Stats on "state specific label growth" (autism &am

While I haven’t taken the time to slog through this presentation in depth, I would like to point out one of the “assumptions” that is based in error.

“However, Leo Kanner, who studied a group of children with what came to be known as early onset autism, more (in)famously reinterpreted autism as non-temporary disorder and emphasized a connection to mental retardation and the need for institutionalization (Kanner, 1943). ”

Actually, this is not what Kanner found at all. I have a copy of “Classic Readings in Autism” which opens with Kanner’s original paper. Of the 11 chidren he had as patients, 8 were fully verbal, 3 were mute. He found that even the mute children were not really so; one of these was reported to mouth words silently in context to questions asked, another would repeat words over and over often. 6 of the children were able to attend typical schools, the other five were placed into residentail school settings with mixed results. 3 tested average in Binet IQ testing, 1 tested genius. Of the 11 only one got the label of MR.

In Kanner’s own words “Even though most of these children were at one time or another looked upon as feebleminded, they are unquestionably endowed with good cognitive potentialities. They all have stikingly intelligent physiognomies (faces, outward appearances)”

The things that Kanner found to be consistant, lack of desire to form interpersonal relationships with the mass of others, difficulties in oral communications ranging from pronoun usage to extreme limitations in verbal language and extreme resistance to change or incompleteness of previously established routines or arrangements of inanimate objects could be a perfect blueprint for the “expanded” criteria of DSM-IV which so many people claim is the reason behind the increase in prevalance.

I will read thru this offering more completely before commenting further, but I did wish to point out that any errors they make in supposition begin both early in their article as well as early in the historical presentation of autism. I believe that correction of mistaken presumptions like this (whether intentionally derived for the point of supporting their POV or simply repeated due to incomplete research) are necessary if effective change in public policy is to be achieved.

A brief aside…

One other common thread appears in Kanner’s work. Of the 11 children, 8 had fathers who exhibited symptoms that would be borderline Asperger’s, success in their professional fields nothwistanding. The other 3 had mothers who had some degree of neurosis. 8 also had family histories of neurotic women and men with Spectrum qualities, leading me to believe that some autism is indeed a matter of inherritance and not simply outside triggering toxins.

This is one thing that has changed somewhat more recently. The last 30 years, especially the last 15 has seen the greatest growth in autism striking without immediately indentifiable genetic stamps. The lack of a singular etiology (as is the case with some other problems of similar magnitude) has done more to cloud the picture than any other single factor, and regardless of what anyone may assert, I fully believe that much of the growth in prevalance since the 70’s can be laid on the exposure of these children to mercury, from the fillings in their mother’s mouths while in utero and from the preservative used in the ever increasing number of jabs kids get before they are 2 years old.

“The incidence of autism was once believed to be 1 to 2 per 10,000 people. More recently, reported incidence has climbed drastically—to around 1 in 500 in most estimates (Mandell et al., 2002). However, specific estimates of the prevalence of autism as recorded in the research and reported to the public vary. For example, in 2001, Bertrand et al, who studied the prevalence of autism in Brick Township, New Jersey, reported, “the prevalence of all autism spectrum disorders was 6.7 cases per 1000 children. The prevalence for children whose condition met full diagnostic criteria for autistic disorder was 4.0 cases per 1000 children, and the prevalence for PDD-NOS and Asperger disorder was 2.7 cases per 1000 children” (Bertrand et al., 2001). However, in a study of the incidence of autism in children born in California between 1987 and 1994, it was found that “a total of 5038 children with full symptom autism were identified from 4,590,333 California births, a prevalence of 11.0 per 10,000. During the study period, the prevalence increased from 5.8 to 14.9 per 10,000, for an absolute change of 9.1 per 10,000” (Croen 2002).”

There is no mention of the methodologies employed to derive these two diverse incidence numbers. The first, which was actually conducted by persons from the CDC who worked with professionals fully qualified and experienced enough to make an accurate diagnosis involved the time honored census method known as “canvas”. These people visited schools, observing children and interviewing staff, advertised to encourage parents to contact them and even went door to door in some neighborhoods to ensure they did not miss anyone. They were closely watched by a group of dedicated parents who had started the ball rolling out of fears this was a cluster spawned by the chemical plants at the edge of town where many of the parents worked. The CDC later echoed the findings of Brick with the Atlanta Study which came up with nearly identical numbers using similar methods.

The Croen Report however did not employ this method but instead did an analysis of the records kept by the CA Regional Centers. They chose a test period (1987 and 1994) and studied the trend in caseload during that time, later comparing it to a single category (MR) from the same database, and since there was a change in incidence (not prevalence, there is a distinct difference) that was close in size (+9.1 in autism -9.3 in MR) they concluded that diagnostic substitution was the answer.

http://www.udaan.org/basic/autism1b.html

SAFEMINDS, a group of people who believe that mercury is indeed the trigger for (much of) today’s autism re-analyzed the same dataset the Croen used and made a startling discovery. Croen only analyzed their data set at the start and end, and did not collate the trend during the period. When the period was broken down it found the decline in MR and growth in AU was actually independent of each other, and at times rose and fell together, not inversely.

http://216.239.39.104/search?q=cache:bC4DV29ZCVEJ:www.safeminds.org/Blaxill_Baskin_Spitzer_JADD.pdf+Croen+2002+autism+incidence&hl=en&ie=UTF-8

The M.I.N.D. Institute (UC-Davis) has done a far more extensive analysis of the CA Regional Centers and more directly answered the question of diagnostic substitution by showing that the CA Regional Centers uses quality diagnostic process and has better than 90% accuracy in their categorization both in the mid 80’s and in the mid 90’s suggesting that neither expanded criteria (the children labeled AU in earlier years had the same criteria as later years) no substitution actually was a factor in any but an insignificant number of cases out of the total. (M.I.N.D. also debunked migration as the cause showing that about 90% of the case load in the mid 80’s and mid 90’s were native born Californians.

One final mistake that Croen made was assuming that the Regional Centers accounted for 100% of the autistic kids in CA that related to the total live births for the target years. They did not allow for outward migration (which would have reduced the total number of auties while leaving them in the birth totals) or for those families who chose for whatever reasons not to participate in the services of the CA Regional Centers.

One thing that is of interesting note… One of the leading “experts” in autism prevalence, Eric Fombonne recently reversed his opinion based upon the work by the CDC in Brick and Atlanta as the continuing growth in caseload in the CA Regional Centers. For several years Dr. Fombonne was a strict proponent of expanded criteria and better awareness as the driving force behind the rise in number. However, in 2002 he issued a statement saying that further analysis does indeed support an actual increase in numbers as real. While he offers no opinions as to possible cause for this, he does now believe that the prevalence ahs increased. The extent of this is also left in the air.

I believe that the article posted above makes one very fundamental mistake. It relies heavily upon reporting by the schools for the basis of its numbers. Admittedly, it is about the best we have in this country to work with, as there is no national registry for autism, doctors are not required to report their autistic patients, and few states have the quality of dataset like the CA Regional Center on which to draw (many states do not even have regional centers at all).

We could answer the question of prevalence and even change in prevalence quiet easily if we wanted to. The simplest way would be to add a deduction on the 1040 like we currently have for blindness, to be accompanied by completed certificate of diagnosis from a selected group of diagnostics centers such as the many Children’s Hospital developmental departments. These hospitals would be paid for the service by the Feds to ensure that those who were too poor to afford the $800 – 1500 such services typically cost would be able to complete the paperwork.

Another way will take longer, but will also be rather telling. The “baby boom” of auties began in the early 90’s. These children will be coming of age soon, and despite the increase in the number of recovered kids (thru intensive remediation therapies, bio-medical interventions and lifestyle changes), the historically high number who go into residential care at states’ expense will still put a tremendous strain on the Medicare budgets of the individual states. If the Feds would require the states to report to a common department the nature of the disability or mental illness for all residential placements along with patient age we would soon get a good idea of how many auties there are and how this has changed over time. And since Aspies and PDD’s are generally able to survive our chaotic society without being placed into residential, there would be no clouding the issue by claiming that persons with “autism-lite” are bumping the numbers.

Dad, I realize that you have a more severely autistic child, but I dislike your use of the term “autism lite”. This implies that there is no disability or the disability is unimportant. I also realize that PDD and Aspergers are new to parents of more severe older children and adults.

However, it would be illogical if there were not a spectrum, as it would be unlike any other disability there is including LD, visual impairment, hearing impairment, cerebral palsy and mental retardation.

I’m sure a parent or individual who is only hearing impaired and not profoundly deaf would not want to be referred to as HI lite. Or someone with a kid with mild cp wouldn’t want their kid referred to as CP lite.

I won’t go into the stuff I experienced as a younger kid, say, or as a young adult, but I will assure you it was not “lite”. I also know of AS adults that were in institutions for mentally ill. That certainly is not lite.

—des

Des -

I use phrases like that not to belittle those individulas on the high end of the Spectrum, but more to help illustrate the arguments that are posed by persons who wish to deny facts that are present. Repeatedly I have heard it claimed that there is no autism epidemic, that the growth is merely the recent inclusion of children with PDD or Asperger’s into the mix (which does not hold for the 3 most recent studies in the US to support the growth as real, Brick, Atlanta md M.I.N.D.).

I have had discussions with persons (teachers and administrators) about the validity of including persons with PDD in the Spectrum, and find that those with less inclination to do their outside reading or who seek more to contain budget than to service their target clients are the most likely to scoff at a problem that is much larger than even some “experts” realize and presents itself clearly before them should they open tehir mind as well as their eyes.

Most recently for instance, I have met a family with a boy who has the diagnosis of Asperger’s. The school he is in has been less than pathetic (I am of the opinion that the Prince and staff there have actually been detremental) because they have rejected his Aspie label as “non-existant”. They have allowed this boy to be tormented (as much by teachers as by the more typical schoolyard bullies) for “being a weirdo”, and because he is capable of getting decent grades in most subjects (and actually excells in science) have rejected any form of accomodation or modification. The Prince went so far as to say “I have never heard of this Asperger’s, it doesn’t exist”. I will tell you I cannot wait to attend the next requested IEP meeting with these morons. (I will also request that the Sped Dir be in attendance, no exception; that woman (who is a menace in her own right) knows full well that Asperger’s is a valid diagnosis requiring some degree of accomodation; hearing why she fails to educate those who are supposed to be fulfilling their obligations to her program shall be “interesting”)

In many ways I think that those on the high end of the Spectrum may have a harder tmie with life than those like my boy in the middle. My boy does not face the harrassment and steady stream of negative peer interaction which many Aspies face (I do not think there has been much study on this but I believe the suicide rate for Aspies is about 3 times average.) I also realize that historically, a large number of Aspies have been placed in institutions under the psychotic label (sometimes after run-ins with the law over incidents which when re-examined are trifling at best). I agree with you that this is beyond tragic, especially when you consider how often they have been forced to take inapproproate medications, which are more likely to damage than to heal.

But I think you will admit Des, that the overall quality of life for a person with PDD or Asperger’s has a much higher potential (assuming they receive the type of support that they need to progress) than those who are fullblown autistic. Aspie’s and PDD’s are able to live independantly, can hold jobs (some of which they excell in) and can remain free to pursue their interests when they have the opportunity. Historically, children with autism get placed in residential care at a high rate (50% by puberty, nearly 90% by the time they are adults) where they face the very real risk of physical abuse, sexual assault and murder (3 times as likely in group home settings, 7 times as likely in larger institutions when compared to living in the home).

I will appologise to you for any offense I have given you, that was not and is not my intention. But I do feel that poltically correct language is more often window dressing, and many of those who are the first to use it are the same ones that are working counter to the efforts of people seeking meaningful change in service offerings and public policies. I have found language to be every bit as powerful a tool as any other, and when debating an issue, carefully chosen phrases can often accomplish what logic and reason can fail to do - pierce a fallacious position and expose the error in the other’s side. (That is why I place such terms in quotations, to set them apart from the general text.)

[quote=”Dad”]Des -

>I use phrases like that not to belittle those individulas on the high end of the Spectrum, but more to help illustrate the arguments that are posed by persons who wish to deny facts that are present. Repeatedly I have

I just would doubt too many people on the spectrum would like that term.
It does kind of dismiss it as a disability. Though I agree that you did use the term with a purpose, ie to illustrate that the PDD, AS addition does not fully explain the increase in autism.

>Most recently for instance, I have met a family with a boy who has the diagnosis of Asperger’s. The school he is in has been less than pathetic (I am of the opinion that the Prince and staff there have actually been detremental) because they have rejected his Aspie label as “non-existant”.

The experience of most of my friends/ aquaintances with kids on the spectrum is that though some are able to excel in certain subjects the school experience is horrendous. I had a pretty similar experience in that regard, but at least you could say that in the 50s and early 60s they didn’t know about this so they could be excused for their behavior. Since I was an excellent reader (comprehension not so excellent) and was “good”, ie well behaved, I no doubt had an easier time from teachers than a boy might have.

>They have allowed this boy to be tormented (as much by teachers as by the more typical schoolyard bullies) for “being a weirdo”, and because he is capable of getting decent grades in most subjects

Things have changed little since I was in school. If anything the tormenting is prolly worse.

>his Asperger’s, it doesn’t exist”. I will tell you I cannot wait to attend the next requested IEP meeting with these morons. (I will also request that the Sped Dir be in attendance, no exception; that woman (who is a menace in her own right) knows full well that Asperger’s is a valid

I hope you cause some trouble. :-)
I have sat in such meetings. It’s an interesting reaction when they actually meet an adult with AS, and know that they are meeting one.

>In many ways I think that those on the high end of the Spectrum may have a harder tmie with life than those like my boy in the middle. My boy does not face the harrassment and steady stream of negative peer interaction which many Aspies face (I do not think there has been much

I have heard this as well. And I suppose there is this side of it. And I agree with it in some ways.

>But I think you will admit Des, that the overall quality of life for a person with PDD or Asperger’s has a much higher potential (assuming

Oh well I never would deny that!! After getting thru my more hellish parts fo my life (ie about 10- 30 or so) I’ve had a pretty good life. I’ve been able to have a job, buy a house, have some relationships etc. This would not be within the realm of a person who is lower functioning.

If I had had the appropriate support, which I did not have, I might have avoided the hellish years entirely. I’d say that 60% or more, is not due to the PDD per se, but to the response of others or their failure to respond appropriately.

>I will appologise to you for any offense I have given you, that was not and is not my intention. But I do feel that poltically correct language is more often window dressing, and many of those who are the first to use

In fact, I have never liked “mentally challenged, physically challenged, learning challenged” and actually found that disabled people do NOT like those terms either. I have also just liked to say that I am autistic or AS vs saying that I am a “person with autism or AS”. My feeling has been the following, and is shared by others is that autism or AS is not a dress or something you put on and that you only have it when it is more or less convenient. It does control or influence how you perceive EVERYTHING.
It isn’t that I am not MORE than that. But you say you are a man or woman. Aren’t you MORE than that as well? But your gender effects pretty much everything and I fele the same about autism. (Some disabilties are more so like this than others.)

>it are the same ones that are working counter to the efforts of people seeking meaningful change in service offerings and public policies. I

Oh yes, I notice how fast school districts and state departments of disabilites grab unto these terms. I think they can feel like they are doing somethign without doing a thing. “Oh yes we are using political correct terms.” Right.

>have found language to be every bit as powerful a tool as any other, and when debating an issue, carefully chosen phrases can often accomplish what logic and reason can fail to do - pierce a fallacious position and expose the error in the other’s side. (That is why I place such terms in quotations, to set them apart from the general text.)[/quote]

I agree but… In this particular case, it is an argument. Whether you agree with it— well I also don’t agree with the whole premise, but I could argue it without resorting to the “lite” phrase. Sounds too much like you mean to imply that there isn’t a disablity there. I actually suspected I knew what you were doing here, I just didn’t like it.

I agree language is powerful.

—des

re denial:

I have previously mentioned how very very bad many of my education courses were.
In the mid-1980’s I took a course in special education for early childhood, just out of personal interest, at the local college. The instructor was breathtakingly ignorant and very confident in teaching her errors and prejudices to others.

When we were discussing Cerebral Palsy, someone asked about what happened when the kids got older, and the instructor just brushed off with “Oh, they all die by high school”. I knew this was flat-out wrong, first because I read about things, and second because I had a friend whose cousin had CP and was already in her twenties in the 1970’s. (Nowadays, I have even seen a man with CP interviewed, and he is in his 30’s and still OK) I mentioned to the instructor that there were new developments in medicine and improved survival, and she just told me I was wrong.

So when it came to autism, she just brushed it off with “Well, now we know it’s just another form of retardation” (I repeat, I know this is wrong, I am just quoting) and she went on with discussions of institutionalization.

All of this went absolutely against the content and design of the course as outlined in the materials from the university, the course being planned around mainstreaming, but I am sure she promulgated these errors and prejudices to lots of young teachers.

So when your principal etc. are in heavy denial, this is the result of their training as well as innate beliefs.

Gee, my brother (with CP) will be turning 50 in 21 days… guess he forgot to die.

I try to be careful about statements like “disabled people don’t like that term” — because there’s bound to be twelve of tehm out there who do. (Always aggravated me to no end when my otherwise perfect grandmother would generalize about an entire segment of the human population based on what one person said on a call-in show on WBAL!)

Victoria -

I agree fully that what people were indoctrinated with in college plays a large part in how they address their chosen career. It is a real shame that those in the halls of higher academia are so often so removed from what really is occuring (that is why I tend to place a bit more faith in the opinions and experiences of practitioners, those who get the grease under their nails often have a better understanding of the situation than those who read books that may be half a century out of date).

That is one of the reasons I have given several presentations at local colleges, especially the one which specialises in the field of education. Got to thumb through the text they use for special ed and I believe autism had all of 2 pages mention in it. Pretty sad when you consider that if the recent prevalance studies hold true for national numbers autism represents almost 1% of the student population and 5% of the Sped population.

I am not going to allow a school administrator (or his bosses) off the hook that easily however. One of the downsides of being a boss is the absolute responsibility to stay current in your field. It could be a lawyer who has to spend hours keeping up with recent court cases and the changing laws, and accountant who has to spend a small fortune buying the latest tax code breakdowns, an HVAC technician who has to take classes on new components for home heating. or an elementary principal who needs to turn on the computer and plunk “Asperger’s” into the google box when a child’s parent hands him a perfectly acceptable diagnosis sheet from a developmental psychologist who is well respected in our area.

I just did that, and in the 300 nanoseconds it took for my broadband to search the world’s database and return I got about 397,000 hits. Here is the one that came up at the top:

www.udel.edu/bkirby/asperger/

A fellow couldn’t ask for a better place to start if they knew absolutely nothing about special education at all.

So no, I am not willing to give this guy the least benefit of the doubt on this one. Were Asperger’s so rare that only 3 children in the US had it, perhaps. But prevalnce studies, faulty as they are suggest that 12 - 15 per 10,000 live births are Aspies, and that is a whole lot of people for someone who receives Federal and State funding to provide Sped services to not know exist. (I am willing to bet that the actual number of Aspies is a sight higher than that; many will likely be misdiagnosed with anxiety issues or BD/CD.)

By the way, I work with a man with CP who is in his late 30’s and lives independantly. He has trouble with his motor functions (one arm twists awkwardly and is for the most part useless and he had several operations on his legs when he was a kid trying to help his gait, so now he has a sort of rolling shuffle that makes him limp. Nothing wrong with his thinker tho ;) he is sharper than alot of people who had typical lives.

Hey Sue, tell your bro Happy B-day from all of us.

>www.udel.edu/bkirby/asperger/

>A fellow couldn’t ask for a better place to start if they knew absolutely nothing about special education at all.

That’s for sure. This is a top notch site, it is sort of an extension of an old chat group on aol.

>So no, I am not willing to give this guy the least benefit of the doubt on

Nah! Give him hell. :-)

>services to not know exist. (I am willing to bet that the actual number of Aspies is a sight higher than that; many will likely be misdiagnosed with anxiety issues or BD/CD.)

Or ADD/ ADHD— a fair number of us were first dxed as that (or in my case “minimal brain dysfunction”— gosh does that date me or what!?)

>By the way, I work with a man with CP who is in his late 30’s and lives independantly. He has trouble with his motor functions (one arm twists

Yep totally crazy what your teacher said, Sue. I have worked with CP adults. (And oh yes, I should qualify my statement of disabled people not liking those terms. Most of them I meet don’t, but you will always get someone who does once in awhile. I even met someone who liked the term “handicapable”. YESH!!! :-))

—des

Dad — one of the fifty-six reasons that I don’t teach in classrooms any more is that teachers and educational administrators are *not* professionals. This is one of the big problems in education, one of those systemic problems that doesn’t budge despite a few very good people working in the trenches.

What is a professional? Well, most people would list doctors and lawyers and then go on to think of others such as dentists, business owners and enterpreneurs, and self-employed accountants, and so on.
Professionals are defined by the facts that (a) They have advanced education and/or training and knowledge that is not common among the general public, and (b) Their work is self-regulated; they set their own schedules, to a certain degree set their own fees, and if they misbehave in their work, they are judged and possibly disciplined by a committee of fellows in their field.

None of these is true for 99% of teachers any more.

We have already discussed at length what a joke *most* education programs are (Those few of you who really do have a good education, you know who you are, and what do you think of the preparation most of your colleagues have?) In most states and provinces, elementary education has the lowest academic requirements for entry and for graduation of any major. Far too many classes involve doing kindergarten work. Scientifically proven methods of teaching the basic skills of reading and math are generally not taught and are often even contradicted. On average and overall, most people going into teaching do not have any special knowledge or skills; in fact new teachers regularly come and beg for help (a good thing, that they do want to improve, a pity that it is so necessary.

Then as far as self-regulation — this is good for a laugh. Teachers don’t even choose what subjects they teach; a more-or-less qualified history teacher finds himself handed an algebra class because once ten years ago he took pre-calculus; regularly, every September. Often they don’t choose even the schools they go to, the district just assigns them. Teachers have little or no input into the curriculum they are supposed to teach, and often even the classroom methodology is prescribed (eg “whole language”) or even scripted. Teachers have absolutely no control over schedules. Wages are usually set far away at state level, and even if more local are based on a strict degrees-plus-seniority grid by the board, no input ever from people in the field. If anything goes wrong, it is immediately out of the hands of the teaching staff and in the office of professional administrators, most of whom have never been in front of a classroom, and certainly not in the past ten years.

Teachers *want* to be professionals.
In some other countries they come a little closer; in many European countries almost all teachers have doctorates, and in many they choose their own texts and plan the curriculum with the proviso (very strong) that students have to be able to pass tests on fixed criteria.
But teachers around here have taken the opposite direction — it’s OK ask for professional level wages and protest firings of tenured teachers (provisional new teachers can take their lumps for two years) but also OK to resist strongly any attempt to upgrade academic standards or to police themselves for professional conduct. The unwritten rule is “be nice” so even if your colleague spends all day in the lounge with his supposed students in the library (yes, I’ve seen this) nobody ever complains; if you say the wrong thing to the wrong person and break the “be nice” rule, then you will be reported of course, but not for not teaching.

This isn’t the behaviour of professionals, and if you’re expecting responsible take-charge decision-making from the classroom teachers, you are going to get frustrated an awful lot. Classroom teachers are taught and hired to play nicely with others, be nice, follow the rules, and keep everyone happy.

<<In fact, I have never liked “mentally challenged, physically challenged, learning challenged” and actually found that disabled people do NOT like those terms either. I have also just liked to say that I am autistic or AS vs saying that I am a “person with autism or AS”. My feeling has been the following, and is shared by others is that autism or AS is not a dress or something you put on and that you only have it when it is more or less convenient. It does control or influence how you perceive EVERYTHING.>>

Des,

Add these to the list, differently abled and learning differences.. However, since I am short, I do like vertically challenged<grin>.

Someone I know made an excellent point demonstrating the absurdity of these terms in my opinion. This person said that if you don’t refer to blind people as having seeing differences, why would you do the same thing to people with LD?

By the way, I share your viewpoint on saying I am — vs. I am a person with –. You hit the nail on the head in saying our conditions influence how we perceive everything.

Now some folks with NLD have disagreed with me in saying that it sound like I am saying I am my NLD when NLD is only a part of me. True, but I still maintain it has that total effect on perception.

PT

Hi Victoria,

I don’t think teachers are the only group of professionals who suffer from the inability to police themselves. Doctors are the example that comes to mind but I think this is true with alot of groups.

Unfortunately, at least in the US, whistleblowers in any situation pay a very heavy price. Until they see that their lives and careers aren’t going to be destroyed, I am afraid the situations you mentioned will continue. No, that isn’t right but I do feel we need to look at the entire picture.

PT

IT takes a lot of effort to create and maintain self-correcting systems of people. Soon as you have a true heirarchy, the ones at the top get into that “absolute power corrupts” place :( It’s almost like lake ecology — ya gotta keep it turning over and re-sorting itself… time for minor revolutions :-)

“…or in my case “minimal brain dysfunction”— gosh does that date me or what!?”

I can barely remember back that far. :)

Back in the ’70s I also coded some cases on my general voc rehab caseload as minimal brain dysfunction because there was no Federal RSA code for learning disabilities either. No code = no service. I was never caught at it either. :) Or maybe ‘they’ just let it slide.

John