of receipt will be provided. More information about the IACC is available at https://iacc.hhs.gov/​.

Susan A. Daniels,

Director, Office of National Autism Coordination, National Institute of Mental Health, National Institutes of Health.

Wednesday, September 10, 2025

There Is No Single Cause of Autism

 In The Politics of Autism, I discuss various ideas about what causes the condition

Allison Parshall at Scientific American:

[In] the 1970s studies of twins revealed that autism is highly heritable, not something that develops after birth. Thus began the search for the genes responsible. “We had rather simple views about what it might be” that caused autism, says Helen Tager-Flusberg, a professor emerita at Boston University. The idea in the 1990s, she recalls, was that “we’re talking about six to 10 genes.” Instead researchers found hundreds.

No simple theory of autism has ever panned out, and the scientific community has moved on from the search for a simple answer. Researchers now know that autism develops from a staggeringly complex interplay between genes and factors that can influence development in utero. But attempts to pin the condition on one root cause abound, most famously in the disproven idea that vaccines cause autism. And earlier this year U.S. Secretary of Health and Human Services Robert F. Kennedy, Jr., announced that he will reveal the “interventions” that are “almost certainly causing autism” in September.

...

Untangling genetic factors from nongenetic ones (which scientists call “environmental factors”) can be tricky. For example, studies have consistently shown that parental age at conception can play a role, with older parents being more likely to have autistic children. But that could be because of the effect of age on genes: people accumulate mutations with age and can pass these on to their kids. Other factors that have been linked to autism include people being bornprematurely or through cesareansection, as well as pregnant people having obesity, using certain medications (such as the antiseizure drug valproate) and the pain reliever acetaminophen (the active ingredient in Tylenol) and being exposed to air pollution. The strength of the evidence for these links varies, though, and the increases in risk tend to be small. The evidence is also only correlational, meaning it can’t establish what caused what.

...

A large portion of autism research funding has gone toward searching for causes of the condition. And while this research is crucial, it seems unlikely to improve the lives of autistic people and their loved ones in the short term.

“The average autistic person, or their average family member, doesn't wake up in the morning thinking, ‘Oh, have they discovered a better mouse model [for simulating autism in laboratory research]?’” explains Ari Ne’eman, co-founder of the Autistic Self Advocacy Network and a health policy researcher at Harvard University. What autistic people and their loved ones most need is research into kinds of support that effectively address their day-to-day needs. A rebalancing of our research priorities, he says, is “long overdue.”

Wednesday, July 3, 2024

Autism CARES Reauthorization


The Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act, first enacted in 2006 and signed into law by President George W. Bush, represents a landmark in coordinated federal efforts to address the increasing prevalence of Autism. With the Centers for Disease Control and Prevention (CDC) now reporting that approximately 1 in 36 kids are diagnosed with Autism and 4.5 million adults in America have Autism, the need for a comprehensive approach to Autism has never been more critical. The Autism CARES Act has established crucial programs and committees, including the Interagency Autism Coordinating Committee (IACC) and various initiatives across the Department of Health and Human Services (HHS), aimed at enhancing our understanding and management of Autism.

Issues:

Despite significant advancements in Autism research and services, the rising diagnosis rates underscore the ongoing urgency to bolster federal response. The Autism CARES Act, reauthorized last in 2019, faces a sunset deadline of September 30th, 2024. Without timely reauthorization, the future of these essential programs and the progress they represent is at risk.

Members of Congress must act swiftly to reauthorize and enhance the Autism CARES Act. The continuation and expansion of these programs are not just a matter of policy but a necessity for the countless individuals and families affected by Autism. Together, we can ensure a future where every person with Autism has the opportunity to lead a fulfilling and supported life.

Your Voice Matters:

The House Energy and Commerce Committee passed the bill out of committee unanimously on June 12th. The bill now goes to the House floor and then the Senate to become law. Contact your Senators and Representatives today and urge them to support the reauthorization and enhancement of the Autism CARES Act. Your advocacy can make a difference in the lives of millions.

Sunday, December 31, 2023

IACC Summary of Advances in Autism Research


From the Interagency Autism Coordinating Committee 
The Interagency Autism Coordinating Committee (IACC) has released its 2022 Summary of Advances in Autism Research. This publication provides short, plain language summaries of the top 20 advances in autism biomedical and services research selected by members of the IACC. In addition, the IACC has released an accompanying easy-read version that summarizes the full publication in a briefer, more accessible format.

The 20 studies selected for 2022 highlight potential ways to improve early screening and diagnosis of autism, including through the use of telehealth, and insight into brain differences that may contribute to autism and impact social communication, language development, and sensory processing. The studies also improve our understanding of disparities between autistic adults from different racial and ethnic backgrounds. In addition, a study using data from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network found significant racial and ethnic disparities in the receipt of early intervention services. However on a positive note, a separate ADDM study found that the number of U.S. children identified early in life has increased greatly since 2002, providing greater opportunity for the receipt of early intervention services and supports. Lastly, several studies selected for the Summary of Advances investigate important lifespan issues such as disruptions in Medicaid services, vocational outcomes, and differences in the prevalence of co-occurring conditions between autistic individuals diagnosed as children versus those diagnosed as adults.

Articles in the Summary of Advances are grouped according to the topics represented by the seven Questions of the 2021-2023 IACC Strategic Plan for Autism Research, Services, and Policy. Citations for the articles selected for the Summary of Advances, as well as a complete listing of nominated articles, are included in the publication. The 2022 Summary of Advances meets the requirements of the Autism Collaboration, Accountability, Research, Education, and Support (Autism CARES) Act of 2019.

Among the research findings that the publication summarizes:

  • Less than half of the children in New Jersey diagnosed with autism between 2006 and 2016 received early intervention services, and significant socioeconomic and racial/ethnic disparities were observed, underscoring the urgency to address disparities and increase access to early intervention. 
  •  Pediatricians can identify early mental health concerns in school-age children with autism through screening during well-child appointments, and opp
  •  International survey results indicate several barriers, particularly communicating with providers and sensory challenges in waiting rooms, that may affect autistic adults in scheduling and completing primary care visits, leading to worse health outcomes. 
  • Factors measured in childhood such as IQ, adaptive functioning, and degree of autistic traits may predict levels of independence, employment and education, and, to a lesser extent, physical health in autistic adults. 
  • Autistic people diagnosed as adults are more likely to have co-occurring psychiatric conditions than those diagnosed as children, highlighting the importance of mental health supports across the lifespan and the need for research on how timing of diagnosis affects well-being. 
  • Work readiness skills (e.g., adaptability, success in daily routines) may improve employment outcomes for autistic adults. 
  • Medicaid data suggest that co-occurring health conditions among autistic adults, which occur more often than in non-autistic peers, differ based on race and ethnicity. 
  • Lack of lifelong Medicaid coverage for autistic adults in many states leads to higher rates of coverage loss and lower re-enrollment compared to non-autistic peers with intellectual disabilities. 
  • The number of autistic children identified early increased substantially between 2002 and 2016 in the United States, though racial and ethnic disparities remained; analyses suggest median age should not be used to measure progress. 


Saturday, December 30, 2023

Complexity of Services

Uncertainty and complexity are major themes of The Politics of Autism.

Political scientist Steven M. Teles has coined a term that comes in handy for any discussion of autism services: kludgeocracy. In computing, a “kludge” is a system consisting of ill- matched elements or parts made for other applications. Engineers patch it together and hook it up to an existing system in order to solve a new problem. Kludges are complicated, hard to understand, and subject to crashes. Teles says that this description fits much of American public policy: “From the mind-numbing complexity of the health care system … our Byzantine system of funding higher education, and our bewildering federal-state system of governing everything from the welfare state to environmental regulation, America has chosen more indirect and incoherent policy mechanisms than any comparable country."
The U.S. Department of Health and Human Services (HHS) has released the 2022 Report to Congress on Supportive Services for Individuals with Autism. This report was requested by the U.S. House of Representatives Committee on Appropriations in House Report 117-96.
From pp. 76-77 of the report:
The complexity of the supportive services landscape points to one important area of need: family navigation supports to help families identify and coordinatecare among the various providers, service types, and forms of coverage. Services are often fragmented among many different providers and in some cases, families may not be aware of the types of supports that are available to them. Families who are already facing significant functional impairments and disabilityassociated life stressors may have to shoulder additional burden of navigating complicated gatekeeping requirements before even identifying whether appropriate supports and services are actually available in their community. In some instances, providers may receive conflicting guidance on whether or not they are able to serve a person with autism, or if they should be referred to other services specific for those with DD. As a result, autistic individuals’ co-occurring conditions, such as mental health conditions, may go unaddressed. Family navigation services have been found to be effective in improving access and adherence to services over time,371 but tools designed specifically for families following a diagnosis of autism are currently limited.372 To be offered starting in October 2022, a new Medicaid health home benefit for children with medically complex conditions is a step towards meeting this need. This benefit will help state Medicaid programs provide person-centered care management, care coordination, and patient and family support. Fragmentation of the service system may be further improved by enhanced “wrap-around” or “continuum of care” services. Wrap-around services refer to the practice of providing all the various services that anindividual may need over time across different areas in their life (e.g., home, school, community). Wrap-around service delivery is a team-based, collaborative case management approach where a number of professionals work together to provide a holistic program of supports. This coordinated approach can help to improve outcomes for individuals and their families.373,374

Sunday, January 22, 2023

Diagnosing Adults

In The Politics of Autism, I write:

Many analyses of autism speak as if it were only a childhood ailment and assume that parents are the main stakeholders. But most children with autism grow up to be adults with autism, and they suffer uniquely high levels of social isolation. Almost 40 percent of youth with an autism spectrum disorder never get together with friends, and 50 percent of never receive phone calls from friends. These figures are higher than for peers with intellectual disability, emotional disturbance, or learning disability. When school ends, many adults with autism have grim prospects. Though evidence is sparse, it seems that most do not find full-time jobs. Compared with other people their age, they have higher rates of depression, anxiety, bipolar disorder, and suicide attempts.

From the 2023 IACC Draft Strategic Plan: 

[A]ncreasing numbers of adults are presenting to clinics for first-time diagnoses of ASD, and recent studies suggest that many adults with ASD may be unidentified and living in the community without appropriate supports84,85. Many autistic individuals diagnosed as adults report being misdiagnosed with other mental health conditions initially, such as borderline personality disorder, generalized anxiety, or mood disorders such as depression or bipolar disorder86, 87 . These misdiagnoses may result in being overmedicated or being subjected to unnecessary medical treatments. Others report receiving care for mental health conditions such as eating disorders while displaying traits of autism that were unrecognized or ignored by healthcare providers88. Thus, there is a need to improve diagnostic tools that are specific for adults. There is also a need to practitioner training to recognize traits of autism in adults.
84. Brugha TS, McManus S, Bankart J, et al. Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry 2011;68:459-65.
85. Croen LA, Zerbo O, Qian Y, et al. The health status of adults on the autism spectrum. Autism 2015;19:814-23.
86. Lupindo BM, Maw A, Shabalala N. Late diagnosis of autism: exploring experiences of males diagnosed with autism in adulthood. Curr Psychol 2022:1-17.
87. Rødgaard EM, Jensen K, Miskowiak KW, et al. Childhood diagnoses in individuals identified as autistics in adulthood. Mol Autism 2021;12:73.
88. Bargiela S, Steward R, Mandy W. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. J Autism Dev Disord2016;46:3281-94.






Thursday, January 19, 2023

IACC and Research Priorities

  In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

The Interagency Autism Coordinating Committee has released a draft strategic plan.

Figure 1 shows the trend in funding for each of the Question areas over time. In 2008, the reported autism research funding for federal agencies and private organizations was $222.2 million and 745 projects. In 2020, funding for autism research among both federal and private funders totaled $409.2 million and spanned 1,536 research projects. Over the thirteen years, autism research showed a general upward trend in funding, increasing by 84% since 2008. However, not all Question areas have shown the same pattern of growth. Question 2 (Biology) is the research area that has shown by far the most dramatic increases in funding, peaking at $195.6 million in 2019. In 2020, research on genetic and environmental factors (Question 3) received the second largest amount of research dollars. Funding amounts for Question 3 started out relatively high in 2008, then dipped from 2011-2014, but have shown relative increases in recent years. Question 1 (Screening and Diagnosis), Question 5 (Services), and Question 7 (Infrastructure) have received largely consistent investments in research since 2008. Funding for Question 4 (Interventions) has also been fairly stable but has been on a slight downward trend in recent years. Research focused on lifespan (Question 6) has consistently received the lowest levels of funding but has shown encouraging growth over the past four years.





Wednesday, January 11, 2023

Eric Garcia on Early Diagnosis


Eric M. Garcia at MSNBC:
\Focusing too intensely on early biological markers, early testing and early diagnosis is a symptom of America’s focus on what causes autism or puts people at risk for it. Two years ago, the Interagency Autism Coordinating Committee found that in 2018, 6% of all U.S. research dollars given toward autism research went to screening and diagnosis, 44% went to understanding the biology of the disability and another 19% went toward better understanding the risk factors. Another 13% was devoted to researching “treatments and interventions.”

After all that, only a meager 6% went to services for autistic people, and just 3% went to “lifespan issues” — even though autistic people are adults far longer than they are children and we should all support the idea of autistic people living long, happy lives.

Earlier diagnosis is not inherently bad, nor is a focus on biology inherently wrong. Those avenues of research can help find solutions to the impairments autistic people face.

But they are only the first step toward building a better world for autistic people. As much as neurotypical people tend to find autistic people’s tendency to be single-mindedly focused on a topic annoying, it is they who seem incredibly focused on the biology of autism and how to detect it early, rather than creating a system that supports autistic people throughout life. And here we are giving them plenty of hints that we have other priorities.

Monday, May 23, 2022

Sources of Autism Research Funding

 In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

Portfolio Analysis Report IACC Autism Spectrum Disorder Research 2017-2018

(IACC published the data last year.)

The federal government provides most of the research funding:

Most of the federal money comes from NIH:


The Army is one of these sources:

The Office of the Congressionally Directed Medical Research Programs (CDMRP) was created in 1992 from a powerful grassroots effort led by the breast cancer advocacy community that resulted in a Congressional appropriation of funds for breast cancer research. This initiated a unique partnership among the public, Congress, and the military. Since that time, Congress has added additional research programs and topics. Funds for the CDMRP are added to the Department of Defense (DoD) budget, in which support for individual programs such as the Autism Research Program (ARP) is allocated via specific guidance from Congress. Since its inception in fiscal year 2007 (FY07) and on through FY20, appropriations totaling $104.4 Million have been directed to the ARP by the Peer-Reviewed Autism Research Congressional appropriation.

Why the Army?

Strategies to Leverage Research Funding Guiding DOD's Peer Reviewed Medical Research Program Institute of Medicine (US) Committee on Alternative Funding Strategies for DOD's Peer Reviewed Medical Research Programs; Editors: Michael McGeary and Kathi E. Hanna


CDMRP was initiated in 1992 in response to several forces. One was the emergence of women's health as an urgent public policy issue. In July 1991, for example, the New England Journal of Medicine published several studies showing that there was sex bias in the management of coronary heart disease. In addition, the National Institutes of Health (NIH) had recently launched a women's health initiative and was requiring the inclusion of women in clinical trials.






...

One attractive source of funding at that time was DOD, which had approximately $29 billion in unobligated funds from prior years for the development of weapons systems planned before collapse of the Soviet Union in 1991.1 Those funds were put off limits by the Budget Enforcement Act of 1990, which established “firewalls” between the budgets for defense, foreign affairs, and domestic programs and imposed strict caps on funding increases in each of the three categories. A number of attempts were made to breach the firewalls by transferring defense funding to domestic programs, including two attempts in September 1992 that would have increased funding for breast cancer research specifically, but they all failed.2 Ultimately, Senator Tom Harkin put forward an amendment to the FY 1993 defense budget to increase funding for breast cancer research within DOD (rather than at NIH) by $185 million, to bring the total breast cancer research program within DOD to $210 million (Watson, 1992). As a transfer within DOD's research and development (R&D) budget, the amendment did not violate the budget agreement's firewalls. The funds were to be taken from the Strategic Defense Initiative and thus would be above and beyond the battlefield medicine-oriented core program of the U.S. Army Medical Research and Materiel Command (USAMRMC),3 which was funded at $410 million in the Senate bill. The “Harkin Amendment for Breast Cancer” which passed in the Senate by a vote of 89 to 4, also stipulated that all projects funded by the resulting Breast Cancer Research Program (BCRP) would have to undergo peer review (Mervis, 1993).


.

Friday, April 15, 2022

Hari Srinivasan Wins Soros Fellowshp

In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities. Many posts have discussed programs to provide them with training and experience.  
I also discuss the growing number of college students on the spectrum

A release from UC Berkeley:
You can hear Hari Srinivasan’s confident voice in his academic research papers, his Daily Californian newspaper articles and in his poetry and essays. But in person, you’re not likely to hear him speak.

That’s because the UC Berkeley psychology major’s ability to vocalize is severely limited due to regressive autism and a neurological disorder known as oral-motor apraxia.

It closed many doors to him. But not at Berkeley, and certainly not now.

Srinivasan is the first nonspeaking person, or as he puts it, “minimally speaking autistic” to win a prestigious Paul & Daisy Soros Fellowship for New Americans. He will receive $90,000 to fund his Ph.D. studies in neuroscience at Vanderbilt University in Tennessee.

Along with Dave Epstein, a Ph.D. student in computer science at UC Berkeley, Srinivasan is among 30 erudite U.S. undergraduate and graduate students selected this year for the 1998-founded fellowship. The honor recognizes immigrants and children of immigrants “who are poised to make significant contributions to U.S. society, culture or their academic field.”
...
As a Haas Scholar, Srinivasan has conducted research on emotions, among other scholarly pursuits, and will graduate Phi Beta Kappa and Psi Chi. Beyond the campus, he has served on the Interagency Autism Coordinating Committee of the National Institutes of Health, which advises federal policy around autism, and on the boards of several national advocacy nonprofits.

Saturday, April 2, 2022

World Autism Awareness Day

In The Politics of Autism, I discuss efforts to raise the issue's profile.

California Assembly Member Suzette Valladares:


 From President Biden:

On World Autism Awareness Day, we reaffirm our commitment to ensuring that the more than 5 million Americans who live with autism are able to make the most of their talents and participate fully in our society, and we celebrate the contributions autistic Americans have made to our families, our communities, our Nation, and the world.

We have made significant progress in improving access to opportunity for people with developmental disabilities in recent years.  However, many autistic individuals still experience gaps in employment and income.  The COVID-19 pandemic has compounded these inequities, creating unique challenges and strains for people with autism and their families.

That is why my Administration is committed to addressing the systemic barriers people with autism face in their daily lives.  The pandemic upended school routines for children and students living with disabilities.  That is why the Department of Education is working tirelessly to accelerate pandemic recovery for special education programs.  In addition, the Department of Health and Human Services and the Department of Housing and Urban Development are committed to ensuring individuals with disabilities have access to affordable housing as we come through this pandemic.

In order to improve quality of life for people with autism and their families in every community, my Administration is committed to funding cutting-edge research to help us better understand, diagnose, and treat autism, including funding research at the National Institutes of Health and the Centers for Disease Control and Prevention that seeks to better understand the underlying mechanisms of autism from childhood through early adulthood, improve methods of early identification and diagnosis, and develop innovations in the delivery of interventions and services.

My Administration remains committed to reducing barriers in access to early diagnoses, interventions, and services for people with autism — regardless of race, gender, ethnicity, culture, or geography — and to incorporating the lived experiences of individuals with autism into their research.  Last June, when I signed the Executive Order on Diversity, Equity, Inclusion, and Accessibility in the Federal Workforce, I promised to cultivate a Federal workforce that draws from the full diversity of the Nation.  One of the ways we are delivering on that promise is through a partnership between the Department of Labor and the Administration for Community Living, which is expanding access to competitive, integrated employment opportunities for people with disabilities, including autism.

In addition, my Administration will continue to build on the work done by the Interagency Autism Coordinating Committee, the National Autism Coordinator, and others to make certain that autistic Americans have access to the care, services, and support they need, so they can pursue their educational, career, and life interests without discrimination.

Today and every day, we honor autistic people and celebrate the meaningful and measureless ways they contribute to our Nation.  We applaud the millions of educators, advocates, family members, caregivers, and others who support them.  As we continue to build a better America, we reaffirm our promise to provide Americans with autism the support they need to live independently, fully participate in their communities, and lead fulfilling lives of dignity and respect.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim April 2, 2022, as World Autism Awareness Day.  I call upon all Americans to learn more about autism to improve early diagnosis, to learn more about the experiences of autistic people from autistic people, and to build more welcoming and inclusive communities to support people with autism.

IN WITNESS WHEREOF, I have hereunto set my hand this first day of April, in the year of our Lord two thousand twenty-two, and of the Independence of the United States of America the two hundred and forty-sixth.