National autism trend exemplified in North Carolina

by Dalton Cox and Matthew Krause 

One in 68 people in the United States have been diagnosed with an autism spectrum disorder (ASD). In North Carolina, the ratio is higher — one in of 58, and recent data suggest the prevalence of ASD has risen in recent years.

A March 2014 study by the Centers for Disease Control and Prevention surveyed 8-year-olds across North Carolina. Currently, more than 65,000 North Carolinians have an autism spectrum disorder.

“That is a number, but that doesn’t tell the true story,” said David Laxton, director of communications for the Autism Society of North Carolina. “That’s about prevalence. That means one in 58 kids in the counties that were sampled would meet the criteria for a diagnosis of autism.”

The autism spectrum encompasses a broad range of brain development disorders, characterized by social difficulties and restricted patterns of behavior.

“No two people are alike, and you have a wide range of levels of independence, functioning, strengths and weaknesses within the individuals who have the diagnosis,” Laxton said.

Patients might also experience body rocking, lack of verbal communication and aggression.

“On the other end of the spectrum you may have somebody who is out in the workforce, living on their own and driving,” Laxton said. “They have other challenges relating to processing information and organizing their day.”

Watson
Linda Watson

Though these individuals have higher functioning intellectual abilities, their challenges are no less significant. They typically struggle to process social interactions in their personal and professional lives.

“The adults who are higher functioning may suffer more than the adults with intellectual impairments related to autism,” said Linda Watson, a professor who specializes in autism research at the University of North Carolina School of Medicine. “The services that are available are oftentimes geared more towards the individuals who have intellectual impairments.”

Diverse disorder rises in prevalence

This prevalence rate of ASD diagnoses is consistently growing. Within the past 10 years, the number of students with autism in the North Carolina public school system has more than tripled. According to Laxton, two other factors have gone in to these increased rates – better research in to autism and overactive diagnoses.

But Watson doesn’t believe that overactive diagnoses are as great of a threat.

“With more awareness, we are going to get more misdiagnoses, but on the whole we’re probably missing more kids than we are misdiagnosing kids,” Watson said.

Others say environmental factors may play a role in the increase in prevalence rates.

Boyd
Brian Boyd

“There may also be something unknown happening that truly reflects a rise in autism” said Brian Boyd, a professor at the University of North Carolina School of Medicine. “It could be something environmental, but the prevailing theory is just that we’re better at screening and diagnosing kids than we were in the past.”

Most medical experts agree that the increase in ASD diagnoses are at least partially due to milder cases of autism now being more prevalently diagnosed. However, despite significant progress in diagnostic techniques, there are still improvements to be made.

“We’re still working on bettering bilingual assessment and diagnosis,” Boyd said. “Kids that are bilingual or learning English as a second language sometimes have communication delays, and we have to distinguish what’s autism and what’s communication delay. We’re also still trying to work out assessment of kids who have other intellectual disabilities that may be mistaken for autism.”

Diagnosing ASD

Children diagnosed with ASD can exhibit developmental irregularities at as early as 18 months. Though infants could still be developing language skills at this early age, children should express their needs in other ways, such as crying or making noises. Red flags are raised when an infant cannot express a need for food, a diaper change or parental attention. Autistic children may also avoid making eye contact when interacting with people or objects. A lack of interest in toys, pets or environmental changes may be a warning sign of ASD.

The American Academy of Pediatrics recommends that newborn children be screened for ASD after 18 and 24 months during their routine well-child visits. Still, the mean age of ASD diagnosis in North Carolina is 37 months.

Parents typically answer a questionnaire known as the Modified Checklist for Autism in Toddlers (M-CHAT). These questions assess the social skills of the child and restricted behaviors. Suspicious responses merit further testing.

A sample M-CHAT test. From www.m-chat.org
A sample M-CHAT test. From http://www.m-chat.org

“There are developmental milestones that people are supposed to reach at certain ages,” Laxton said. “If there are some delays in reaching those milestones, especially around language and communication, that’s something that needs to be looked at pretty closely.”

Because autism disorders vary across the spectrum, each individual’s intervention plan is unique. Autism treatment usually involves behavioral and educational therapies, possibly combined with medicines. Many individuals with ASD typically face additional medical conditions that require further medical treatments.

Adults with ASD struggle to compete

Increased awareness has led to a rise in ASD being diagnosed in early childhood, but individuals who reach adulthood have struggles of their own.

“They can continue in to high school until they are 21,” said Lisa Guy, clinical director of the UNC TEACCH Autism Program’s Greensboro Center. “Then at 21, they graduate from the special education system. We are seeing that there really is a lack of services for individuals as adults. That’s really true for individuals in North Carolina as well as throughout the country.”

Despite a lack of services across the autism spectrum, high functioning individuals with ASD are making plans for post-secondary education at a rate that has outpaced empirical research.

“Oftentimes people get their college educations, and they still are not successful once they get out in to the job world,” Watson said. “So it’s not a panacea for solving the problems of careers and independent living.”

Brian Boyd agrees that adulthood is especially challenging for individuals across the autism spectrum.

“One of the things that we found is that if you compare kids with autism to kids with other intellectual or learning disabilities, it is children with autism who are most likely to not be employed post high school,” said Boyd. “They have some of the worst post high school outcomes. A lot of them may unfortunately end up staying at home, because they can’t fight competitive employment or even supported employment.”

What can be done?

Aside from doing research and learning more about ASD, Laxton encourages people not directly affected to contribute time and resources.

“The Autism Society of North Carolina is a nonprofit, and we do provide a lot of services throughout the state. It costs money to do that and providing services to individuals with autism is a very expensive proposition,” Laxton said.

As more people are diagnosed, treatment and support become increasingly expensive, placing a greater strain on societal efforts.

“We have to do more fundraising on an annual basis to try to meet the need,” Laxton said.

That increase in diagnoses haScreen Shot 2015-05-04 at 9.40.17 PMs an additional byproduct – a higher possibility of knowing someone affected. With one in 68 people on the autism spectrum, there is a greater chance of having a connection with someone affected than ever before. Laxton says that fact alone should encourage people to research the facts behind autism.

“It’s not a matter of, ‘do you know somebody?’” Laxton said.  “It’s a matter of, ‘when will you know somebody?’ That’s why it’s important to understand for people to understand it.”

The Autism Society also conducts several community events, such as Autism Walks, to promote awareness of autism across the state. In 2015, eight walks are scheduled in cities such as Raleigh, Greensboro and Wilmington. The society also gives the opportunity for people to design their own fundraiser to support autism and its treatments.

Laxton says that even though the cause always needs support, those directly affected don’t realize it.

“They don’t view themselves as folks that need to fixed or cured, they like themselves just the way that they are and the more that you spend time in this community you realize that it is like a big extended family.”


For more reporting on ASD in Alamance County, North Carolina visit http://www.cdonohue.com/autism-alamance/

Children seek immigration status in North Carolina

Photo by Dalton Cox
Photo by Dalton Cox

by Dalton Cox

She lived in world’s murder capital

A year ago, Miriam was a 13-year-old living in San Pedro Sula, Honduras – reportedly the murder capital of the world. She would never have dreamed back then that she would be living in Durham, North Carolina, today.

At the time it was a daily struggle for her simply to attend school. She was harassed each morning by menacing gang members she could not avoid along the way. She finally resorted to taking a taxi to the private school she attended in San Pedro Sula.

Though the final stretch of her daily commute still had to be made on foot, Miriam would then likely encounter only one group of thugs before reaching her refuge. The threatening men had made a target of Miriam, often claiming they might murder her or take her as one of their wives.

Miriam knew that the gangsters’ threats were not all hollow. Two of her cousins had been members of rival gangs. As retribution for this genetic disloyalty, gangsters murdered the wives of each cousin, leaving the two men to their grief.

Hensley. Photo by Dalton Cox
Hensley. Photo by Dalton Cox

“I’ve worked on a number of cases where the gang threats have stopped children from going to school,” said Derrick Hensley, the attorney handling Miriam’s immigration case. “I’m really surprised Miriam didn’t stop going – at least, she didn’t stop going until the time that led to her coming to the United States.”

In 2013, San Pedro Sula had a homicide rate of 187 homicides per 100,000 inhabitants. In April 2014, the city experienced a surge in child murders – Miriam had known several of these victims. Feeling increasingly threatened by gang violence, Miriam decided to risk the journey to the United States to be reunited with her mother, Sophia.

She almost did not survive.


Thousands of undocumented children still wait in North Carolina

Miriam is one of thousands of undocumented alien children who crossed into the United States during the immigration surge of the summer of 2014. They traveled primarily from Honduras, El Salvador and Guatemala. She was also one of 53,518 unaccompanied minors released by the Office of Refugee Resettlement to sponsors in the United States between October 2013 and September 2014; 2,064 of those children were released to sponsors in North Carolina.

A sponsor is a parent or guardian capable of housing and providing for a child awaiting an immigration hearing. Approximately 10 percent of children who cannot identify a sponsor are placed in to federal foster care.

To maintain lawful status to reside in the United States, children typically must prove their eligibility for either asylum or special immigrant juvenile status. If children are unable to make out their claim, then they generally are unable to stay in the United States.

Scavone
Scavone

“I think that saying that these children are receiving due process might be presumptive,” said Heather Scavone, director of the Humanitarian Immigration Law Clinic (HILC) at the Elon University School of Law. “There have been instances of in absentia deportation orders for some of these kids when they have not been put on notice that they have a hearing. Also, unless they are able to pay for an attorney they don’t have a constitutional right to counsel in the same way criminal defendants do – so you have in some cases, a 9-year-old child who has to defend himself in court without an attorney.”

If a child is exceedingly fortunate, the Office of Refugee Resettlement may refer him or her to a non-profit organization that can offer social services casework or pro bono legal service.

One such organization is the Elon University School of Law’s HILC. It primarily works with individuals who have already been granted asylum or refugee status in navigating the immigration bureaucracy; however, Scavone recently traveled with several students to a Texas detainment center to provide philanthropic service.

“The work the clinic does here is pretty unique,” said Marty Rosenbluth, clinical practitioner in residence at HILC. “The reason we got involved in the immigration surge was out of broader concern for the issue.”

Another one of several organizations that provide casework for undocumented alien children in North Carolina is the social ministry organization Lutheran Services Carolinas. LSC increased its casework in 2014, from assisting approximately 50 undocumented alien children to now handling 84 cases.

“Their route to staying in the United States probably becomes much better the point where they gain advocates,” said Mary Ann Johnson, director of community relations for Lutheran Services. “They get pretty good care and are looked after.”

Photo by Dalton Cox
Photo by Dalton Cox

Bedrija Jazic is the director of refugee services at LSC. When Jazic fled Bosnia in 1996, she was in her 20s.

She explained that in the cases of refugees LSC only takes on cases referred by the Office of Refugee Resettlement, and all must be individuals at high risk. This risk may broadly encompass anything from physical abuse to posttraumatic stress-like symptoms.

“I cannot say it’s a fair process, because of the costs that this involves,” Jazic said. “I would think that we should provide more post-relief services and take care of more of the kids who are received.” 


Miriam held for ransom, finally reaches refuge 

Sophia had left Honduras in 2003. She fled in part from Miriam’s father. He was an abuser who had thrown bottles of beer in to Sophia’s face at parties, an addict who had once held a loaded gun to Sophia’s head and a member of Honduran military who would stalk and threaten Sophia after she left him.

“It is pretty well established that you can’t call the police on a member of the military or else you’re likely to get shot or put away somewhere,” Hensley said.

When Sophia sought sanctuary in the United States she left toddler Miriam in the care of relatives in San Pedro Sula. Sophia regularly sent her family financial support from abroad, but a decade passed before she would be reunited with her daughter in the United States.

Before Miriam could cross the Rio Grande, members of the Mexican criminal syndicate Los Zetas abducted her, along with several other migrants, to be held for ransom.

“They closed their eyes, so they wouldn’t see people coming and going,” Hensley said. “They heard people getting executed, and there were dead people lying about. They heard gunshots, and they were blindfolded or had their eyes covered. They could only leave the room to go to the bathroom.”

Sophia was contacted and asked to pay $3,300 for her daughter’s release. Miriam was held captive for three weeks, until her mother’s payment was received in full.

When Miriam finally reached the United States, she was taken in to the custody of the United States Customs and Border Protection (CBP), and placed in a frigid holding cell – often referred to as the hielera, or icebox.

Now in the land of the free, Miriam’s body relinquished its strength. She was having trouble breathing. The teenager began to cough up blood and developed a serious fever. Eventually, her condition would cause her to slip in to a comma.


Undocumented children struggle to be ‘productive citizens’ in North Carolina

In July 2014, North Carolina Gov. Pat McCrory joined the Republican governors of Alabama, Kansas, North Carolina, Pennsylvania, Utah and Wisconsin in signing a letter of concern, sent to President Barack Obama, regarding the border surge.

“We are concerned that there will be significant numbers who will end up using the public schools, social services and health systems largely funded by the states,” the governors wrote in arguing against the intake of too many refugees.

Derrick Hensley takes argument with this logic.

“It’s not widely disproportionate to our overall population,” Hensley said. “Durham has almost 250,000 residents, and we got about 200 unaccompanied alien children. That’s less than one tenth of one percent. It’s a highly vulnerable and needy population, but it’s sort of remarkable that people are worried that these children will bring the plague, that this is upsetting our economy, that this is a threat to our national security.”

Number of unaccompanied minors in states compared to state population. Based on information taken from the U.S. Office of Refugee Resettlement and the U.S. Census Bureau. Click to enlarge. Infographic by Dalton Cox
Number of unaccompanied minors in states compared to state population. Based on information taken from the U.S. Office of Refugee Resettlement and the U.S. Census Bureau. Click to enlarge. Infographic by Dalton Cox

Receiving mental health care and making up any educational deficit are two elements that Hensley considers to be foundationally important once children have settled in the United States.

Though it is illegal to deny children public education based on their immigration status, several reports were made in 2014 of North Carolina school districts allegedly denying undocumented children the right to enroll.

“It’s difficult to know the scope of the problem,” said Matt Ellinwood, a policy analyst for the North Carolina Justice Center’s Education and Law Project. “What’s exceptionally common was substantial delays in the process. We call it the chilling effect.”

“Chilling” describes the systematic barriers that undocumented alien children encounter when attempting to enroll in school or to receive health services. For instance, it can be especially difficult for migrant children to provide proof of residence when registering for school. Such inabilities to provide correct documentation generally take one month before they can be resolved.

“It’s extremely difficult and costly to provide the remediation needed to move people ahead,” Ellinwood said. “There’s no way to get back that time that is lost, when you face that kind of delay. The children have every right to be in school. We want to get them educated and to get them to be as productive citizens as they can be. The earlier we can get them enrolled, the more it’s going to help.”

In May 2014, the U.S. Justice and Education Departments provided updated guidelines to deter the chilling effect. These seem to have reduced the number of complaints made against North Carolina schools for denying undocumented children enrollment.

Ellinwood believes that, despite logistical tangles and deficits of individual education, the children are generally socially accepted by their classmates.

Ellinwood
Ellinwood

“These children always amaze me with how much more excepting they are than adults are,” Ellinwood said. “They’re extremely welcoming from what I’ve seen, and I’ve never heard of any negative incidents. Many migrant children are coming into the United States with better English language skills, so they’re better integrated than in years past.”

While these young people are extensively disadvantaged and face various mental health repercussions due to their challenging lives, Hensley said most unaccompanied alien children are capable of resilient progress, provided some resources. Hensley is typically in close contact with unaccompanied alien children and their families for about a year, while providing them legal service.

“I do see a change in the children over that time,” Hensley said. “They’re healthier. They’re happier. All of them attend school and make good progress eventually. Most of them tend to try very hard.”


Daughter and mother reunited in home of the brave 

Miriam spent five days in a hospital when she finally reached the United States.

When Sophia finally arrived at the hospital where Miriam was receiving care she was not allowed to see her daughter immediately because of immigration policies.

Today mother and daughter live together in Durham. Since fleeing Honduras Sophia has remarried and had two children, both of whom are United States citizens. Miriam is currently continuing her secondary education, and she is seeking special immigrant juvenile status.

To protect the individuals, the actual names of Miriam and Sophia were not used in this article.


Panel Discusses Hunger and Food Hardship in Alamance County

(From left to right) Norwick, Nepocatych, Crawford, and Allison discuss the issue of food hardship in Alamance County and encourage volunteerism
(Left to right) Norwick, Nepocatych, Crawford, and Allison discuss food hardship in Alamance County and encourage volunteerism

On March 31 Elon University and the Times-News of Burlington, N.C. organized a panel discussion, entitled Hunger in Alamance County, as part of the organizations’ Community Connections program. Local community members, including students, local residents, activists and city government officials filled Elon’s McKinnon Hall to listen to the guest speakers discuss the issue and answer questions from the audience.

The panel included President of United Way Alamance County, Heidi Norwick, assistant professor of Exercise Science at Elon University Svetlana Nepocatych, Executive Director of Allied Churches of Alamance County Kim Crawford, and Deputy Director of Alamance County Department of Social Services Linda Allison.

The issue that these ladies discussed may be more pertinent to Alamance County than many Elon students ever realize, despite North Carolina ranking tenth in the United States in food hardship. Svetlana Nepocatych explained that much of Alamance County is considered a food desert, where nutritional food sources are scattered and not easily available to those with limited means. Nineteen percent of the citizens of Alamance County are food insecure; the national average is only 14 percent. Also, over half students in Alamance County public schools were eligible for free and reduced school lunches in 2011.

“For us, anytime we talk about numbers it leaves an indication that some number’s ok,” Crawford said. “As long as one person is having to deal with this issue then we have one too many in Alamance County.”

The food hardship of Alamance County was intensified in September 2013 when Loaves and Fishes Christian Food Ministry was forced to close. Crawford worked with Allied Churches of Alamance County to help fill the gap of approximately 7,000 meals previously provided by Loaves and Fishes.

“When the previous food bank closed, we had so many step up,” Allison said. “We didn’t sit back and watch it happen. Everybody came together immediately, beginning the very day we knew it was happening, and started meeting to see how we could pull together.”

Though this effort has evolved in to a community-wide process, Crawford explained several issues that still stand as obstacles to eliminating food scarcity.

“The biggest challenge is nutritional food,” Crawford said. “I will tell you we don’t need corn, and we don’t need green beans. We need to provide more of a balanced product to people that are coming. Most of the people in our shelter have chronic health issues. Many of the people coming to the pantry have chronic health issues. What they eat and what we provide for them often doesn’t help.”

To learn more about the challenges exacerbating food hardship, watch Crawford’s detailed explanation below.

Crawford described the best efforts of community members to aid in overcoming such hardship and hunger in three words: “time, talent and treasure.” Volunteerism for any amount of time is beneficial, especially if one is able to aid in a unique area of expertise – such as nutritionist or a person able to give cooking classes.

Approval of police body cameras highlighted by Elon University

Elon’s Director of Campus Safety and Police Dennis Franks (left) and Town of Elon Police Chief Cliff Parker discuss body cameras
Elon’s Director of Campus Safety and Police Dennis Franks (left) and Town of Elon Police Chief Cliff Parker (right) discuss the use of body cameras by police

by Dalton Cox

Though the majority of US citizens support the use of body cameras by police, the logistics of equipping police with cameras have generated debate in the past several months. Such deliberation considers issues of transparency, privacy concerns, and cost. North Carolina lawmakers have recently proposed legislation to require the use of body cameras by some, if not all, law enforcement officers, and a recent poll conducted by Elon University found that 91 percent of the North Carolinians agreed that police should wear body cameras while on duty.

Police Body Cameras Info
Infographic by Cassidy Stratton

“Support for police body cameras is nearly universal and is clearly a response to increased media attention on police shootings,” said Kenneth Fernandez, director of the Elon University Poll.

In August 2014, Elon Police began using four body cameras, primarily to record the enforcement of parking violations. Elon police did not begin using cameras in cars until 2013.

“We were exploring this before Ferguson and before the national conversation started,” said Cliff Parker, Town of Elon Police Chief.

Elon Assistant Police Chief James Perry suggested the contemporary requirement for officers who are equip with body cameras to use the camera.

“A lot of the situations we have are very fluid,” Perry said. “If we get out of the car quickly and forget to hit the button it looks negative. It looks like we’re trying to hide something.”

This year, lawmakers in at least 15 states have introduced legislation to keep recordings of police encounters out of public records.

The Elon poll found that approval for publicly releasing recordings varied based on respondents’ political affiliations and race.

Approximately 70 percent of Democrats favored transparency, compared to 48 percent of Republicans. Seventy-eight percent of African Americans respondents favored transparency, while only 58 percent of Caucasians favored such public availability.

The average cost about of a body camera is approximately $1,000, and the recordings from such devices are typically kept in the police database for 90 days, according to Elon’s Director of Campus Safety and Police Dennis Franks.

“I’ve had a positive response,” said Franks. “They act as an impartial witness and record both sides of an event. The only negative I can see to them is if they go down. Obviously, we enjoy a low crime rate and they’re just another tool”

Still, Parker described that the recordings from such devices were only a piece of the evidence considered in conducting an investigation.

“ We don’t just rely on one account,” Parker said. We look at officers’ statements, witnesses’ statement, victims’ statements. The body camera acts as part of the picture but not the whole thing.”

Videos by Dalton Cox

Local opinions vary on religious satire after Charlie Hebdo

The Sanctuary of Elon Community Church
The Sanctuary of Elon Community Church, photo by Dalton Cox

by Dalton Cox

Community members of Elon University and the greater Triad area typically expressed a need to exercise the right of freedom of expression with a respect to all religious traditions. It has been over a month since French jihadists initiated a terrorist attack that began at the office of Charlie Hebdo and ended with the deaths of 17 people. As the initial shock of the violence waned, a global debate began in which seemingly everyone from schoolchildren to Pope Francis weighed in on the perpetual question – where does democracy draw the line between freedom of expression and offensive speech?

Pope Francis particularly was cited by CNN as promoting religious reverence above any disrespectful expression.

“One cannot provoke, one cannot insult other people’s faith, one cannot make fun of faith,” Francis said.

Taken in the meditation garden of Elon University's Numen Lumen Pavilion
Taken in the meditation garden of Elon University’s Numen Lumen Pavilion, photo by Dalton Cox

Local religious leaders also spoke of limits to be regarded by satirists in such cases. Reverend Marisa Thompson of Burlington’s Holy Comforter Episcopal Church echoed Francis’ opinion that free speech has its boundaries.

“I’m mixed on religious satire,” Thompson said. “I think that being respectful of other traditions is paramount to us as human beings. It’s also about time and place [regarding religious satire]. It’s one thing to satire a particular piece. It’s another to satire a particular leader.”

Outside the church, most Americans seemingly disagree with this ethical exception to free speech. According to a recent poll by the Pew Research center, 60 percent of adults believed it was it was “okay” for Charlie Hebdo to publish cartoons depicting the Prophet Muhammad, although any illustration of Muhammad is considered offensive to Islamic tradition.

Local community members seemed to agree with this opinion. Views differed, however, regarding the opinion that the media should consider risk as a factor when practicing the right to free speech.

“I think that people do have the right to say whatever they want to, but you have to know that you might draw negative attention,” Alexandra Fung, an Elon first year, said.“If they want to take the risk of drawing that attention, they can do that.”

Alexandra Fung
Alexandra Fung, photo by Dalton Cox

The consideration of such risk was commonly echoed across generations. Religious Studies Professor Mark Justad of Guilford College shared his similar view.

“It’s a judgment call every time,” Justad said.

Still, other community members argued that risk should not be an overwhelming factor when deciding whether to publish offensive material.

“I don’t think you should not be able to produce those articles because of religious intimidation, through the religious extremist lens,” Chris Essman, an intern at Elon’s Truitt Center for Religious and Spiritual life, said. “It’s obviously a generalization to say that every Muslim acts that way, but I do think we need to be more critical of religions that don’t hold themselves accountable to those sorts of reactions.”

As one evaluates these opposing opinions of the consideration of risk, individuals are able to determine which viewpoint seems the most valid to them. The same reasoning applies for many when justifying freedom of expression. Elon media law professor Jonathan Jones explained that in this marketplace of ideas it is easier for citizens to determine reasonable social ethics.

“Even when we’re dealing with ideas that may be on the fringes of society, it’s important to allow people to express themselves so that their ideas can be put forward and society can evaluate those ideas and reject them as is appropriate,” Jones said.

According to Jones, this principle is applied even more liberally to free speech in the United States than in France and most western European countries. In the United States, constitutional law protects the press from any censorship of religious satire.

“I don’t particularly agree with the cartoons that Charlie Hebdo was showing . . . but I will argue and fight for the right to publish those kinds of things because I think it is important to have in a free society to have a free flow of ideas.”