Respectful Insolence

Autism in the Presidential debate?

Was it just me, or did anyone else find it jarring when suddenly John McCain interjected special needs children and autism into the debate last night? As you may recall, a few months ago he was tripped up by the antivaccine fearmongers who think, despite an absence of scientifically compelling evidence supporting their view, that vaccines cause autism. Now that Sarah Palin is on the ticket, he’s doing it again, this time in the context of discussing her qualifications to be President. As part of a response to a question about why the country would be better off if his choice of a running mate became President compared to Barack Obama’s choice (Joe Biden), he said:

She’ll be my partner. She understands reform. And, by the way, she also understands special-needs families. She understands that autism is on the rise, that we’ve got to find out what’s causing it, and we’ve got to reach out to these families, and help them, and give them the help they need as they raise these very special needs children.

In the context of a question about special education, he said:

And I just said to you earlier, town hall meeting after town hall meeting, parents come with kids, children — precious children who have autism. Sarah Palin knows about that better than most. And we’ll find and we’ll spend the money, research, to find the cause of autism. And we’ll care for these young children. And all Americans will open their wallets and their hearts to do so.

Ugh.

I suppose I should give McCain some credit in that someone probably told him to cool it about the whole vaccine thing, that there was no science supporting it, but someone needs to tell him that whether or not the prevalence of autism is truly on the rise is pretty much an open question. Indeed, there is plenty of good evidence that it is not and that the apparent increase in autism cases is due the broadening of diagnostic criteria, greater awareness, and diagnostic substitution, in which children who would in the past have been diagnosed as mentally retarded or with other developmental disorders are now more appropriately classified as being on the autistic spectrum. Given how much out of left field these comments are (especially the comments about how having a special needs child somehow makes Palin more qualified to be President), I have to wonder if this is nothing more than pandering to the antivaccine crowd in a more subtle way. Dad of Cameron wonders the same:

She understands that autism is on the rise? Really? Can she clearly convey the distinction between more diagnoses, and an actual increase in prevalence? Does she understand diagnostic substitution? What about the broadening criteria and the changes in the very definition of autism? Does she really understand this? Or, is McCain pandering and simply parroting anti-vaccination and anti-autism advocate fundraisers’ “autism epidemic” rhetoric?

So does Sullivan:

Senator McCain may have thought that he was winning my vote, but he just lost it. Yes, disability issues, especially autism, play a role in my choice. But, this looks too much like pandering to the vaccine-autism crowd while doing the politician’s two-step around the sticky details.

I.e. it was “let’s use code words about the epidemic and vaccines to gather votes”.

I really hope I am wrong, but that was my read.

That was my read, too. Although one could argue that mentioning autism in the context of a discussion about education is part of the topic, in the context of whether Sarah Palin would make a good President, mentioning special needs children and autism seemed to come right out of left field. “She understands reform, and, by the way, she understands special needs families”? Such an awkward segue is the indication of a politician slipping a talking point in whether it fits the conversation or not. It was clearly planned to mention this, no matter whether it was appropriate or not. It came across as pandering, with a wink and a nudge.

It’s also very distasteful the way McCain and Palin use her son with Down’s syndrome every chance they get for political purposes, as Charles Fox points out:

I have been simmering on a daily basis every time Governor Palin holds up her son Trig as a political symbol. I have to say, that I think all small children should be left out of the political forum, and it is wrong to use an infant with special needs as an emblem of your own personal rectitude.

Indeed.

Comments

  1. #1 D. C. Sessions
    October 16, 2008

    Given how much out of left field these comments are (especially the comments about how having a special needs child somehow makes Palin more qualified to be President)

    It qualifies Jenny McCarthy to lecture immunologists and neurologists on vaccines and autism, so why is it a stretch to believe that it would endow another (and can we agree much brighter) woman with special insight into national and international affairs?

    I have been simmering on a daily basis every time Governor Palin holds up her son Trig as a political symbol. I have to say, that I think all small children should be left out of the political forum, and it is wrong to use an infant with special needs as an emblem of your own personal rectitude.

    And how many “wrongs” does it take to cancel out one “it works?”

  2. #2 DrugMonkey
    October 16, 2008

    I found the whole thing very peculiar. What is it about having a, what, 6mo yr old with Down Syndrome that gets Palin magically up to speed on the issues of autism???

  3. #3 ehoff
    October 16, 2008

    I was on the same page as DrugMonkey. Seemed to me that McCain was saying her child had autism, instead of Down syndrome. It just made him seem like a confused Grampa Simpson.

  4. #4 I am so wise
    October 16, 2008

    Hey, if having a special needs child makes one qualified to be vice president and since I was a special needs child and now a handicapped adult, I must be more qualified than Palin. Hell, I got more useful education than Palin, was vice president of the student council in middle school, and my kids haven’t gotten knocked up.

    Clearly, this means you should vote for me.

  5. #5 Bourgeois_Rage
    October 16, 2008

    Right on, DrugMonkey and ehoff. I thought it sounded as if McCain was saying that Trig had autism as well. He ought to be called out on that.

  6. #6 Mark Miller
    October 16, 2008

    McCain talked about autism intentionally, and it’s not the first time he’s done it. He talked about it in a joint interview last week. Look at the political statistics — more children have autism than Down Syndrome, so autism pandering = more votes. Or not.

    As the father of a 4-year-old girl with autism, I created http://specialneeds08.blogspot.com to expose the GOP’s hypocrisy and empty promises. It’s been visited by people from all 50 states and 25 other countries — more than ever after last night’s debate.

  7. #7 Noadi
    October 16, 2008

    I played that bit of the debate for my mom, she more or less exploded. She’s a special education teacher who grew up in foster care with several special needs kids. Those kids are now adults and she’s been the legal guardian for them since her foster mother passed away a couple years ago. One has Down Syndrome and several of her students have autism. I pointed out that she is clearly more qualified than Palin on every point including foreign policy since she grew up 5 miles for the Canadian border and crossed it numerous times. Needless to say that did not make her feel any better.

  8. #8 Rogue Epidemiologist
    October 16, 2008

    iamsowise, your ideas are intriguing and I wish to subscribe to your newsletter. Tell me about your stance on public education funding…

  9. #9 Sigmund
    October 16, 2008

    That anti-vaccination shrill David Kirby was on about this on the Huffington Post.
    He claims Palin has an autistic nephew and that this is what McCain was referring to.

  10. #10 PalMD
    October 16, 2008

    I was disturbed by it as well. It is, however, consistent with the candidates’ platforms.

    Deirdre Imus (!) weighed in as well—more later.

  11. #11 Pam
    October 16, 2008

    Yes, I also found his statements to be jarring. It seemed to me that the rest of the comments during the debate were about broader, more general topics, and suddenly the comments about the specific problem of autism were inserted. This felt forced to me, like…a product placement.

  12. #12 Jay
    October 16, 2008

    Yes, I also think, with ehoff and others, that there’s strong evidence that McCain indeed keeps confusing autism with Down syndrome. Whaddaya know! Next time he might even go so far as to confuse a Zeiss Mark VI planetarium star projector with an overhead projector. Naah, just kidding.

    ^_^J.

  13. #13 UncleDave
    October 16, 2008

    The level of ignorance displayed by the candidates, McCain and Palin in particular, on the subject of education let alone special education I personally find offensive.

    This is not to say they are the only ones, many of your congressional and senate reps are merely policy followers and have not a clue as to where the money goes let alone what is required of public institutions both monetarily and administratively.

    Our State (CA.) and federal government over the last 20 years or so has placed more and more requirements on public schools while not funding any of them.

    NCLB has led to a horrendous symptom of teachers being required to teach on the same page at the same time from the same book. Hardly a situation that drives young people to decide to become teachers. The failure of schools much like our financial lending system has deep roots inside our government.

    The best that could happen would be to eliminate the dept. of Education and roll it back into the Health Education & Welfare and get them out of the education meddling business.

    Give the schools some autonomy or lattitude to either succeed or fail; currently they are required to follow all the stae and federal rules, then when they fail following those rules your elected officials like to point it our as though they have no part in that failure.

  14. #14 pinky
    October 16, 2008

    Wow. I thought helping the downtrodden was the work of the Democrats? I am a bit confused by this statement by Mccain. I thought the Republican were suppose to just leave the Government alone unless the Dow Jones got screwed up. These are some confusing times.

  15. #15 madder
    October 16, 2008

    @ ehoff:

    I’m with you; it seems to me that the simplest explanation is that McCain doesn’t know that Down’s and autism aren’t the same thing.

  16. #16 Rubber Ducky
    October 16, 2008

    I could be wrong, but I believe one of her siblings has a child with autism. Or it could be one her husband’s siblings………I think that is why she brings that up.

  17. #17 Liz Ditz
    October 16, 2008

    From the Fox News Raw Data Transcript

    And, by the way, she also understands special-needs families. She understands that autism is on the rise, that we’ve got to find out what’s causing it, and we’ve got to reach out to these families, and help them, and give them the help they need as they raise these very special needs children.

    She understands that better than almost any American that I know.

    If Sen. McCain thinks Gov. Palin has such expertise, he is clearly far, far out of touch. Given the age of his children, it isn’t surprising. IDEA and NCLB have both, in their separate ways, changed the game for parents of special-needs children.

    Every Thursday morning I have coffee with a group of women. Most have special-needs children. JennyAlice said, “She has not even had one IEP meeting! And how many times has she had a respite-care meeting?” Squid just rolled her eyes. Double Trouble wasn’t there, but, well, she has twin boys. Both with autism. Sage wasn’t there either — but as a speech-language therapist and with a child in special education, she would have a lot more expertise than Gov. Palin.

    In fact, every one of those women have years more experience than Gov. Palin, and know first-hand what it takes to keep a family with special-needs children thriving.

    I thought it was a bizarre form of pandering. At least Obama said a few of the right things:

    I do want to just point out that autism, for example, or other special needs will require some additional funding, if we’re going to get serious in terms of research. That is something that every family that advocates on behalf of disabled children talk about.

    And if we have an across-the-board spending freeze, we’re not going to be able to do it. That’s an example of, I think, the kind of use of the scalpel that we want to make sure that we’re funding some of those programs.

    Well, we have a tradition of local control of the schools and that’s a tradition that has served us well. But I do think that it is important for the federal government to step up and help local school districts do some of the things they need to do.

    Now we tried to do this under President Bush. He put forward No Child Left Behind. Unfortunately, they left the money behind for No Child Left Behind. And local school districts end up having more of a burden, a bunch of unfunded mandates, the same kind of thing that happened with special education where we did the right thing by saying every school should provide education to kids with special needs, but we never followed through on the promise of funding, and that left local school districts very cash-strapped.

    Sensible stuff. All McSame can say is Vouchers!

  18. #18 ebohlman
    October 16, 2008

    She does in fact have an autistic nephew, which of course gives her special expertise in developmental disabilities by the same mechanism that living near Russia makes her a foreign policy expert. Oh yeah, and apparently during her term as Governor, the State of Alaska was sued by some autism parents for failing to provide appropriate services to their kids.

    I’m inclined to think he brought up autism simply because one of his advisors told him it was currently a hot topic, what with McCarthy’s and Offit’s books out there.

  19. #19 D. C. Sessions
    October 16, 2008

    Next time he might even go so far as to confuse a Zeiss Mark VI planetarium star projector with an overhead projector. Naah, just kidding.

    Or getting the detail wrong on the B52 he flew over Vietnam.

  20. #20 Emily
    October 16, 2008

    Between the bizarre autism comments and the scare quotes he used around ‘health of the mother’ when talking about abortion, I wound up getting really, really worked up during the debate last night. Ugh.

  21. #21 leigh
    October 16, 2008

    mccain/palin: eh, if you’ve had a kid with one type of special need, you’ve had ‘em all.

    that comment made me ill.

  22. #22 Thomas D. Taylor
    October 16, 2008

    People interested in learning the facts about autism and vaccines are welcome to listen to the free autism spectrum podcasts entitled “Autism and Vaccines: Parts I & II” by Midnight in Chicago. They are located at http://www.mic.mypodcast.com

  23. #23 I am so wise
    October 16, 2008

    Rogue Epidemiologist,

    Every teacher would be equipped with a taser and a mandate to use it. I’d also federal government salaries, welfare payments, government contracts, and so forth to parental participation. In other words, no welfare, corporate or personal, unless the teacher signs off on the fact you are a good parent.

  24. #24 Chris Lowel
    October 17, 2008

    Michael Moore once “anonymously” gave a major detractor of his, Jim Kenefick (www.moorewatch.com), $12,000 for Jim to pay for his wife’s life-saving medical bills (shown at the end of his doc “Sicko”).
    Now Michael has planned to do this again, with me, another pro-Moorewatch Moore hater, to demonstrate how universal health care works, raise awareness, and hopefully sway the vote in favor of Obama.

  25. #25 Natalie
    October 17, 2008

    Emily, don’t forget “pro abortion lobby”. Or lumping transplants in with cosmetic surgery as unnecessary procedures that insurance shouldn’t cover.

  26. #26 D. C. Sessions
    October 17, 2008

    I know I’m going to hate myself, but:

    Or lumping transplants in with cosmetic surgery as unnecessary procedures that insurance shouldn’t cover.

    That rather depends on the transplant, doesn’t it?

    Put another way, how many at-risk babies can we save for the same price as the third liver transplant for a 63yo drug and alcohol abuser?

    The USA has historically been a very wealthy nation and we’ve never been comfortable making that kind of decision, but reality has a way of not caring about our comfort levels.

  27. #27 Beth
    October 17, 2008

    “Jarring” was the perfect word. I moderte the autism blog for Easter Seals and published a post about this yesterday
    http://autismblog.easterseals.com/confusing-down-syndrome-with-autism/
    but neglected to point out how weird it was to hear McCain bringing this up out of nowhere. Thanks for reminding me: it was jarring!

  28. #28 Keenacat
    October 17, 2008

    @ D.C.Sessions:

    I’m not quite in touch with the american way of transplantation ethics, but here in germany no alcoholic or drug addict would get even one liver transplant, let alone another one after ruining the first. Because of the severe shortage of transplants, the ethics commitees tend to be very, very sensible about such issues. And every submission to the transplantation lists has to pass the investigation of an ethics commitee.
    Don’t they check such issues in the US?

  29. #29 D. C. Sessions
    October 17, 2008

    Keenacat:

    The simplest answer is, there are no simple answers. However, I was deliberately pointing out that “transplants … as unnecessary procedures that insurance shouldn’t cover” is not necessarily indefensible.

    Then again, in Deutschland government funding for pre- and perinatal medical care wouldn’t be a hot political issue either. Around here, the funding allocation for poverty-level maternal and child health is a budget line item of its own, and so is the funding for medical care for the retired. The retired vote — a lot. Babies don’t. You can figure out the result.

  30. #30 ReesieKitty
    October 17, 2008

    I work at a Chicago magazine and we recently put out a new edition for parents of kids with special needs. In the past 2 and a half years, I have had the privilege of working with many different parents and advocates. I did not think for a minute that they would buy into McCain/Palin. These parents have had to advocate tirelessly for their own kids and do their own research. They watch political issues that affect their kids closely- the McCain/Palin record speaks very clearly that they are not friends to these kids. Sarah Palin’s family will have a lot to adjust to in the future. I don’t respect her for hauling her son out in front of crowds and waving him around like that every day. I don’t respect her for not insisting that the McCain campaign clarify his condition. Working in advertising and marketing, I believe that the use of the word ‘autism’ is not coincidental or by accident. It is a huge buzz-word right now, with a lot of media attention. I think the campaign thought that by merely using that term and repeating it over and over, they could draw support- without really knowing or caring what they were talking about. I’m glad to see it hasn’t worked. Parents of children with special needs of ANY kind are too careful and know how to do their research too well. They won’t just fall into line behind empty promises. Go to http://www.ChicagoParent.com and check out Chicago Special Parent! We’re really proud of it :)

  31. #31 Carlie
    October 17, 2008

    McCain and Palin have both made jokes about health insurance that covers hair transplants, so I assumed that’s what he meant and he flubbed the line, like he flubbed so many others during that debate. I also thought he completely confused autism and Down syndrome, because he’s never mentioned autism specifically before, oh, last week. He’s overworked, he’s overtired, and he can’t keep his thoughts straight at all.

  32. #32 Rogue Epidemiologist
    October 17, 2008

    iamsowise, okay, to hell with the newsletter. marry me. it might be legal in this state.

  33. #33 Lisa
    October 19, 2008

    I don’t deny that autism exists, and that at least some of the children diagnosed with autism have that disorder. I do think that “Autism Spectrum Disorder” has become the replacement for “ADHD” in the previous decade, that teachers spuriously label difficult children as “special needs/learning impaired”, that parents want an interesting-sounding label for the kid who isn’t meeting everyone’s expectations, and that Jenny McCarthy is so wrong that it isn’t even funny. I also think that labeling a child as having an “Autism Spectrum Disorder” allows everyone else to go on being repressively bound to a very narrow set of behavioral norms, instead of accepting those who are really only a little bit different.

    Rather than concentrating on one neurological disorder, I think it would be far more important and far more beneficial to our country at large to work for mental health parity in treatment and insurance coverage. The mind is, after all, so inextricably bound to the body (and vice-versa), and it’s time that insurers, health care providers and policymakers acted accordingly.

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