Is Autism an "American Disease?" Somali Immigrants Reportedly Have High Rates

NOTE: Please also see my post today at AGE OF AUTISM -- "Top Researcher: Spread Shots Out 'As Much As Possible' With Mitochondrial Disorders"

A very interesting article was published today by Elizabeth Gorman on MinnPost.com that should be researched further: It might shine new light on genetic, and possibly environmental factors in autism.

The article reports that an unusually large proportion of Somali-speaking children in Minnesota have autism, something that has also been noted in Sweden, where Somali immigrants call autism "the Swedish Disease," because they did not see it back in East Africa.

According to the report, almost 6 percent of the Minneapolis school district's total enrollment is made up of Somali-speaking students. But in the city's early childhood and kindergarten programs, "more than 12 percent of the students with autism reported speaking Somali at home," and over "17 percent of students in the district's early childhood special education autism program are Somali speaking," the article said.

Somali kids with autism seem to be doing worse, on average, than their school mates: "About a quarter of all autism children who attend autism classrooms for students functioning too low to be mainstreamed in regular schoolrooms are Somali."

The statewide autism rate in Minnesota is already quite high -- at 100 per 10,000 children, as compared to the national average estimate of 67 per 10,000. In the Somali immigrant community, however, it could be much higher than either of those figures.

Why would that be? There is almost certainly a strong genetic connection at play here, but there may be other factors as well, including a lack of vitamin D from sunlight, (see the Swedish study in article) or, yes, vaccinations.

I do not know if vaccines are playing a role at all here. In fact, this report says that the Somali children were all born and vaccinated in the United States (though it seems to me that some must have immigrated here).

The "American Disease" idea comes from Somali parents themselves, and from some of the experts who work with them.

Anne Harrington, an early childhood special education coordinator for the Minneapolis school district and a specialist on the topic, told Gorman that Somalis "Are given more [vaccines] than we get, and sometimes they're doubled up. Then their children are given immunizations. In Somalia, their generations have not received these immunizations, and then suddenly they're getting just a wallop of them in the moms and then in the babies. That's certainly a concern that's been expressed to me by the Somali population."

I have never heard that before, and there may be nothing to it. On the other hand, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends that refugee adults receive at least 10 vaccines -- including pregnant women. Some of them contain thimerosal.

In addition, any of these kids who are older than five -- meaning they were born in 2002 or earlier -- could have received thimerosal in their vaccines.

Whatever the reason for the apparent higher rates of autism (ie, genes, sunlight, vitamins, vaccines, all of the above, none of the above) it is an interesting phenomenon and, it seems to me, an intriguing avenue of research.

There are data out there to suggest that elevated autism rates may not be limited strictly to immigrants from Somalia:

# A study of pervasive developmental disorder (a form of ASD) prevalence in Montreal school districts in 2003-2004 showed that the average PDD rate in the city's five predominantly French-speaking school districts (ie, largely Canadian-born) was 42.3 per 10,000 students, but in the largely English-speaking school district, where many immigrant children live, the rate was 69.2 per 10,000.

# In the English-speaking district, although the overall PDD rate was 69.2 per 10,000, among foreign-born children it was 106.6 per 10,000, and among Canadian-born children it was 67.6 per 10,000 - or 58% higher in the foreign born population.

# In Sweden, researchers reported that the incidence of autism among Somali immigrant children is far higher than among children living in Somalia (though better medical care and diagnostics would play a role, I'd think). Swedish media report that Somalis living in Sweden have dubbed autism, "The Swedish disease," because it is so common among Somali immigrants.

# These data might support reports that autism rates are also higher in immigrant communities in North America. On June 6, 2007, the Canadian Broadcasting News reported that, "autism rates are higher in immigrant families." Health-care specialists in Montreal, it said, were, "trying to understand why such a high number of autistic children come from immigrant families, a phenomenon seen in major cities across North America."

# This information MIGHT also help explain why autism numbers in California (and Minnesota, for that matter), are still high. In California, between 2003 and 2007, the rate of autism among black and white children enrolled in the state's DDS program increased by 50%. But the rate among Asian children in the same period went up by 79%, and the rate among Hispanic kids increased by 84.2%. The growth rate was about 58% higher among Asian and Hispanic children than black and white children.

# One in four California residents are foreign born. The majority are from Mexico, Central America, China, Korea, the Philippines and other countries with high vaccination rates (Mexico's is about 92%) and that still use the full amount of thimerosal in shots. Many if not most of these children are routinely revaccinated upon entry into the United States.

It would be very interesting, I believe, to look at autism rates in high and low immigration states. Not to implicate vaccines, but to find out if children of immigrants are more at risk than our native born population -- and why.

Comments

[bluevalentine]

Thanks David, another interesting read.

[zizyphus]

I have absolutely no confidence in the ability of the vaccine manufacturers, or the the FDA, to guarantee the safety of vaccines.

After his two week vaccinations, my son exhibited "cri du chat", and screamed ceaselessly in pain for hours in a high-pitched screech like a cat. That is caused by the vaccine inflaming the inside of his head. He had every vaccine required after that, although his doctor would not to give him the pertussis part of the DPT shot anymore.

If I knew then, 1984, what I know now, I would do everything in my power to keep my kids away from vaccines, and out of the public school system.

My son was diagnosed at age 18 with Asperger's Syndrome. You can't tell me there is no link between these filthy, contaminated liquids they inject into infants and the rise of autism and PPD, because I am not buying it.

Plus, the fact that Rumsfeld made sure to protect his precious Gilead Corp, a vaccine maker he used to work for, by slipping in a rider on a bill that will prevent people from suing the vaccine makers. The vaccine makers can now make any sort of garbage vaccine with impunity, then if DHS says a bioterrorism threat exists, all Americans would be forced to undergo vaccinations, without any recourse in the courts for the damages they will cause.

[BlackJAC]

Twenty bucks says you still take aspirin when you get a headache. Double or nothing says you still get flu shots every winter.

[CraigWilloughby]

Well, if it were me, you'd lose on all accounts. I don't take aspirin, and I never get flu shots.

[klmebane]

i will continue to vaccinate my child. every possible medical treatment has risks associated with it, but there were also a much larger number of children who died from communicable diseases that we now prevent through the use of vaccines. The diseases we vaccinate for are not extinct in this world. also, i want my child to go to public school, and they will not allow her to if she is not vaccinated because she then poses a risk to every child she comes into contact with. home schooling is not an option for us for a few reasons. we both need to work for one. also, we don't know anyone with children our daughter's age so she wouldn't have the opportunity for socialization, which is very important to her development and to learning how to talk to other people. i think that some ingredient in some vaccines (thimerosol) may be partly involved in autism, but i don't believe it is caused strictly by one thing. recent research suggests that there is a genetic component. my childs pediatrician is not worried, and neither am i. the vaccines they use at her doctor's office do not contain thimerosol.

[DocWylie]

Wouldn't the OBVIOUS line of inquiry seem to be: Why do UNvaccinated children seem to have a much lower rate of autism than vaccinated ones?

[AutismNewsBeat]

That would only be an obvious line of inquiry if it was true. "Seems true" isn't the same as "is true".

[CraigWilloughby]

You are correct, Ken. The fact that vaccines do not cause autism SEEMS to be true, doesn't mean it is true.

[Twyla]

HuffPost's Pick

nobelisto said, "The early childhood special education person lost all credibility when she referred to vaccines as delivering a 'wallop.' Obviously this is not a person who understands anything about the mechanism of action of a vaccine..."

nobelisto, maybe you missed the testimony of Dr. Douglas Wallace, a leading mitochondrial researcher, Professor of Molecular Medicine at the University of California, Irvine and director of its Center for Molecular and Mitochondrial Medicine in Genetics, with about 40 years of experience. He spoke on behalf of the United Mitochondrial Disease Foundation, where he sits on the Scientific and Medical Advisory Board, to the Vaccine Safety Working Group of HHS’s National Vaccine Advisory Committee. Here is a quote:

“I think it's fair to say that the Scientific and Medical Advisory Board strongly advocates continued vaccination of children... However, I think it's also fair to say, and this is true for my practice, that we have always advocated spreading the immunizations out as much as possible because every time you vaccinate, you are creating a challenge for the system, and if a child has an impaired system that could in fact trigger further clinical problems.”

"Delivering a wallop", "creating a challenge" -- pretty similar concepts, I'd say.

[doctorparikh]

CONFOUDING FACTORS ABOUND

Again, interesting post, but finger pointing to vaccines is, as always, premature. That's because there is no scientific rigor or discipline in this report. In good scientific studies, there are always confounding factors that the authors report. Though this is a news and not science report, a few possible confounding factors are worth noting.

1) Immigrant children here and in Sweden are going to receive health care (Sweden, has universal health care). Access to health care means more than universal immunizations: it means that kids with developmental problems are going to be picked up (regardless of whether they are vaccinated). In their native country, they will not; thus, we see diagnoses of developmental disorders here versus in Somalia

2) In the US, kids are going to attend public schools, where astute teachers will pick up their issues--again, not something that's likely to happen in Somalia.

In other words, what's reported as autism or other developmental problems isn't reported at home for these families.

As for epidemics of autism to worry parents into not vaccinating their kids, I've posted many links refuting that in Mr. Kirby's past blogs. That's not to say that autism needs research, funding and a SERIOUS look into causes and treatments. Accusing vaccines, though, is not the answer.

(incidentally, I have no ties to vaccine companies nor have I ever served as a spokesperson for any company)

Rahul K. Parikh MD

[CraigWilloughby]

Fair enough, Dr. P. You bring some interesting points to the discussion, and I would like to comment on at least one of them that could possibly be applied to the other one as well.

"2) In the US, kids are going to attend public schools, where astute teachers will pick up their issues--again, not something that's likely to happen in Somalia."

Very true, particularly about the latter part. But, here's the key, and I don't know if you picked up on it. David said that teachers are noticing an unusually high occurence of it in these children. You are implying that teachers and doctors of children here in the US or those in Sweden would not have picked up on native children with these problems; they do. Teachers usually notice ASD and ADHD behaviors in children. What David is saying is that the Somali children have an unusually high occurence of it.

[nobelisto]

I would offer one point to add to Dr. Parikh's analysis: as new-ish immigrants, most of the Somali families are of low socioeconomic status, and so are likely to be more closely followed by social services agencies and school personnel who are tasked with integrating English language learners. They are thus more likely than the average Minneapolis child to have someone who is autism-aware notice something amiss about their development.

With autism, it always comes down to this: the more you look, the more you find.

The early childhood special education person lost all credibility when she referred to vaccines as delivering a "wallop." Obviously this is not a person who understands anything about the mechanism of action of a vaccine or how small the antigenic load is in today's vaccines compared to that of even ten years ago.

[Twyla]

I'm sick and tired of being told that it is so hard to discern people with autism. If these Somali immigrants say that they are seeing autism in the U.S. and in Sweden but not in Somalia, I believe them. It's worth looking into the question of, why?

Yes, there are some high-functioning autistics that may have just received the label "nerd" in a former time. But, most parents I know are struggling with extreme behavioral and learning and communication issues in their kids. If a child is not talking by the age of three, everyone notices. If a child is spending his or her time self-stimming and shrieks if you don't let him just lie on the floor and stare at a spinning object, everyone notices. Autism is usually not subtle.

[foe2Hg]

Dr P

You said-
"incidentally, I have no ties to vaccine companies nor have I ever served as a spokesperson for any company"

You are a spokesperson for the AAP and have done reports for Pediatrics on squashing any discussion regarding honest research, vaccine adverse effects, and autism, so I guess those facts would make you indirectly, if not directly, having ties.

Below are just some examples of how you have no *ties* or *conflict*-
You have 2 done on March 13th--where do you find time to actually be a doctor?

Cases - Showing the Patient the Door, Permanently - NYTimes.comPrint; Reprints; Save. By RAHUL K. PARIKH, M.D.. Published: June 10, 2008
http://www.nytimes.com/2008/06/10/health/views/10case.html?partner=rssuserland&emc=rss&pagewanted=all

What the Poling Autism Case Means
Your Scientific Guide to Autism
The widely publicized court victory for the family who claimed vaccines
caused autism in their daughter does not prove a link.
Rahul K. Parikh, M.D.
March 13, 2008
http://www.autism-watch.org/news/poling.shtml

Fighting for the Reputation of Vaccines: Lessons From American .
..Mar 13, 2008 ... Address correspondence to Rahul K. Parikh, MD, Kaiser Permanente
http://pediatrics.aappublications.org/cgi/content/extract/121/3/621

Beware Dr. Google
Rahul K. Parikh, M.D.
Sunday, November 18, 2007
http://www.sfchroniclemarketplace.com/cgi-bin/article.cgi?f=/c/a/2007/11/18/CMA1SRM3R.DTL

[foe2Hg]

Well, I missed the CBS newscast on "Vaccine Industry Money, Where Does It Go?" as I had an important phone call but by reading some of the comments on the Age of Autism website-I think Dr P, you may have some explaining to do-

http://www.ageofautism.com/2008/07/watch-cbs-news.html#comments

"Paul Offit, the AAP and Every Child by Two just took a DRUBBING on CBS - for the MILLIONS they accept from pharma. I think parents will be shocked to hear that children now get 55 shots by age 6. And that their children's health is clearly compromised by money.

Teresa

[doctorparikh]

Sure,
I have my opinion, but that's not the same as having financial conflicts of interest. Again, let's not blur the line between opinion, innuendo, and fact.

[thebossthetruth]

Parikh,
No one disputes your right to an opinion...
The question is why?

Myself and the majority of the posters here, we're the parents of Autistic children,
Vaccine damaged autistic children... That's why we do it.. Many of us are members of Autism
recovery groups and advocates for safe vaccines... I can assure you that I receive nothing from
any vaccine manufacturer

So, in the interest of full disclosure, why do you post?
"I have no ties to vaccine companies nor have I ever served as a spokesperson for any company."That's a very specific statement..

So in the interest of full disclosure, will you answer the following?

1)Are you compensated or reimbursed in any manner for your time spent on various posts on the subject of vaccines and autism?

2) How did you determine where you would post, did you discuss this with anyone prior to beginning your on-line advocacy defending vaccines.

3) Has any of the material for your posts been provided to you.

4) Do you discuss your posts prior to placing them?

5) Which Vaccine advocacy organizations are you affiliated with?

6) Has a Pharmaceutical manufacturer or their representative (public relations firms, employees) ever provided you,any member/staff of your practice or family member with
a) Free meals
b) free educational materials
c) free promotional materials
d) free samples of their products
e) paid travel or attendance to any social/educational functions

Just wondering?

[doctorparikh]

As I understand, this group is open to anyone who wants to participate.

A typical strategy of anti-vaccine folks is to 1) claim we're all in bed with drug companies and get money from them 2) censor different opinions, like the writer above is implying here.

Thousands of pediatricians who care for kids aren't lemmings to drug companies or vaccine makers. Infact, the cost of vaccines now is so high that many don't make a cent from them. We do it because it's the right thing to do--because vaccines are safe and effective.

I think we all agree that autism needs attention and we need to focus on treatments and cures. But continuing to accuse vaccines of being the cause isn't supported by any objective evidence. And that's question nobody has been able to answer.

I post because I believe that vaccines save lives and are safe and that people who accuse them of being dangerous need to be held accountable for answering tough questions.

regarding question 6: No--my medical group has banned drug reps:
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/07/15/EDDO11OUJ1.DTL&hw=robert+pearl&sn=005&sc=399

[ThoJ]

Thanks again for speaking out Dr. Parikh.

Not all autism parents subscribe to the vaccine-injury theory of autism. That includes this parent.

Mr Kirby--please, give up on the "California numbers". Immigration doesn't account for why the numbers are still climbing. You even acknowledged that thimerosal is likely not the reason why the numbers have been climbing.

[CraigWilloughby]

The numbers are still climbing (which is debateable, currently) because Thimerosal is still in the vaccines. Don't say they are getting a less exposure because that isn't true. Take the thimerosal in 10 shots and spread it out over 36 shots. Guess what you have? That is called a shell game or moving the goalposts....you know, what you guys accuse the pro-safe vaccine crowd of?

[AutismNewsBeat]

"Mr Kirby-...You even acknowledged that thimerosal is likely not the reason why the numbers have been climbing."

Mr. Kirby now blames Chinese industrial pollution, forest fires, and crematoriums. Like I said - moving the goal posts.

[consciousmom]

Another interesting point that wasn't raised is that the diets of the Somali children would have drastically changed living in Sweden. This could very potentially change their gut flora, which has a role in removing toxins like mercury from the body. It would be interesting to do a mercury-load test like the Porphyrins on these children to assess their mercury levels. Also, nutritional panels can be done that indicate if the body has attempted to rid itself of toxic metals -- being depleted of certain trace minerals, like manganese, for example.

I'm glad to see David Kirby is still writing about this issue, and asking the good questions.

Lisa
http://www.holistic-treatment-for-depression.com

[AutismNewsBeat]

Another interesting point is that the Swedish medical establishment is evidence based and won't take holistic treatment and detoxifying gut flora seriously unless there is evidence for it.

[ThinkForYourself2]

This is a human rights issue that everyone should be concerned about and I think it's time to organize regular protests until we get justice for those harmed and ensure that things change. Parents should have all the necessary data to make informed decisions about vaccines and should not be coerced into vaccinating their children with these poisons. And yes, they are poisons.

[msfiskvletterman]

7/24/08
5:39pm
University of Oregon

Thank you for the article, David.

[HeatherO]

I'm in Minnesota and have attended meetings with Somali parents of children with autism. They say in Somalia, their children got very few, if any, vaccines because they could not afford them and autism was non-exisistent. Now in America, their children are all vaccinated, and as David reports, autism is a BIG epidemic for the Somali children in the US. They suspect their children's disorders are linked to vaccinations.

[nobelisto]

This is the kind of thinking that comes from people who simply have the heebie-jeebies about vaccines but nothing like a scientific theory to back it up. If something bad happens, it MUST be because of vaccines.

Think about the harm that comes from making these kinds of statements. Think about how to be a responsible member of society.

[CraigWilloughby]

She is being a responsible member of society. She is questioning the motives of the pHARMa-scum (tm) and asking why these things occur. It is good to question. Think about all of the harm that these vaccines are doing to our kids.

[TakeSake]

Please offer your theories of what is going on, both in the Somali community as in society in general.

[AutismNewsBeat]

Somalis are the new Amish.

[GrammaKnows]

I don't believe Somali children are the only immigrants thus affected. There have been quite a few reports of adopted children, from all over the world, who have been double and even tri[ple vaxed in the adoption process - and are then dx with autism once settled into their new American homes.

It may be this particular population, with a higher than even US schedule of vaccine exposures is the most glaring evidence of the harm...

[nobelisto]

Because if you were born to a mother who'd had a poor diet and no prenatal care, spent your infancy and toddlerhood in a Third World orphanage, and were whisked to a country where autism is the diagnosis du jour, then received some vaccines...it would obviously be the vaccines that would make you autistic.

[TakeSake]

That response implies three things:
1) That Somali parents would have been unable to tell that there was something wrong.
2) That the Somalis who come here are the poorest ones - they aren't.
3) That autism is somehow "fashionable".

[TimKasemodel]

From the MinnPost .com article:

"The Minnesota Department of Health is scrambling"and "has not developed a plan to assess numbers of immigrant children with autism "

The part about "has not developed a plan" is a gross understatement. Just this last October I attended the first (and only mind you) "Autism Hearing" in the House Health Policy Committee. Two hours to learn about autism - shameful. The MDH and other "experts" poo poo-ed the idea of an increase - it is all better diagnosing of an ever existant constant rate of autism.

I asked a Mayo clinic Dr. to explain why there are twice as many 10 year olds with autism than 18 year olds with autism if they had 8 extra years to find them? "They slipped through the cracks, they are there, getting by in high school" without assistance and unnoticed by others

The rate autism for kids born between 1997 and 2000 in Minnesota avarages one in 75 - twice the 1 in 150 often quoted. The rate for boys in that age group averages 1 in 45. The mayo clinic doc believes the rate of autism adult men is likely higher.

Where are they? Getting by, without assistance, unnoticed by others he says.

Maybe the MDH is scrambling because they will have no where to hide if people actually investigate the vaccination records of the Somali population.

[nobelisto]

Actually, Tim, it isn't just better diagnosing - it's also greater incentives to diagnose and expansion of the diagnostic criteria.

It is well established that many children with autism become less obviously autistic as they mature. It should not be at all surprising that children born before autism was all the rage haven't bothered to get diagnosed as they get close to leaving the school system. What would be the benefit?

[ObjectiveAutismDad]

Well established by who??? My son was closer to age appropriate when he was 3 -- it's not so noticeable that he's still acting like a 1 year old. Now he's 17 and he's way off course (acting like a 5 year old in a 17 year old body is very noticeable). Of course, this is just my experience... However, being in the position I'm in I see a lot of autistic kids (probably more than Dr. P. ever saw -- because he shows most of them the door), and the same holds true for them. Some of them seem rather normal when they're younger -- but because they develop so much more slowly it becomes more noticeable.

And, where are the incentives to diagnose this??? Who does that benefit? Certainly not the parents as many insurance companies deny coverage because it's "incurable". And the Doctor wouldn't benefit for the same reason. We never went back to the Doctor who diagnosed our son because she said there wasn't anything we could do except prepare for a lifetime of full time care for our son.

[AutismNewsBeat]

The Somalis wouldn't have that problem if they lived with the Amish.

[foe2Hg]

ANB-

Glad you are finally seeing that connection of limited vaccination=limited autism, though you are most likely being sarcastic as honest discussions are not on your blogging resume.

[CraigWilloughby]

Teresa, watch it! You're using ANB and honest in the same post. That's an oxymoron if I've ever seen one.

;)

[thebossthetruth]

Ken,
I am stunned. You writing a truth under one of your many alias's???
No, the Somalian children wouldn't be austistic if they were living with the unvaccinated Amish.

Now, I have to go outside and see if pigs are flying, or the sky is falling, or if George Bush has developed a conscience

[foe2Hg]

and yes, the boss has spoken the truth! High five my friend!

Teresa--you can call me Red

[linlou34]

LOL!!!

[CraigWilloughby]

Heh...a truer statement has never been spoken. Bravo, my friend. Hats off to you.

[AutismNewsBeat]

You would have a point if the Amish were unvaccinated.

[Gatogorra]

Really interesting report.

Other than the possible high-hg hypervaccination of the mothers in their country of origin or as a condition of entering the country, there's other things to consider besides genes.

Found this on Yahoo Health:

http://tinyurl.com/6c9jxs

What struck me about it wasn't necessarily the TB rates from Somalia, Vietnam and other countries but concern about the side effects of any treatments offered in those countries via their own medical systems or through Western "aid" which might impact mitochondria.

And last but not least, are women who emigrate from certain countries being targeted for other treatments here which could potentially effect mitochondrial function of a nursing infant or fetus? Are immigrant women, particularly those who may have experienced trauma in their country of origin or on arrival here (famine, political violence, separation from family, culture shock) more prone to depression and are they falling prey to prenatal "mental health" screening? Are they being offered antidepressants or other drugs (which all effect mitochondria) at higher than average rates in pregnancy or while nursing? Are some women compliant to any treatment suggested, either through the Medicaid program (the lawsuits against the drug companies for bilking Medicaid for high priced psych drugs which have been mounted by the attorneys general of so many states raises the issue) or private health care?

I'm wondering what's setting these children up for the fall, what pushed them far enough to the edge that perhaps vaccines pushed them easily over it.

[amdachel]

HuffPost's Pick

All this frightening information should be setting off alarms everywhere. Officials can't pretend that this is acceptable. For years as more and more children were diagnosed with autism, we've heard one bizarre claim after another. We're to believe that all this is merely the result of "better diagnosing" by doctors, as if a generation of children with autism is nothing new.
Officials claim that autism is genetic, yet Somali parents call it, "the Swedish Disease" and "the American Disease" because they did not see this disorder back home. Something must be triggering autism in Somali children in Sweden and the U.S. We need to start moving mountains to stop this disaster from getting worse.
Polio affected one in 3,000 Americans at the height of the epidemic in the 1950s. That was a national health crisis. Autism now strikes one in every 150 children, based on outdated CDC studies done on eight year olds back in 2000 and 2002, and still no one will admit that this epidemic is real.
Anne Dachel
Media editor
AGE OF AUTISM

[linlou34]

I live in MN and for the 2006-2007 school year it has been reported that 1:81 children in this state have some sort of autism. This report comes from local WCCO week long special about autism. This number is very disturbing! In my opinion, our schools are not doing as they should for our kids with autism. Sure they have autism programs for our kids in some of the schools, but when they fail to provide necessary services for our kids, they fail to succeed. If it is common knowledge that these kids should get intensive speech therapy, why are they only receiving very little of it during a typical school week? Perhaps the funding for the therapies for these children are spent elsewhere, like the sports programs, hint hint!
As for the vaccines and schools, I was told, you will have an expensive and tiresome battle if you do not vaccinate your child and expect that child to go to school. Just horrible any way you look at it.