The Ruderman White Paper on Law, Media, Disability

DF version available for download here

 

For a searchable database of all 2013-2015 news coverage of police violence involving persons with disabilities, click here.

 

EXECUTIVE SUMMARY

Disability is the missing word in media coverage of police violence.

Disabled individuals make up a third to half of all people killed by law enforcement officers. Disabled individuals make up the majority of those killed in use-of-force cases that attract widespread attention. This is true both for cases deemed illegal or against policy and for those in which officers are ultimately fully exonerated. The media is ignoring the disability component of these stories, or, worse, is telling them in ways that intensify stigma and ableism.

When we leave disability out of the conversation or only consider it as an individual medical problem, we miss the ways in which disability intersects with other factors that often lead to police violence. Conversely, when we include disability at the intersection of parallel social issues, we come to understand the issues better, and new solutions emerge.

Contents

Disability intersects with other factors such as race, class, gender, and sexuality, to magnify degrees of marginalization and increase the risk of violence. When the media ignores or mishandles a major factor, as we contend they generally do with disability, it becomes harder to effect change.

This white paper focuses on the three years of media coverage of police violence and disability since the death of a young man with Down syndrome, named Ethan Saylor, in January 2013. After reviewing media coverage of eight selected cases of police violence against individuals with disabilities, the paper reveals the following patterns in the overall data:

• Disability goes unmentioned or is listed as an attribute without context.
• An impairment is used to evoke pity or sympathy for the victim.
• A medical condition or “mental illness” is used to blame victims for their deaths.
• In rare instances, we have identified thoughtful examinations of disability from within its social context that reveal the intersecting forces that lead to dangerous use-of-force incidents. Such stories point the way to better models for policing in the future.

 

We conclude by proposing best practices for reporting on disability and police violence.

Content Analysis

How often do American police use force against disabled civilians? No one knows because we lack comprehensive data sets. Currently, there is no legal requirement for local, state or federal law enforcement agencies to aggregate or collect the number, type, and result of violent incidents that occur between police officers and disabled people. From a purely practical standpoint, those who seek to track, monitor, and/or analyze trends related to police violence and disability are limited to collecting the data themselves from print and online media coverage.

From individual cases to a broad analysis of media representation of incidents of police violence against disabled people, we have compiled and summarized media coverage of stories about police violence and disability by year, organized the stories into various categories, and offered brief commentary on a few examples.

Our review and analysis reflects the patterns of media coverage on issues related to disability and police violence. Generally speaking, reporting on police violence against disabled people includes the date of the incident along with specific details about when and where the event occurred. Using this as our starting point, we added the reactions of law enforcement agencies and community responses to allegations of police violence as reported wherever possible.

We close by offering some ideas for “best practices” that journalists might consider when reporting cases linking police violence and disability.

As an addendum to this white paper, we have prepared an online spreadsheet which can be searched by name, date, state, and disability.

Conclusion

Twenty-five years after the U. S. Congress passed the Americans with Disabilities Act, notions of disability continue to evolve. An increasingly powerful set of concepts, they push us to redefine how to build an inclusive society that is accessible to all.

When disabled Americans get killed and their stories are lost or segregated from each other in the media, we miss an opportunity to learn from tragedies, identify patterns, and push for necessary reforms.

Disability rights are civil rights. Disability rights are human rights and disability justice is intersectional.

The needs of disabled people aren’t special. There is nothing special about not wanting to be shot. What disabled people seek are the same things (employment, education, access, consideration, respect, etc.) that non-disabled people likewise desire. The obstacles faced by disabled people, though, too often go unseen. The language used to report issues that confront disabled people—especially issues linked to injury and death—should reflect that disparate reality.

White Papers and Research

Statements and Press Releases

In the News

 

NYC Comptroller Scott Stringer Wants Proxy Access To Universal Health Services

Scott Stringer

NYC comptroller seeks more control at UHS, other companies

By Tara Bannow, Modern Healthcare, April 5, 2018

New York City's comptroller isn't giving up on his uphill battle to get proxy access to for-profit hospital chain Universal Health Services.

Scott Stringer is the custodian of about 136,000 UHS shares owned by five New York City public employee pension funds and retirement systems. For the third consecutive year, his office is calling upon fellow shareholders to vote for a change to the company's bylaws that would let certain outside shareholders with at least 3% ownership for at least three years nominate up to 25% of its board members.

"We believe proxy access is a fundamental shareholder right that will make directors more accountable and enhance shareholder value," Stringer wrote in his proposal.

The proposal is unlikely to pass, however, as it would need support from UHS CEO Alan Miller, who controls 83.6% of total voting power. UHS management is calling on its shareholders to reject the proposal, which it calls "counterproductive." Shareholders can vote on the proposal remotely or at the company's annual meeting at its King of Prussia, Pa., headquarters on May 16.

Stringer and the five funds—the New York City Employees' Retirement System, the New York City Fire Department Pension Fund, the New York City Teachers' Retirement System, the New York City Police Pension Fund and the New York City Board of Education Retirement System—launched their campaign, the Boardroom Accountability Project, in 2014. That year, the funds, which manage about $193 billion in assets, submitted proxy access proposals to 75 companies at once. The terms—shareholders with at least 3% ownership for three years can nominate up to one-quarter of board membership—were identical to a proxy access rule enacted by the Securities and Exchange Commission in 2010. That rule was later overturned by a federal appeals court.

At the end of last year, 3% of outstanding UHS shares constituted approximately $320 million worth of shares, according to the company. UHS shareholders are divided into classes, and Stringer's proposal would apply to Class B and D shareholders, who would nominate Class B and D directors. Currently, those classes elect two of UHS' seven directors, but they don't have a say over the contenders.

Despite success at large companies like Chevron, Hasbro, Staples and Priceline, Stringer's group has not made headway with UHS. The proposal garnered less than 10% of shareholder votes in 2016 and 2017, according to Stringer's website and UHS.

Two-thirds of the proposals the Boardroom Accountability Project submitted last year didn't go to votes, since the companies agreed to make the changes voluntarily, Stringer's office wrote in a 2017 post-season report. More than 440 U.S. companies have enacted meaningful proxy access, including more than 60% of the S&P 500, up from only six companies when the project was launched in 2014, according to the report.

In its response, UHS management wrote that despite the "significant publicity" proxy access has received in recent years, it has been implemented at a relatively small number of U.S. public companies.

UHS, which declined to comment for this story, wrote in a response to Stringer's proposal that proxy access is not in the company's best interests.

"The Board recommends that you vote against this proposal because it advances a solution for a problem that does not exist at our Company, does not take into account the effective voice our stockholders already have, undercuts the role of the independent Nominating and Governance Committee, and would introduce an unnecessary and potentially expensive and destabilizing dynamic into the Board election process," UHS wrote to shareholders.

Stockholders currently can communicate directly with any director, propose director nominees and submit proposals for consideration at annual meetings, UHS wrote. The company also does not have a "poison pill" limiting the amount of shares a group of stockholders can hold.

UHS also noted the U.S. Court of Appeals for the District of Columbia overturned the SEC's proxy access rule because the agency hadn't assessed the rule's economic effects, specifically the expense and distraction companies might face as a result.

For its part, the California Public Employees' Retirement System will vote in favor of proxy access at UHS, spokesman Mike Osborn wrote in an email. CalPERS owned about 346,000 UHS shares in 2016, the most recent publicly available number.

HCA Healthcare's board voted in December to allow proxy access to shareholders that have owned at least 3% of the company's stock for at least threeyears. They can nominate up to two directors or 20% of the board, whichever is greater.

Community Health Systems' shareholders, despite a recommendation to the contrary from the hospital chain's board, voted to adopt proxy access in 2016. The proposal was the second from Connecticut Treasurer Denise Nappier.

UHS wrote that since 2000, the company's shares have outperformed the S&P 500 Index by a margin of 5.2 to 1. A purchase of $1,000 worth of common stock in 2000 would now be worth about $13,600, compared with $2,560 for a $1,000 investment in the S&P 500 Index during the same period.

UHS' net income rose 7.1% to $752 million in 2017 compared with $702 million in the previous year. Net revenue increased 6.6% during that period, hitting $10.4 billion last year.

FOR IMMEDIATE RELEASE

Thursday, April 12, 2018
Banner Health Agrees to Pay Over $18 Million to Settle False Claims Act Allegations
https://www.justice.gov/opa/pr/banner-health-agrees-pay-over-18-million-settle-false-claims-act-allegations

Banner Health has agreed to pay the United States over $18 million to settle allegations that 12 of its hospitals in Arizona and Colorado knowingly submitted false claims to Medicare by admitting patients who could have been treated on a less costly outpatient basis, the Justice Department announced today.  Headquartered in Arizona, Banner Health owns and operates 28 acute-care hospitals in multiple states.
“Taxpayers should not bear the burden of inpatient services that patients do not need,” said Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division.  “The Department will continue its efforts to stop abuses of the nation’s health care resources and to ensure that patients receive the most appropriate care.”

The settlement resolves allegations that 12 Banner Health hospitals knowingly overcharged Medicare patients unnecessarily.  In particular, the United States alleged that from Nov. 1, 2007 through Dec. 31, 2016, Banner Health billed Medicare for short-stay, inpatient procedures provided at the 12 hospitals that should have been billed on a less costly outpatient basis.  The settlement also resolves allegations that Banner Health inflated in reports to Medicare the number of hours for which patients received outpatient observation care during this time period.

“This enforcement action is another example of this office’s commitment to protecting the Medicare program,” said Elizabeth A. Strange, First Assistant United States Attorney for the District of Arizona.  “The United States Attorney’s Office, working with our law enforcement partners, will continue to protect Medicare by aggressively pursuing False Claims Act allegations of wrongdoing in the health care industry.”

Banner Health also entered into a corporate integrity agreement with the U.S. Department of Health and Human Services – Office of Inspector General (HHS-OIG) requiring the company to engage in significant compliance efforts over the next five years.  Under the agreement, Banner Health is required to retain an independent review organization to review the accuracy of the company’s claims for services furnished to federal health care program beneficiaries.

“Hospitals that bill Medicare for more expensive services than are necessary will be held accountable,” said Christian J. Schrank, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.  “Medical decisions should be made based on patients’ conditions and needs, not on providers’ profits.”

This settlement resolves a lawsuit filed in the U.S. District Court for the District of Arizona by Cecilia Guardiola, a former employee of Banner Health, under the qui tam or whistleblower provisions of the False Claims Act, which permit private citizens to bring lawsuits on behalf of the United States and obtain a portion of the government’s recovery.  Guardiola will receive roughly $3.3 million.  The case is captioned United States ex rel. Guardiola v. Banner Health and NCMC, Inc. No. 2:13-cv-02443. 

The government’s resolution of this matter illustrates the government’s emphasis on combating health care fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The settlement was a result of a coordinated effort by the Civil Division, the U.S. Attorney’s Office for the District of Arizona and the HHS-OIG.  The claims resolved by this settlement are allegations only and there has been no determination of liability.
Topic(s): 

False Claims Act

Health Care Fraud
Component(s): 
Civil Division
USAO - Arizona

U.S. Supreme Court Refuses to Hear Case on Teacher Free-Speech Protection

U.S. Supreme Court

By Mark Walsh March 19, 2018

Washington

The U.S. Supreme Court on Monday declined to take up the appeal of a former New York City teacher who traced her dismissal to a clash with administrators over whether it was appropriate to teach her 9th grade students about the "Central Park Five," a group of teenagers convicted of the brutal 1989 rape of a female jogger but later exonerated in the notorious incident.

Lawyers for the ex-teacher, Jeena Lee-Walker, had urged the justices to grant review of her case to decide whether public school teachers have First Amendment free speech rights in the classroom. They argued that the federal appeals courts are in disagreement about whether a key 2006 Supreme Court decision removing First Amendment protection from most on-the-job speech by public employees applies to educators.

 The 2006 case, Garcetti v. Ceballos , had involved a prosecutor's office and the court's opinion left some uncertainty about whether it would apply to "scholarship or teaching." Many lower courts, with some exceptions, have applied Garcetti to educators in a way that denies them any First Amendment protection for their teaching. 

Lee-Walker's troubles began in 2013 when she was a 9th grade English teacher at the High School for Arts, Imagination, and Inquiry in Manhattan. An assistant principal conducted a classroom observation and noticed a lesson about the Central Park Five, which Lee-Walker was using to teach about the dangers of rushing to judgment and what that meant for black males.

The five black males convicted in the 1989 rape served 10 years in prison before they were exonerated after the actual perpetrator confessed and his story was supported by DNA evidence.

The assistant principal, Christopher Yarmy, questioned whether there had been a rush to judgment and asked Lee-Walker to offer a more balanced lesson, court papers say.
The conflict over the Central Park Five lesson subsided, but Lee-Walker contends she was labeled as obstinate and insubordinate, leading to her eventual non-renewal as a probationary teacher. She sued administrators and the New York City school system alleging that her dismissal was retaliation for exercising her First Amendment rights in the classroom.

A federal district court agreed that Lee-Walker's free speech rights were violated, but it granted qualified immunity to the defendants. 

The U.S. Court of Appeals for the 2nd Circuit, in New York City, in 2016 affirmed the qualified immunity finding on different grounds. That court noted that it had not yet decided whether Garcetti applied to classroom instruction and thus there was no clearly established law upon which administrators would understand that Garcetti had removed such protections from the teacher. 

The teacher's Supreme Court appeal in Lee-Walker v. New York City Department of Education (Case No. 16-4164) asked the justices to resolve a circuit split over First Amendment protections for classroom instruction.

The advocacy group Foundation for Individual Rights in Education filed a friend-of-the-court brief in support of Lee-Walker.

"The First Amendment bears a special relationship to the classroom, where academic freedom is essential to facilitating the marketplace of ideas," the brief said. "Despite this important relationship between the First Amendment and academic freedom, the law governing the limits of public educators' freedom of speech in the classroom has been left in a state of uncertainty" since Garcetti, it said.

The New York City school system and the individual defendants did not file a response to the appeal and the high court did not request one.

The justices declined the appeal without comment.

 

Recent Decisions on the First Amendment

Conrad Black On Clinton Political Mischief and Robert Mueller's Russian Drama

Special Counsel Robert Mueller

Clinton Political Mischief
Emerges as Key Tale
In an Astounding Drama

By CONRAD BLACK, Special to the Sun | February 21, 2018

 

 

It is both dismal and amusing to see the rationalizations of the diehard Kremlin collusionists after Robert Mueller’s spurious indictment of the 13 Russians who will never encounter the vagaries of United States justice. The charge of conspiring against the United States is nonsense, and the whole ambiance of the investigation now is that of a phantom consolation prize for the absence of a crime, a victim, or a culprit, all amplified by the hollow sanctimony of an official America that has meddled countless times in the elections of other countries (usually for the general good of the Western alliance).

 

The desperation of the Trump impeachers is piquant: This indictment doesn’t cover hacking — where might that lead? And the fact that Deputy Attorney General Rosenstein said, “This indictment refers to no Americans,” and that it contains no allegation of affecting the election result or of collusion by Americans, may mean that perhaps another indictment will. It is to this pathetic wisp that the New York Times’ Tom Friedman’s claim of a Russian assault on American sovereignty equivalent to Pearl Harbor and 9/11, and Senator Mark Warner’s thousand Russian agents delivering Wisconsin to Mr. Trump on election night, have been reduced.

 

It is all, and always has been, nonsense. The Russian activities Mr. Mueller has attacked began before Mr. Trump had announced his candidacy, were favorable to Senator Sanders and the Green candidate, Dr. Jill Stein, as well as to Mr. Trump, and were almost entirely Internet advertisements decrying the state of the country in terms many Americans would sadly endorse — violence, corruption, poverty, crime, racism, etc. — in a presidential campaign in which the major candidates spent $2.5 billion, and Mrs. Clinton spent the unheard-of sum of $250 million on attack ads.

 

This was her version of “going high when they go low”: She was obviously speaking of money spent, not moral tone. And that was without counting the 10 to 12 million dollars the Clinton campaign contributed to assembling the outrageous Steele dossier, which Mrs. Clinton cites in her book as evidence of the ”treason” Trump committed with Russia to cheat her of the election. Trump critics are correct to say that this piffling pseudo-prosecution is not “a complete vindication,” in that it is not an explicit exculpation, but it is a stark confession of the extent of the collusion fiction.

 

When the rabidly Americophobic British newspaper the Guardian is reduced to finding evidence of collusion in Trump’s supposed generosity to Russia, the Red Queen is made to sound like Louis Brandeis. We must be fairly close to the point where it is impartially recorded that Trump-Kremlin collusion was a nasty fairy tale commissioned and paid for and carpet-bombed on the press by the Clinton campaign, and used to infect and mislead the Justice Department and the FBI, by senior Clinton-campaign and Obama-administration officials.

Peter Strzok

The Steele dossier remains the only visible justification for a false Foreign Intelligence Surveillance Act warrant against Carter Page and, incidentally, the Trump campaign; and for the Mueller investigation itself, even though that investigation was prompted by fired FBI director James Comey with an illegal leak to the New York Times of a memo of contested accuracy that was probably illegally removed government property. Mr. Mueller arrived after Mr. Comey had dismissed the Steele dossier as “malicious and unverified” and after the Trump-hating Clinton-helper Peter Strzok, whom Mr. Mueller inexplicably recruited, had reluctantly concluded that there was “no there there.”

 

With this Russian indictment and whatever flailing about Mr. Mueller may commit over hacking and WikiLeaks, Mr. Mueller can make his gesture to the fact that the Russians nibbled ineffectually at the edges of the 2016 election, and use that as his cover to withdraw from the whole misconceived collusion foolishness in which the United States is being reduced to a laughingstock for the whole world. Or, Mr. Mueller can exercise the plenitude of his mandate and unearth the proportions of the chaos caused by the Steele dossier (which the egregious Senator Warner assured us “is taken seriously by the British, our ally”).

 

It is an astounding tale that is emerging of Clinton political mischief tainting the entire justice system and misleading tens of millions of Americans to imagine their political system was being manipulated by foreigners and might have produced an illicit presidential-election result. This is the exposure that must be made, and while I would not necessarily favor prosecuting them all, Mrs. Clinton, Mr. Comey, deputy FBI director McCabe, and quite possibly former senior Justice Department officials including Loretta Lynch and Sally Yates, have committed offenses that put them in the danger zone of indictable acts.

 

Instead of Keystone Kops charges against untouchable Russians and shock-and-awe intimidation of prior bit-players for alleged tax offenses and minor indiscretions, Mr. Mueller should lay this immense, scandalous rotten egg before the country. If he can’t face that challenge and service, he should shut down this charade so that Attorney General Sessions can end his recusal and we can bring on the main event and identify the authors of this monstrous farce.

 

As his greatest problem melts, President Trump has an opportunity to build on the new need of Democrats to be more cooperative than their mindless obstructionism until recently has permitted. To build on the historic success of his tax reform, Mr. Trump should cut across party lines and do the right and surprising thing, as President Lyndon Johnson did with civil rights, President Nixon did with China, and President Reagan did with arms control.

 

He should reaffirm the right of all qualified people to own handguns and rifles, but sharply tighten access to automatic weapons, require licenses to carry concealed weapons, fund substantial security in all schools and for public meetings, including religious services and concerts, and intensify the collection of relevant behavioral information and response to it (an area bungled by the FBI and local authorities in the Parkland, Fla., massacre last week).

 

Gun supporters cannot justify a laissez-faire legal framework, but will continue to be able to collect and enjoy guns if they meet high but reasonable criteria. This might not have interdicted the Las Vegas murderer, but would have flagged the Parkland misfit. All unauthorized firearms should be seized.

 

The other march the president could usefully steal legislatively, and bring the Democrats into formation with him, would be to increase the infrastructure proposal to the $4.5 trillion that is generally recognized to be needed, and fund the increase from anticipated reductions in the gasoline price resulting from increased U.S. production, by maintaining the present price and applying the differential to this program. The anti-Trump resistance is collapsing and we are almost back to normal political blocking and tackling.

 

With these notches in his belt, Mr. Trump would have a chance of complete immigration and health-care reform in the second half of his term. There will be plenty of opportunity for the president to gloat about the collusion idiocy; now is the time to make Washington work and build credentials as a negotiator and champion of the system, and not just the great outsider.

Mr. Trump has brought down the walls like Joshua at Jericho; now is the time to bury gridlock and rebuild public confidence that America’s legislators are not just the corrupt, ineffectual lobbyists-in-waiting that a great many Americans, with some reason, think they are.

 

CBLetters@gmail.com. From the National Review.

 

Robert Mueller's Indictment Could Be a Win for Russia's Trolls

By Simon Shuster , TIME 

February 21, 2018

It turns out you don’t need much to meddle in a U.S. election. Some cheap cell phones. An Internet connection. Maybe a few airline tickets and a good grasp of the English language. That was enough for the Russian troll farm to get started on their U.S. operation back in 2015. And they achieved what they set out to do.

Thirteen of them, mostly errand runners for the group known as the Internet Research Agency, have been charged for allegedly trying to skew the U.S. electoral process. The indictment against them, handed down on Friday by Special Counsel Robert Mueller, reads both like a warning and a potboiler. But it could also serve as an instruction manual, one that any determined group could use to replicate the operation. This is clearly not what the Special Counsel intended.

 When it comes to catching criminals and deterring copycats, the indictment may yet succeed. It might at least become harder for the Internet Research Agency to recruit new trolls around its home base in St. Petersburg, especially now that some of them are wanted by the FBI and unable to travel outside Russia without fear of arrest and extradition. Their summer holidays may now be limited to the beaches of Sochi and Crimea.

But for the broader aims of the troll factory and its investors, the indictment could serve as a victory in disguise. Apart from providing a blueprint for their methods, it may further diminish public trust in the platforms people use to receive information, share ideas, and to engage in civic discourse. Disseminating those kind of doubts has been the aim of Russian propaganda for years.

“It does not function like traditional propaganda,” says David Patrikarakos, the author of War in 140 Characters, a recent book on modern information warfare. It doesn’t seek to promote any ideology or convince people to join any single cause. Instead, says Patrikarakos, “It tries to muddy the waters. It tries to sow as much confusion and as much misinformation as possible, so that when people see the truth, they find it harder to recognize.”

Take, for example, one of the troll factory‘s earlier campaigns in Russia, the one that followed the murder of Boris Nemtsov. On February 27, 2015, the Russian dissident and former Deputy Prime Minister was shot in the back while walking home a few steps from the Kremlin walls. Suspicion among his allies soon fell on the man he had spent his career trying to unseat: President Vladimir Putin, who denied any involvement.

The day after the killing, the staff at the Internet Research Agency received detailed instructions on how to spin the news. Their orders were to flood Russian news websites and social media with comments about Nemtsov’s killing, all in the hope of confusing the online discussion about who was responsible. “Technical instructions for Feb. 28,” the orders began, according to a copy that was later leaked to local journalists. “Create the opinion that Ukrainians could have been mixed up in the death of the Russian opposition figure.”

Other theories spouted that week by the Agency’s trolls put the blame on Nemtsov’s girlfriend, his fellow dissidents, his American allies and his former business partners. They did not focus on dispelling the notion that Putin or his allies could have been involved. They simply crowded the debate with so many theories and alternative facts that everything about the case began to seem suspicious. “Next they’ll say that space aliens did it,” Nemtsov’s personal assistant, Olga Shorina, told me after watching these theories spread on social media at the time. “I can’t even look at it anymore.”

About three weeks after Nemtsov’s death – when a decorated veteran of the Russian security services had already been arrested for pulling the trigger – an independent polling agency in Moscow found that only 15% of respondents believed the Russian authorities had been involved. Perhaps even more surprising, the same survey found that only 10% of respondents were even paying close attention to the highest profile political murder of the Putin era. A far larger number had simply tuned out.

The Kremlin’s main propaganda outlets – the television news – no doubt played a more powerful role in shaping public opinion around that case. But the role played by the Internet Research Agency suggested a shift in strategy. Long before Nemtsov’s killing, in 2011, Russia had overtaken Germany as the nation with the highest number of Internet users in Europe. Even then the public was beginning to turn off state TV and going online for uncensored news.

Across Russia, and especially in the big cities, the political debate was also migrating to the Web around that time, especially to the blogging platform known as LiveJournal, whose audience in Russia around 2011 had come to rival some of the state-run news networks – it had 5 million Russian accounts with 30 million monthly readers. It wasn’t long before that space also came under attack. In April 2011, hackers targeted not just the blogs of the dissidents and opposition figures who were writing on LiveJournal; they took down the entire service.

“There’s no ideology at play here, unless you want to talk about an anti-blogging ideology,” Alexander Plushchev, one of Russia’s leading tech journalists, told me at the time. “These are clearly just Internet hit men who got the order to take out LiveJournal.” The aim, in other words, was to stop the conversation. And for a little while it worked. The raucous debates on LiveJournal ground to a halt as the site remained inaccessible for days, and many of its users began migrating to Facebook, which is a lot more difficult for hackers to knock offline.

The rise of the Internet Research Agency in 2013 was, at least in part, a reaction to that shift. Its managers recognized that trying to shut down the means of political debate was no longer enough. In the age of social media, people would just find another place to exchange ideas. The best way to stop them would be to infiltrate the discourse itself — and, whenever possible, to fill it with nonsense, conspiracies and lies.

The indictment of the Internet Research Agency shows in minute detail how easily this can be done. Reading through the schemes it describes – the fake accounts the suspects created on social media, the fake activist groups they formed, the fake causes they claimed to champion, and the phony protests they were able to organize in American cities – it is hard to avoid the tug of paranoia, the feeling that the civic discourse in any democracy is vulnerable to sabotage, and that every political statement is worthy of suspicion.

The reaction to such doubts could, in many cases, be a healthy sort of skepticism. It could remind people to check their sources of information and to question the voices that reach them online. But that sort of vigilance is hard to maintain. For many people, the easier option would be to withdraw from the debate for fear of being fooled again. And as the efforts of the Agency’s trolls have shown in the past, that outcome would serve their interests perfectly well.

With reporting by Sandra Ifraimova / New York

What Do Asthma, Heart Disease And Cancer Have In Common? Maybe Childhood Trauma

Re-posted from Parentadvocates.org
A child can be traumatized at a very early age, and this trauma will affect everything the child does and believes, from that date until way into the future.

For these reasons, we must try to deal with the consequences of our actions, as well as the health, welfare and safety of the child, often and with diligence.

Betsy Combier
Editor, ADVOCATZ.com
Editor, ADVOCATZ BLOG
Editor, Parentadvocates.org
Editor, New York Court Corruption
Editor, NYC Rubber Room Reporter
Editor, NYC Public Voice
Editor, National Public Voice
Editor, Inside 3020-a Teacher Trials  

What Do Asthma, Heart Disease And Cancer Have In Common? Maybe Childhood Trauma
CORY TURNER • JAN 23, 2018
90.1 FM WABE

“Trauma” is a heavy and haunting word. For many Americans, it conjures images of troops returning from Iraq and Afghanistan. The emotional toll from those wars made headlines and forced a healthcare reckoning at the Department of Veterans Affairs.

Dr. Nadine Burke Harris, a pediatrician, would like to see a similar reckoning in every doctor’s office, health clinic and classroom in America — for children who have experienced trauma much closer to home.

Burke Harris is the founder and CEO of the Center for Youth Wellness in San Francisco. She’s spent much of her career trying to spread awareness about the dangers of childhood toxic stress. Her 2014 TED talk on the subject has more than 3.5 million views; the message is simple and research-based:

Two-thirds of Americans are exposed to extreme stress in childhood, things like divorce, a death in the family or a caregiver’s substance abuse. And this early adversity, if experienced in high enough doses, “literally gets under our skin, changing people in ways that can endure in their bodies for decades,” Burke Harris writes in her new book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity:

“It can tip a child’s developmental trajectory and affect physiology. It can trigger chronic inflammation and hormonal changes that can last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase the risk for heart disease, stroke, cancer, diabetes — even Alzheimer’s.”

In short, early stress can shorten your life.

That’s why, as a clinician, Burke Harris asks parents and guardians of new patients to fill out a short, confidential questionnaire. She wants to understand just how much stress these children have experienced.

Are this child’s parents or guardians separated or divorced?
Is anyone in the home depressed or mentally ill?
Has the child seen or heard household members hurt or threaten each other?
Has a household member sworn at, insulted, humiliated, or put down the child?

The list goes on, including exposure to sexual abuse, drug or alcohol addiction in the house, neighborhood violence, food insecurity and housing instability.

I recently spoke with Burke Harris about the impact this exposure can have on children and what can be done about it. Our interview has been edited for length and clarity.

What are we talking about when we talk about toxic stress?

When kids are exposed to very high levels of chronic stress or adversity — or really intense and scary experiences — it actually changes the way their brains and bodies are wired. And that can lead to changes in brain development, changes in the development of the immune system, our hormonal systems, and even all the way down to the way our DNA is read and transcribed. And that is what can lead to this condition that’s now known as toxic stress — and put folks at an increased risk of lifelong health problems.

To help our readers understand toxic stress, I’d like you to explain how, exactly, the body responds to stress. In the book, you use an analogy that makes this really accessible: The bear.

Absolutely. Imagine you’re walking in the forest, and you see a bear, right? The first thing that happens is that the amygdala, which is our brain’s alarm center, sounds the alarm. So, our brain sends a signal down to our adrenal gland, which makes adrenaline and other stress hormones, including cortisol, and so your heart begins to pound, your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear.

But, if you were to think about it, fighting a bear wouldn’t seem like a good idea, would it? Because bears are big and they have teeth and they have claws. And that is why this alarm center in your brain, your amygdala, actually sends neurons to the part of your brain that regulates executive functioning: your prefrontal cortex. And it says, ‘You know what? We’re not going to do a lot of thinking right now. So we’re just going to turn you down. Just be quiet. Because now is not the time for thinking. Now is the time for reacting.’

Another nice thing that your brain does for you when you’re facing a mortal threat is it activates your immune system. And that’s not obvious, but when you think about it …

That’s totally not obvious.

Yeah, but it makes a ton of sense — because, if you’re getting ready to fight a bear, that bear may get his claws into you, and so you want your immune system to be primed to bring inflammation to stabilize the wound, right? All of this, it’s absolutely brilliant. It makes total evolutionary sense.

This is exactly what we need to be able to survive an encounter with a bear in the woods. And, if it happens once in a while, then that’s okay.

But the problem is: What happens when it occurs over and over and over again, especially when children’s brains and bodies are just developing?

What sorts of things in a child’s life can lead to toxic stress?

The real, seminal research that was done on this topic was the Adverse Childhood Experiences Study (ACEs) that was published in the ’90s. And in that study the researchers at the Centers for Disease Control and Prevention and Kaiser Medical Center looked at 10 categories of adverse childhood experiences. Those include physical, emotional, and sexual abuse, physical and emotional neglect, or growing up in a household where a parent is mentally ill, substance-dependent, incarcerated, where there’s parental separation or divorce, or where there’s domestic violence.

And these 10 adverse childhood experiences from the original research are the ones that were associated with huge increases in risk for things like heart disease, cancer, chronic obstructive pulmonary disease, even Alzheimer’s. All of these long-term health problems.

About two-thirds of the population have experienced at least one adverse childhood experience, and about 13 percent have experienced four or more, according to the CDC.

Since that research was done, we’re also now understanding that there may be other risk factors that can also activate a child’s stress response and lead to changes in the way the brain and body function, and there’s still more research happening with that. You can imagine other things that would be pretty scary for kids — things like having your parent deported or being a victim of discrimination or racial violence.

What about the relationship between poverty and toxic stress?

We can’t raise kids in a bubble, right? And the key ingredient to protecting children from toxic stress is really this safe, stable, nurturing relationship from a loving caregiver who can act as a buffer.

But it’s much more difficult to act as a buffer when you’re working three jobs to put food on the table. It’s much more difficult to act as a buffer when you are dealing with existential threats.

If you are a caregiver and you’re living in a dangerous neighborhood, trying to get your kids to school and deal with the day-to-day trauma and drama of life, then physiologically your stress hormones are going to be pumping. Right?

That’s going to be much more difficult for you, and therefore, it’s going to be much more difficult to be a buffer to that child.

What we see is that poverty itself may have a very significant impact on, first, kids being exposed to adversity, and second, the probability that the kids who are exposed will go on to develop toxic stress, because of the impact of the stress of poverty on their caregiver.

How do you begin to diagnose and treat toxic stress?

I give a great example of this in the book, the story of Lila. She was a 3-year-old girl who came to see me, and her mom’s only concern was that Lila wasn’t growing well. She was itty-bitty, and I made the diagnosis of “failure to thrive.”

This was after we had already begun regular screening for adverse childhood experiences in our practice and developed our multidisciplinary intervention team. And so, as part of the regular routine physical exam for Lila, I also got her adverse childhood experiences score. It was a seven.

A seven? That’s extremely high.

Yes, especially for a 3-year-old. It’s very, very high.

In terms of treatment, step one was just letting Lila’s mom know what was going on, what my clinical suspicion was.
So, once I got that ACE score, I was able to explain to her mom: “Hey, because of what your child has experienced, I believe her body is making more stress hormones than it should. And I think that’s what’s leading to the problems with your child’s growth. And so this is what I’m going to recommend.”

And so we did, in this case, something called child-parent psychotherapy, when a therapist meets with both the child and the caregiver together. And it’s really focused on the experience of trauma and adversity and how to help both the child and the caregiver overcome and develop tools for reducing the amount of stress that the child is exposed to.

And what’s totally nuts is that, when I did that — along with nutritional supplementation — within six months that child was back on the growth curve.

That’s one of the reasons I created the Center for Youth Wellness here in San Francisco, because our goal is not just to advance the standard of practice here in our center but to advance the standard of practice period. Our goal is that every pediatrician in the United States or — heck! — around the world for that matter is doing routine screening for adverse childhood experiences. Because one of the things that all of this science tells us is that, the No. 1 thing that makes a difference is early intervention.

I want to ask you about schools. If you could design the ideal school support system for children with toxic stress, what would it look like?

When we’re talking about vulnerable communities and what have been traditionally called “underperforming” schools, you have huge numbers of kids who are exposed to very high levels of adversity. And we’re like, ‘Huh, I wonder why they’re not scoring well on that test?’

If you had that many kids in a class and they all had epilepsy, what would you be doing? It seems unfair, right? Because we’re talking about a neurotoxin.

In the book, I really tried to give an example of folks who are doing great work with this, specifically looking at what the team at Turnaround for Children in New York learned as they were designing interventions for schools.
Initially, their thought was providing these supports in terms of, you know, social work and counselors for kids. And then they recognized that it wasn’t 1 or 2 or 5 or 10 percent of the kids in the school that needed some kind of service or some kind of acknowledgment of the impact of adversity. It was the entire school. Sure, there may be 10 or 15 percent of kids who are so disruptive that they’re coming to our attention, but, for most of the kids in that class, they are experiencing some significant dose of adversity.

That required a totally different approach. And one of the things I talk about in the book is how Turnaround learns, like, “Hey, we need to train every single person that’s interacting with these kids. Every teacher, every counselor — the person who is taking out the garbage at night. Every single person who is working in the school environment needs to understand what toxic stress looks like, how to identify it and how to support a child in de-escalating their stress response.

What does that stress response look like in the classroom?

One of the most obvious and easy to spot manifestations is behavioral problems. Difficulty with impulse control, difficulty with self-regulation, trouble with attention. From that standpoint, the symptoms often overlap with ADHD. A lot of my patients were being referred by teachers or principals or other folks in the school environment for ADHD. The challenge is, the treatment for ADHD is stimulants. But, if your underlying problem is an overactive stress response, stimulants may not be the appropriate treatment.

Understanding how to get that stress response regulated, how to de-escalate it — that’s something the team at Turnaround for Children did in their training of all of the folks in the school environment. They helped folks recognize, “OK, when a child is becoming disregulated, here are some of the things that you can do to help them re-engage and de-escalate the situation.”

The one thing that I just want to add is, that kid who has asthma all the time — that may also be a symptom [of trauma]. Or the kid who has the chronic headaches or the chronic tummy pain. Those may be symptoms that are less obvious and certainly less intrusive in the school environment, so they can be overlooked.

We’re asking schools to do something remarkably difficult here — something that requires time and training and money. Most schools don’t have a trained social worker or psychologist on staff …

This is why I feel like this science is so important because, as I mentioned, if you had a teacher who was trying to teach a class of 30 kids with epilepsy … no way. Like, no way would you do that, right? That’s not even doable. And yet we have teachers who are teaching in a class of 30 kids and, frankly, 20 of them might be dealing with toxic stress.
Which helps explains why teacher attrition rates are so high in so many schools.

It’s crazy! For teachers, it’s a completely uphill battle. It’s completely unfair. I’m glad we’re talking about this because, if we’re talking about the school system alone trying to solve this problem, we’re hosed. If we’re talking about pediatricians alone trying to solve this problem, it’s too big for us.

Folks often ask me, like, “God, you’re talking about two-thirds of the population exposed to adverse childhood experiences, and all of this science about what it does to the brain and body is so overwhelming! How do you deal with it?”

But, knowing that the problem is so big, for me, it’s like, “Oh shoot, we need a different set of tools. This is not a problem with, you know, Dashaun or Jorge or Sam or Sarah. This is a public health problem! And in fact this is a public health crisis.”

So guess what, schools you need help! Doctors offices, you’re part of the solution! You know, if you’re in early childhood, you’re part of the solution. If you’re in juvenile justice, you’re part of the solution. We all need to be part of the solution. If we each take off our little piece, it’s nuts how far we’ll be able to go, together as a society, in terms of solving this problem.

But we’ve got to own it, and acknowledge that trauma is everyone’s problem …
Definitely. This is not a poverty problem. This is not a race problem. This is a function of human biology. It is the way all of our bodies are wired. And now we can use this science to improve outcomes for everyone.
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