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Hey, remember all those schools the city closed the last couple of years?


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The projection — driven largely by an increase in disability diagnoses for toddlers, who by law must be given an education as soon as they turn 3...

And there you have it. Bogus special needs diagnoses leading to massive bleeding in the budget.

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You are an expert on this, are you?

You must thus be aware that screening kids at an early age for issues with physical and cognitive development and resolving many of them before the kids hit school SAVES ENORMOUS AMOUNTS OF MONEY compared to dealing with disabilities at later ages, no?

My son had problems with sensory integration - problems that two years of thrice-weekly occupational therapy resolved before he entered school.

Yes these kids have always been around, too - they just suffered preventable consequences of delays in treatment, dropped out of school after years of teacher and student abuse, or simply kept quiet and got passed from grade to grade, and it mattered less because even marginally capable or ignorant people could find work pushing buttons or repeatedly attaching fenders.

Just in case you haven't noticed, that world isn't here anymore. If you want people who are able to be employed in the coming years and not dependent on aid, this is what has to happen.

You can go back to your never-was nostalgic dreamworld of yesteryear - the one with the soaring crime rates and police looking the other way.

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Padded rooms even fell out of favor in Lexington, which is a good thing.

While diagnosis of special needs has improved greatly, is there a problem with exploding numbers of special needs kids? One in fifty boys with autism spectrum?

Just as vaccines are the most cost-effective way to treat infectious disease, wouldn't more money isolating the environmental and parental age causes of all this expensive care? Don't laws forcing insurance coverage for fertility treatment of those wanting to be parents past their shelf life or in poor health produce more kids with special needs? Treating kids earlier saves money, but prevention is even better!

Society doesn't have infinite money to do everything and some good judgement is needed. Sorry folks, its not society's fault either/both of you waited too long to have kids. Adopt a kid or a pet instead.

The other thing at work here is that public schools and taxpayers are bearing the high cost from a greater share of special needs kids than private schools. Its like having a health insurance plan and ending up with a much higher than average proportion of high-cost members. Fixing the causes of developmental problems is urgently needed.

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Nobody can really explain what's behind the sudden explosion in autism-spectrum diagnoses, although there are theories. It's not entirely accounted for by better diagnosis, although better diagnosis is part of it. In past years a lot of kids on the autism spectrum would simply have been incorrectly classed as "learning-disabled" if they were low-functioning or "poorly socialized" or just "odd" if they were high-functioning.

"Assortative mating", wherein people who are high-functioning autistic and undiagnosed seek each other out as mates and have autistic kids, is one theory. Another is that we're having kids later--fathers over 40 seem to produce more autistic children.

I hate to self-diagnose but I think if anyone with modern training in this stuff had seen me at toddler or early school age I think someone would have pushed my parents to have me evaluated.

One big part of why people become parents later these days is that the level of education that's required to earn enough money to provide for your kids keeps taking longer and longer, especially when you include the time required to pay off the debt incurred. In one century we've gone from education taking up to age 14 (rural America, pre-WWI) to 16 (1920-1940) to 18 (post-WWII up through the 80s) to 22 (1980-2010) and now by the time you include graduate or professional school you're at the mid to late 20s. That does not include the additional years required to pay off educational debt before one has the spare cash flow needed to raise a child.

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All of those theories seem really plausible. I also think the time and place we're living in has something to do with why we're seeing a huge rise in the kids with mild ASD but not a huge rise in more severe ASD.

The evidence-based therapies for kids anywhere along the spectrum involve strategies like adults requiring functional communication before giving a child anything, adults completely refusing to allow any sort of tantrum from a child who is past early toddlerhood, severely restricting time spent with TV and electronic gadgets, pushing kids to advance to the next step in terms of self-help skills like dressing and feeding, etc.

I think the strategies used are similar to how kids are raised in less-industrial societies or how kids were raised in the US in previous decades, so the mild or borderline kids might have just been shaped to be more neurotypical without anyone even noticing anything was majorly different or needing to label it. (And yes, this of course wasn't entirely a positive thing, because there certainly are/were people who struggle/d a lot in day-to-day life without anyone noticing or appreciating this, and I imagine life to be quite lonely and frustrating for these folks.)

In present-day US, a majority of kids are being raised in ways where if their brain wiring is a bit predisposed toward preferring electronic toys and having poor social skills, this is permissible and often even encouraged. There are a lot of educated and well-intentioned parents who don't recognize for the first couple years that their child has any difficulties, so they're just going along with societal norms of right now and thinking that it's fine and perhaps even educationally beneficial that their child spends hours a day interacting with a LeapFrog or memorizing TV shows, and thinking that they're giving the child a peaceful and happy childhood by not pressuring to learn manners or self-help skills before the child initiates. In this society, if a preschooler is grabbing things without asking, I can't necessarily tell whether the child understands how social skills work, because so many children are being raised to express themselves and be free spirits and learn things on their own timetable. In a society where that sort of thing just isn't OK, every adult the child encountered would require the child to ask for things until the child quickly learned that you don't get things any other way.

(And again, I do think there are a lot of positive aspects to living in a society where we don't have such rigid norms and we respect that people are individuals. I just can't help but think that there's some happy medium between the two.)

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I'd be happy to see the body of scientific evidence (not pop science articles) definitively supporting your contention here.

One of the things I work with, critique, and supervise is studies of birth outcomes. Maternal age is always entered as a variable in scientific studies of such phenomena, but it doesn't explain things all by itself. Neither does paternal age. There are some hypotheses that imply that maternal era is actually more important because a huge neurocognitive toxin load from leaded gasoline was phased out in calendar time, not maternal age time. (meaning: older mothers had kids with issues NOT because they were older but because they were more highly exposed to lead). Then there are the epigenetic things recently discovered but not even beginning to be understood.

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t something is telling me that the rise in special ed costs in boston Isn't because of older parents using IVF.

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As a clinician who refers three-year-olds to BPS and sits in on a number of evaluations and eligibility meetings, I can tell you that BPS is one of the most strict in terms of eligibility. They use the exact numbers that federal law requires when doing standardized tests to determine whether a child has delays. Other districts will offer services "just in case" for kids who are concerning but don't meet federal eligibility guidelines, but BPS doesn't do this and provides only what they are required to. This has been the same for the 12 years that I've been working in Massachusetts with kids with disabilities.

What HAS changed is that there is more awareness in the community about disabilities and more parents are aware that their child needs help and are feeling more comfortable seeking it out. Pediatricians are doing more developmental screenings earlier and it's become less stigmatized to have a child getting help. There have always been preschoolers with disabilities who would have been eligible for BPS services, but 5 and 10 years ago these families either didn't realize anything was wrong or realized it on some level but said "she'll grow out of it" or whatever. I used to see a lot of families refusing services, saying they'd call back if their child wasn't talking by kindergarten. Seriously. This has fortunately dwindled, and I don't think it's bogus that a nonverbal three-year-old is getting special ed services.

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