Social care: pressure mounts for urgent and radical reform

Dear Editor

Everywhere across the country new special schools are opening. You can read this every day in local newspapers. When a new school opens or is planned it is always good news, just as when the government announces 3000 new places and 35 new schools under its "free school" plan [1], but the "free school" initiative is just one bit of it. Newham has just announced a new school for with 104 places for 2022 but that is just the beginning [2]:

"Primary age pupils identified with complex ASD rose 78 per cent from 2015 to 2018, which is leading to increased demand for ASD provision for secondary age children.

"The council estimates it will require 800 additional places for complex or high needs-funded ASD pupils by 2025."

There is no reason to suppose it is different anywhere else.

In Northern Ireland the system is understandably in breakdown [3] and the system is blamed and not the unprecedent flow of ASD cases [4].

But the heartbreaking truth is that the new schools and systems failures are only a tragic manifestation of public healths failure to engage with why this is happening as families and the education bear the brunt. How much worse does it have it get before the DHSC raises an eyebrow?

[1] Press release: Thousands of places created in new special free schools 19 July 2020, https://www.gov.uk/government/news/thousands-of-places-created-in-new-sp...

[2] Andrew Brookes, 'New school for pupils with complex autism spectrum disorder to be opened in Newham', 22 July 2020, newhamrecorder.co.uk/news/education/school-for-pupils-with-asd-receives-funding-1-6756160

[3] Robbie Meredith, ''Progress expected' on special needs places', BBC 26 June 2020, https://www.bbc.co.uk/news/uk-northern-ireland-53186171

[4] John Stone, 'SEND not for whom the bell tolls 2020 (ASD reaches 4.2% in Northern Ireland, 6.9% in Belfast)', 21 May 2020, https://www.bmj.com/content/366/bmj.l4564/rr-8

Dear Editor

The annual Northern Ireland ASD schools census has just been published [1]. The percentage of ASD children in Northern Ireland Schools school is now 4.2%, up 350% from 11 years ago (1.2%) and up 27% from last year (3.3%) [1,2]. To be clear these are not figures for entry level but for the entire 15 year cohort. The rate in Belfast is now 6.9%. The percentage at Stage 5, the most serious level of impairment, is now 2.7% against 1.9% last year. It is a daunting thought that if services had not been in paralysis for the last two months the figures would surely have been even higher.

In 2006 Francis Collins, then head of the Human Genome Project, now and for a long time head of the United States National Institutes of Health, told Congress in a budgetary request [3]:

"Recent increases in chronic diseases like diabetes, childhood asthma, obesity or autism cannot be due to major shifts in the human gene pool as those changes take much more time to occur."

But in 2020 the possibility of official science getting to the bottom of it seems ever more remote. Thank you Northern Ireland for counting because almost everyone else seems to have given up.

[1] Heidi Rodgers and Jessica McCluney, 'The Prevalence of Autism (including Asperger Syndrome) in School Age Children in Northern Ireland 2020', Information Analysis', Directorate 21 May 2020, https://www.health-ni.gov.uk/sites/default/files/publications/health/asd...

[2] Ian Waugh, 'The Prevalence of Autism (including Asperger Syndrome) in School Age Children in Northern Ireland 2019', Information Analysis, Directorate 10 May 2019, https://www.health-ni.gov.uk/sites/default/files/publications/health/asd...

[3] https://www.genome.gov/18016846/nhgri-fy-2007-budget-request

Following my letter here in July [1] I wrote to the Office for Budget Responsibility and have yet to receive a reply, but the problem will not go away. Last week The Times reported the concerns of the House of Commons Education Committee:

"The Children and Families Act 2014 was supposed to transform support for Send (special educational needs and disability) children by making it easier to identify their requirements. However, the government deeply underestimated how many children had special needs and the number of children with education, health and care plans (EHCPs) soared. Schools and councils struggled to fund the support."

While the Department of Education are failing to meet this human catastrophe it is manifestly the Department of Health and Social Care who have presided in silence over it. The bell, of course, tolls for countless families across the the country and not the government bureaucracy which is failing them every of the inch of the way. They have also been failed by the mainstream media who never ask the question "why". And by the medical profession. Dare one say it, the Secretary of State for Health and Social Care ought to be panicking over this rather than a few cases of measles.

[1] John Stone, 'Re: Social care: pressure mounts for urgent and radical reform - the cost of Brexit is a blip compared with the cost of the unexplained surge in ASD', 23 July 2019, https://www.bmj.com/content/366/bmj.l4564/rr-1

[2] Rosemary Bennett, 'Parents despair at special needs ‘chaos’', The Times 23 October 2019.

I write papers involving in-depth analyses. Currently, I am working on a 4-part series on Polio, Part 1 completed (Harrison, 2018). On my to-do list is the history of ASD diagnoses. Below I list some of the KNOWN causes of Stone’s “unexplained surge.”

HIDING IN PLAIN SIGHT

The late Autism researcher Lorna Wing (2005). wrote: “Nothing exists until it has a name.” As an example, in 910 treatise, the Persian/Arab physician, Al-Razi, noticed that a disease, up to then considered one, actually was two separate diseases, smallpox and measles (Cliff, 1993, p.52). So, did smallpox or measles suddenly develop in the 10th Century?.

Contributing Factors to Diagnoses of Autism Spectrum Disorders:

Leo Kanner’s 1943 article introduced the diagnosis of Autism and gave estimated statistics (based only on his own office practice); but in 1971, at a conference, he admitted that he rejected minorities and working class whites, believing it only a diagnosis for children of educated whites.

A number of journal articles and other reports, going back to early 1900s, used mental retardation and childhood schizophrenia diagnostic categories; but if I gave the listed symptoms without the source, they would definitely be categorized as Autism Spectrum Disorders.

A few described cases from various sources from the 19th Century and earlier would similarly be today diagnosed as ASD.

Psychiatry was a relatively new profession, only developing the last two decades of the 19th Century, so nearly impossible to know how people with problems would have been diagnosed earlier.

Prior to World War II, there were few to no social services in the U.S., the age required for school attendance was lower and children with problems were either just kicked out, some finding menial jobs, some institutionalized.

After World War II, with the rise of America’s middle class and family politics, more attention was paid to children. After the 1957 Soviet launch of Sputnik, more funds and programs and emphasis on public education was developed and the minimal age for leaving school increased.

Psychology became a popular degree in American universities and we began churning out psychologists, school counselors, and more psychiatrists and, of course, this led to more work needed for them.

Originally ASD was diagnosed by psychiatrists using various techniques; but gradually standardized diagnostic instruments were developed, allowing for easier and quicker diagnoses by others.

In 1986 the Federal government passed legislation for grants to local schools for special education, dealing with children with problems. In the early 1990s this was extended to include ASD.

Studies have found as the number of cases of ASD increases, the number of cases diagnosed as mentally retarded or childhood schizophrenia have decreased, at least, partially a response to availability of funds.

What was originally classical autism cases, became Autism Spectrum Disorders. Asperger’s wasn’t added until 1994 and there are cases of men in their 70s who have been diagnosed with Asperger’s. ASD includes kids with a variety of different signs and symptoms; but with some in common. As an example, in the 19th Century, high levels of white blood cells were originally thought to be signs of infectious disease; but then discovered to be cancer, so they were included in the category Cancer. Certainly doesn’t mean that cases of cancer were increasing, just another group was added. Blood cancers differ in many respects from solid tumor cancers; also have signs and symptoms in common. Another example, imagine that medicine begins looking at respiratory diseases, first including just asthma and pneumonia, then later emphysema, chronic obstructive disease, cancer, etc. Imagine the government creates a separate institute with lots of funding and grants, both for research and education, ending up with more and more respiratory therapists, pulmonologists, and researchers and, of course, diagnosed cases.

Increased awareness/screening/surveillance.

Childhood mortality has been decreasing over the past century. Children who would have died at birth or early on, e.g., low birthweight, especially very low birthweight, and genetic disorders, now can live long lives; but often have physical, cognitive, and emotional problems.

A relationship has been found between ASD and children born to older parents, more mutations in eggs and sperm.

We live in the age of a therapeutic society. More and more people are being diagnosed with something. If this continues, no one will exist who doesn’t have some medical/psychiatric label (e.g., Brownless, 2007; Hadler, 2007; Payer, 1988, 1992; welch, 2011).

Since World War II over 85,000 new chemicals have been introduced into our environment with little to no oversight. Before then, despite overwhelming medical science, lead was added to gasoline. A mass of studies has found that HIGH levels of lead in the blood of fetus and children results in lowered intelligence, behavioral problems, etc. And studies have found some post-war chemicals “cause” ASD when fetus exposed. High levels, not the minuscule levels of various additives in vaccines. So, yes, one can attribute some increase in ASD to the environment, either interaction with genes or by itself; but this doesn’t change that the vast majority of cases can be explained by the above.

I believe in community and wish a society where all human beings are treated with dignity and resources provided for them to obtain whatever potential they have, so I support evermore funding for children and adults labeled with ASD; but also cerebral palsy, Down’s Syndrome, etc. All lives are precious.

And we can “easily” afford this if our governments didn’t continuously lie to us about threats from abroad, while acting on behalf of corporations (access to raw materials and selling of weapons), resulting in CIA, MI6, and military spending trillions of dollars, risking our loyal military, and killing, crippling and impoverishing people in developing nations who were NEVER a threat to us. Of course, by killing them, we become the enlistment stimulus for terrorist groups, which we then claim the need to defend against, a vicious circle. Trillions of dollars that could have benefited us and used for real foreign aid (Blum. 2003; Butler, 1935; Gaffney, 2019; Schlessinger, 2005).

REFERENCES:

Blum W (2003). Killing Hope: US Military & CIA Interventions since World War II. Available at: https://www.cia.gov/library/abbottabad-compound/13/130AEF1531746AAD6AC03...

Butler, Major General Smedley (1935). War Is A Racket. Available at: https://www.cia.gov/library/abbottabad-compound

/13/130AEF1531746AAD6AC03EF59F91E1A1_Killing_Hope_Blum_William.pdf
[Butler is the most decorated Marine in history]

Brownlee S (2007). Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer.

Cliff A, Haggett P, Smallman-Raynor M (1993). Measles: An Historical Geography of a Major Human Viral Disease. Blackwell.

Gaffney M (2018 Mar). Corporate Power and Expansive U.S. Military Policy. American Journal of Economics and Sociology; 77(2): 331-417. Available at: https://www.globalresearch.ca/corporate-power-and-expansive-u-s-military...

Hadler NM (2007). The Last Well Person: How to Stay Well Despite the Health-Care System.

Harrison JA (2018 Nov 9). Wrong About Polio: A Review of Suzanne Humphries, MD and Roman Bystrianyk’s “Dissolving Illusions” Part 1. Science-Based Medicine. Available at: https://n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com/wp-content/uplo...“Dissolving-Illusions”-long-version.pdf

Payer L (1988). Medicine & Culture: Varieties of Treatment in the United States, England, West Germany, and France.

Payer L (1992). Disease-Mongers: How Doctors, Drug Companies, and Insurers are Making You Feel Sick.

Schlesinger SC, Kinzer S (2005). Bitter Fruit: The Untold story of the American Coup in Guatemala (revised version). Harvard University Press.

Welch HG, Schwartz LM, Woloshin S (2011). Overdiagnosed: Making People Sick in the Pursuit of Health.

Wing L (2005 Apr). Reflections on Opening Pandora’s Box. Journal of Autism and Developmental Disorders; 35(2): 197-203.