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Monday, February 20, 2017

Attention-Deficit/Hyperactivity Disorder is Linked to Delayed Brain Development

From The Washington Post Blog
"To Your Health"

By Amy Ellis Nutt
February 15, 2017

Scientists can now point to substantial empirical evidence that people with attention-deficit/hyperactivity disorder have brain structures that differ from those of people without ADHD.

A new study confirms that ADHD, especially in children, such as this
Maryland adolescent negotiating a laser maze, is a brain disorder.
(Katherine Frey/The Washington Post)

The common disorder, they conclude, should be considered a problem of delayed brain maturation and not, as it is often portrayed, a problem of motivation or parenting.

In conducting the largest brain imaging study of its kind, an international team of researchers found that ADHD involves decreased volume in key brain regions, in particular the amygdala, which is responsible for regulating the emotions.

Although the study, published Wednesday in the Lancet Psychiatry, included children, adolescents and adults, the scientists said the greatest differences in brain volume appeared in the brains of children.

[ADHD linked to banned chemical still in use in hospitals]

Of seven subcortical brain regions targeted in the study, five, including the amygdala, were found to be smaller in those with ADHD, compared with those in a control group. The other regions that showed reductions in volume were: the caudate nucleus (which has been linked to goal-directed action), the putamen (involved in learning and responding to stimuli), the nucleus accumbens (which processes rewards and motivation) and the hippocampus (where memories are formed).

The first author, geneticist Martine Hoogman of Radboud University in the Netherlands, said the amygdala,

“... is a structure that is not so well known to be implicated in ADHD. … We do know from other functional studies of the amygdala that it is involved in emotion regulation and recognizing emotional stimuli. But it is also involved in the process of [inhibiting] a response. Both cognitive processes are characteristic of ADHD, so it does make sense to have found this structure to be implicated in ADHD.”

The research was conducted by an ADHD working group that is part of a worldwide consortium called ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis). The group aims to bring together scientists in fields such as imaging, genomics, neurology and psychiatry to better understand brain structure and function. Its ADHD project was four times the size of the previously largest study and was conducted at 23 locations in nine countries by 80 researchers, primarily psychiatrists and neuroscientists.

A total of 3,242 people, ages 4 to 63, underwent MRI brain scans. Almost half of them had been diagnosed with ADHD. The other half were control subjects.

“The reliability of ADHD research has not been great, because of [small] sample sizes,” said Jonathan Posner, who did not take part in the study but who does pediatric brain imaging research at Columbia University Medical School. “So because this study was orders of magnitude higher in terms of participants, and because it involved sampling broadly and internationally, it gives us more confidence.”

[My daughter has my eyes, my hair and my ADHD]

By being able to point to measurable differences in the brains of those with ADHD, the ENGIMA scientists hope their study will also help the general public better understand the disorder.

“I think most scientists in the field already know that the brains of people with ADHD show differences, but I now hope to have shown convincing evidence … that will reach the general public,” said Hoogman, “and show that it has [a basis in the brain] just like other psychiatric disorders. … We know that ADHD deals with stigma, but we also know that increasing knowledge will reduce stigma.”

The researchers were able to conclude that the brain differences were not related to medication people took, to other psychiatric disorders people with ADHD may also have had, or even to the severity of their symptoms.

The smaller brain structures in children with ADHD but not in adults fits with a “delayed peak volume” theory that ADHD is associated with an “altered velocity of cortical development,” the authors said. That is, their brain development may be delayed compared with children who do not have ADHD, but it may catch up as they grow into adulthood.

Finding that the amygdala, the brain's emotional regulator, had the greatest volume reduction in ADHD was particularly important to the researchers because of the ubiquity of emotional problems in the disorder. The study might be relevant for updates to the Diagnostic and Statistical Manual, the guidebook psychiatrists use to identify conditions.

“Those [emotional] symptoms are often present in patients with ADHD,” the authors wrote, “but these disease characteristics have not [yet] been included into the official DSM criteria.”

At a School in Brooklyn’s Poorest Neighborhood, Literacy is Up and Disciplinary Problems are Down

From The Hechinger Report

By Meredith Kolodner
November 4, 2015

How one school prepared for poverty-related trauma and has succeeded where others failed.

Amir Brann, current social work director, leads second-graders in an art
exercise that helps build collaborative skills. Photo: Brian Hatton

BROOKLYN, N.Y. — Three years ago, when Public School 446 opened in a building where two others had failed, it inherited many of the youngest students. Among them was a second-grader who was supposed to be in fourth grade and was reading at a kindergarten level.

The boy was one of a handful of students who had regular violent outbursts — he threw chairs and hit other kids.

“He was coming to school with a lot of stress, and he wasn’t being successful academically, so he was acting out,” said Meghan Dunn, the principal of P.S. 446 in Brownsville. “Kids would rather be known as the bad kid than the dumb kid.”

Dunn was well aware of the building’s troubled history when she agreed to open the new school in 2012, after two previous elementary schools in eight years were closed for poor performance. Dunn knew she’d be working in a community that desperately needs stability: Brownsville has the second-highest rate of student homelessness in Brooklyn and the highest elementary school student absenteeism in the city — 40 percent of its children miss 20 or more days of school per year.

The neighborhood is the poorest in Brooklyn and also has one of the highest rates of psychiatric hospitalizations and incarcerated residents in the city. Two years ago a man was shot in broad daylight in front of the school while classes were going on. Once the murder capital of Brooklyn, residents say they have seen improvements in the neighborhood.

Still, the Brownsville police precinct had the third highest number of major felonies in Brooklyn last year and is sandwiched between the first and second highest.


So Dunn decided to try something different when she opened the school three years ago. She assumed many students would arrive with lots of physical and emotional needs, and structured the school to handle their issues in ways that regular public schools can’t. It took extra money from a foundation and a small army of social workers, and the results are promising.

The percentage of students reading at grade level climbed to 41 percent last spring, up from 32 percent the previous year, according to a widely used literacy benchmark. The number of disciplinary incidents during the same time period dropped by more than a third.

In Brownsville, Brooklyn, 40 percent of elementary school children miss 20 or more days of school a year.

At a time when schools are under increasing pressure to teach tougher standards (known as the Common Core) and begin the path to college readiness in kindergarten, this school, and several others around the city, are taking care of kids’ emotional and physical needs as a route to improving their ability to learn.

“When some of the trauma that happens out of living in a shelter or being in poverty causes problems, people say, ‘Oh, I can’t believe this happened,’” said Dunn. “Actually, these are very predictable problems, because we have a lot of information about what happens when you are constantly under stress, as a kid or as a parent.”

The struggling second-grader was immediately matched with a social worker who began seeing him individually and also met with his parents to help connect them to an outside evaluation of the boy’s possible learning issues. (Problems like ADHD and dyslexia must be diagnosed by a doctor.)

To help shift his behavior, the social worker told him to write down every time he walked away from a conflict. After he avoided a fight five times, he got 15 extra minutes of basketball.

Dunn also assigned him 30 minutes a day of one-on-one literacy help, which allowed him to improve his reading.


Still, the boy was getting in fights every day at recess, so the school created an “alternative recess” for him and made him the “assistant gym teacher” for kindergartners. This year, as a fifth-grader, he is one of the school’s “junior coaches” who helps run recess and resolve conflicts between students.

Amir Brann, the school’s social work director, emphasizes that the work his staff does with parents is as important as the work with kids, since it is difficult to have an impact on children if their families are in constant crisis. Dunn estimates that about one in eight of her students are homeless.

P.S. 446 gets its extra staff and support from Partnership With Children, a citywide nonprofit that sends social workers into schools. The extra services at P.S. 446 cost about $200,000 per year, according to the Partnership, and are paid for through a combination of private funding and the school’s budget — Dunn forgoes an assistant principal to make it work.

The team of three full-time social workers, plus three social worker interns, meets with about 100 of the 370 students each week, about a third in individual sessions and the rest in groups. Older kids can choose a group, like “art” or “school newspaper,” and meet after school. They also get dinner and homework help.

Younger children meet during lunch in playgroups. Also, once a month, the social workers run a morning parents group and an evening fathers group, where dads can talk about their struggles.

In addition, the social workers accompany parents to medical appointments and housing court and do home visits. And this year they have added office hours just for teachers.

“Kids would rather be known as the bad kid than the dumb kid.”
--P.S. 446 Principal Meghan Dunn

Partnership social workers are in 32 schools around New York City, including in some of Mayor de Blasio’s recently designated “community schools,” which receive extra funding from the city to allow them to function as social service centers in low-income communities.

The group says not only has safety and attendance improved in the schools where it works, but the number of elementary schools students performing at grade level has increased by 17 percent on state English exams and by 14 percent on state math tests.

The group has always measured students’ social skills and emotional health, and when the city began to introduce the more-demanding Common Core standards a few years ago, Partnership staff embarked on an effort to connect the skills they considered important to those required by the Common Core. It took about a year, and the group had city education department officials review their curriculum to make sure their work was accurately linked.


“We don’t want to be fighting the Common Core,” said Margaret Crotty, executive director at Partnership With Children, who said she supports the standards in spite of the brewing statewide controversy over revamping them.

Crotty believes that the critical thinking skills required by the Common Core is in keeping with her social workers’ efforts to have students think carefully about the decisions they make about their own lives, inside and outside school.

“If kids can’t sit still and pay attention through a class, how can they even begin to sit through a test?” she asked.

Sometimes the fix is simple. One P.S. 446 student was chronically late to school and a social worker discovered that the shelter where the family was staying didn’t have alarm clocks. The mom’s phone, which they had used as an alarm, had broken. The school purchased an alarm clock, and the tardiness ended.

“When some of the trauma that happens out of living in a shelter or being in poverty causes problems, people say, ‘Oh I can’t believe this happened.’ Actually these are very predictable problems.”
--P.S. 446 Principal Meghan Dunn

“We work a lot with kids to be able to ask for what they need,” said Dunn. “So kids know if you need anything, you just have to ask for an adult … if you don’t have a winter coat, we’ll find you one. When kids are acting out, a lot of time it’s because they don’t know how to communicate what they need.”

Parents say they appreciate the extra support. Latoya Watson’s third-grade daughter, Kalian, began in the building as a pre-k student at the previous school that was closed. She switched in to P.S. 446 in kindergarten and Watson has seen a big difference.

“It’s been a positive influence in my life,” said Watson, 33, who is the PTA vice president. “[The social workers] deal with not just the school or the kids – they try to help you as a person. They have a lot of ways to help yourself and to help your child.”

Watson went to Amir Brann when her older son, then in middle school, was badly beaten up in the neighborhood. Although he clearly had kidney damage, he wasn’t getting properly treated at the local clinics, so Brann connected her with a specialist, who helped.

Meanwhile, her daughter Kalian, 7, often wouldn’t speak in school when she was younger. She joined the school’s art group and then the environmental group that meets after school, and Watson says she has “come out of her shell.” The social workers also helped out when Kalian was being bullied in first grade.

“Now she feels comfortable at school – she knows there’s someone to talk to without feeling like she will get in trouble,” said Watson, who also attends the monthly parent meetings. “That means a lot to me. I don’t have to worry about her in school.”

Like most schools, P.S. 446 uses literacy assessments to keep track of reading levels, which became even more important after about 70 percent of the parents opted not to have their children take the state standardized tests last spring.

The school’s third grade pass rate on the state reading exam was more than twice the district’s average, and they performed better on the math exam as well, but comparisons are shaky, due to the small number who took the exam. Still, the school follows the same standards as other schools in the state.

“All of our curriculum is Common Core-aligned,” Dunn noted in an email.

She says the assistance of the social workers is indispensable and allows for teaching instead of constant crisis management.

“They’re able to do things that we just can’t do,” said Dunn. “There’s only so much schools alone can do.”

This story was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education.

Sunday, February 19, 2017

A Disabled Student’s Open Letter to Betsy DeVos: Please Protect All of Us

From The Huffington Post

By Sammy Park
February 15, 2017

Dear Ms. DeVos,

Your confirmation as the US Education Secretary has left Anti-Trumpists furious. They have made fun of your comment on grizzlies and mocked your grammar.

But I was not upset with your confirmation as Secretary because of your policies on bears, or because you allegedly can’t spell W.E.B. Du Bois’ name correctly. Despite not agreeing with anything President Trump says or does, I, unlike some of your opponents, was not upset based solely on the fact that you were nominated by Trump.

I am a junior in high school who attends a federally funded, public high school. I am disabled. I am a beneficiary of every single right that the Individuals with Disabilities Education Act (IDEA) provides me; I represent one of the millions of students with disabilities who are allowed the freedom to receive an education in the United States.

Despite my parents’ dreams, I am not the best student. But the fact that I can even call myself a student is a testament to every single activist and politician who made education a right for all, and not a privilege for the able-bodied.

During your confirmation hearing, I heard you first say that whether or not schools follow the regulations set by the IDEA should be up to the states. Next, you stated that you may have confused the IDEA with another legislation. Your lack of knowledge about fundamental education legislation is not even what is most frightening to me.

It was your unwillingness to state that you will enforce every federal law that gives me and all of my peers opportunities to a quality education that makes me fear for the worst.

While our current special education system is in desperate need of more federal attention, your history with supporting charter and private schools that force students with special needs and disabilities to sign over their federally promised rights is troubling.

The IDEA has provided me with ample resources to be an educated member of our society. It has given me the tools to succeed in college and beyond. While sometimes I am bitter that I have to be tested on fundamental trigonometric identities, I know that individuals with disabilities in generations before me were not given the right to receive a quality education.

So, Ms. DeVos, I am not angry with you. I do not reject your position as Education Secretary. I am simply asking for you to protect the rights to a quality education regardless of ability. It is my sincerest hope that your leadership will genuinely increase the educational opportunities for all.


A Worried Teen

KCS Third Quarter 2016 BSEA Commentary Now Available!

From Special Education Today
A Special Education Law Blog from Kotin, Crabtree & Strong, LLP

By Eileen Hagerty and Alicia Parmentier
February 17, 2017

Our commentary on the Bureau of Special Education Appeals (“BSEA”) decisions and rulings for the third quarter of 2016, written by KCS attorneys Eileen Hagerty and Alicia Parmentier for the Massachusetts Special Education Reporter, is now available on our website.

The commentary offers summaries of recent cases, along with useful tips for parents and practitioners. As the comment headings show, the range of subjects is wide and the outcomes are varied.

Among the topics discussed:

  • Lenox Public Schools: Student’s absence from school is excused; district’s failure to provide tutoring is not.
  • Framingham Public Schools: District’s failure to explain placement options and stay-put rights to parents leads to award of compensatory education.
  • Boston Collegiate Charter School: Behavior need not be the same in all circumstances, in order to constitute manifestation of disability in disciplinary context.
  • Abby Kelley Foster Charter School and Walpole Public Schools: Lack of expert testimony dooms pro se parents’ cases.
  • Belchertown Public Schools: No reimbursement for unilateral placement in unapproved private school; no relief for district’s inappropriate transition planning.
  • Randolph Public Schools: Residence of guardian determines district responsibility for student over 18.
  • Westford Public Schools, North Middlesex Regional School District, and Natick Public Schools: The alphabet soup of joinder – when are state agencies such as DMH and DCF necessary parties to special education cases?
  • Andover Public Schools and Arlington Public Schools: Discovery disputes, including rulings on discoverability of peers’ IEPs, text messages exchanged by school employees, and test protocols.
  • Maynard Public Schools, Norton Public Schools, and Holyoke Public Schools: To exhaust or not to exhaust – are special-education-related damages claims required to be filed first at the BSEA before parents resort to court?
  • Shrewsbury Public Schools and Natick Public Schools: General pleading principles (statute of limitations, sufficiency of parents’ hearing request).
  • Medford Public Schools: No basis in stay-put law for order changing student’s placement from public to private placement pending BSEA decision.

The commentaries always provide interesting reading. Please take a look!


Eileen Hagerty is a partner and Alicia Parmentier is an associate in the Special Education & Disability Rights practice group at Kotin, Crabtree & Strong, LLP in Boston, Massachusetts.

MRIs Predict Which High-Risk Babies Will Develop Autism as Toddlers

From University of North Carolina Health Care
via ScienceDaily

February 15, 2017

This first-of-its-kind study used MRIs to image the brains of infants. Researchers used brain measurements and a computer algorithm to accurately predict autism before symptoms set in.

Using magnetic resonance imaging (MRI) in infants with older siblings with autism, researchers from around the country were able to correctly predict 80 percent of those infants who would later meet criteria for autism at two years of age.

The study, published in Nature, is the first to show it is possible to identify which infants -- among those with older siblings with autism -- will be diagnosed with autism at 24 months of age.

"Our study shows that early brain development biomarkers could be very useful in identifying babies at the highest risk for autism before behavioral symptoms emerge," said senior author Joseph Piven, MD, the Thomas E. Castelloe Distinguished Professor of Psychiatry at the University of North Carolina-Chapel Hill.

"Typically, the earliest an autism diagnosis can be made is between ages two and three. But for babies with older autistic siblings, our imaging approach may help predict during the first year of life which babies are most likely to receive an autism diagnosis at 24 months."

This research project included hundreds of children from across the country and was led by researchers at the Carolina Institute for Developmental Disabilities (CIDD) at the University of North Carolina, where Piven is director.

The project's other clinical sites included the University of Washington, Washington University in St. Louis, and The Children's Hospital of Philadelphia. Other key collaborators are McGill University, the University of Alberta, the University of Minnesota, the College of Charleston, and New York University.

"This study could not have been completed without a major commitment from these families, many of whom flew in to be part of this," said first author Heather Hazlett, PhD, assistant professor of psychiatry at the UNC School of Medicine and a CIDD researcher. "We are still enrolling families for this study, and we hope to begin work on a similar project to replicate our findings."

People with Autism Spectrum Disorder (or ASD) have characteristic social deficits and demonstrate a range of ritualistic, repetitive and stereotyped behaviors. It is estimated that one out of 68 children develop autism in the United States.

For infants with older siblings with autism, the risk may be as high as 20 out of every 100 births. There are about 3 million people with autism in the United States and tens of millions around the world.

Despite much research, it has been impossible to identify those at ultra-high risk for autism prior to 24 months of age, which is the earliest time when the hallmark behavioral characteristics of ASD can be observed and a diagnosis made in most children.

For this Nature study, Piven, Hazlett, and researchers from around the country conducted MRI scans of infants at six, 12, and 24 months of age. They found that the babies who developed autism experienced a hyper-expansion of brain surface area from six to 12 months, as compared to babies who had an older sibling with autism but did not themselves show evidence of the condition at 24 months of age.

Increased growth rate of surface area in the first year of life was linked to increased growth rate of overall brain volume in the second year of life. Brain overgrowth was tied to the emergence of autistic social deficits in the second year.

Previous behavioral studies of infants who later developed autism -- who had older siblings with autism -revealed that social behaviors typical of autism emerge during the second year of life.

The researchers then took these data -- MRIs of brain volume, surface area, cortical thickness at 6 and 12 months of age, and sex of the infants -- and used a computer program to identify a way to classify babies most likely to meet criteria for autism at 24 months of age. The computer program developed the best algorithm to accomplish this, and the researchers applied the algorithm to a separate set of study participants.

The researchers found that brain differences at 6 and 12 months of age in infants with older siblings with autism correctly predicted eight out of ten infants who would later meet criteria for autism at 24 months of age in comparison to those infants with older ASD siblings who did not meet criteria for autism at 24 months.

"This means we potentially can identify infants who will later develop autism, before the symptoms of autism begin to consolidate into a diagnosis," Piven said.

If parents have a child with autism and then have a second child, such a test might be clinically useful in identifying infants at highest risk for developing this condition. The idea would be to then intervene 'pre-symptomatically' before the emergence of the defining symptoms of autism.

Research could then begin to examine the effect of interventions on children during a period before the syndrome is present and when the brain is most malleable. Such interventions may have a greater chance of improving outcomes than treatments started after diagnosis.

"Putting this into the larger context of neuroscience research and treatment, there is currently a big push within the field of neurodegenerative diseases to be able to detect the biomarkers of these conditions before patients are diagnosed, at a time when preventive efforts are possible," Piven said.

"In Parkinson's for instance, we know that once a person is diagnosed, they've already lost a substantial portion of the dopamine receptors in their brain, making treatment less effective."

Piven said the idea with autism is similar; once autism is diagnosed at age 2-3 years, the brain has already begun to change substantially.

"We haven't had a way to detect the biomarkers of autism before the condition sets in and symptoms develop," he said. "Now we have very promising leads that suggest this may in fact be possible."

Journal Reference
  • Heather Cody Hazlett, Hongbin Gu, Brent C. Munsell, Sun Hyung Kim, Martin Styner, Jason J. Wolff, Jed T. Elison, Meghan R. Swanson, Hongtu Zhu, Kelly N. Botteron, D. Louis Collins, John N. Constantino, Stephen R. Dager, Annette M. Estes, Alan C. Evans, Vladimir S. Fonov, Guido Gerig, Penelope Kostopoulos, Robert C. McKinstry, Juhi Pandey, Sarah Paterson, John R. Pruett, Robert T. Schultz, Dennis W. Shaw, Lonnie Zwaigenbaum, Joseph Piven, J. Piven, H. C. Hazlett, C. Chappell, S. R. Dager, A. M. Estes, D. W. Shaw, K. N. Botteron, R. C. McKinstry, J. N. Constantino, J. R. Pruett Jr, R. T. Schultz, S. Paterson, L. Zwaigenbaum, J. T. Elison, J. J. Wolff, A. C. Evans, D. L. Collins, G. B. Pike, V. S. Fonov, P. Kostopoulos, S. Das, G. Gerig, M. Styner, Core H. Gu. Early brain development in infants at high risk for autism spectrum disorder. Nature, 2017; 542 (7641): 348 DOI: 10.1038/nature21369

Saturday, February 18, 2017

Stop Humiliating Teachers

From The New Yorker

By David Denby
February 11, 2016

The U.S. has a tendency, when there’s an economic or social crisis, to affix
unfair blame on public-school teachers.Photo by Carolyn Drake / Magnum

A necessary commonplace: Almost everyone we know has been turned around, or at least seriously shaken, by a teacher—in college, maybe, but often in high school, often by a man or a woman who drove home a point or two about physics, literature, or ethics, looked at us sternly and said, in effect, You could be more than what you are.

At their best, teachers are everyday gods, standing at the entryway to the world. If they are fair and good, they are possibly the most morally impressive adults that their students will ever know. For a while, they are the law, they are knowledge, they are justice.

Everyone celebrates his or her personal memory of individual teachers, yet, as a culture, we snap at the run-down heels of the profession. The education reporter Dana Goldstein, in her book “The Teacher Wars,” published in 2014, looks at American history and describes a recurring situation of what she calls “moral panic”—the tendency, when there’s an economic or social crisis, to lay blame on public-school teachers. They must have created the crisis, the logic goes, by failing to educate the young.

We have been in such a panic for more than a decade, during which time the attacks on public-school teachers have been particularly virulent. They are lazy, mediocre, tenaciously clinging to tenure in order to receive their lavish pay of thirty-six thousand dollars a year (that’s the national-average starting salary, according to the National Education Association).

As Goldstein put it, “Today the ineffective tenured teacher has emerged as a feared character, a vampiric type who sucks tax dollars into her bloated pension and health care plans, without much regard for the children under her care.” Because of this person, we are failing to produce an effective workforce; just look at how badly we’re lagging behind other nations in international standardized tests. Our teachers are mediocre as a mass; we have to make a serious effort to toss out the bad ones before they do any more damage. And so on.

It’s not just Republicans who talk this way. Democrats, too, are obsessed with ridding the system of bad teachers. From the President on down, leaders have been demanding “accountability.”

There’s an element of this rage at bad teachers that’s hard to talk about, and so it’s often avoided: the dismaying truth that we don’t know how to educate poor inner-city and rural kids in this country. In particular, we don’t know how to educate African-American boys, who, according to the Schott Foundation for Public Education, graduate high school at rates no better than fifty-nine per cent.

Yet if students from poor families persistently fail to score well, if they fail to finish high school in sufficient numbers, and if those who graduate are unable, in many cases, to finish college, teachers alone can hardly be at fault. Neither the schools nor the teachers created the children or the society around them: the schools and the teachers must do their best with the kids they are given.

By the time kids from poor families of all races enter kindergarten, they are often significantly behind wealthier children in vocabulary, knowledge, and cognitive skills. Of course, good teachers can help—particularly that single teacher who takes a kid in hand and turns him around. But, in recent years, teachers have been held responsible for things that may often be beyond their powers to change. They are being assaulted because they can be assaulted.

The real problem is persistent poverty.

Our view of American public education in general has been warped by our knowledge of these failing kids in inner-city and rural schools. In particular, the system as a whole has been described by “reformers” as approaching breakdown. But this is nonsense. There are actually many good schools in the United States—in cities, in suburbs, in rural areas. Pathologizing the system as a whole, reformers insist on drastic reorganization, on drastic methods of teacher accountability.

In the past dozen or so years, we’ve seen the efforts, often led by billionaires and hedge-fund managers and supported by elected officials, to infuse K-12 education with models and methods derived from the business world—for instance, the drive to privatize education as much as possible with charter schools, which receive public money but are independently run and often financed by entrepreneurs. This drive is accompanied by a stream of venom aimed at unions, as if they were the problem in American education. (Most charter schools hire non-union teachers.)

In the real world, however, highly unionized areas of the country, such as the Northeast, produce students with scores higher than the national average in standardized tests; the Deep South, where union teachers are more scarce, produces scores that are lower. So unions alone can hardly be the problem.

Public-school teachers have been trapped in a maze of standardized tests. There were the tests mandated by the Bush Administration’s No Child Left Behind program, passed in 2001, which yoked schools’ survival to test scores; and then there was the Obama program, Race to the Top, passed in 2009, which encouraged states to promote charter schools and the Common Core and linked promotion or dismissal to teachers’ ability to get kids to score well on tests; and there’s the Common Core itself, which has new, more difficult tests reinforcing it. Teachers run from one testing regiment to another.

But using the tests to evaluate teachers themselves has been questioned again and again by statistical experts as well as by critics of these programs. The heart of the criticism: the tests measure demographics (the class and wealth level of the students) more than teachers’ abilities.

As recent surveys have shown, the high-stakes testing mania has demoralized the profession as whole. It has forced teachers, if they want to survive, to teach to the test, in effect giving up curriculum for test preparation. Trying to score high, some schools gamed the system, or simply cheated on the tests; some abandoned such essentials as the arts, gym, and even recess.

Teachers were discouraged from co√∂perating and from sharing material—this competitive ethos found in school, where co√∂peration and the sharing of information, particularly in the lower grades, is essential. Corporate thinking, mostly inappropriate to education, has turned teachers into individual operators potentially at war with one another. But men and women with that kind of competitive temperament are unlikely to go into teaching in the first place. The ones who do go into it may feel that their best instincts have been violated.

Reformers have denigrated public-school teachers in many ways—the governor of Wisconsin, Scott Walker, and other governors have successfully attacked collective bargaining, and many reformers have advocated abolishing or limiting teacher tenure. The purpose of tenure is to protect free speech, to make it impossible for principals to fire people for personal or political reasons. My own feeling is that it should be easier than it is now for principals to fire bad teachers, but that tenure should not be abolished.

The political atmosphere in the country has become so polarized that spirited teachers—men and women who actually say something—will not survive hostile parents or a disapproving principal without the protection of tenure. Abolishing tenure would create instability and even chaos.

In December, the Obama Administration pulled the plug on No Child Left Behind, deputizing the states to administer tests and to reward and punish—a de-facto admission that the program wasn’t working well as a general goad to improvement and especially as a way of eliminating bad teachers. The Common Core has run into trouble with both the left and the right.

In New York state, the tests aligned with it were abruptly made much more difficult, which produced a drastic shift downward in students’ scores. Last December, Governor Andrew Cuomo established a task force that recommended temporarily banning schools from making decisions about teacher status based on these scores. But, by that time, teachers had been humiliated yet again.

We can admit that bad teachers, if they can be fairly identified, should be removed. But what can be done to recruit a new cadre of better teachers? Most centrally, we can increase teacher pay and status. According to Samuel Abrams, a professor at Columbia University’s Teachers College, an American teacher earns, on average, around seventy per cent of what her peers from college earn (i.e., fellow-professionals who become engineers, accountants, financial consultants, and so on).

If we seriously want to improve the over-all quality of teachers, we have to draw on more than idealism (in some cases) or desperation (in other cases). We have to make teaching the way to a decent middle-class life. And that means treating public-school teachers with the respect offered to good private-school teachers—treating them as distinguished members of the community, or at least as life-on-the-line public servants, like members of the military.

We also have to face the real problem, which, again, is persistent poverty. If we really want to improve scores and high-school-graduation rates and college readiness and the rest, we have to commit resources to helping poor parents raise their children by providing nutrition and health services, parenting support, a supply of books, and so on. We have to commit to universal pre-K and much more. And we have to stop blaming teachers for all of the ills and injustices of American society.

How the Anti-Vaxxers Are Winning

From The New York Times

By Peter J. Hotez
February 8, 2017

HOUSTON — It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America.

Measles is one of the most contagious and most lethal of all human diseases. A single person infected with the virus can infect more than a dozen unvaccinated people, typically infants too young to have received their first measles shot.

Such high levels of transmissability mean that when the percentage of children in a community who have received the measles vaccine falls below 90 percent to 95 percent, we can start to see major outbreaks, as in the 1950s when four million Americans a year were infected and 450 died. Worldwide, measles still kills around 100,000 children each year.

The myth that vaccines like the one that prevents measles are connected to autism has persisted despite rock-solid proof to the contrary. Donald Trump has given credence to such views in tweets and during a Republican debate, but as president he has said nothing to support vaccination opponents, so there is reason to hope that his views are changing.

However, a leading proponent of the link between vaccines and autism said he recently met with the president to discuss the creation of a presidential commission to investigate vaccine safety. Such a commission would be a throwback to the 2000s, when Representative Dan Burton of Indiana held fruitless hearings and conducted investigations on this topic.

And, a documentary alleging a conspiracy at the Centers for Disease Control and Prevention, Vaxxed: From Cover-Up to Catastrophe,” has recently been shown around the country.

As a scientist leading global efforts to develop vaccines for neglected poverty-related diseases like schistosomiasis and Chagas’ disease, and as the dad of an adult daughter with autism and other disabilities, I’m worried that our nation’s health will soon be threatened because we have not stood up to the pseudoscience and fake conspiracy claims of this movement.

Texas, where I live and work, may be the first state to once again experience serious measles outbreaks. As of last fall, more than 45,000 children here had received non-medical exemptions for their school vaccinations. A political action committee is raising money to protect this “conscientious exemption” loophole and to instruct parents on how to file for it.

As a result, some public school systems in the state are coming dangerously close to the threshold when measles outbreaks can be expected, and a third of students at some private schools are un-vaccinated.

The American Academy of Pediatrics has produced a 21-page document listing all of the studies clearly showing there is no link between vaccines and autism, in addition to more recent epidemiological studies involving hundreds of thousands of children or pregnant women that also refute any association.

A study of infant rhesus monkeys also shows that vaccination does not produce neurobiological changes in the brain.

Vaccines are clearly not the reason children develop autism. So what is? There is strong evidence that genetics play a role, and that defects in the brain of children on the autism spectrum occur during pregnancy. Exposure during early pregnancy to particular chemicals in the environment or infections could be involved.

Researchers have suggested that damage could be done by the drugs thalidomide, misoprostol and valproic acid; by exposure to the insecticide chlorpyrifos; and by infection of the mother with the rubella virus.

This is what we need to be focusing on, not the myth that vaccines cause autism. Yet I fear that such myths will be used to justify new rounds of hearings or unwarranted investigations of federal agencies, including the C.D.C.

This would only distract attention from these agencies’ crucial work, and the real needs of families with children on the autism spectrum, such as mental health services, work-entry programs for adults and support for the research being done by the National Institutes of Health.

Today, parents in Texas have to live in fear that something as simple as a trip to the mall or the library could expose their babies to measles and that a broader outbreak could occur. Perpetuating phony theories about vaccines and autism isn’t going to help them — and it’s not going to help children on the autism spectrum, either.

Peter J. Hotez, a pediatrician at Baylor College of Medicine, is director of the Texas Children’s Hospital Center for Vaccine Development.