On Special Education

Just in case its position wasn't clear yet, the American Academy of Pediatrics is promoting a mercury-in-vaccines study in its journal because of the controversy over the ABC drama "Eli Stone." The show, which premieres tonight at 10 p.m. Eastern time, features a lawyer who successfully argues that a mercury preservative in a vaccine caused a child's autism.

The AAP demanded that the "reckless" episode be yanked, but ABC has agreed only to run a disclaimer.

The University of Rochester (N.Y.) study says that babies excrete thimerosal, a mercury-based preservative used in vaccines, much faster than originally thought. Therefore, the study's authors claim there's little chance that the chemical can build up and have toxic effects. Thimerosal has been removed from childhood vaccines given in the United States, but not in Argentina, where the study was conducted. The full study, which will appear in the February issue of Pediatrics, doesn't appear to be online, but the university has written a press release on it.

Understandably, this issue has stirred up the always-passionate autism activists in the blogosphere. I'm not wading into this fight, but for those who are interested, here's a blog post by author and journalist David Kirby, who believes there is a link between mercury and autism. And here's a link by a blogger called "Orac," who seeks to refute Kirby's points.

I'd love to hear what readers think of the episode after it airs! Was it worth all the furor? Please come back and share your thoughts.

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The American Academy of Pediatrics sent out a huffy press release this week, demanding that ABC cancel the premiere episode of a new television show, "Eli Stone," because the main character, a lawyer, successfully argues that a child's autism was caused by mercury in a vaccine. The show might scare parents away from vaccines, the release said.

ABC's response? No way. But the network has agreed to add a disclaimer to the premiere. (See The New York Times article here.)

Some disability advocates have argued that thimerosal, a mercury-based preservative, has played a role in the explosive growth of autism cases seen nationwide. Scientists have failed to find a link, however, as noted in an article I wrote in 2006. However, the Centers for Disease Control and Prevention and the pediatrician group recommended in 1999 that the preservative be removed from childhood vaccines. Today, most childhood vaccines are thimerosal-free. "Eli Stone" is scheduled to air at 10 p.m. Thursday.

Speaking of disabilities on TV, a young actor with cerebral palsy is being featured on a new cable television show,"Breaking Bad," on AMC. I can't speak to the realism of a burned-out chemistry teacher becoming a meth-cooking criminal in this dark comedy, but 15-year-old RJ Mitte offers a fine performance as his son. Interestingly, the biographical information on Mitte indicates that he had to re-learn some manifestations of cerebral palsy for this role that he had worked in real life to shed; for instance, his character uses crutches and has some problems with verbal articulation. I'd like to see more of him.

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The reauthorization of No Child Left Behind may have stalled, but that's not stopping education groups from trying to mold the law in their favor.

One of the latest suggestions for an amendment, backed by the National Association of State Directors of Special Education, would start a pilot program to allow "out-of-level testing" for students with disabilities. The chief sponsor of H.R. 4100 is Rep. Lynn Woolsey, a Democrat from California. The bill is sitting in committee.

Under the pilot program, a 6th grade student reading at a 3rd grade level could take a 3rd grade reading test. This wouldn't count for adequate yearly progress, the bill states--the results would just be studied to see how fast the students in the pilot move toward grade-level proficiency.

Nancy Reder, the governmental relations head for NASDSE, was straightforward in saying that her organization wasn't trying to drum up support among disability advocacy groups. (She already knows they won't like it. Teachers won't push toward grade-level standards if the tests aren't there to hold them responsible, these groups believe.)

The U.S. Department of Education also has come down against out-of-grade-level testing. Even the "2 percent tests" that states are allowed to administer to slower learners must measure grade-level standards, although with simpler language and less complex problems than the regular grade-level tests.

"We support high expectations for students with disabilities, but there needs to be an element of realism in how kids are assessed," Reder said. And giving a grade-level assessment to students who are clearly behind is meaningless, she said.

"We're more interested in teaching kids where they are," she said.

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It's safe to say that school organizations are still stung by a federal decision made in December to stop reimbursing schools for some of the services schools provide to students with disabilities. (See my last story on this topic here.)

When schools offer programs like speech or occupational therapy to low-income students, Medicaid pays them back. However, the Centers for Medicaid and Medicare Services, the government agency responsible for administering Medicaid, decided to cut out reimbursements for getting those kids to school. School is primarily an educational setting, the agency said. The government also won't pay school personnel for the administrative costs of managing its Medicaid programs. School districts say they have to bear these costs no matter what, so cutting out the reimbursements takes a big chunk out of their budgets.

The CMS made these changes by publishing new rules. In late December, Congress stepped in to give schools some breathing room by passing a bill preventing the rules from going into effect until July.

Now, for the strategizing. I met earlier today with representatives from a coalition of education groups, including the National Association for State Directors of Special Education, the American Association of School Administrators, and National Conference of State Legislatures.

Bruce Hunter, a public policy chief with the AASA, said a lawsuit isn't off the table if interested groups are able to find the money, along with a brave enough plaintiff. But the education groups are also reaching out to non-education groups that are mad about other changes made to Medicaid rules. What these groups all share is a feeling that their objections were dismissed during the public comment period on the changes, said David Shreve, an education policy official with NCSL.

"Any input was ignored," Shreve told me. "The common denominator for us is that the process was perverted."

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The great thing about a blog is that it allows writers a chance to share information that can’t make it into the print edition of the newspaper. So, this is a perfect way to start On Special Education: with an interview on response to intervention with Department of Education official Louis Danielson.

Tight scheduling kept me from speaking to Danielson, the director of the research to practice division in the office of special education, before my articles (here and here) went to press, but I was able to spend a half hour talking with him about RTI, an educational framework that is gaining widespread attention.

Federal assistance on RTI: “One of our clear, key investments is the RTI center,” said Danielson, referring to the National Center on Response to Intervention, a $14.2 million, five-year project. The new center will take over some of the functions of the National Center on Student Progress Monitoring and the National Research Center on Learning Disabilities, both of which are wrapping up their grants this year. Some of the regional technical assistance centers are also helping states with RTI, though that’s not their sole focus, he said.

How to “scale it up”: Michael Gerber, an education professor at the University of California-Santa Barbara, takes a dim view of how successfully RTI can be expanded nationwide. Too many other education initiatives have fallen into disuse because people don’t take into account the differences in the thousands of schools and teachers who must implement a plan, he says.

Danielson said that he understands that concern, pointing out that it’s an issue with any educational innovation. However, the department has had a great deal of success with “positive behavior supports,” which is a way of using RTI to affect student behavior. He pointed to Virginia as a state where RTI is being introduced gradually, in a carefully controlled manner.
“They’re going to start with a small number of school districts and not to force it down people’s throats. The risk of doing it that way is that they’ll do it badly and say it doesn’t work,” Danielson said. “It is hard work to do, we’ve got to be deliberate about it and we’ve got to be smart about it.”

RTI and due process: Some parent groups are concerned that response to intervention might delay the identification of a child as learning disabled. Special education shouldn’t be seen as a negative, said Naomi P. Zigmond, a professor at the University of Pittsburgh. It should be seen as a way for students to get the targeted help that they need to succeed.

But students usually aren’t identified with learning disabilities quickly now, Danielson said. He referred to one district that was studied after it implemented RTI. It didn’t change its percentage of children who were identified as having learning disabilities—it held steady at about 5 or 6 percent, he said—but now 1st and 2nd graders were identified, which he sees as a good thing. “While there could be a fear that [RTI] could drag things out; in this district it didn’t happen,” Danielson said.

Expect to hear much more about RTI, the officials suggested. It’s too early to make definitive pronouncements, but the early information is exciting. "If well implemented, we can get really good results for kids,” Danielson said.

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