Explosions and anxiety: Adult special needs life is a tough haul

My 26yo son, "#1", is pretty solidly in the 3-4th (bottom) percentile of cognitive abilities. It's a cognitive continuum of course; what's true of the 3rd percentile can also be true of the 10th or the 20th -- especially when lack of sleep or alcohol is involved. So this isn't just about special needs adults. It's something useful to understand for tens of millions of Americans.

The other day he exploded. No harm came of it, except to him. It's a behavior we've known from childhood though it's only with time we came to understand how closely tied it is to his anxiety.

It happened during an ice hockey game. We play together at local pickup games. He's a good mid-level adult hockey player, a step above me and our usual pickup skaters, but he's not a fitness guy. He gets tired towards the end of a game and, unlike a neurotypical player, he doesn't push himself. He just takes it easy. (This logical but socially wrong behavior isn't unique to #1.) This can irritate teammates who expect him to perform well.

In this case a teammate made a mildly inappropriate (for this kind of hockey) criticism of #1s lackadaisical play. Once upon a time I'd have made a similar comment, but I've learned it doesn't work. What works is to praise the things he does well. (This simple principle took me forever to learn and apply.)

I get those kinds of comments myself from better players sometime -- but I enjoy them.  It means I can guilt my critic into being a reluctant game-long coach. (Sadly this only works once, they don't really want to coach.) Or, if it's late in the game, I'll laugh and say "yeah, I suck". 

That's advanced stuff. In this case #1 was tired. He exploded with a red faced rant and various scary seeming threats. I was nearby though, so I sat between him and his critic and explained to the poor guy that my son was a special needs adult and that I'd sort things out. #1 hates to hear himself described that way (you would too) but the moment passed for everyone but my son. For him these things endure.

I've learned not to criticize these behaviors -- for him it's all about extinction-reinforcement. I was able to walk him through how I'd have handled the comment. It wasn't over though. He's been kind of wreck since. He's complaining of a variety of physical symptoms consistent with somatization (or some horrible disease that we'll feel very bad about -- my wife and I are both physicians). It's hard to understand his internal reasoning but his behavior is consistent with shame, guilt, and a deep fear of exploding again. His usual response to an episode like this is to replay it for years and avoid the setting. I don't know if he'll continue to do the pickup hockey. For now we're managing what we think is somatization (and not, say, some post-COVID neuropathy or lymphoma [1] or whatever) and working on resetting him.

Not a good day, but also not avoidable. But it could have gone much worse. It does go much worse. A lot of men with limited cognitive or emotional control can melt down like this. If police are involved and aren't at the top of their game it can escalate very badly. Even if police aren't involved it can turn into a physical fight with all of the problems that come from that. Most special needs adults, and most men, don't have a 60+ neurotypical father to sit between them and the guy they are excessively angry with.

It's a hard world out there. If you're one of the lucky guys with good emotional control and understanding it might help to know how this goes. If you're a cop -- I hope you're getting the autism/special needs training now being introduced into high performing police forces.

- fn -

[1] That's physician humor. Any symptom can always be early lymphoma.

See also:

• The Explosive Child and other books (2007)

ABLE (529A) plans -- what's a good one and who has it

Wikipedia has a succinct description of the 529A (ABLE) plan:

ABLE programs are similar to tax-advantaged 529 plans for college savings.[8] In addition, a 529 plan can be rolled over into an ABLE account for a qualified beneficiary.

An ABLE account can be opened by a disabled individual who became disabled before 26 years of age.[8] An ABLE account can receive after-tax cash contributions from any person, including its owner.[1] Contributions in a year are limited to the federal gift tax exclusion [9] for that year — $15,000 in 2018.[10] If the beneficiary works and does not contribute to a 401(a), 401(k), 403(b), or 457 plan, the beneficiary can contribute an additional amount above that limit. The additional amount is equal to the lesser of the beneficiary's annual compensation or the federal poverty level for an individual — $12,060 in 2018.

ABLE plans were based on 529 plans, but the comparison misleads. The value of a 529 plan is that after-tax donations can grow and be disbursed without taxation. That's also true of a 529A, but it's not the point. People with ABLE accounts don't pay income tax anyway.

The entire value of an ABLE account is that it bypasses the savings limits of Social Security Income. SSI savings limits are extremely low -- about $2000. SSI recipients can't save more than that. The cap was last updated in 1989, it's been minimally changed since 1974. It's insanely low. There are limits on income too; and gifts are part of income.

ABLE accounts bypass that crazy low limit. In an ABLE account savings can grow to $100,000; 50x higher than the SSI limit.  Money can come gifts or from the account owners's contributions. The catch is those savings can only spent on qualifying expenses. Rent is the big one. Things that are related to independence -- like a smartphone, maybe gym expenses (health), legal fees, disability expenses. Training and education, health costs, transportation.

ABLE accounts launched in 2016-2017. I don't think they've been super successful. The rules are fuzzy and people on SSI learn mistakes are punished severely. There's also not enough money in play to excite the banks.

Our #1 has an ABLE account through Minnesota - currently managed by MinnesotABLE. They aren't a great solution. The web site is mediocre at best and key topics are undocumented, It's easy to add money, hard to remove it. In particular there isn't a useful debit card.

MN doesn't do anything special for residents so I went looking for better plans using the ABLE National Resource Center State Compare app. I want:

• A debit or credit card tied to the account. I want self-documenting transactions. If #1 is buying a new iPhone I want that on the transaction record.
• Low fees
• Small management fees
• A quality web site

It's very hard to find information on ABLE plans. This is one of the best discussions of the general options and why expenses are high or hard to discover (from 2018):

... 529 plans, especially ABLE accounts can only be administered by a state. When does a state see money and not figure out a way to skim off the top. The dirty little secret is that a significant portion of program management fees goes to the state. For example, Maryland and Oregon take 0.30% in administrative fees themselves in their 529 ABLE plans. 

The best I have seen so far is LA ABLE for Louisiana state residents only. No annual fee, no program management fee and 0.07%-0.15% for six Vanguard funds, including the four LifeStrategy Funds. There is a state alliance of GA, KY, MO, NH, OH, SC, and VT that offers funds with asset based fees of 0.31%-0.34% for those state's residents (0.57%-0.60% non-residents). 

For non-residents the National ABLE Alliance of AK, CO, DC, IL, IA, IN, KS, MN, MT, NC, NV, PA and RI. Offers funds with asset based fees of 0.34%-0.38%. Their program management management fee is 32% and I'm sure the states gets a significant chunk of that. The underlying expense ratios are 0.02%-0.06% (based on fixed portfolios using Vanguard, Schwab and iShares funds/ETFs). They have a $15 ($11.25 e-delivery)/qtr account fee. 

The best plan for non-residents based on cost might be Tennessee's ABLE TN, offering Vanguard and DFA funds with asset based fees mostly in the range of 0.35%-037% (Wellington at 0.35%) with no account fees. As always the devil is in the details. E.g. the plan does not offer a debit card.

I'll update this post with what I find, for tonight I'll review:

Ohio

• STABLE card: loadable prepaid debit card
• Vanguard
• $42/year maintenance fee

Massachusetts

• Has debit card
• Fidelity Attainable Savings Plan
• No annual fees

Oregon

• web site information unimpressive, doesn't explain how the prepaid card works
• has annual fee, does at least describe management fees on mutual funds (most sites don't do this)

Pending: Tennessee, Lousiana,Virginia

See also

• ABLE Plans and special needs trusts 7/2018
• ABLE plans 2016

When imagination becomes memory

I think this is terribly important, but I’ve never seen it described. So, in a few minutes, I’ll share what I think.

Almost animals have memory, save perhaps the simplest single celled organisms. We think plants have a form of memory as well. There’s nothing uniquely human about memory.

Imagination is less common. It’s not uniquely human either; crows, wolves, cephalopods, cetaceans, primates — they all have some form of something that looks like imagination. We think humans have much more of it though. We can create memories of things that have not happened or did not happen. Imagination is a form of ‘false memory’ that we know to be false.

Except … when we don’t know it to be false. And there lies a problem — but I’ll come back to that.

When did humans develop the ability to create false memories and know them to be false? We think it is older than what we call “human” now — we think our fellow modern hominids, Neandertal, Denisovan and more had well developed imaginations. We suspect we have more of this talent though, and that we might have picked up additional abilities as recently as 50,000 to 75,000 years ago.

That’s very recent evolution, so it’s not surprising that, like strength and height, imagination might vary among people. It might vary in the ability to create “false” memories, and, perhaps independently, in the ability to know them to be false.

The latter variation is key. We know from research over the past forty years that it is relatively easy to create false memories in many people, but we also know that some study subjects, typically healthy university students, are more resistant to false memories than others. If we consider imagination as the generation of false memories that we know to be false, then similarly some people will be better at retaining the knowledge of what happened versus what they imagine happened.

So we know this ability to divide imagination from memory varies. It is plausible, and it fits my own experience, that people with “connectopathies” and other cognitive disabilities may have not only more limited imaginations, but also more difficulty separating the memory of what is imagined from all other memory.

I have seen this in someone close to me. When he was a child I would be upset that he was not telling me the truth, but over time I have come to believe that for him memory and imagination are inextricably blurred. What he imagines, what he wishes to be or have been, is poorly separated from what has been. There is just enough separation, I think, to create anxiety or agitation around the recall of false memory, but not enough to tell what is true memory and what is imagination.

I don’t think this problem is unique to persons with an IQ below the 5th percentile. I suspect it’s true for very many people, and it may explain why so many today are susceptible to novel kinds of media manipulation.

It’s a problem we need to research and understand both for persons with cognitive disabilities and for our society.

Apartheid in Minnesota: Disabled need not apply

This shocked me:

West St. Paul, South St. Paul restrict housing for disabled

West St. Paul and South St. Paul have taken steps to restrict housing options for people who receive state assistance for being both low-income and disabled…

…. “We have enough of these properties in the community,” said Tom Seaberg, a South St. Paul City Council member. “It’s not a discriminatory thing, it’s an economic issue.”…

… West St. Paul passed an ordinance in November prohibiting people who get government rental assistance and support services, a category the state calls “registered housing with services,” from living in the city’s apartments unless they’re already residing there….

People receiving assistance may be mentally ill, physically or mentally disabled or elderly. The services they get range from transportation and nursing care to help with cleaning or money management.

South St. Paul approved an ordinance last month allowing just one unit, or 5 percent of a multifamily building, whichever is greater, to be occupied by people receiving both rental help and support services….

… Kori Land, the attorney for both cities, said that “registered housing with services establishments” is simply a land-use classification in state law. She denied that the ordinances discriminate against any specific group…

 

How is this not like banning people by race or religion?

Beware passport process post-guardianship

We’re renewing #1’s passport. Should be routine, but he is now in guardianship.

The post-guardianship passport process is currently undocumented. Our local passport office didn’t know the process. We’re now told we need not only the letter of guardianship but also the court order. All certified. The letters we’ve received on this have been misleading or incomplete.

It is an amazing mess going on for 2-3 months now. Our next stop will be to contact the office of our local Senator.

Be warned.

Passport for adults with guardians -- similar to procedure for passport for minor

We’re redoing #1’s passport renewal — because we followed the adult procedure, not the children’s procedure I wrote about in 2007. We were told since we are #1’s legal guardians we have to repeat the procedure with both of us present. (I’m not sure if we pay again, I wouldn’t be surprised.)

Even knowing about this requirement I’m unable to find anything online about it. I wonder if it’s a recent change.

529A (Able tax-free savings accounts) slowly state-by-state rollout starts 2016.

Able accounts are coming, slowly starting next year. On my quick review the fund looks like a good way to pay for housing.

The Arc has a useful fact sheet, but it predates authorization and treasury rules are only up for public hearing in October 2015. I think some of this is now incorrect:

• At $100,000 SSI benefits are suspended and restarts if falls under 100K, but medicaid benefits continue. When individual dies balance goes to medicaid.
• residents of one state can open accounts in another state, so you don’t need to wait for your state to create an account. (But NYT article below suggests we have to wait? Confusing)
• beneficiaries can rollover from an ABLE to a 529 if no longer disabled including another family member’s ABLE or 529 (Doesn’t say whether one can go the other direction, from a 529 to an ABLE). Rollovers can also go to a special needs trust. (q: So if the 100K limit nears can one rollover to the trust? What about other direction? 
• The fund can be used to pay housing (this is the big one), transportation (bicycle?), health related (gym?), disability care expenses (legal fees, oversight, etc).

The http://www.ablenrc.org domain is supposed to go live in September 2015 with more information. There is a $14K limit to fund per year.

The NYT has a more current review of 529A accounts, emphases mine. It’s unclear whether the 100K limit will be a balance limit or a lifetime contribution limit and whether that will vary by state. If it’s a lifetime contribution limit that’s not so good. It’s also unclear what happens if someone changes residences.

Tax-Free Savings Accounts for Disabled Are Expected in 2016 - NYTimes.com

… each must approve its own legislation to set up a plan. As of Aug. 13, 40 states and the District of Columbia either had passed laws or had proposals pending, but 10 states had no bill pending, according to an online registry maintained by the Arc, an advocacy group for people with intellectual and developmental disabilities.

The Treasury, meanwhile, has proposed rules to govern the accounts, and will hold a public hearing on them in October.

As with 529 college savings plans, 529A accounts allow contributed funds to grow tax-free, and to be withdrawn tax-free for eligible expenses. Anyone — including family and friends of a disabled person, as well as the disabled person — can contribute to the accounts, but there is no federal tax deduction for the contribution.

An important feature of the accounts is that they allow people with special needs to save for their care and education without disqualifying them from receiving government benefits….

… Typically, families must set up a special-needs trust to set aside funds for a disabled child without putting benefits at risk — a step that can involve costly legal fees to establish and maintain the trust. Funds in the Able accounts, however, won’t count toward that limit, so they may provide a simpler, lower-cost alternative for many families.

The accounts, however, have some limitations. To qualify, you must have been disabled before age 26. The funds have an annual contribution limit equal to the annual gift tax exclusion — currently $14,000. The account can grow to $100,000 without jeopardizing federal benefits (although some states may set much higher overall total contribution limits), but balances over that amount may prompt a suspension.

…  families may want use a combination of a 529A and a special-needs trust, depending on their financial situation, said Christopher Krell, a financial adviser and principal with Cassaday & Company. With special-needs trusts, there is no contribution limit and they can be structured to avoid Medicaid repayment. “The 529A accounts are great,” Mr. Krell said, “but they’re not going to get rid of special needs trusts.”

■ Can an individual have more than one 529A account?

No. Unlike 529 college savings accounts, you can have just one 529A account, and it must be established in the state where you live (or through the program your state contracts with).

■ How can I find out when 529A accounts will be offered in my state?

You can check with the agency that administers your state’s 529 college savings plan for updates. In early September, look for an online 529A resource center at www.ablenrc.org.

The state-by-state rules sound like a mess; I wonder if that was a GOP congress outcome. If the plans end up restricting an individual ability to move between states I wonder if there will be a constitutional challenge.

My gut sense is that we’re going to get a lot less than what we’d hoped for, but maybe things will improve over time. The special needs trusts remain very important. The real impact could be on paying for housing — that’s increasingly important given the seeming collapse of programs designed to provide housing for disabled adults.

Guardianship (Minnesota)

We went through the Minnesota guardianship procedure with #1. He was anxious and sad — both appropriate. The procedure went better than we’d expected and he was in good spirits afterwords. A few notes if this is on your radar:

• It’s a courtroom legal procedure with two “opposing” attorneys and a judge. In most cases of uncontested special needs guardianship the attorneys are probably cooperating rather than truly oppositional, but legally they are opposed. We had our lawyer and #1 had his lawyer.
• We used a legal procedure the county recommended for #1’s lawyer - In forma pauperis. Since he has no assets he can get a court appointed counsel. His lawyer was respectful, supportive, professional and obviously experienced.
• We paid for our lawyer, using a firm recommended by #1’s county social worker who does this work. By legal standards his fee was low and he was happy to do everything by phone and email. We met him briefly just before the hearing.
• We visited the parking area and building the day before, driving by with the whole family. This always helps #1 — he likes to know what’s coming up. We were lucky that one person went ahead of us, so we saw the routine. In some cases it might be helpful to observe a hearing beforehand, I believe they are public.
• The lawyer and judge referred to documents rather than explicitly stating detailed disability — I was concerned some of the topics raised would be hurtful but they were referenced by document.
• The proceedings were thoughtful and respectful, but probably lasted about 10 minutes. I’d heard of experiences where a guardianship candidate would be repeatedly reminded of restrictions ahead, but in this case #1 was just reminded that he could petition yearly for judicial review. We have paperwork to file yearly.

Special needs in Minnesota - notes from an ARC and family sponsored meeting

I joined a meeting tonight hosted by Arc Minnesota [1] which was both an opportunity to learn from the work of the local Bender family and a chance to chat with a few local politicians (all of whom I voted for of course).

Unfortunately I was delayed and missed part of the meeting, but I'll share some of the issues that came up. There's much more on these topics in a post from last year - Transition and employment - notes from a Minnesota presentation.

•  I heard some good things about the Legacy Endeavors, I think they'd be categorized as a "supported Employment Service Provider" though I'm fuzzy on the divisions.
• Arc is pushing for a 5% increase in reimbursement for aides and other caregivers in the special needs system. They've gone a long time with no salary increases.
• The ACA is reducing or eliminating the "parental fees" associated with buying into medical assistance (TEFRA) (!)
• Minnesota's Olmstead plan, which came out of a court settlement following the meto case, is starting to turn into laws. There's a focus on licensing and quality improvement for provider organizations and moving towards individual annual budgets and "increased flexibility" [2]. A long promised self-directed support option for personal are attendants might become real.
• There's some legislative pressure to limit use of family members as paid Personal Care Attendants due to vague fears of fraud and abuse. This practice is most common amongst 'communities of color' . The common pattern in special needs services is to put in place so many 'fraud and abuse' safeguards that programs become almost useless.
• The Federal move to limit use of group homes realized most of its money savings from reducing 24 hour surveillance costs.
• Minnesota schools are have accelerated inclusion programs in late High School. Personally we haven't noticed any changes - certainly not any improvements. (For example.)
• States vary in how they deal with maintenance of disability benefits when income rises above poverty level. Minnesota is particularly harsh -- ensuring special needs persons with disabilities will be just barely out of federal poverty. There didn't seem to be a lot of energy for changing this.

[1] I believe The Arc used to be A.R.C, and the R stood for what you might expect. Now it's an "Arc" as in the curvy thing. Incidentally, The Arc has a legislative blog. I had no idea - I've added it to the MSP special needs search engine.

[2] "Flexibility" can be a euphemism for "free to do whatever you want and here's a ticket out of town". We'll see.

A lawyers guide to the high-evidence IEP process

IEPs and Evidence was written by Katie Kelly, a special needs lawyer and mother of two special needs children. It's a more adversarial approach than we've had to take - so far. I recommend reading the original and saving the document. For example:

Prior Written notice. ... The PWN is a procedural safeguard that makes the school put in writing the service or Individual Education Plan (IEP) term you asked for, the data they considered in refusing you that service, and their reason for doing so.  You will not get a copy at the meeting; it will be mailed to you.  It should be very specific.  Warning: the school will make it as vague as possible.  Tell them to do it again using the specifics that you got entered into the meeting notice...

She recomends recording all IEP meetings, optimizing formal minutes, using email to document and clarify all communications and actions, and dedicating a special journal to each IEP. The first two we haven't done and won't start doing until we see more trouble. Email and a special journal are easy to do anywhere.

Ritalin and Adderall shortages -- the DEA and the other side of outrage

Beyond outrage, there is a point where we can only laugh and cry...

F.D.A. Is Finding Attention Drugs in Short Supply - NYTimes.com

... While the Food and Drug Administration monitors the safety and supply of the drugs, which are sold both as generics and under brand names like Ritalin and Adderall, the Drug Enforcement Administration sets manufacturing quotas that are designed to control supplies and thwart abuse. Every year, the D.E.A. accepts applications from manufacturers to make the drugs, analyzes how much was sold the previous year and then allots portions of the expected demand to various companies.

How each manufacturer divides its quota among its own A.D.H.D. medicines — preparing some as high-priced brands and others as cheaper generics — is left up to the company.

Now, multiple manufacturers have announced that their medicines are in short supply. The F.D.A. has included these pills on its official shortages list, as has the American Society of Health-System Pharmacists, which tracks the problem for hospitals. And the American Academy of Child and Adolescent Psychiatry has told the more than 8,000 doctors in its membership that shortages seem to be “widespread across a number of states” and are “devastating” for children.

Officials at the Food and Drug Administration say the shortages are a result of overly strict quotas set by the Drug Enforcement Administration, which, for its part, questions whether there really are shortages or whether manufacturers are simply choosing to make more of the expensive pills than the generics, creating supply and demand imbalances...

Let us set aside the trivial matter. Drug company CEOs would sell their mother's liver to "meet expectations". I'm sure they're exploiting every legal and even semi-legal angle they can find in an age where patents are expiring and the drug pipeline is dry.

That's not the problem though. Just think for a minute about how this is supposed to work. The DEA wants to stop the recreational use of stimulant drugs. They do this by restricting the supply. So recreational use will stop because one of two things happen. Maybe the drug companies, who get paid either way, will start assassinating stimulant dealers. Alternatively, parents of kids with ADHD will put on capes and masks and start beating up college kids prepping for exams.

Yeah, think about that. How else are these DEA restrictions supposed to work?

Now if you're a relatively young person you may be thinking senior leadership at the DEA couldn't really be this stupid. Trust me, powerful people are often stupid. It's almost a prerequisite.

It's time to contact Senators and Representatives. Again. Here's what I'm sending Al Franken and Amy Klobuchar..

Dear Senator

I read in the New York Times that DEA quotas on stimulant drug production are leading to shortages of critically important medications for the treatment of ADD and related disorders.

I understand that the DEA has set these quotes to motivate parents of children with ADHD to prevent the recreational use of stimulant medications. I assume we're supposed to don costumes and start pummeling stimulant dealers to reduce diversion.

Please ask the head of the DEA to explain to you and all of us how their production quotes are supposed to work. In detail. Repeatedly. Until they get a clue.

Thanks very much...

Persuasion, adolescence, and the joys of prison life

Low IQ special needs adolescence does not come as a "thief in the night". It comes as a ton of bricks.

Behavioral management, which was never terribly effective, has become even less effective. We may still have a "paradoxical permission" effect, whereby when we give permission for an annoying behavior it becomes less attractive. I'm not sure we have even that however.

Medications are still available, but of course side-effects may be less tolerated.

Which is why I'm turning, with a measure of desperation, to my favorite sales book: Three Steps to Yes: The Gentle Art of Getting Your Way by Gene Bidell. I hope I can use some of Bidell's techniques to change my son's choices.

Bidell emphasizes understanding your Prospect's recognized and unrecognized needs and aversions, then figuring ways to meet them to get the sale. The Prospect "needs to win", for example, so find a way they can win and you can lose -- while still getting the Sale.

Understanding my son's world is a real challenge. He combines the limited knowledge of an early teen with a limited capability to understand and assimilate new knowledge.

I think, for example, that I erred by describing prison as the outcome of particularly poor choices. In my son's mind, I now realize, prison means no school, association with the police and K9 dogs he loves, comforting concrete instead of disturbing nature, agreeable routines, few challenges, plain meals, lots of television, regular exercise, no frightening choices, no concerns about employment, and congenial like minded peers.

In his mind, prison is not a bad thing, it's a bit heavenly. The worst bit is that in some ways he's quite right. He might actually find a well run low security prison more congenial than the alternatives.

So I need to persuade him that there are better options than prison (even if I'm not entirely sure there are - but that's a different story). Juvenile detention, for example, does include math class. It doesn't provide much police contact, and there are no K9 dogs. Most of all, there are no girls and his companions may not be very friendly.

At the same time I need to come up with a better future alternative for him to work towards - and I need to come up with it very quickly.

Any ideas?

Update: In our community the local police are happy to enter a special needs person into their database with a special "tag" including disability and contact information.

Update 6/26/2010: UK study on low IQ prison population.

Federal court vaccine ruling was very science based

These Wall Street Journal health blog excerpts make it clear that the decision Federal vaccine court special masters was very clear cut. This was not a hard call, the scientific evidence is overwhelmingly against the vaccine-autism beliefs (emphases mine):

WSJ Health Blog : What the Court Said In the Autism Vaccine Cases

One ruling:

After careful consideration of all of the evidence, it was abundantly clear that petitioners’ theories of causation were speculative and unpersuasive. Respondent’s experts were far more qualified, better supported by the weight of scientific research and authority, and simply more persuasive on nearly every point in contention.

A second:

I concluded that the evidence was overwhelmingly contrary to the petitioners’ contentions. … The numerous medical studies concerning these issues, performed by medical scientists worldwide, have come down strongly against the petitioners’ contentions.

A third:

[P]etitioners’ experts tended to assign greater weight to speculative conclusions offered by the investigators involved in the studies than did the investigators themselves. Petitioners’ experts also urged reliance on a few carefully selected sentences from particular articles which, when considered in the proper context of the referenced articles, did not support the propositions advanced by the witnesses. Moreover, because petitioners’ experts relied on a number of scientifically flawed or unreliable articles for several important aspects of their causation theory, their testimony on those aspects of their offered theory could not be credited as sound or reliable. Finally, petitioners’ experts made several key acknowledgments during testimony that rendered their proposed theory of vaccine causation much less than likely.

The third opinion emphasizes that the petitioner's own experts, under examination, contradicted the belief that autism arises from immunization.

This won't be the end of the autism-vaccine meme of course. It long ago became a matter of quasi-religious belief rather than something amenable to data or reason. It will, however, make it very hard to press these arguments in the court system. It's not the judgments alone, it's the ferocity and clarity of the opinions that will make a difference going forward.

Update 9/20/09: Good f/u article on the decision. My favorite line:

... Among those expressing shock and disappointment was Rebecca Estepp, the mother of an autistic child, who is one of the claimants and the national manager of the advocacy group Talk About Curing Autism. "It's tough when you're taking parent support calls and you hear the same story day after day," she told the Wall Street Journal. "When does anecdotal evidence become enough?"

Her question isn't a new one, especially in a society where belief, emotion and science so often conflict. For scientists, the answer to Estepp's question is never.

Thousands of years of anecdotal stories about witches causing disease didn't make it true.

Center for Education Law: Legal Tips for Effective Education Advocacy

Updated 3/2010

Back in 2004 the center for education law wrote ...

Put everything in writing and keep a copy for your records. Write a letter to school personnel when they deny you or your child some educational opportunity. Always think that this letter may one day be read by a neutral third party so make sure you are very clear about the facts and be very polite. Also make sure the letter has the name and address of the person you are sending the letter to, the date you are sending the letter, your name and address, and your signature. Make sure to make a copy of the letter for your records

Now they're the "School Law Center" but I don't see any advice on their current web site.

Google local search: Special Education Attorney (lawyer) for Saint Paul

Google Search: lawyer special education near 1661 Grand Avenue, Saint Paul, MN 55105

Google's local search is impressive. Saint Paul area educational lawyers.