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The Special Ed Epidemic: What Is Happening To Our Children? Part 1 of 4

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WMP Note: In this 4-part series, World Mercury Project partner, Focus For Health,  examines the special needs epidemic and its effects on schools, the US economy, life after age 21 and the many theories that point to potential causes of the explosion of chronic disease and disability in our children.

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Pick up a paper anywhere in the world and you are more than likely to see a story about the special needs epidemic affecting public schools.

Recent headlines read “Wolf Creek Public Schools hires additional staff to work with severely disabled students” and “York school system nearly $1M over budget in special education spending,” and “7 EV teen suicides in 6 weeks alarm schools,” and, “How Vermont schools manage food allergies.”

If you take the time to read some of these disturbing articles, you will see quotes from school directors making comments like “What’s different from past years is the students we’ve received really do have severe, very particular learning needs that are well beyond what we would typically see. It caught us by surprise, for sure,” admits Jayson Lovell, Superintendent for Wolf Creek Public Schools. This school district is one example of districts needing to hire additional staff in order to accommodate a sharp rise in the number of students requiring services through IDEA (Individuals with Disabilities Act) due to their severely complex special education needs.

Every child with or without special needs is affected, just as every tax payer, with or without a child with special needs, will bear the burden.

The US Centers for Disease Control and Prevention (CDC) reports disabilities affect 1 in 7 children. From the increased number of children requiring special education and related services to the increased number of health care professionals needed to care for children with chronic physical and mental health issues in the schools, school budgets are depleting rapidly. Fast-forward, when these children are adults, the workforce is affected, as is the housing industry. Every child with or without special needs is affected, just as every tax payer, with or without a child with special needs, will bear the burden.

According to The National Center for Educational Statistics, the percentage of youth ages 3-21 served by IDEA, a federal mandate which provides a free and appropriate education has risen significantly since 1990. Data from school years 1990/91 through 2004/05 showed 4.7 million, or 11 percent, of the total public school enrollment required special education services. By 2014/15, children and youth served under IDEA had risen to 6.6 million, or 13 percent, of the total public school enrollment. And it isn’t only a rise in special education demands; sadly, there is great demand for nurses and even health clinics on school property to manage the dramatic increase in children with chronic health conditions and mental health disorders as well.

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Over the past 2 decades, the number of children with chronic health conditions doubled from 12.8 percent in 1994 to 26.6 percent in 2006.

With limited resources, public schools are dealing with an epidemic of children with various special needs including behavioral, learning, physical, and mental health disorders, as well as chronic health issues like severe food allergies, asthma, diabetes, autism, ADHD, seizures, and more. We read about it in our headlines, so why aren’t we asking, “What is happening to our children?”

Mental Illness

As referenced in the Morbidity and Mortality Weekly Report, published by the CDC in 2013, mental health disorders among children are described as “serious deviations from expected cognitive, social, and emotional development.”

According to this report, a total of 13–20% of children (<18 yrs. of age) living in the United States experiences a mental disorder in a given year. Among children aged 3-17 years, these disorders include:

Attention-deficit disorder = 6.8%
Behavior and Conduct Disorder = 3.5%
Anxiety = 3.0%
Depression = 2.1%
Autism Spectrum Disorder = 1.1%
Tourette ’s syndrome = 0.2% (amongst children 6-17 yrs. of age)

  • As many as 1 in every 33 children may be depressed. Depression in adolescents may be as high as 1 in 8.
  • In 2010, suicide was the second leading cause of death for individuals aged 12-17 yrs. The suicide rate for this age group was 4.5 suicides per 100,000.
  • It is estimated that 4.7% of adolescents aged 12–17 years reported an illicit drug use disorder in the past year and 4.2% had an alcohol abuse disorder in the past year.
  • Of the 100,000 teenagers in juvenile detention, an estimated 60% have behavioral, cognitive, or emotional problems.
  • Less than 1/3 of the children under age 18 who have a serious mental health problemreceive any mental health services.
  • Mental health disorders are said to be the most costly disorders to treat in children because of the impact on the child, family, and community, costing the US an estimated $247 billion dollars annually for health care, special education, juvenile justice and decreased productivity.

Mental health disorders in children can result in difficulties in school, at home, and with peer relationships. Studies show 40% children with mental health disorders also have a second mental health diagnosis and are also more likely to develop chronic health disorders including asthmadiabetes and epilepsy. They also have a greater risk for mental health disorders as adults which negatively affects productivity, increases substance abuse, and ultimately becomes a financial burden to the individual and society.

Autism

  • The CDC reports autism rates of 1 in 68 American children, up 30% from the 1 in 88rate reported in 2008, and more than double the 1 in 150 rate in 2000.
  • Autism affects 4-5 times as many boys than girls.
  • Compared to the general pediatric population, children with autism have higher rates of co-occurring psychiatric and medical illnesses including GI disorders, epilepsy, dyslipidemia, vision and hearing impairments, hypertension, autoimmune conditions, asthma, allergies, and others, extending across all age groups.
  • Economic costs for 2015 were at an estimated $268 billion in the United States.
  • A study published in 2015 in The Journal of Autism and Developmental Disorders projects economic costs rising to $461 billion in 2025 if autism’s prevalence continues at today’s rates. Projected costs could exceed $1 trillion by 2025 if prevalence continues to rise at the same rate it has this past decade.
  • Direct costs include medical care, hospitalizations, special education, special therapies (occupational, speech and physical therapy), and paid caregivers. Indirect costs include lost productivity for family caregivers due to the inability to maintain employment while caring for affected individuals as well as lost wages and benefits.

ADHD

  • The National health Interview Survey (NHIS) 2011-2013 reported 9.5% of children ages 4-17 had been diagnosed with ADHD.
  • This study also reported the rate of ADHD in children aged 5–17 years increased significantly from 7.0% to 10.2% between 1997–1999 to 2012–2014.
  • Boys (13.3%) continue to be more than twice as likely as girls (5.6%) to have current ADHD.
  • According to a more recent population-based study using DSM-IV criteria, 15.5% of school children enrolled in Grades 1 to 5 have ADHD.
  • The economic cost of ADHD is reported to range between $143 billion to $266 billion in the US (adjusted to 2010 U.S. dollars) every year.
  • Of the total annual cost of ADHD, 26–27% was incurred by children ($38 billion–$72 billion).
  • Direct costs are inclusive of special education, special therapies (occupational, speech and physical therapy), school counseling, and disciplinary incidents. Other costs related to health care include primary care and specialty care visits, medications, emergency room visits, behavioral and emotional health care.

Food Allergies

  • Food allergies have been skyrocketing in the United States in the last fifteen years. According to the CDC, food allergies increased 50% between 1997 and 2011.
  • Researchers estimate that up to 15 million Americans have food allergies, including 5.9 million children under age 18. That’s 1 in 13 children, or roughly two in every classroom.
  • The CDC reported a 265% increase in the rates of hospitalizations related to food allergic reactions in a ten year period.
  • Between 1997 and 2008, the prevalence of peanut or tree nut allergy appears to have more than tripled in U.S. children.
  • The New York Times reports record sales growth for EpiPens, a life-saving medical device for those with food allergies.
  • Nearly 40% of children with food allergies have experienced a severe allergic reaction such as anaphylaxis.
  • Private insurance claims for anaphylactic food reactions rose 377% from 2007 to 2016.
  • Researchers reporting in the Journal of the American Medical Association state that the costs of food allergies, from medical care to food to pharmaceuticals, is $4,184 per child per year, costing our economy $25 billion, including lost productivity.

The economic burden to care for children with developmental and medical needs affects not only families, but school districts, federal and local government budgets, social security, health insurers, and the insured, as well as every tax-payer in our nation.

REFERENCES

  1. https://www.cdc.gov/mumps/outbreaks.html/
  2. https://nces.ed.gov/programs/coe/indicator_cgg.asp 
  3. https://www.foodallergy.org/life-food-allergies/food-allergy-101/facts-and-statistics
  4. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a11.htm
  5. http://www.chadd.org/understanding-adhd/about-adhd/data-and-statistics/general-prevalence.aspx
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058092/
  7. http://childhealthdata.org/docs/default-source/cahmi/asdchartbookfinal.pdf?sfvrsn=2
  8. https://www.cdc.gov/mmwr/pdf/other/su6202.pdf
  9. https://www.ncbi.nlm.nih.gov/pubmed/25911091
  10. https://bangordailynews.com/2017/09/27/news/york-school-system-nearly-1m-over-budget-in-special-education-spending/ 
  11. http://www.eastvalleytribune.com/news/ev-teen-suicides-in-weeks-alarm-schools/article_5a3bf82a-9fe6-11e7-9e50-7f4f87c5e0ec.html 
  12. http://digital.vpr.net/post/how-vermont-schools-manage-food-allergies#stream/0
  13. https://www.ncbi.nlm.nih.gov/pubmed/26183723

This concludes Part One of “The Special Ed Epidemic: What is Happening to our Children?” Part Two, “Burying our Heads and Crippling our Economy,” will explore these financial burdens, especially the responsibility on school districts to accommodate the ever-growing and expanding nature of the special needs population.

Written by By Sheri A. Marino, MA, CCC-SLP, from WMP Partner: Focus for Health

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Boy or Girl – Baby Gender Selection Issues

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Some parents have the possibility to opt for gender selection; however, being able to decide whether to have a baby boy or girl is a controversial issue.

Many couples expecting a baby do not think it’s a big issue whether they have a boy or a girl; however there are several medical, social, and personal reasons that could influence parents to recur to some form of gender selection.

Like many other controversial practices, the legality of gender selection, also known as sex selection, varies from country to country.

The Legality of Baby Gender Selection

The United States has perhaps some of the most relaxed laws regarding baby gender selection in the world. Most European countries and Australia, on the other hand, have bans on sex selection and only allow it for medical reasons. For example, if a parent is a carrier of a mutation or gene with more chances of manifesting itself in a certain gender, baby gender selection is valid. However, if parents simply wish to balance the ratio of boys and girls in their family, they are not allowed to recur to sex selection.

This has generated a form of medical tourism in which couples from countries where gender selection is illegal, like the UK, travel to the US in order to be able to choose whether to have a baby boy or girl.

On the other hand, sex selection is illegal in the two most populated countries on Earth, China and India. In these countries, baby gender selection has been performed clandestinely for many years and for reasons other than family balancing or avoiding genetic diseases. In these societies, having a baby boy is preferred mainly for cultural and economic reasons. Parents believe that boys have better chances of earning income and eventually support them when they reach an old age.

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Methods of Baby Gender Selection

There are two major types of gender selection methods: the first one is called sperm sorting, and involves separating X-chromosome sperm from Y-chromosome sperm by flow cytometry, a purification technique in which chromosomes are suspended in a stream of sperm and identified by an electronic detector before being separated. Intra-uterine insemination or in-vitro fertilization can then be performed with the enriched sperm. The success rates for this method vary from 80% to 93%.

The other method, called pre-implantation genetic diagnosis, consists in generating several embryos through in-vitro fertilization, which are then genetically tested to determine a baby’s gender. The chosen embryos can then be implanted. This method has a success rate of almost 100%; however, it can be quite expensive, costing up to $15,000.

Issues Regarding Baby Gender Selection

While there are few objections against baby gender selection when it is performed for medical reasons, it has become a highly controversial issue when it is used for balancing the number of boys or girls in families. Some people raise the obvious ethical question of whether people who opt for gender selection are “playing God” by manipulating whether to have a baby boy or girl. Others believe that new parents will raise a baby more appropriately if he or she belongs to their preferred gender.

Gender Imbalance Caused by Baby Gender Selection

Gender selection has caused demographic concern in China and India since it has contributed to generate a gender imbalance in the populations of those countries. In some regions of China, for example, the sex ratio for newborns is 118:100, boys to girls. This phenomenon has in turn been associated with social problems such as an increase in violence and prostitution.

It seems like a logical solution for governments around the globe to legalize baby gender selection but to analyze the personal reasons why each couple intends to select a baby boy or girl. Gender selection for medical reasons should even be encouraged, since it could prevent serious genetic diseases such as cystic fibrosis, Huntington’s disease, and Haemophilia A. Balancing the gender ratio of a family should be accepted if by doing this, a healthy family environment is created. On the other hand, China and India have shown that baby gender selection as a result of a bias towards a particular gender can not only create a gender imbalance in the population, but contribute to social problems as well.

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Organic Certification: What the USDA Organic Label Means

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In Brief

  • The Facts:

    Organic and natural labels mean different things, and various types of labels tells you what percentage of ingredients are actually organic. We'll explore what to look for.

  • Reflect On:

    Do you sometimes buy products thinking they are organic or fully natural based on their wording? Have you later found out that those products aren't natural or organic at all? Read labels more closely at grocery stores to be aware.

Don’t get conned by fraudulent claims of “natural” or “organic.” Learn what to look for, and why it’s important, to ensure you’re getting the quality you are paying for.

The industrial age of the 20th century brought about changing agricultural practices that have generated increasing alarm about the effects of these practices on the environment and health. The use of chemical fertilizers and pesticides, antibiotics, hormones, irradiated and genetically altered food and fiber products has created a groundswell of rightful concern. It has led to the growing demand for non-toxic, organic products that many are willing to pay a higher price for to ensure the healthful purity of food and clothing provided for their families.

With such profit opportunities, it’s little wonder that the lucrative organic product market has suffered abuse with so-called “organic” labels being fraudulently placed on products that have not earned the right. As a result of pressure from farming and consumer groups, legislation for the standardization of organic certification was introduced in the 1980s. It has been updated to include more vigorous enforcement and control methods since, with the current standards established in 2002 by the USDA.

The Standards of USDA Organic Certification

Specific standards must be met in order to legally claim a product as USDA certified organic. Organic producers must utilize methods that conserve water, maximize soil health, and reduce air pollution. The specific standards to earn USDA organic certification include:

Free of synthetic chemicals such as insecticides, herbicides, fertilizers, hormones, antibiotics, and additives

Free from irradiation and genetically modified organisms

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Agricultural products grown on land that has been free of prohibited substances for a period of three years

Animals used for meat, eggs, milk or other animal products must be exclusively fed foods that are organically grown, may not be given antibiotics or hormones, and must have access to outdoors.

Clean and sanitized harvesting and processing equipment throughout the process from harvest to finished, packaged product

Detailed chain-of-handling records from the field through final sales

Physical separation of certified organic products from non-organic products throughout the process of production

Regular on-site inspections from USDA-approved inspectors to ensure compliance

Understanding the Certified Organic Label

Once the rigorous process of certification has been completed, organic producers may place the USDA certified organic seal on their products. Currently, there are four levels of certified organic products, with a specific definition of the percentage of organic ingredients the final products contains. They are as follows:

• 100% organic: all production methods and ingredients are USDA certified organic.

• Organic: at least 95% of the production methods and ingredients are USDA certified organic with remaining ingredients included on the National List of allowed ingredients.

• Made With Organic Ingredients: at least 70% of the ingredients are USDA certified organic with remaining ingredients included on the National List of allowed ingredients.

• No organic wording or seal: less than 70% of the ingredients are USDA certified organic and no claims may be made on the front or back of the product.

Manufacturers or producers who knowingly label a product “organic” when it does not meet the USDA standards are subject to fines up to $11,000 per violation.

Why Organic Certification is Important

When you see the official USDA organic certification seal on food, clothing, and bedding products, you can be assured that these products have met the meticulous standards required and are free of chemicals, toxins, antibiotics, and hormones. When you see the USDA certified organic label, you will understand the value of the higher priced organic products as compared to non-organically produced products.

With the current stringent organic certification requirements enforced by regular inspections from USDA accredited agents, the USDA certified organic label has great meaning and importance to the consumer. Look for the label to know that you are getting the quality you are paying for.

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WHO Finds Global Lack Of Inactivity Rising Especially In Wealthier Countries — What You Can Do

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In Brief

  • The Facts:

    Inactivity is on the rise and it's the cause of a wide range of health concerns. Our population is only becoming more inactive, not less, and it's time to change that.

  • Reflect On:

    There are many factors of our modern world that make us less active. Our jobs, driving rather than walking/biking, too much screen time. What can you do differently to bring more activity into your life? What story stops you from starting?

The World Health Organization (WHO) estimates that more than a quarter of the entire population on this planet are not getting enough physical exercise, this number has barely improved since 2001. There are many factors that contribute to this, but just how much damage are we doing by failing to be active?

The lack of physical exercise raises the risk of many health problems, such as heart disease, type-2 diabetes and various types of cancers.

Interestingly, according to their study published in The Lancet Global Health, higher income countries, such as the UK, were among the least active population. Women were also found to be more sedentary throughout the world, excluding two regions in Asia.

The study looked at self-reported data on activity levels from 358 population based surveys covering 168 countries and included 1.9 million people.

The populations of higher income countries, which include the UK and USA showed an increase in the proportion of inactive people and had actually risen from 32% in 2001 to 37% in 2016, in the lower income countries it remained at 16%.

Those who were classified as inactive did less than 150 minutes of moderate exercise and around 75 minutes of intense activity per week.

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It was found that women were less active than men overall, except for in South and Central Asia, the Middle East, North Africa and higher-income Western countries. The authors believe that this was caused by a few different factors including extra childcare duties and cultural perspectives that may have made it more difficult for them to exercise.

Why More Inactivity In Wealthier Countries?

According to the researchers, in the wealthier countries, many of the jobs have transitioned to more office or desk jobs, meaning a more sedentary type of lifestyle. On top of that much of the population of these countries drive automobiles or take public transit to and from work which in many cases accounts for a lot of their time.

In the lower income countries, many of the jobs require the people to be more active, are physically demanding and people often have to walk to and from their jobs.

The WHO has had a goal to reduce the global levels of inactivity by 10% by 2025, the authors of the study feel that at the rate we are currently going, this target will be missed.

Lead author of the study, Dr. Regina Guthold said, “Unlike other major global health risks, levels of insufficient physical activity are not falling worldwide, on average, and over a quarter of all adults are not reaching the recommended levels of physical activity for good health.”

Regions with increasing levels of insufficient physical activity are a major concern for public health and the prevention and control of non-communicable diseases.”

Co-author, Dr. Fiona Bull added, “Addressing these inequalities in physical activity levels between men and women will be critical to achieving global activity targets and will require interventions to promote and improve women’s access to opportunities that are safe, affordable and culturally acceptable.”

According to the WHO,

Exercise guidelines for 19- to 64-year-olds

How much?

  • at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity every week
  • strength exercises on two or more days a week that work all the major muscles
  • break up long periods of sitting with light activity

What is moderate aerobic activity?

  • Walking fast, water aerobics, riding a bike on level ground or with a few hills, doubles tennis, pushing a lawn mower, hiking, skateboarding, rollerblading, volleyball, basketball

What counts as vigorous activity?

  • Jogging or running, swimming fast, riding a bike fast or on hills, singles tennis, football, rugby, skipping rope, hockey, aerobics, gymnastics, martial arts

What activities strengthen muscles?

  • lifting weights, working with resistance bands, doing exercises that use your own body weight, such as push-ups and sit-ups, heavy gardening, such as digging and shovelling, yoga

What activities are both aerobic and muscle-strengthening?

  • circuit training, aerobics, running, football, rugby, netball, hockey

Final Thoughts

I was surprised to see that the WHO didn’t touch on inactivity due to too much screen time — watching television, Netflix, Facebook scrolling, messaging, texting, browsing etc. Certainly, the increase in screen time plays a roll with the amount of inactivity, especially in the higher income countries. If you are someone who spends too much time staring at a screen, then it is important to consider the above information. Can you limit your screen time and replace it with something active? Or would you consider jumping rope, or rebounding while watching the television? Our health is our greatest wealth and having awareness about an issue is the first way to create change and take responsibility for our lives.

Could you walk or bike to work instead of drive? What about trying a new sport? Could you commit to adding a few hours each week of physical activity? These small decisions could have a profound impact on your health, longevity and overall well-being.

Much Love

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