SCHAFER AUTISM REPORT "Healing Autism: No Finer a Cause on the Planet"

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Monday, January 27, 2003

SIGNIFICANT NEW RESEARCH

(Abstracts – contains some technical language.)

* New Prevalence Study: "ASD is Considerably Greater Than Previously Recognised"

* Genetics of Childhood Disorders: XLVII. Autism, Part 6

* How Autism Looks

* Pilot Study of Parent Training Intervention

* Children's Environ. Health: 1 Yr. in Ped. Environmental Health Specialty Unit

AWARENESS

* The Podunk Roots of a National Autism Organization

TREATMENT

* Nonstimulant ADHD Medication Wins Approval

* Methylphenidate Patch Effectively Treats ADHD

CARE

* Yr 2002 Tax Benefits for Parents of Learning Disabled Children

LETTERS

* To NPR's Science Friday Program Jan. 24

* Prestigious Institute of Medicines Does Quiet Flip

RESEARCH

New Prevalence Study: "ASD is Considerably Greater Than Previously Recognised" 'The Prevalence of Autism Spectrum Disorders Recent Evidence And Future Challenges.

ds=12541002&dopt=Abstract <- - address ends here.

Charman T.

Behavioural and Brain Sciences Unit, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. t.charman@ich.ucl.ac.uk

BACKGROUND: Until recently best estimate prevalence rates for autism spectrum disorders (ASD) were 0.5/1,000 for autism and 2.0/1,000 for the broader spectrum.

Three recent studies have suggested a significantly higher prevalence rate for ASD of 6.0/1,000 (mean 95 % CI = 4.8-8.0).

METHOD: Possible determinants of the apparent increase in the prevalence of ASD are outlined.

Methodological aspects of the three recent studies are examined.

FINDINGS: Increased recognition, the broadening of the diagnostic concept over time and methodological differences across studies may account for most or all of the apparent increase in prevalence, although this cannot be quantified.

CONCLUSIONS: Findings from ongoing studies should help confirm or disconfirm the putative rate of 6.0/1,000 for all ASD.

The possibility that autism has been over-diagnosed in recent studies needs to be ruled out.

Notwithstanding these outstanding questions, it appears likely that the current true prevalence of ASD is considerably greater than previously recognised.

This has significant implications for our scientific understanding of ASD and for families and services.

Future directions for epidemiological research are outlined.

PMID: 12541002 [PubMed - in process]

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Genetics of Childhood Disorders: XLVII. Autism, Part 6: Duplication and Inherited Susceptibility of Chromosome 15q11-q13 Genes in Autism.

ds=12544187&dopt=Abstract

[No text supplied.]

Sutcliffe JS, Nurmi EL, Lombroso PJ.

PMID: 12544187 [PubMed - as supplied by publisher]

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How Autism Looks

Harvard Mental Health Letter

January 2003

Psychologists at Yale using new technology have found a way to scrutinize human faces through the eyes of autistic people.

The results promise to provide insight into the way autism cripples the capacity to grasp the meaning of emotional reactions and social situations.

The experiments were inspired by the familiar observation that autistic people don't make eye contact.

To monitor the eye movements of their subjects, the researchers used an ingenious two-camera tracking device originally developed for fighter pilots.

Young autistic men described as "high-functioning" - they had IQs in the normal range and adequate language - watched brief clips from the 1966 movie, "Who's Afraid of Virginia Woolf?" starring Richard Burton and Elizabeth Taylor.

This film was chosen because its drama is concentrated in the talk and facial expressions of four characters, with little distracting background activity or scene shifting.

The autistic men's eye movements were compared with those of controls matched for age, sex, and verbal IQ.

The autistic view The results vividly showed how little of the emotional and social context of the drama the autistic men were absorbing.

The controls looked mainly at the region around the actors' eyes, where most of us direct our gaze when we're trying to judge the mood, thoughts, and intentions of speakers.

The autistic men looked mostly at mouths and bodies and at objects in the room.

On average, they directed their attention at eyes 2.5 times less, at mouths twice as long, and at bodies and inanimate objects 2.5 times longer.

There was almost no overlap; no control subjects looked less at eyes or more at mouths than any of the autistic men.

As a corollary, the controls were much more likely to look at (and presumably notice the reactions of) characters who were not speaking.

The way the viewers' gaze changed direction from moment to moment was also revealing.

In one scene, for example, a character points to a picture hanging on the wall behind him and asks who painted it.

Control subjects followed the pointing finger with their eyes; autistic men often did not, but responded only to the words that came a few seconds later.

As the conversation continued, the autistic viewers' eyes tended to move from one picture to another along the wall, as though they were not sure which one the characters were talking about.

They usually had no trouble afterward saying what the pointing finger meant, but they hadn't been able to use that knowledge to comprehend the situation presented in the film.

A different approach Advanced technology was not the only novelty in this study.

It also differed from most earlier experimental research in its approach to understanding the social competence of autistic people.

Experiments testing their ability to understand and respond to social cues usually involve set problems with definite solutions, often stated in words.

Intelligent autistic persons sometimes do fairly well on these tests; for example, they can work out the meaning of facial expressions if they're told what to look for.

What sets them apart is the way they perform the task - the process rather than the result.

In unusual situations, their abnormal processing can even give them an advantage; they sometimes read expressions equally well whether a face is upside down or right side up.

But in the complicated social situations of real life, we're not told in advance what the problem is.

We have to extract meanings for ourselves, deciding what's relevant among many rapidly passing cues, most of which are not verbal.

That's more like the situation of viewers watching a movie.

Researchers who try to explain the lack of capacity for empathy and communication among people with autism have often looked for an underlying neuropsychological deficiency in attention, perception, or language.

They may speak of poor "central coherence" - difficulty in integrating bits of information into a meaningful whole - or lack of executive function, the skill that allows us to make plans and adjust them to meet goals.

They may say that autistic people are missing a "theory of mind" - the ability to sense intuitively, without using explicit rules or making a conscious effort, the beliefs, desires, and purposes of others, and to use those intuitions in understanding behavior.

But these deficiencies are not confined to autism, and attempts at experimental measurement of the capacity for central coherence or a theory of mind have not thrown much light on the social capacities of autistic persons.

Unexpected finding To their surprise, the Yale experimenters found that among the autistic subjects, higher IQ and better social adjustment (as measured by a standard questionnaire) were correlated not with more time looking at the actors' eyes but with more time looking at their mouths, where the words were coming from.

(The longer an autistic man looked at objects, the lower his social

competence.) The psychologists suggest that the autistic men may have been unable to learn anything from the actors' eyes, not simply because of a neuropsychological deficiency that made the understanding of facial expressions difficult, but because they had rarely looked at people's eyes and lacked the experience necessary to interpret their expressions.

They were comparatively expert at reading mouth movements and understanding the content of speech.

An implication is that the relationship between neuropsychological deficiencies and social development in autistic people may go both ways.

Failures in social learning may be more significant for their adaptation than most researchers have thought.

Early social engagement could facilitate the development of the characteristics described by the terms central coherence, executive function, and theory of mind.

In the future, the researchers mean to study eye tracking in autistic children and in autistic people who are either retarded or have milder conditions like Asperger's syndrome.

They are interested in the relationship between poor social competence and the tendency to look at objects rather than faces.

They also want to see how brain scan images change as a person's gaze changes its focus.

And they hope that some day similar experiments with infants will help in the study of autism at a stage of life where it's now often difficult to detect and describe.

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Pilot Study of Parent Training Intervention

'A pilot randomised control trial of a parent training intervention for pre-school children with autism Preliminary findings and methodological challenges.'

ds=12541005&dopt=Abstract <- - address ends here.

Drew A, Baird G, Baron-Cohen S, Cox A, Slonims V, Wheelwright S, Swettenham J, Berry B, Charman T. Autism Research Centre, Departments of Experimental Psychology and Psychiatry, University of Cambridge, Cambridge, UK.

Few attempts have been made to conduct randomised control trials

(RCTs) of interventions for pre-school children with autism.

We report findings of a pilot RCT for a parent training intervention with a focus on the development of joint attention skills and joint action routines.

Twenty-four children meeting ICD-10 criteria for childhood autism (mean age = 23 months) were identified using the CHAT screen and randomised to the parent training group or to local services only.

A follow-up was conducted 12 months later (mean age = 35 months).

There was some evidence that the parent training group made more progress in language development than the local services group.

However, the present pilot study was compromised by several factors: a reliance on parental report to measure language, non-matching of the groups on initial IQ, and a lack of systematic checking regarding the implementation of the parent training intervention.

Furthermore, three parents in the local services group commenced intensive, home-based behavioural intervention during the course of the study.

The difficulties encountered in the conduct of RCTs for pre-school children with autism are discussed.

Methodological challenges and strategies for future well-designed RCTs for autism interventions are highlighted.

PMID: 12541005 [PubMed - in process]

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Kid's Environ. Health: 1 Yr. in Ped. Environmental Health Specialty Unit

ds=12540255&dopt=Abstract <- - address ends here.

Shannon M, Woolf A, Goldman R.

Division of Emergency Medicine and the Program in Clinical Toxicology, Children's Hospital; The Division of Occupational/Environmental Medicine, Cambridge Hospital; and the Harvard Medical School, Boston, Mass.

Background/Objective.-As a result of an increasing desire among physicians and parents for clinical centers that can evaluate children with known or suspected exposures to environmental toxicants, a network of federally funded "pediatric environmental health specialty units" has recently been created.

This descriptive study profiles the children seen in one unit of this program.

Setting.-A New England, university-affiliated Pediatric Environmental Health Center (PEHC).

Methods.-Review and analysis of all children seen in the PEHC in calendar year 1999.

Results.-Over the course of the year, 281 children made 863 visits to the PEHC.

Presenting complaints fell into 4 major categories: new visit for management of lead intoxication (n = 248), return visit for management of lead intoxication (n = 569), new visit for evaluation of exposure to an environmental toxicant other than lead (n = 33), and return visit for the management of exposure to a non-lead toxicant (n = 13).

Among those children with new visits for a non-lead toxicant, the most common chief complaints were exposure to solvent-contaminated water (n = 7), pesticide exposure (n = 6), illness associated with proximity to a hazardous waste site (n = 6), autism from suspected mercury intoxication (n = 4), and evaluation of school-induced, building-related illness ("sick school syndrome")(n = 4).

Eleven children had autism or pervasive developmental delay.

Families traveled distances as great as 450 kilometers for evaluation by a pediatric environmental health clinical specialist.

Every child was evaluated by a pediatrician with subspecialty training in medical toxicology.

Environmental investigation of air, water, paint, dust, or land was conducted for all except 4 children (all foreign-born adoptees).

Therapeutic interventions included chelation therapy, relocation to a safe environment, removal from school, and termination of chelation therapy that had been initiated by another practitioner.

Third-party payors provided full reimbursement for all visits.

Conclusions.-The chief complaints of the children brought to pediatric environmental health specialty units are diverse, involving exposures to a wide range of toxicants from all environmental media (air, water, soil, and food).

Parents desiring such an evaluation must often travel extensive distances, suggesting the need for a broader network of such centers.

Third-party payors and health maintenance organizations are willing to provide full reimbursement for these services.

PMID: 12540255 [PubMed - in process]

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AWARENESS

The Podunk Roots of National Autism Organization

Unlocking Unlocking Autism in the local paper

6202&S=594&PubID=9056&EC=0 <- - address ends here

Jeana Smith, executive director of Unlocking Autism, holds up pictures of autistic children gathered through her organization’s work. Unlocking Autism is a national nonprofit organization based in Walker, Louisiana whose goals include working to educate people on autism and raising funds for autism research. (News photo [not shown here] by Aaron E. Looney)

Who would have thought that a nationally recognized non-profit organization would have originated from the small town of Walker [Pop. 5,000]?

A group of volunteers located in a business suite in the D’Shawn Shopping Center on U.S. 190 have done just that with Unlocking Autism, a nonprofit organization which works to educate the public on autism and help families who may have autistic children.

Unlocking Autism Executive Director Jeana Smith, a native of Oregon and current resident of Denham Springs, said the beginnings of the organization came from discussions with friends who have autistic children. Smith herself has an autistic child.

“I had a son diagnosed with autism,” Smith said. “Six months later, (UA President) Shelly Renyolds did. Through a friend, she hooked up with me and we started talking about autism. My autistic child is one of a pair of identical twins, which is extremely rare.

Autism is a developmental disability that generally appears between the ages of 15 and 20 months of age, according to a release from the Autism Coalition. In most cases, the child progresses normally and then begins to regress, losing speech, social skills and physical abilities. While there are varying degrees of severity, most children completely withdraw from society.

“The thing that we found out off the bat was that no one knew what autism was,” Smith said. “My pediatrician told me he didn't believe my son had autism.

According to information from Unlocking Autism, the organization’s mission includes bringing the issues of autism from individual homes to the forefront of national dialogue, joining parents and professionals in one concerted effort to fight for children who cannot life their voice to the nation for help and to educate parents about pending legislation, existing laws and biomedical treatments for the disorder.

“The thing that was most shocking to us was that 10 years ago, one in every 10,000 children had autism,” Smith said. “At the time my son was diagnosed, it had become one in every 500, which is a dramatic increase. We didn't understand why it was not in the media. So, we'd sit around and have lunch and talk and joke about starting an organization. So, I suggested we start collecting pictures of autistic children around the nation and put them all together.”

Smith said she and Renyolds came up with the idea of putting the pictures of the children on large poster boards, organized by state. She said the idea came from seeing the Vietnam Veterans Memorial Wall in Washington, D.C.

“You look at it with the 57,000 names, and it is so awesome,” Smith said. “We were getting ready for an autism awareness rally in Washington when we discussed raising a voice for the children who can't raise their own and having these children represented in Washington. This was a way for us to represent the children, to put faces to names.

“We thought that if we could get 58,000 pictures, that would be more than the Vietnam Wall and, at that time, would represent 10 percent of the children with autism in America,” Smith said. “Now, that number would only represent three percent.”

Smith said she currently has approximately 10,000 pictures for the project, which would span 17 football fields in length when completed. She said the current amount spans two football fields.

It's been one of the most rewarding, heartbreaking and incredible things I've ever done,” Smith said of the project, which she did nearly on her own. “I made every board, saw every picture, read every letter.”

Smith said the organization also assists parents of newly diagnosed children by providing direction through a parent-to-parent support hotline in an effort to network families across the country.

Unlocking Autism also raises funds for research and projects in the study of autism through sales of merchandise and by holding special events, Smith said.

“We work to help those on the autism spectrum reach their greatest potential in leading fulfilling and productive lives in relationships, society and employment,” Smith said.

Smith expressed her thanks to the people of Livingston Parish in helping with the organization and invites anyone who wants to be a part of the organization to stop by and visit.

“The people here in Livingston Parish are wonderful,” Smith said. “I love the volunteers. They help me in so many ways. The people I’ve worked with in the schools and in law enforcement have helped us tremendously. This is a volunteer organization and we can use all the help we can get.”

Smith said Unlocking Autism is also looking for contributions and any kind of donations of office supplies, including computer and photocopy equipment.

“This organization has come so far in so short of a time,” Smith said. “This has become a passion in my life. I am glad to have the help of so many volunteers who help to get the word out about autism. Helping families with autistic children know that there are people who understand and there are people who are there to help.”

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TREATMENT

Nonstimulant ADHD Medication Wins Approval

Atomoxetine not a controlled substance. First new drug type for disorder in 30 years.

Physicians now have an alternative to prescribing stimulants to treat attention-deficit hyperactivity disorder.

Atomoxetine (Strattera) is the first nonstimulant drug to receive Food and Drug Administration approval for the treatment of attention-deficit hyperactivity disorder (ADHD), and the first new type of drug approved for the disorder in 3 decades.

Data from six double-blind trials presented to the FDA—with 697 patients taking atomoxetine, 427 of whom were children and adolescents—found the drug to be significantly more effective than placebo. It also is effective for adults who suffer from ADHD, and is in fact the first drug approved to treat the disorder in adults. Atomoxetine has not been tested in children under 6 years of age.

As a nonstimulant, atomoxetine dodges a controlled substances classification, unlike stimulant medications currently prescribed for the disorder; this makes it more convenient for physicians to distribute samples and to phone in prescriptions and refills to pharmacies. The reason for not classifying atomoxetine as a controlled substance is that it does not appear to have a potential for abuse, according to several physicians at a teleconference sponsored by the manufacturer of atomoxetine, Eli Lilly & Co.

However, the convenience this allows is a cause of concern for some pediatricians. “Convenience is a double-edged sword,” Dr. Andrew Adesman, who is director of the Attention-Deficit Hyperactivity Disorder Center at Schneider Children's Hospital in New York, said in a later interview when asked to comment on the approval.

His concern is that the convenience of prescribing multiple refills will decrease monitoring of children, which he considers an important determinant in how well patients do with the disorder. Dr. Adesman has not been involved in research involving atomoxetine, but is considered a knowledgeable source who is willing to share his experience using a variety of medications to treat ADHD.

+ Article continues:

Copyright © 2003 by International Medical News Group.

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Methylphenidate Patch Effectively Treats ADHD

Once-daily application

A once-daily methylphenidate transdermal system was effective at varying doses in controlling symptoms of attention-deficit hyperactivity disorder, especially when used with behavior modification, Dr. Martin Hoffman said at the annual meeting of the Society for Developmental and Behavioral Pediatrics.

“These studies demonstrate that a wide range of methylphenidate patch doses improve the behavior of children with ADHD,” commented Dr. Hoffman, who is a pediatrician at the Center for Children and Families at the State University of New York at Buffalo.

Even the lowest dose of 0.5 mg per hour showed efficacy, suggesting that a low dose of this formulation may have larger effects than a similar methylphenidatedose given orally, he added.

The use of the methylphenidate transdermal system (MTS) patches significantly improved the gains made by behavior modification in both studies, which were set in multisite, camplike summer treatment programs in the United States, Dr. Hoffman said.

The MTS patch, known as the MethyPatch, is manufactured by Noven Pharmaceuticals Inc. A pivotal clinical trial earlier this year found that the patch improved teacher ratings of attention and behavior in 200 patients between the ages of 6 and 12 years.

In the first study, which was an 8-day single-dose, crossover, multicenter study, 36 children with ADHD (aged 6-12 years) were randomized to receive MTS at doses of 0.45, 0.9, or 1.8 mg per hour or placebo.

In the second study performed at a single center, 27 children aged 6-12 years with ADHD received MTS at doses of 0.9, 1.8, and 2.7 mg per hour for 6 weeks, Monday through Thursday. On three Fridays, the participants received an MTS dose, which was removed at 6 hours, and took timed math tests. Behavioral modification was implemented during 4 of the 6 weeks.

The children were rated by parents and teachers on behaviors such as following classroom rules, frequency of interruption, seat-work completion, and negative verbalizations. Each child also was given a daily behavioral report card. If the child reached 75% of his goals, parents were asked to reward him or her at night.

In both studies, there was a significant improvement in behavior at all doses of the medication. Behavior modification made the most difference for children on the low and moderate doses of MTS in both studies. A low dose of the MTS patch combined with behavioral modification had the same effectiveness as a high dose of the medication alone.

There were no significant adverse events. Erythema underneath the patches was moderate or severe in only 8% of patients and was usually not evident by morning.

In the first study, the researchers also tested whether different application times—a half hour or an hour before camp started—made a difference in efficacy. But application time had little effect, and the patches remained on during swimming, sports, and in 90° F weather.

In the second study, on the three Fridays, four children withdrew from the study because of one primary side effect of the patch—tics—but these occurred only at the highest dose. Three young, small children (weighing under 20-25 kg) had moderate to severe side effects, including headache and stomachache, at the highest dose; they were stabilized by switching to a lower dose and continued in the study.

In the second study, the patches were effective for 2 hours after removal at all doses, but moderate doses did not retain their effectiveness after 4 hours, while the higher doses did. The flexibility of using the patch needs to be further investigated, Dr. Hoffman said. Copyright © 2003 by International Medical News Group.

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CARE

Year 2002 Tax Benefits for Parents of Learning Disabled Children

[This is provided for our readers' information only and should not be construed as financial advice by the Schafer Autism Report. Differing, or additional material or views from a credible source can be submitted for

If you have a child with a severe learning disability, you may qualify for valuable tax benefits. If your child has AD/HD, or other physical, mental or emotional impairment, you may also qualify for tax benefits. Because tax laws are complex, and many tax preparers often do not have occasion to use these unique tax benefits, families are at risk of losing refunds worth many thousands of dollars. It’s likely that 15-30 percent of families with a disabled child have one or more unclaimed tax benefits.

This guide provides a brief summary of the most significant tax benefits and should not be considered legal advice. Tax decisions should not be made simply on the basis of the information provided here. You are advised to print out this guide and give a copy to your tax advisor.

Internal Revenue Service (IRS) “Publications” represent the most accessible form of guidance to the tax rules for the general public, and relevant IRS publications are cited for each of the tax benefits listed below. The IRS also issues interpretations of the code and regulations called “Revenue Rulings.” These interpretations are formal, binding policy statements. Tax professionals rely on revenue rulings in advising clients about tax liabilities and tax benefits. For example, Revenue Ruling 78-340, discussed later, authorizes a medical expense deduction for tuition or tutoring fees paid for a child with a severe learning disability who is attending a special school at the recommendation of the child’s doctor.

Tip: Relative caretakers, such as grandparents or aunts, and non-relative caretakers, such as foster parents, also may qualify for tax benefits. See a related tax guide of the Casey National Center for Resource Family Support.

Tax Benefits: Deductions vs. Credits

It’s important to distinguish between two different categories of tax benefits. One category is a “deduction from taxable income” or simply “a deduction.” The value of a deduction is based on the marginal tax rate of the taxpayer. If a person has a tax deduction “worth $1,000,” the actual value of the deduction will be determined by the taxpayer’s tax rate. So a taxpayer in the lowest tax rate bracket, 10 percent, will have taxable income reduced by $1,000, and save $100 (10 percent of $1,000). However, a taxpayer in a higher bracket, say the 30 percent, will have taxable income reduced by $1,000, and save $300 (30 percent of 1,000).

The second tax benefit is a tax credit, which is a dollar for dollar reduction in tax liability. An individual with a tax credit worth $1,000 will have his tax bill reduced by $1,000. This means that the actual amount of taxes is reduced by the amount of the tax credit. However, because tax laws and procedures are very complicated, other factors can influence the ultimate value to the taxpayer.

The following summarizes the principal tax benefits that may be available to families caring for children with severe learning disabilities.

Retroactive Claims for Refunds

The IRS allows taxpayers to file amended returns, and collect refunds for unclaimed tax benefits, retroactively up to three years. This means a taxpayer can file an amended return for the 1999 tax year and claim a refund if the return is filed not later than April 15, 2003. (See IRS Publication 17, Tax Guide 2002, at pp. 18-19.)

Medical Expense Deductions

The IRS has ruled that tuition costs for a special school that has a program designed to educate children with learning disabilities and amounts paid for a child’s tutoring by a teacher specially trained and qualified to deal with severe learning disabilities may also be deducted. (Revenue Ruling 78-340, 1978-2 C.B. 124.) Special instruction or training or therapy, such as sign language instruction, speech therapy, and remedial reading instruction also would be deductible. Related books and materials can qualify for the medical expense deduction.

Generally, to qualify for the deduction, the child’s doctor must recommend the special school, therapy, or tutoring, and there must be a medical diagnosis of a neurological disorder, such as severe learning disability, made by a medical professional. Transportation expenses to the special school or to the tutor also qualify for a medical expense deduction. If transportation is by car, the allowable expense in 2002 is thirteen cents per mile plus parking and tolls, or the actual cost of operating the vehicle.

Diagnostic evaluations also qualify for a medical expense deduction. This can include testing by a psychologist, neurologist, or other person with professional qualifications.

Note: Expenses claimed as a medical expense deduction and later reimbursed by a school district or insurance company must be reported as taxable income for the year in which the reimbursements are received.

Not everyone who has medical expenses can use them on their tax return. Medical expenses must be claimed on Schedule A, Itemized Deductions, and are subject to certain limitations. First, the family must have itemized deductions that exceed their standard deduction in order to use Schedule A (about 65 percent of taxpayers do not itemize for this reason). Second, medical expenses are allowed as a deduction only to the extent that they exceed 7.5 percent of adjusted gross income, a significant threshold for many families. (See IRS Publication 502, Medical and Dental Expenses.)

Deduction for Disability Related Conferences

In May 2000 the IRS issued Revenue Ruling 2000-24, which offers guidance — and good news — for parents of children with disabilities. Parents who attend conferences to obtain medical information concerning treatment for and care of their child may deduct some of the costs of attending a medical conference relating to a dependent’s chronic health condition. The important points to remember are:

Medical expenses are deductible only to the extent that they exceed 7.5 percent of an individual’s adjusted gross income, and that limitation applies to this deduction as well;

Costs for admission and transportation to a medical conference relating to your dependent’s chronic health condition are now deductible, if the costs are primarily for and essential to the care of the dependent.

Costs of meals and lodging related to a conference, however, are not deductible. (Note, however, lodging, up to $50 per night, is deductible if you must travel and stay at a hotel while your dependent is receiving medical treatment from a licensed physician in a hospital or a related or equivalent setting.)

Costs are “primarily for and essential to the care of the dependent” (and therefore deductible) if:

The parent attends the conference upon the recommendation of a medical provider treating the child;

The conference disseminates medical information concerning the child’s condition that may be useful in making decisions about the treatment of or caring for the child;

The primary purpose of the visit is to attend the conference. While at the conference, the parent’s social and recreational activities in the city he or she is visiting are secondary to attendance at the conference;

The conference deals with specific issues related to a medical condition and does not just relate to general health and well-being.

The full text of IRS Revenue Ruling 2000-24 is available at Amicus for Children, Inc. or can be retrieved by using the tax links search engine.

Child and Dependent Care Credit

The Child and Dependent Care Credit is allowed for work related expenses incurred for dependents of the taxpayer. Generally the dependent must be under the age of 13. However, if the child has a disability and requires supervision, the age limit is waived. For example, a 16-year-old with severe AD/HD and a behavior disorder who cannot be left alone would be a qualifying child for this credit.

Expenses up to $2,400 per year per dependent are allowed. Expenses for regular childcare services, after-school programs, and summer camp qualify although overnight summer camp expenses do not. Payments to a relative to care for a child also qualify, as long as the relative is not a dependent of the taxpayer. The credit is calculated at 20-30 percent of allowable expenses, based on the family’s adjusted gross income. The average credit is about $420 but can be as high as $1,440. (See IRS Publication 503, Child and Dependent Care Expenses.)

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LETTERS

To NPR's Science Friday Program Jan. 24

I listened to Science Friday and I was appalled at the lies and half truths which were presented on the program. In particular the professor [Neal Halsey] on vaccine safety was arrogant, dissmissive and not truthful. As a scientist who is familiar with the methodology and criticisms of these studies, not to mention the political and financial conflicts of interest which surround these studies, I was appalled that such information was permitted on the radio unchallenged. What he presentd as truth is hardly settled.

The damage is done and again families, with whom I and others work, have been victimized again by your program. It is sad, sad, sad, sad and makes me very angry. You owe these parents and children a major apology, publically.

- Gerald Gluck, Ph.D., LMFT, Fellow, BCIA-EEG

To contact NPR: The host of Science Friday is Ira Flatow, 1-203-975-8560, iflatow@npr.org

* * *

Prestigious Institute of Medicines Does Quiet Flip

In Friday, Jan 24, 2003 Atlanta Journal Constitution, tucked far off from the from page, was an article titled "Leukemia Linked to Agent Orange."

What does this have to do with autism? Evidently researchers have finally acknowledged a link between exposure to Agent Orange in Vietnam veterans and the later development of chronic lymphocytic leukemia. The Dept. of Veteran Affairs announced that it would now extend benefits to veterans diagnosed with the illness. My question, how many veterans who suffered with this illness are still alive some forty years after the fact?

Evidently the Institute of Medicines previous review lumped all forms of leukemias together and found that not enough scientific evidence existed to determine if the two were associated. (Not certain if they found it biologically plausible.)

This time scientist examined the rates of CLL separately and found an association. Sound familiar? And now the IOM has not altered its previous findings. How many years will it take for the IOM to alter their findings on Thimerosal and adverse neurological outcomes?

We can't wait forty years!

- Lyn Redwood, SAFE MIND's

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