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Myths & Facts Behind The Campaign To Attack Disability Benefits
Media outlets including NPR and Fox News are targeting federal disability benefits programs through a campaign deceptively portraying these programs as wasteful and unsustainable. In reality, these programs have low fraud rates and help the rising number of Americans with severe disabilities survive when they are unable to work.
Is the recent increase in the number of people receiving disability benefits surprising?
Is there widespread fraud in disability programs?
Is it difficult to receive disability benefits?
Have medical advancements stopped the rise in disabilities?
Does the number of people receiving disability benefits harm the economy?
Do disability benefits for children help families?
Britain recently changed its disability benefits system. Should we copy that model?
MYTH: The Recent Rise In Disability Benefits Is "Astonishing"
Fox News' Rich Lowry: "The Growth ... Has Been Astonishing." As a guest on America Live, Fox News contributor and National Review editor Rich Lowry claimed the growth in the number of people receiving federal disability benefits "has been astonishing." [Fox News, America Live, 3/27/13]
NPR's Planet Money: The Rise Of Disability Benefits In America Is "Startling." A report on the public radio program Planet Money -- which was also featured on Chicago Public Radio's This American Life and NPR's All Things Considered -- was subtitled "The startling rise of disability in America" and claimed "the number of Americans who are on disability has skyrocketed." [NPR, Planet Money, 3/22/13]
FACT: Growth In Benefits Largely Due To Changing Demographics And The Financial Crisis
Demographic Changes Account For Much Of Disability Insurance Enrollment Growth
Former Social Security Commissioners: Social Security Actuaries Accurately Projected That Demographic Changes Would Fuel Growth In Disability Programs. Eight former commissioners of the Social Security Administration wrote an open letter in response to the story produced by NPR's Planet Money to express their "significant concerns" about the story's accuracy:
[T]he series aired on NPR sensationalizes this growth, as well as the DI trust fund's projected shortfall. History tells a less dramatic story. Since Social Security was enacted, Congress has "reallocated" payroll tax revenues across the OASI and DI trust funds - about equally in both directions - some 11 times to account for demographic shifts. In 1994, the last time such reallocation occurred, SSA actuaries projected that similar action would next be required in 2016. They were right on target. [An Open Letter from Former Commissioners of the Social Security Administration, 4/4/13]
CBPP: "Changes In The Workforce Explain Most Of The Growth In The Disability Rolls." According to the Center on Budget and Policy Priorities (CBPP), "[c]hanges in the workforce explain most of the growth in the disability rolls." CBPP explained:
Several important factors have swelled the number of disabled workers substantially during the last few decades:
- Baby boomers have aged into their high-disability years. Aging takes a toll on many workers' bodies and minds long before retirement age. People are roughly twice as likely to be disabled at age 50 as at age 40, and twice as likely to be disabled at age 60 as at age 50. (See Figure 2.) As the baby boomers -- the huge cohort of people born between 1946 and 1964 -- have grown older, the number of disability cases has risen substantially.
- More women have qualified for disability benefits. In general, workers with severe impairments can get disability benefits only if they have worked for at least one-fourth of their adult life and for five of the last ten years. Until women joined the workforce in significantly greater numbers in the 1970s and 1980s, relatively few women met those tests; as recently as 1990, male disabled workers outnumbered women by nearly 2 to 1. Now that more women have worked long enough to qualify for disability benefits, the ratio has fallen to 1.1 to 1. This has been a large factor behind the increase in the number of DI beneficiaries.
- Social Security's full retirement age rose from 65 to 66. When disabled workers reach full retirement age, they begin receiving Social Security retirement benefits rather than disability benefits. The increase in the retirement age has delayed that conversion for many workers. In December 2011, more than 400,000 people between 65 and 66 -- nearly 5 percent of all DI beneficiaries -- collected disabled-worker benefits; under the rules in place a decade ago, they would have been receiving retirement benefits instead. [Center on Budget and Policy Priorities, 8/9/12]
Increased Child Poverty And The Recession Account For Rise In Supplemental Security Income
CBPP: Number Of Children Receiving SSI Benefits Rising Due To Higher Rate Of Child Poverty And Prolonged Economic Downturn. CBPP found that the number of children receiving Supplemental Security Income (SSI) benefits for their disabilities has not risen substantially over the past decade, and explained that the recent temporary increase was due to the higher rate of child poverty and the prolonged economic downturn:
Is the number of children receiving SSI benefits mushrooming?
In a word, no. In October 2012, SSI provided monthly cash benefits to 1.3 million disabled children under age 18 whose families have low incomes and few assets (these are basic eligibility criteria) -- or about 1.7 percent of all children in the United States. That rate has inched up very gradually for the last decade, probably due to advances in detection and diagnosis of certain disabling conditions and the rising rate of child poverty, and has temporarily increased in the wake of the prolonged economic downturn, which has increased the number of families with low incomes and hence the number of disabled children eligible for SSI. [Center on Budget and Policy Priorities, 12/14/12]
CEPR: Increase In Child Poverty Made More Children With Disabilities Financially Eligible For Benefits. A presentation from the Center for Economic and Policy Research (CEPR) found that the "increased poverty rate among families with children" contributed to growth in individuals receiving SSI benefits because in order to be eligible for the program, families have to meet certain financial need requirements.
The presentation included the following graph:
[Center for Economic and Policy Research, 8/7/11]
For more information on media misrepresentations of federal programs that benefit the families of children with severe disabilities, click here.
MYTH: There Is Widespread Fraud In Federal Disability Programs
Fox News' Shannon Bream Suggested All Federal Disability Payments Are Fraudulent. Fox News reporter Shannon Bream, guest hosting America Live, pushed the notion that the fraud rate in federal disability programs is 100 percent, claiming "[t]here are reportedly 8.8 million people in the U.S. collecting disability benefits under false pretenses." In fact, 8.8 million is the total number of workers who received Social Security Disability Insurance in 2012. [Fox News, America Live, 2/4/13, via Media Matters]
Time Magazine's Joe Klein: Social Security Disability Is Full Of "Scammers." Time Magazine political columnist Joe Klein claimed that "the government has gotten sloppy about admissions" in Social Security disability programs, and that he knew from what people told him on road trips he had taken that "in all but the most severe cases" the recipients of benefits could work in public service jobs, which would decrease the number of "scam artists":
Now, to be sure, there are workers who fit the program's inevitable intent: older workers who suffer serious injuries and need support until they reach the age of eligibility for social security. There are others whose medical or mental disabilities make them clearly unable to work. But the government has gotten sloppy about admissions. Remember, a good chunk of people receiving welfare simply disappeared when the work requirement was added. The reason? They already had full-time jobs in the black or grey markets. It took a while, but a great many of those folks finally figured out there was another scam to be had--social security disability.
An argument can be made that it was humane to expand the SSD acceptance rate after the housing crash of 2008. There were no jobs to be had. But we are in recovery now--and scamming the system is never a good idea. The neighbors inevitably figure out who is gaming the system. The stories grow and become exaggerated--I've heard specific tales of abuse all over America on my road trips.
Indeed, in all but the most severe cases, there are public service jobs that can be done as a way of paying back--and a way of culling the scam artists. All too often, the scammers find support on the left from people who believe that free enterprise is inherently unfair and the "victims," even the unworthy poor, deserve any help they can get. That sort of thinking is insidious and morally deficient. [Time Magazine, In the Arena, 4/9/13]
Fox News' Megyn Kelly: "Just Because [The GAO] Didn't Unearth The Fraud Doesn't Mean It's Not Being Committed." On Fox News' America Live, host Megyn Kelly insisted fraud was "so high" in federal disability programs, despite the fact that the Government Accountability Office (GAO) found no evidence of widespread fraud:
KELLY: Nobody's going to question you, you've got bad heart disease, or you know, you can't work, people understand that. But people think fraud, when they see, you can never work again because of your depression? And now the federal taxpayer has to subsidize your life forever because you're depressed?
There's no question a lot of these claims are legit, and people have no problem supporting their fellow Americans in need, as I mentioned Rich, but you know, you've got, the numbers are just so staggering, it's not just the outlier cases. We covered a case earlier today on Fox of a cop who was getting disability payments and just charged with faking the injury when the feds caught him rocking out with his Brooklyn punk band, oh well. And it's not just one case, I mean you know you hear these stories all the time, in particular about some certain public service employees, who are suddenly permanently disabled, and we have to pay for them now through the rest of their lives.
Just because [the Government Accountability Office] didn't unearth the fraud doesn't mean it's not being committed. I mean, you can get a doctor to say that you've got permanent disabling depression or back pain, that doesn't, the GAO might not be able to snuff that out. You know, the numbers are just so high. [Fox News, America Live, 3/27/13]
FACT: Disability Fraud Is Minimal
GAO Found That Error Rate In Improper Payments Of Social Security Benefits Is Negligible. A FY2011 investigation by the Government Accountability Office found that improper payments of Social Security benefits that include Disability Insurance had an error rate of just 0.6 percent. [Government Accountability Office, 3/28/12]
SSA Deputy Commissioner: 99 Percent Of Social Security Disability Payments Are Accurate. The deputy commissioner of the Social Security Administration testified before the House Committee on Ways and Means that according to the administration's data, disability payments "are highly accurate":
Overall, our SSDI payments are highly accurate. Our most recent data show that, in FY 2010, 99.3 percent of all SSDI payments were free of an overpayment, and 99.0 percent were free of an underpayment. While we are proud of our high accuracy rate for SSDI payments, we recognize that our SSI overpayment accuracy rate falls short of that high standard. To a large extent, inaccuracy is inherent in the complex program rules and the delays in receiving income data. SSI payments can change each month due to income and resource fluctuations and changes in living arrangements. Our overpayment accuracy rate, though improving, reflects that complexity. In the SSI program, 93.3 percent of all payments were free of an overpayment, and 97.6 percent of all payments were free of an underpayment, a significant improvement from FY 2008. [Official Testimony before the House Committee on Ways and Means, Subcommittee on Social Security, 1/24/12]
Fmr. Social Security Commissioner Michael Astrue: Fraud Is Less Than 1 Percent Of SSI Payments. Former Bush Administration Social Security Commissioner Michael Astrue explained on MSNBC's All In with Chris Hayes that fraud constitutes less than 1 percent of the outlays of Supplemental Security Income, one of the federal benefit programs for individuals with disabilities. [MSNBC, All In with Chris Hayes, 4/5/13, via Mediaite]
MYTH: It Is "Easy" To Receive Disability Benefits
Fox's Steve Doocy: "It's Relatively Easy To Get On The Disability List." Fox & Friends co-host Steve Doocy said that the recent increase in disability applicants could "perhaps" be "a sign of a lousy economy," while claiming "it's relatively easy to get on the disability list, so, you know what, I need to feed my family, this is my last option." He concluded: "There should definitely be some different standards, better standards" for the screening of applicants. [Fox News, Fox & Friends, 12/6/12, via Media Matters]
Wash. Post's Charles Lane: Social Security Disability Has "Permissive Eligibility Criteria." Washington Post editorial writer Charles Lane claimed that "a growing body of economic and journalistic evidence suggests that SSDI reduces work incentives, because of its permissive eligibility criteria and relatively high benefits":
[A] growing body of economic and journalistic evidence suggests that SSDI reduces work incentives, because of its permissive eligibility criteria and relatively high benefits, as compared to low-wage workers' potential earnings.
Once a backup plan for dying or incapacitated workers near retirement age, SSDI now serves as ersatz unemployment insurance or welfare -- particularly attractive, and particularly hard to give up, in a sluggish economy.
[C]urrent SSDI eligibility rules reflect the outcry over efforts by presidents Jimmy Carter and Ronald Reagan to trim the rolls during an economic downturn. In 1984, an election year, Congress called a halt to the cutbacks, and Reagan assented. The permissive criteria enshrined in law that year account for much of the program's growth since. [The Washington Post, 4/8/13]
FACT: "Eligibility Criteria Are Stringent," And More Than Half Of Disability Claims Are Denied
SSA: "Denied Disability Claims Have Averaged Nearly 53 Percent." According to the most recent data available from the Social Security Administration, only 34.8 percent of applicants were successfully awarded disability benefits in 2010, down from 56.1 percent a decade earlier. Between 2001 and 2010, "[d]enied disability claims have averaged nearly 53 percent." From SSA:
The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2001 through 2010. The percentage of applicants awarded benefits at the initial claims level averaged 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied disability claims have averaged nearly 53 percent. [Social Security Administration, July 2012]
CBO: 61 Percent Of Initial Disability Claims Are Denied. According to research estimates from the non-partisan Congressional Budget Office (CBO), 61 percent of disability applicants are denied during the Initial Determination Stage. Twenty-seven percent of those applicants then appeal the decision, but only 3 percent of appeals are approved during Reconsideration, the first appeal stage. [Congressional Budget Office, 7/16/12]
GAO: SSA "Denied, On Average, 54 Percent" Of Supplemental Security Income Child Applicants And Recipients With Mental Impairments. According to the Government Accountability Office, "[t]he number of Supplemental Security Income (SSI) child applicants and recipients with mental impairments has increased substantially for more than a decade, even though the Social Security Administration (SSA) denied, on average, 54 percent of such claims from fiscal years 2000 to 2011." [Government Accountability Office, June 2012]
CBPP: "Eligibility Criteria Are Stringent" And Waiting Periods Are Typically Months Long. The Center on Budget and Policy Priorities noted that the eligibility criteria for disability insurance applicants are "stringent," that "applicants must show that they suffer from a 'severe, medically determinable physical or mental impairment that is expected to last 12 months or result in death,'" and that applicants must endure a significant waiting period:
The law requires that the impairment must already have lasted for at least five months before the applicant can qualify for DI. Together with the requirement that the impairment must be expected to last another 12 months or result in death, this emphasizes that DI is not a program for the temporarily disabled. SSI may be available during that period for very poor applicants; sick leave, private insurance, family resources, or savings might tide over others. The waiting period provides an intuitive reason why applications rise during recessions. In a robust economy, few workers will quit a job to subsist on little or nothing for five months with an uncertain prospect of a DI award; but in a recession, a spell of unemployment can last long enough for a disabled worker to be able to satisfy the waiting-period requirement.
Typical processing times at the DDS level are three to four months, and processing times at the hearing level average about a year. The allowance rate at the Administrative Law Judge (ALJ) level (also known as the hearing level, generally the second level of appeal) is quite high, which has led to some valid concerns about inconsistency in decisions; yet it is important to remember that ALJs are often seeing claimants whose condition has deteriorated since their application was turned down and whose case file is better documented when it reaches the ALJ (often with the help of an attorney) than it was at the DDS stage. [Center on Budget and Policy Priorities, 8/9/12]
President Of The Shriver Center: There's Nothing "Squishy" About The Disability Determination Process, "Once You Understand It." In response to NPR's Planet Money report on the recent rise in disability benefits that claimed the definition of disability was "squishy" and therefore difficult to determine with accuracy, President of the Shriver Center John Bourman wrote that Planet Money reporter Chana Joffe-Walt "apparently did not dig enough" to understand the disability determination process, which requires input from medical experts and an assessment of the severity of impairments:
Joffe-Walt says the disability definition is "squishy," especially with respect to impairments that are not readily visible, because "you can end up with one person with high blood pressure who is labeled disabled and another who is not." She apparently did not dig enough to find out that core inquiries in the disability determination process, which may be answered only by medical experts, are about the "severity" of impairments and the impact they have, when combined with all of the person's impairments, on his or her ability to function in the workplace. High blood pressure, in particular, is explicitly blocked from being the basis for disability all by itself. Thus, two people with high blood pressure of different severity, in the presence of different additional medical impairments, can easily fall on different sides of the disability line. Nothing "squishy" about it, once you understand it. [Huffington Post Media Blog, 3/29/13]
MYTH: Medical Advancements Mean Fewer People Have Disabilities
Fox News' Gretchen Carlson Suggested More People Cannot Have Disabilities Because Workplace Safety Has "Gotten Better." On Fox & Friends, co-host Gretchen Carlson questioned the rise in the number of people receiving disability benefits, asking, "What's happened? Is it that many more people who have actually become disabled? Because a lot of experts say nothing has really changed in the workplace for safety. If anything, it's gotten better for people that get injured." [Fox News, Fox & Friends, 4/8/13, via Media Matters]
NPR's Planet Money Questioned Rise In Disability Claims Because "Medical Advances Have Allowed Many More People To Remain On The Job." NPR's Planet Money report on disability benefits suggested the rise in the number of people receiving disability benefits was questionable because of "medical advances" that have "allowed many more people to remain on the job":
In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government. [NPR, Planet Money, 3/22/13]
FACT: Nearly 1 In 5 Americans Has A Disability, And Research Shows Disabling Conditions Are On The Rise
Census: "Nearly 1 In 5 People Have A Disability In The U.S." According to data from the U.S. Census Bureau, "[a]bout 56.7 million people -- 19 percent of the population -- had a disability in 2010," or roughly 1 in 5. Only about 14 million Americans receive benefits from federal disability programs. [United States Census Bureau, 7/25/12; Social Security Administration, April 2013]
SSA: "A 20-Year-Old Worker Has A 3-In-10 Chance Of Becoming Disabled Before Reaching Full Retirement Age." According to the Social Security Administration's handbook on federal disability insurance, "[s]tudies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching full retirement age." [Social Security Administration, June 2012]
Wash. Post: "Study Shows World's People Living Longer But With More Disability." The Washington Post reported that a new study showed that while advances in medicine mean people are living longer, they are also living with more disabilities, particularly conditions like mental illness and back pain, which are harder to treat and prevent than other disabilities:
People are living longer lives, but the time they are gaining isn't entirely time with good health. For every year of life expectancy added since 1990, about 9 1/2 months is time in good health. The rest is time in a diminished state -- in pain, immobility, mental incapacity or medical support such as dialysis. For people who survive to age 50, the added time is "discounted" even further. For every added year they get, only seven months are healthy.
"Progress in reducing disability just hasn't kept pace with progress in reducing mortality," said Joshua A. Salomon of the Harvard School of Public Health, one of the project leaders.
The trend of adding increasing amounts of bad health to life is known as the "expansion of morbidity." It is likely to be the biggest challenge to patients, doctors and people who pay for medical care for the next few centuries.
Mental illness (including addiction) is now responsible for 23 percent of "years lived with disability." Low-back pain is responsible for 11 percent. Those conditions are a lot harder to treat, or prevent, than childhood infections and malnutrition. [The Washington Post, 12/13/12]
NBER: Disability Beneficiaries With Mental And Musculoskeletal Disorders Live Longer With Their Disabilities. A National Bureau of Economic Research working paper explained that the increased number of individuals receiving disability benefits for mental and musculoskeletal disorders, such as arthritis and back pain, was due to "an early onset and low age-specific mortality" of those disorders:
Because mental and musculoskeletal disorders have an early onset and low age-specific mortality, Disability Insurance beneficiaries with these diagnoses experience relatively long durations on the program. Thus, in 1983, 4.9 percent of people receiving disability insurance in that year died; by 2004, only 3.1 percent of those receiving disability benefits in that year died. [National Bureau of Economic Research, August 2006]
Former Social Security Commissioners: About 1 In 5 Male And 1 In 7 Female Disability Beneficiaries Die Within Five Years Of Receiving Benefits. In their open letter response to NPR's Planet Money report on disability benefits, eight former commissioners of the Social Security Administration noted that "about 1 in 5 male DI beneficiaries and 1 in 7 female DI beneficiaries die within 5 years of receiving benefits." [An Open Letter from Former Commissioners of the Social Security Administration, 4/4/13]
CBPP: "People Who Collect DI Are At Least Three Times As Likely To Die As Other People Their Age." A blog post from The Center on Budget and Policy Priorities noted that disability insurance recipients were "at least three times as likely to die as other people their age":
People who collect DI are at least three times as likely to die as other people their age (see chart).
For some DI recipients, the health diagnoses are bleak: cancer, emphysema, congestive heart failure or kidney failure. Many other recipients' primary diagnoses, including mental disorders and impairments that affect their bones, muscles, and joints, aren't usually fatal by themselves -- though often recipients suffer from multiple conditions that can complicate their health.
Moreover, DI beneficiaries typically have low income, limited education, and a history of poor access to the health care system.
The report included the following chart:
[Center on Budget and Policy Priorities, Off the Charts, 4/4/13]
MYTH: People Receiving Disability Benefits Are Hurting The Economy
Charles Lane: Social Security Disability Caused Employment-To-Population Ratio To Decline. Washington Post editorial writer Charles Lane misleadingly cited research to claim that Social Security Disability payments harmed the economy and eroded the workforce, writing, "SSDI is one reason, in addition to recession and aging, that the U.S. ratio of employment to population declined from 62.5 percent to 58.5 percent in the past 10 years." [The Washington Post, 4/8/13]
WSJ: "Workers Stuck In Disability Stunt Economic Recovery." A Wall Street Journal article headlined "Workers Stuck in Disability Stunt Economic Recovery" claimed that "workers who piled into the Social Security Administration's disability program" were costing the economy billions by not instead participating in the labor force:
The unexpectedly large number of American workers who piled into the Social Security Administration's disability program during the recession and its aftermath threatens to cost the economy tens of billions a year in lost wages and diminished tax revenues.
Signs of the problem surfaced Friday, in a dismal jobs report that showed U.S. labor force participation rates falling last month to the lowest levels since 1979, the wrong direction for an economy that instead needs new legions of working men and women to drive growth and sustain a baby boomer generation headed to retirement. [The Wall Street Journal, 4/10/13]
FACT: Disability Benefits Have Minor Effect On Employment Data And People With Disabilities Face Greater Job Losses During Economic Downturns
Increased Employment Rates Among People Who Receive Disability Benefits Would Have A Minor Effect On Total Employment Figures
Wash. Post's Wonkblog: Disability Benefits Are Not "Luring Away People Who Could Work." Washington Post's Wonkblog interviewed Harold Pollack, an expert on disability policy at the University of Chicago's School of Social Service Administration, who explained that data show federal disability benefits are "not pulling people out of the workforce who would otherwise be there":
[Brad Plumer]: Now there's another big concern that once workers qualify for disability, they leave the labor force altogether. They never work again. Is that a real worry? Is the disability program really luring away people who could work?
[Harold Pollack]: I don't think so. One way to see this is to look at the employment rates for people who applied for disability but were then denied. And those are actually quite low, below 50 percent. That suggests we're not pulling people out of the workforce who would otherwise be there. [The Washington Post, Wonkblog, 3/28/13, emphasis original]
CEPR: Study Shows If More Individuals On Disability Benefits Worked It Would Have Minor Effect On Employment Figures. The Center for Economic and Policy research's Dean Baker responded to Charles Lane's aforementioned column in The Washington Post, pointing out that the study actually showed increasing employment rates among people receiving federal disability benefits would have a relatively minor effect on the employment-to-population ratio:
Lane's big club in his attack on the disability system is a new study from the University of Michigan. He quotes from the study:
"the employment rate of new beneficiaries would have been 28 percentage points higher in the absence of benefit receipt."
He then adds:
"SSDI is one reason, in addition to recession and aging, that the U.S. ratio of employment to population declined from 62.5 percent to 58.5 percent in the past 10 years."
This sure sounds like an interesting study. If we go to the study itself, we find in the abstract:
"We find that among the estimated 23% of applicants on the margin of program entry, employment would have been 28 percentage points higher had they not received benefits."
This means that we would see an increase in employment rates of 28 percentage points among the 23 percent who are considered marginal applicants if they had not received benefits. That translates into an increase in employment among all applicants of 6.4 percentage points. If we applied this to the entire population of 9 million workers getting disability, it would mean that employment would rise by about 580,000, or just over 0.25 percentage points of the civilian population.
In short, the paper cited by Lane implies that the bonanza for the government from cracking the whip is much smaller than he claims. It also suggests that any efforts to further tighten eligibility (only 40 percent of claims are approved) is likely to lead to many more people with real disabilities being denied benefits. [Center for Economic and Policy Research, Beat the Press, 4/9/13]
Individuals With Disabilities Were More Likely To Face Impediments To Work During The Economic Downturn
Senate Permanent Subcommittee On Investigations: "Between October 2008 And June 2010, Job Losses Among Workers With Disabilities Far Exceeded Those Of Workers Without Disabilities." In September, the Senate Permanent Subcommittee on Investigations submitted a report on Social Security disability programs. The report found that the increase in disability applications was partially a direct result of the financial crisis, and that "job losses among workers with disabilities far exceeded those of workers without disabilities":
The stress to the disability system was likely exacerbated when the financial crisis hit in 2008, resulting in a number of individuals losing jobs and, in turn, employer sponsored health insurance benefits. Census data indicated that between October 2008 and June 2010, job losses among workers with disabilities far exceeded those of workers without disabilities. Without health insurance, it is possible that chronic conditions held in check by medicine and treatment worsened and became more difficult to manage or even became disabling. Those workers potentially turned to federal disability insurance. In other cases, workers with disabling conditions who had refrained from applying for disability insurance because they were able to manage their impairments and sustain work, lost those paychecks, and then applied for disability insurance payments. [Senate Permanent Subcommittee on Investigations, 9/13/12]
Vice President Of National Academy Of Social Insurance: "Impediments To Work Are Compounded For People With Disabilities When The Economy Turns Sour." Bloomberg reported that "the number of people collecting disability surged as the economy contracted" and that this "gain follows a pattern typical of recessions because Social Security requires that claimants be unable to 'engage in any substantial gainful activity,' a stipulation more easily satisfied when jobs are scarce and wages get cut, according to Virginia Reno, vice-president for income security policy at the National Academy of Social Insurance in Washington." Bloomberg quoted Reno as further saying: "Impediments to work are compounded for people with disabilities when the economy turns sour and there are simply fewer jobs and greater competition for the jobs that remain." [Bloomberg, 5/3/12]
PBS: "During The Recession, Disabled Workers Were Hit Five Times As Hard As Other Workers When It Came To Losing Their Jobs." PBS' NewsHour reported that "during the recession, disabled workers were hit five times as hard as other workers when it came to losing their jobs. People with disabilities have also had more trouble finding new jobs during the recovery." [PBS, NewsHour, 7/26/12]
MYTH: Current System Does Not Help Children With Disabilities
NPR's Planet Money: "The Disability Program Stands In Opposition" To Supporting Children With Disabilities In Poverty. In its March disability report, NPR's Planet Money pushed a series of myths about Supplemental Security Insurance (SSI), a Social Security program that supports families that include children with disabilities. The report concluded that while a majority of Americans are in favor of "some form of government support for disabled children living in poverty" that should encourage children to attend and perform well at school, the current "disability program stands in opposition to every one of these aims":
I haven't taken a survey or anything, but I'm guessing a large majority of Americans would be in favor of some form of government support for disabled children living in poverty. We would have a hard time agreeing on exactly how we want to offer support, but I think there are some basic things we'd all agree on.
Kids should be encouraged to go to school. Kids should want to do well in school. Parents should want their kids to do well in school. Kids should be confident their parents can provide for them regardless of how they do in school. Kids should become more and more independent as they grow older and hopefully be able to support themselves at around age 18.
The disability program stands in opposition to every one of these aims. [National Public Radio, Planet Money, 3/22/13]
NY Times' Nick Kristof: Disability Benefits For Children Perpetuate Poverty. New York Times columnist Nicholas Kristof claimed that Supplemental Security Income (SSI) was "a program that sometimes perpetuates" poverty and argued that money should be taken away from the program to invest in other initiatives:
There's no doubt that some families with seriously disabled children receive a lifeline from S.S.I. But the bottom line is that we shouldn't try to fight poverty with a program that sometimes perpetuates it.
I hope that the budget negotiations in Washington may offer us a chance to take money from S.S.I. and invest in early childhood initiatives instead. [The New York Times, 12/7/12]
FACT: Social Security System Significantly Reduces Poverty For Children With Disabilities
NASI: "Families Raising Children With Disabilities Experience Higher Rates Of Economic Hardship." A report from the National Academy of Social Insurance (NASI) found that "families caring for a child with a disability are more likely than other families with children to experience various forms of economic insecurity," partly because many parents of children with disabilities "have to cut their hours or temporarily leave work to care for the disabled child":
Families caring for children with disabilities incur additional costs and burdens compared to other families with children. Recent research documents the impact on families caring for disabled children. Susan Parish and her colleagues find that families caring for a child with a disability are more likely than other families with children to experience various forms of economic insecurity.
[A]t each income level, families with a disabled child are more likely to experience hardship than families at the same income level, but with nondisabled children. Higher rates of insecurity persist for families with disabled children when incomes are up to twice the poverty level, with more than two thirds of families at those income levels experiencing food insecurity.
Families raising children with disabilities experience higher rates of economic hardship in part because they face additional costs associated with their child's disability, and in part due to foregone parent earnings. Many parents of disabled children -- typically mothers -- have to cut their hours or temporarily leave work to care for the disabled child.
The report included the following graph:
[National Academy of Social Insurance, Social Security Brief, November 2012]
CAP: SSI "Reduces Poverty And Increases Economic Security." The Center for American Progress (CAP) cited research from economists Mark Duggan and Melissa Schettini Kearney which found that receiving Supplemental Security benefits reduces poverty and increases the economic security of families:
Reduces poverty and increases economic security: Supplement Security increases the economic security of families caring for disabled children. Economists Mark Duggan and Melissa Schettini Kearney found that once families with disabled children start receiving Supplemental Security, their overall household income increases by 20 percent on average, and the likelihood of having income below the federal poverty line decreases by about 11 percent. At the same time, the amount of household income derived from the Supplemental Nutrition Assistance Program, Special Supplemental Nutrition Program for Women, Infants and Children, and Temporary Assistance to Needy Families declines. [Center for American Progress, 9/10/12, emphasis original]
NBER: SSI Reduces The Chance A Child Lives In Poverty By 11 Percentage Points. An August 2005 National Bureau of Economic Research working paper found that enrollment in Supplemental Security Insurance "is associated with a statistically significant and persistent reduction in the probability that a child lives in poverty of roughly 11 percentage points." [National Bureau of Economic Research, August 2005]
MYTH: Britain's New Disability System Is A Good Model For Reform
Fox Business' Stuart Varney: Britain's Tests For Disability Eligibility "Exposed A Giant Scam." Fox Business host Stuart Varney claimed on Fox & Friends that it was easy to receive Social Security disability benefits because individuals did not have to "prove" their disability, and further claimed that revisions to the British disability benefit system, which included a test for identifying fraud in the system, "worked" and "exposed a giant scam":
BRIAN KILMEADE (host): Stuart, I thought it was interesting as you told us in the break, the British had the same problem, and they hired a French company to come in and evaluate the legitimacy of these claims. Did it work?
STUART VARNEY: Well it worked, in the sense that it exposed a giant scam. In Britain, they did, it was a computer test. They didn't say go get checked by a doctor, they ran the records through a computer, this is what the French company did. They found that half the people getting these benefits were in fact capable of working. And one-third of the recipients, they were scamming, basically. They walked away, they would walk away if they were subjected to any kind of test. So the British system, they call it incapacity benefit, not disability. It's a giant scam. That's what it is. [Fox News, Fox & Friends, 4/8/13, via Media Matters]
Fox News Contributor Jonah Goldberg: The U.S. Should Emulate Britain And Ask Recipients Of Disability Benefits To Take A Medical Exam To Prove Their Disability. In a column featured in the New York Post and Los Angeles Times, Fox News contributor Jonah Goldberg argued that one way to determine whether there was widespread fraud in disability programs was "to ask every recipient to get a thorough examination, just as they did in Britain":
The British government recently asked everyone receiving an "incapacity benefit" -- a disability program slowly being phased out under new reforms -- to submit to a medical test to confirm they were too disabled to work. A third of recipients (878,000 people) dropped out of the program rather than be examined. Of those tested, more than half (55 percent) were found fit for work, and a quarter were found fit for some work.
But that's Britain, where there's a long tradition of gaming the dole. Americans would never think of taking advantage of the taxpayers or misleading the government. Well, except for the couple dozen people who have pleaded guilty to scamming the LIRR's federal disability system in a $1 billion fraud scheme. A billion bucks would pay for a lot of White House tours.
That points to the even bigger parts of the story. As the nature of the economy changes, disability programs are sometimes taking the place of welfare for those who feel locked out of the workforce -- and state governments are loving it. States pay for welfare, the feds pay for disabilities.
There are those who are quick to argue that this is all bogus, there's nothing amiss with the disability system that greater funding and a better economy won't fix. Maybe they're right. One way to find out would be to ask every recipient to get a thorough examination, just as they did in Britain. Maybe the results here in the United States would be interesting too. [New York Post, 4/2/13]
FACT: UK Disability Benefits Tests Were Largely Overturned On Appeal, And Further Cuts Will Plunge Thousands Of People With Disabilities Into Poverty
BBC: 40 Percent Of New Disability Eligibility Tests Were Overturned On Appeal. BBC News reported that the initial tests evaluating disability claims in the U.K. found roughly 23 percent of recipients were no longer eligible for benefits, and roughly half were "capable of some work." However, the BBC explained that a majority of those decisions were appealed, and 40 percent of the appeals were successful, reversing the initial decision and reinstating benefits for the individual. [BBC News, 3/25/12]
Demos: "Disabled Families Across The Country Faced Significant Reductions In Their Household Income" Following Initial Cuts To Disability Benefits. Demos, a cross-party think tank, studied the impact of cuts to individuals with disabilities in Britain following budget changes in June 2010, and looked at five families that included individuals with disabilities. They found "disabled families across the country faced significant reductions in their household income," and concluded "the deepest cuts were yet to take effect":
We calculated how the welfare reforms announced in the Emergency Budget and in the run up to the Spending Review would affect five typical disabled families. Our research showed that, far from being protected from the worst of the cuts, disabled families across the country faced significant reductions in their household income. Losses of two to three thousand pounds over the course of the next parliament were typical and overall, we estimated that disabled people would lose £9 billion in welfare support in the next five years.
Demos has now published the final instalment of the study, Destination Unknown: Summer 2012. The report found that despite the drop in income and worsening conditions for each of our five families over the preceding two years, the deepest cuts were yet to take effect. [Demos, accessed 4/24/13]
Demos: New Disability Benefit System "Most Likely To Increase Disability Poverty Rather Than Incentivise Work." Demos found that the new disability benefit system the UK is implementing in 2013, known as the Disability Living Allowance (DLA), is "most likely to increase disability poverty rather than incentivise work":
However, there are four concerning aspects to the nature of the reforms which are accompanying them. The first is that the government believes cutting benefits will inevitably incentivise work. This takes no account of those who may be unable to work (those with complex needs as well as carers) or those who can only work with personalised support. For these groups, cutting benefits will undermine their quality of life and little else. The second is that DLA, the only benefit which compensates for the additional costs of living with a disability and is non-means tested, is increasingly mis-represented as an 'out of work' benefit and so subject to the same cuts as other benefits to 'incentivise work'. Again, this is most likely to increase disability poverty rather than incentivise work. The third is an increasing focus on the medical aspect of disability, to the detriment of the social model - that is, a recognition that social and practical factors have a role to play in a person's disability, not just their medical impairment. This is leading to the adoption of exclusively medical testing to assess eligibility for incapacity benefits and even DLA - which can only feasibly be based on a calculation of additional living costs. The fourth and final problem is the government's exclusive focus on people's economic contribution to society. Finding employment is seen as the only successful outcome for welfare-to-work providers to achieve. This creates perverse incentives only to help those who are easiest to employ; it overlooks those who may not be able to engage in formal employment but who can contribute to society in other ways (eg volunteering, building social capital), and it also leads to work programmes that do not build people's capabilities or recognise distance travelled towards employability. This is particularly inappropriate in the current economic climate, where jobs are harder to come by. [Demos, accessed 4/24/13]
The Guardian: Research Shows Benefit Cuts Will "Plunge Tens Of Thousands Of Disabled People Deeper Into Poverty." The Guardian reported that research shows further reforms to the disability system in the U.K. will "plunge tens of thousands of disabled people deeper into poverty":
Thousands of disabled people will be hit by up to six different welfare cuts, with the very worst off potentially losing up to £23,000 each over five years, research shows.
The effect of the changes, the bulk of which kick in after 1 April, will be to plunge tens of thousands of disabled people deeper into poverty, says a study that captures the multiple impacts of social security reforms for the first time.
The research, carried out for the Guardian, estimates that by 2017-18 about 3.7 million disabled people will collectively lose £28bn as a result of the reforms. Individuals will be hit by one of seven combinations of welfare cuts and small numbers could lose more than £20,000 each. [The Guardian, 3/26/13]


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Colored wood pieces on wire and chain
That's Right!!! We have opened another location in Vista, California. For more information see below.
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First Aid is essential for the immediate treatments of accidents before help from the emergency services arrive. Taking this course could really mean the difference between life and death and help minimize the severity of an injury. The objective of the course is to ensure that an individual is aware of basic first aid techniques until a qualified First Aider arrives at the scene.
At the end of the course, trainees will:
- Appreciate the importance of first aid at work
- Recognize the legal obligations and minimum provisions with respect to first aid
- Identify the correct steps when responding to an accident, incident or injury
- Take appropriate action in response to accidents and emergencies at work.
Who would benefit from the course?
This course is designed not only to make employees appreciate the importance of fist aid at work but also learn how to correctly respond to various incidents, accidents or injuries and take appropriate actions accordingly.
Course Format : Video
Running Time: 30-40 minutes
First aid in the workplace for employees is delivered online as an interactive course to each trainee on their computers, or Apple and Android mobile devices at any internet enabled location. The interactive course is engaging, informative and exciting to use.
Using up-to-date, modern graphical images, users will be faced with a selection of interactive elements and mini quizzes to test their knowledge. Users will receive informative advice and guidance and will be tested on their understanding of the subject at the end of the course by completing the compulsory self-test.
This course also features a risk checklist which asks the user a series of questions relating to their current working environment.
Contact our Expert to find the best safety course training
On successfully completing the assessment, the delegate would obtain a completion certificate and can print a wallet card with a unique identifier number. These can be checked either by scanning the QR code or in the 'Check a Card' function on the home page of Human Focus International LMS.


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Glenn Beck's Ad Dollars Crater in Wake of Boycott
Now we know why Glenn Beck hates Van Jones so much: Fox News' ad revenue from Beck's show has been cut in half since Color of Change launched an advertiser boycott against the show.
Color of Change, the advocacy organization co-founded by Glenn Beck's archnemesis Jones, began calling on advertisers to pull their ads from Beck's show in early August, shortly after Beck accused Obama of having a "deep-seated hatred for white people." Since then, 62 advertisers—from Geico to Proctor & Gamble to Men's Wearhouse—have pulled their ads from his show even as his ratings surged.
Fox's stock response to the boycott has been that, while some advertisers may have moved their spots to other shows on the network, no one was pulling ads from Fox outright, so the whole hubbub wasn't affecting the network's revenues. But today, citing "data analyzed from industry sources," Color of Change announced in a release that Beck's weekly ad revenue dropped from $1,060,000 in the first week of August, when the boycott began, to $492,000 in the first week of September. The chart above shows the drop.
Color of Change's release doesn't say where it got that data, but we've been told the source and shown the raw data on the condition that we don't reveal where it came from: a well-known firm that tracks advertising revenue and sells its proprietary data. The firm monitors advertising on shows and uses rate-cards, ratings information, and its own industry contacts to estimate how much advertisers paid for each spot. While the firm sometimes performs analysis for the media, it generally doesn't like its proprietary information becoming public, which is why Color of Change won't let anyone say where it came from. While the numbers are only estimates and can't really account for the sorts of deals networks make with advertisers all the time, the firm is respected and regularly used as a best-guess estimate of ad revenue.
The chart puts the lie to Fox's claim about ads just shifting around the network—that may be true, but salesmen sell shows, and at some point the dearth of people who are willing to use Beck's paranoid sideshow to promote their brands has to affect pricing. And as we've shown before, he's been pretty much reduced to shilling for penis-enlargers and miracle egg-cookers. We've asked Fox for comment, but they haven't responded and almost certainly won't. UPDATE: They did! Kind of—a Fox spokeswoman directed us to the response they offered to TVNewser: "The Color of Change figures are wildly inaccurate on all fronts — revenue has not been affected in any way."
The irony here is that the revenue plunge comes during a month when Beck's ratings were off the charts, and Fox couldn't even capitalize on it. And in Beck's defense, the biggest week-to-week drop—from nearly $900,000 during the week ending August 16 to to just over $500,000 during the week ending August 23—came when he was off the air.


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When indefinite becomes arbitrary: James, Wells and Lee v UK
24 September 2012
JAMES, WELLS AND LEE v. THE UNITED KINGDOM – 25119/09 57715/09 57877/09 – HEJUD [2012] ECHR 1706 – Read judgment / press release
As Andrew Tickell noted in his post on Wednesday the European Court of Human Rights this week ruled that the UK violated the Article 5(1) ECHR rights of three prisoners sentenced to indeterminate prison sentences for public protection, where reasonable provision for their rehabilitation was not made.
In April 2005, the Government introduced indeterminate imprisonment for the public protection, or "IPP sentences", whereby certain prisoners would not have a right to parole. Instead, under section 225 of the Criminal Justice Act 2003, they would remain in prison following expiry of their tariff periods until a Parole Board had decided they were no longer a risk to the public. Prior to an amendment in 2008, an IPP sentence was mandatory where there was a future risk of further offending, and there was an assumption of risk where there was a previous conviction for a violent or sexual offence unless the sentencing judge considered it unreasonable to make such an assumption.
James, Wells and Lee
Last week, three men who found themselves on the wrong end of IPP sentences under the 2005 scheme were successful in their applications before the European Court of Human Rights. The Court held unanimously that the failure to make appropriate provision for rehabilitation services resulted in breaches of Article 5(1) of the European Convention on Human Rights, which protects the individual from arbitrary detention.
Despite the introduction of the IPP scheme being premised upon rehabilitation services being made available to offenders, the Court observed that there had been considerable delays and that the applicants "had no realistic chance of making objective progress" towards parole. It considered that this had been the result of "lack of resources, planning and realistic consideration of the impact of the sentencing scheme introduced in 2005," which has since been applied to more than 6,000 offenders.
The applicants were recommended to take part in various rehabilitative courses, which are administered in the main by certain lifer prisons around the country. Yet, by the expiry of their tariffs, and some two and a half years post-tariff, each remained in his local prison unable to begin processing through the prison system in order to eventually emerge – he would hope – from the other end. The Court noted that it took a further five months post-transfer for Mr Lee to begin work under a rehabilitative programme – a delay of 34 months in the context of a nine-month tariff.
This important judgment shows that the lawfulness of indeterminate sentences based on offenders' risk to the public must depend upon the extent to which that risk is addressed in detention.
Strasbourg's approach differed from that of the domestic courts when confronted by the applicants' Catch 22 predicament: they complained that they could not show that they were rehabilitated and therefore suitable for release because of the failure to ensure that they had access to the courses that would progress their rehabilitation. The Court of Appeal (Secretary of State for Justice v Walker [2008] EWCA Civ 30) and House of Lords (Secretary of State for Justice v James [2009] UKHL 22) had been united in their criticism of the Secretary of State's failure to provide adequate resources with which to meet his public law duty, yet each had fallen short of finding the detention to be unlawful in and of itself.
Despite noting the Secretary of State's "deplorable" failure to meet his public law duty, the House of Lords had found no rupture in the causal connection between the ground of detention and the detention itself. In the Court of Appeal in James, Lord Phillips' starting point had been that the primary object of the IPP sentence was to protect the public, not to rehabilitate. For his Lordship, concerns from an Article 5 perspective only arose when the stage was reached that detention was no longer necessary for protection of the public, or where so long had elapsed without a meaningful detention review that detention had to be considered arbitrary.
By contrast, the European Court essentially viewed protecting the public and rehabilitation as two sides of the same coin. A real opportunity for rehabilitation was "a necessary element of any part of the detention which is to be justified solely by reference to public protection." Detention for public protection could not be allowed to "open the door to arbitrary detention." Reasonable provision of rehabilitative services was all that was required. Yes, persons could be detained indefinitely on the grounds of public protection from the risk they posed, but the system had to provide for those risks to be reduced through rehabilitation. As the courts below recognised, this was the basis upon which the Secretary of State had laid the enabling statutory provision before Parliament. It was, for Laws LJ in the Divisional Court in Wells, "inherent" in the way the legislation was intended to work in practice. It appears that for the Strasbourg Court, however, it was also inherent to the question of lawfulness.
In the House of Lords, Lord Judge had insisted that an IPP sentence did not render prisoners "confined to penal oblivion. To the contrary, common humanity, if nothing else, must allow for the possibility of rehabilitation." Yet, whatever the level of humanity involved, it is now clear that proper resourcing and planning was required in order to ensure that a prisoner progressed along the continuum between offending and release, within which rehabilitative courses are an accepted vital stage. Instead, short-tariff prisoners like the applicants might well find themselves in a position that feels very much like penal oblivion.
The Court's judgment could have immediate, practical consequences. Whilst, unsurprisingly, the Ministry of Justice does not intend to release the 3,531 prisoners currently being held beyond their tariff dates on IPPs and intends to appeal the Court's judgment. The Prison Reform Trust is calling upon the Justice Secretary to urgently review those cases.
There is perhaps an additional headache for the Justice Secretary as the judgment could pave the way for damages claims brought on behalf of those 3,531 people, as well as other IPP prisoners who have been released but were themselves arbitrarily deprived of their liberty as a result of the systemic failings noted by the Court. These could be grounded in the tort of false imprisonment and/or Section 8 of the Human Rights Act 1998. Whilst HRA claims would be limited to relatively low awards reflecting "just satisfaction" within the meaning of Article 41 ECHR (the applicants received only a few thousand Euros each), proceedings in tort could lead to much larger damages payments, especially for prisoners considered to have been held arbitrarily for periods of months or years.
This could lead to further drain on a public purse already lightened by the need to fund the detention of prisoners who might have been suitable for release long ago had prisons been provided with the promised resources.
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Related posts:
- The UK and Strasbourg: a victim fantasy
- Courts should take note of Strasboug's doctrine of deference
- European Court of Human Rights retreats but doesn't surrender on prisoner votes
- Refusal of child care leave to female prisoners was unlawful, rules High Court
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SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
Print version ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.101 n.1 Pretoria Jan. 2011
Down syndrome in paediatric outpatient wards at Durban hospitals
Horacia NaidooI; Colleen AldousIII; Hemendra RamdhaniIV; William WinshipV; Nadine HenriquesVI; Emil KormuthII
IBSc (Hons). School of Biochemistry, Genetics and Microbiology, University of KwaZulu-Natal, Durban
IIPhD. School of Biochemistry, Genetics and Microbiology, University of KwaZulu-Natal, Durban
IIIPhD. Nelson R Mandela School of Medicine, University of KwaZulu-Natal
IVMB ChB, DCH (SA), FCPaed (SA), Cert (Medical Genetics) (SA). Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal
VMB ChB, MMed (Paed). Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal
VIMB ChB, DCH, FC Paeds. Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal
To the Editor: The birth of a child with Down syndrome (DS) has many serious implications - physical and mental deficiencies, medical conditions and lifestyle challenges.1 The high incidence (1 in 600 births in South Africa2) and high cost of medical care highlight the need for effective health care.2 The South African Human Genetic Policy Guidelines include a rudimentary list pertaining to the management of DS.2 In the USA, the American Academy of Pediatrics (AAP) has addressed this issue by devising clinical protocols3 focusing on improving the level of functioning and quality of life of children with DS. Countries such as Thailand4 and, to a lesser extent, South Africa, in KwaZulu-Natal,2 have adopted and adapted these guidelines. The importance of the guidelines for clinical and counselling practices and their routine adherence is a daily challenge for 3 Durban hospitals with a total of 2 staff members dedicated to genetic matters.
DS studies4,5 have recognised the value of routine screening tests and genetic counselling, as they pre-empt the need for targeted therapy, early intervention programmes and support groups, which results in better quality of health and significant developmental progress.
We investigated and compared the clinical management of DS children at King Edward VIII, Prince Mshiyeni and Inkosi Albert Luthuli Central Hospitals in Durban with that occurring in countries such as Thailand, where the guidelines are implemented.4
Medical chart checklists in accordance with AAP guidelines3 (Table I) were used to record information from hospital charts (Biomedical Research Ethics ref. no. BE100/08), to compare the care received by DS children and their families at Durban hospitals with the AAP recommendations and that observed in the Thai study.4 The 72 most recently treated cases of DS were assessed, and the relevant clinical staff facilitated the provision of further patient information including observation of routine patient practice in dealing with DS.
The data were captured on a Microsoft Excel spreadsheet, which allowed simple derivation of the frequencies of DS in maternal age groups, patient age groups, screening tests and counselling performed. The frequencies of screening tests conducted and genetic counselling services offered were used as a measure of efficiency of health care and compared with AAP recommendations and findings reported by a study conducted in Thailand.4
Table II shows the standard of clinical care offered to paediatric DS patients in this study in terms of screening tests and genetic counselling services, and a comparison with that observed in a Thai study4 and the AAP recommendations.3 The Thai study did not have recorded data for antenatal counselling and support group referrals.
Irregularly performed screening tests and minimal genetic counselling indicate a need for specific DS guidelines for the strict adherence and employment criteria of genetic staff.
The SA guidelines2 on the clinical management of DS offer a generalised list rather than a specific protocol. They include points addressing advanced maternal age, prenatal and postnatal diagnosis, preventive measures, rehabilitation and genetic counselling. Although relevant, there are no specific and utilisable clinical protocols on the management of DS patients in terms of the types of screening tests, preventive measures and rehabilitation. They also lack focus on the factors of age groups and development of DS patients.
Our study indicated a significant difference between AAP guidelines (Table I), the statistics from the Thai study, and the observed frequencies of tests and services offered cumulatively at the three Durban hospitals (Table II). While the Thai study adhered to the AAP recommendations, the Durban hospitals lagged in both screening tests (thyroid function, hearing and vision) and genetic counselling services (antenatal and support groups). However, screening tests for cardiac defects were performed often (84.7%) owing to their frequent occurrence and cause of morbidity and mortality in DS.6
Another concern is the large number of mothers (42.9%) of advanced maternal age and low frequency of antenatal counselling observed in the study. Advanced maternal age (a crucial factor in DS, illustrated by 80% of births being to mothers >35 years old) should be considered in a resource-poor setting such as South Africa.
Regarding genetic staff, there was during the study one full-time geneticist, one part-time geneticist, and no genetic counsellors employed across the three hospitals - a stark contrast to the recommendations made by the Human Genetics Policy of SA which prescribes a minimum of 36 genetic counsellors and 18 medical geneticists for KZN.2 The subsequent inadequate clinical care of DS patients is highlighted in this study and has prompted media attention and lawsuits for negligence.7
The provincial and national health departments bear the ultimate responsibility for implementing an agreed set of protocols that are strictly adhered to, and for employing sufficient genetic staff to ensure effective health care for DS patients and their families. Besides the financial benefit of a largely preventive health care programme, the quality of life of DS patients and their families will increase exponentially while alleviating the strain on the health care system.
We gratefully acknowledge the National Research Foundation (NRF) for funding, and the University of KwaZulu-Natal for a postgraduate scholarship.
1. Antonarakis SE, Lyle R, Dermitzakis ET, Reymond A, Deutsch S. Chromosome 21 and Down syndrome: From genomics to pathophysiology. Nat Rev Genet 2004;5:725-738. [ Links ]
2. National Department of Health. Human Genetics Policy Guidelines for the Management and Prevention of Genetic Disorders, Birth Defects and Disabilities. Pretoria: Department of Health, 2000. [ Links ]
3. Cunniff C, Frias JL, Kaye C, Moeschler JB, Panny SR, Trotter TL. Health supervision for children with Down syndrome. Pediatrics 2001;107(2):442-449. [ Links ]
4. Wasant P, Boonyawat B, Tritilanunt S, et al. Factors influencing development of Down syndrome children in the first three years of life: Siriraj Experience J Med Assoc Thai 2008;91(7):1030-1037. [ Links ]
5. Thornton Jones H, Hampshaw S, Solton H, Madhok R. Reviewing local screening policies - a worthwhile exercise? British Journal of Clinical Governance 2002;7(3):165-176. [ Links ]
6. Fuchs KM, Peripert JF. First trimester Down syndrome screening: Public health implications. Semin Perinatol 2005;29:267-271. [ Links ]
7. Naidu E. Our disastrous doctors. The Sunday Tribune. Durban: 2 May 2010.
Accepted 17 September 2010.
Corresponding author: H Naidoo (firstname.lastname@example.com)


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"The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary." ~ H.L. Mencken
Cops Are Now Less Cautious Than Soldiers In Iraq
"Since returning from my service as an Army combat medic in Baghdad six years ago, I have watched American police become more aggressively violent than my fellow soldiers and I were ever trained to be."
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Jonathan Carp may not be an STR model, but his words shriek with the sour breath of reality. It seems, according to Carp, that the military has a better handle on how to police than the currently employed storm troopers in uniform here. I have the same feeling. With all the new whizbang gizmos available on the market today to produce a less violent situation you would think the LEO agencies would be training more and policies changed to reflect a new approach rather than what Cathy Lanier purports "these officers did exactly what they were supposed to do."
I believe these actions to be nothing more than a forecast of the future of this nation.
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In the 2016 race, June belonged to two outsiders who could not be more dissimilar.
Bernie Sanders is a socialist senator from Vermont and Donald Trump a celebrity capitalist and legendary entrepreneur and builder.
What do they have in common? Both have tapped into what the bases of their respective parties believe is wrong with America.
Bernie is the Willie Nelson of national politics, a leftist voice of a working class whose jobs and factories have been exported and whose wages have stagnated as banksters and the Davos-Doha crowd amass mammoth fortunes by playing games of three-dimensional Monopoly.
The 73-year-old Sanders may have no chance of beating Hillary. But the size of his crowds testifies that he speaks for millions.
Trump's success comes from the issues he has seized upon—illegal immigration and trade deals that deindustrialized America—and brazen defiance of Republican elites and a media establishment.
By now the whole world has heard Trump's declaration:
"When Mexico sends its people, they're not sending their best. . . . They're sending people that have lots of problems, and they're bringing those problems to us. They're bringing drugs. They're bringing crime. They're rapists. And some, I assume, are good people."
Politically incorrect? You betcha.
Yet, is Trump not raising a valid issue? Is there not truth in what he said? Is not illegal immigration, and criminals crossing our Southern border, an issue of national import, indeed, of national security?
Women and girls crossing Mexico on trains are raped by gangs. The "coyotes" leading people illegally across the U.S. border include robbers, rapists and killers, who often leave these people to die in the desert.
"State of Emergency: The Third World Invasion and Conquest of America" by this writer in 2006 cited researcher Heather Mac Donald of Manhattan Institute. She reported that two-thirds of the 17,000 outstanding fugitive felony warrants in Los Angeles were for illegal immigrants, as were 95 percent of 1,200-1,500 outstanding warrants for homicide.
Of 20,000 members of the 18th Street Gang operating across Southern California, 12,000 were illegal immigrants. One of the Beltway Snipers, who terrorized the D.C. area, shooting 13 and killing 10, was a 17-year-old illegal immigrant from Jamaica, John Lee Malvo.
The reaction to Trump's comments has been instructive. NBC and Univision dropped his Miss USA and Miss Universe contests. Macy's has dropped the Trump clothing line. New York Mayor Bill de Blasio is talking of terminating city contracts with Trump.
The reaction of Trump's Republican rivals has been even more instructive. Initially, it was muted. But when major media began to demand that GOP candidates either denounce Trump or come under suspicion or racism themselves, the panic and pile-on began.
As The Washington Times relates, at a July 4 parade in New Hampshire, Jeb Bush said Trump "doesn't represent the Republican Party or its values.
"I don't assume that he thinks that every Mexican crossing the border is a rapist. . . . So he's doing this to inflame and to incite and to draw attention, which seems to be his organizing principle of his campaign."
Sen. Marco Rubio also found his voice. Trump's comments "were not just offensive and inaccurate, but also divisive."
Imagine that, "divisive" politics.
Ex-Gov. Rick Perry said Trump's remarks were "offensive," as "Hispanics in America and Hispanics in Texas, from the Alamo to Afghanistan, have been extraordinary . . . citizens of our country."
But most of the Hispanics at the Alamo were in the Mexican army of Santa Anna, not under Col. Travis, and hardly "extraordinary citizens of our country" as Texas did not even belong to the USA then.
Sen. Ted Cruz on NBC's "Meet the Press" took a different stance: "I salute Donald Trump for focusing on the need to address illegal immigration."
"The Washington cartel doesn't want to address that. The Washington cartel doesn't believe we need to secure the border. The Washington cartel supports amnesty, and I think amnesty's wrong."
Trump "has a colorful way of speaking," said Cruz, "It's not the way I speak. But I'm not going to engage in the media's game of throwing rocks and attacking other Republicans." Cruz might have added, "like Jeb and Rick and Marco are doing."
What Trump has done, and Cruz sees it, is to have elevated the illegal immigration issue, taken a tough line, and is now attacking GOP rivals who have dithered or done nothing to deal with it.
Trump intends to exploit the illegal immigration issue, and the trade issue, where majorities of middle-class Americans oppose the elites. And he is going to ride them as far as he can in the Republican primaries.
In the coming debates, look for Trump to take the populist and popular side of them both. And for Cruz to stand by him on illegal immigration.
Americans are fed up with words; they want action. Trump is moving in the polls because, whatever else he may be, he is a man of action.
Patrick J. Buchanan is the author of the new book The Greatest Comeback: How Richard Nixon Rose From Defeat to Create the New Majority. To find out more about Patrick Buchanan and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.


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Deep Learning
What it is and why it matters
Deep learning is a type of machine learning that trains a computer to perform human-like tasks, such as recognizing speech, identifying images or making predictions. Instead of organizing data to run through predefined equations, deep learning sets up basic parameters about the data and trains the computer to learn on its own by recognizing patterns using many layers of processing.
The evolution of deep learning
Deep learning is one of the foundations of artificial intelligence (AI), and the current interest in deep learning is due in part to the buzz surrounding AI. Deep learning techniques have improved the ability to classify, recognize, detect and describe – in one word, understand.
For example, deep learning is used to classify images, recognize speech, detect objects and describe content. Systems such as Siri and Cortana are powered, in part, by deep learning.
Several developments are now advancing deep learning:
- Algorithmic improvements have boosted the performance of deep learning methods.
- New machine learning approaches have improved accuracy of models.
- New classes of neural networks have been developed that fit well for applications like text translation and image classification.
- We have a lot more data available to build neural networks with many deep layers, including streaming data from the Internet of Things, textual data from social media, physicians notes and investigative transcripts.
- Computational advances of distributed cloud computing and graphics processing units have put incredible computing power at our disposal. This level of computing power is necessary to train deep algorithms.
At the same time, human-to-machine interfaces have evolved greatly as well. The mouse and the keyboard are being replaced with gesture, swipe, touch and natural language, ushering in a renewed interest in AI and deep learning.
Deep Learning for Animal Conservation
How does a computer "see" an image? Jared Peterson, Senior Manager of SAS Advanced Analytics R&D, shows how deep learning neural networks are the science behind computer vision.
In this deep learning example, the computer program is learning to interpret animal tracks to help with animal conservation.
Deep learning opportunities and applications
A lot of computational power is needed to solve deep learning problems because of the iterative nature of deep learning algorithms, their complexity as the number of layers increase, and the large volumes of data needed to train the networks.
The dynamic nature of deep learning methods – their ability to continuously improve and adapt to changes in the underlying information pattern – presents a great opportunity to introduce more dynamic behavior into analytics.
Greater personalization of customer analytics is one possibility. Another great opportunity is to improve accuracy and performance in applications where neural networks have been used for a long time. Through better algorithms and more computing power, we can add greater depth.
While the current market focus of deep learning techniques is in applications of cognitive computing, there is also great potential in more traditional analytics applications, for example, time series analysis.
Another opportunity is to simply be more efficient and streamlined in existing analytical operations. Recently, SAS experimented with deep neural networks in speech-to-text transcription problems. Compared to the standard techniques, the word-error-rate decreased by more than 10 percent when deep neural networks were applied. They also eliminated about 10 steps of data preprocessing, feature engineering and modeling. The impressive performance gains and the time savings when compared to feature engineering signify a paradigm shift.
Deep learning in today's world
The impact that the deep learning has had on the world has been significant – and it's only getting started. Learn more about what people are saying.
Looking beyond the deep learning hype
Why is deep learning unequaled among machine learning techniques? It has achieved success in a wide range of tasks were difficult for computers to accomplish in the past, especially in the areas of machine perception. Learn more about how deep learning works and why it's not overhyped.
How to do deep learning with SAS®
Find out how deep learning techniques are developed and deployed using SAS software. This step-by-step guide compares multiple neural network models and explains how to use them. You'll get an introduction to deep learning techniques, applications and how SAS supports the creation of deep neural network models.
Analyze streaming sports data with deep learning
SciSports uses streaming data and applies machine learning, deep learning and artificial intelligence to capture and analyze this data, making way for innovations in everything from player recruitment to virtual reality for fans
How is deep learning being used?
To the outside eye, deep learning may appear to be in a research phase as computer science researchers and data scientists continue to test its capabilities. However, deep learning has many practical applications that businesses are using today, and many more that will be used as research continues. Popular uses today include:
Speech Recognition
Both the business and academic worlds have embraced deep learning for speech recognition. Xbox, Skype, Google Now and Apple's Siri®, to name a few, are already employing deep learning technologies in their systems to recognize human speech and voice patterns.
Image Recognition
One practical application of image recognition is automatic image captioning and scene description. This could be crucial in law enforcement investigations for identifying criminal activity in thousands of photos submitted by bystanders in a crowded area where a crime has occurred. Self-driving cars will also benefit from image recognition through the use of 360-degree camera technology.
Natural Language Processing
Neural networks, a central component of deep learning, have been used to process and analyze written text for many years. A specialization of text mining, this technique can be used to discover patterns in customer complaints, physician notes or news reports, to name a few.
Recommendation Systems
Amazon and Netflix have popularized the notion of a recommendation system with a good chance of knowing what you might be interested in next, based on past behavior. Deep learning can be used to enhance recommendations in complex environments such as music interests or clothing preferences across multiple platforms.
Advanced Analytics from SAS
Deep learning is just one technique in the data scientist's toolkit. Learn about other advanced analytics techniques, including forecasting, text analytics and optimization.
Learn more about analytics solutions from SAS
How deep learning works
Deep learning changes how you think about representing the problems that you're solving with analytics. It moves from telling the computer how to solve a problem to training the computer to solve the problem itself.
A traditional approach to analytics is to use the data at hand to engineer features to derive new variables, then select an analytic model and finally estimate the parameters (or the unknowns) of that model. These techniques can yield predictive systems that do not generalize well because completeness and correctness depend on the quality of the model and its features. For example, if you develop a fraud model with feature engineering, you start with a set of variables, and you most likely derive a model from those variables using data transformations. You may end up with 30,000 variables that your model depends on, then you have to shape the model, figure out which variables are meaningful, which ones are not, and so on. Adding more data requires you to do it all over again.
The new approach with deep learning is to replace the formulation and specification of the model with hierarchical characterizations (or layers) that learn to recognize latent features of the data from the regularities in the layers.
The paradigm shift with deep learning is a move from feature engineering to feature representation.
The promise of deep learning is that it can lead to predictive systems that generalize well, adapt well, continuously improve as new data arrives, and are more dynamic than predictive systems built on hard business rules. You no longer fit a model. Instead, you train the task.
The vendor's [SAS'] new Visual Data Mining and Machine Learning platform lets you round-trip between visual machine learning pipelines and code, and has integrated features for automated machine learning. All of this is packaged in a slick, visual (veteran SAS users take note), unified environment that includes a growing set of well-thought-through visual tools for creating models – even deep neural networks.
The Forrester Wave™: Multimodal Predictive Analytics and Machine Learning (PAML) Platforms, Q3 2018
Read more about advanced analytics
- Key questions to kick off your data analytics projectsThere's no single blueprint for starting a data analytics project. Technology expert Phil Simon suggests these 10 questions as a guide.
- What is a data lake & why does it matter?As containers for multiple collections of data in one convenient location, data lakes allow for self-service access, exploration and visualization. In turn, businesses can see and respond to new information faster.
- The opportunity of smart grid analyticsWith smart grid analytics, utility companies can control operating costs, improve grid reliability and deliver personalized energy services.
- The future of IoT: On the edgeFrom cows to factory floors, the IoT promises intriguing opportunities for business. Find out how three experts envision the future of IoT.


text:
Alumni Letters
From Brian Portock , Class of 1996
Hey Everyone,
The Phoenix mission will be landing on Mars in 6 days! (May 25) This is the project I've been working on for the last 4 years. The spacecraft launched from Earth on August 4, 2007. After landing, the spacecraft will be analyzing the soil in the northern polar region of Mars. The lander sports a robotic arm that includes a shovel and scoop to dig up soil that contains water ice. The robotic arm will deliver the soil to the science experiments on the lander deck. There will also be a bunch of great pictures returned to Earth.
As of today, the spacecraft has travelled over 416 million miles during its journey and it has about 8 million more miles to go. My team, the navigation team, has been working their butts off since launch to make sure we can land in a landing area that is 62 miles long and 12 miles wide. This is analogous to a par 5 golf hole where you tee off in Philadelphia, Pennsylvania and the green is in Dallas, Texas! We just hit our birdie putt last Saturday with our fourth flight path maneuver. We're watching our birdie putt track, if its not on target 24 hours before arrival, we will hit our par putt with our final maneuver. Tiger Woods, whatever . . .
Once the spacecraft reaches the atmosphere, it is all on its own. It needs to slow down from 12,500 mph to 0 mph at landing in about 7 minutes!
Vince Guiseppe, Postdoctoral Research Associate, Los Alamos National Laboratory
From Dave Rosenfeld, Class of 1988
When I started playing with high temperature superconductors, something like twenty years ago, one of the pie in the sky uses was that we could use them as wires to transmit power on the utility grid without the losses due to resistance in conventional wire. We would say that, and then quickly add how difficult it would be, almost impossible really, given that they were ceramics and not very good at flexing without breaking, and that they had to be cooled with liquid nitrogen. Well, now someone has finally done it. Check out the story here. In the interest of full disclosure, I own shares in American Superconductor (AMSC) and this is neither a recommendation or solicitation to buy it.
From Ben Schull, Class of 2004
I graduated from Penn State - Harrisburg with my Master of Engineering degree in December of 2007. My masters paper was entitled "Arsenic Removal Treatment in a Non-Community Non-Transient Public Water System" I also passed my Fundamentals of Engineering Exam to receive my Engineer-In-Training(EIT) certificate. I currently work at Wm. F. Hill & Assoc., Inc., a consulting firm in Gettysburg, PA. I work on a variety of projects ranging from land development to water and wastewater management.
The MU physics program made Graduate School feel easy. I was very well prepared to take on graduate school and working at the same time. The strong mathematical background I developed at MU far exceeded expectations in my Graduate studies.
On the home front my wife and I are expecting our first child in April.
From Leah Gallek, Class of 2006
We bought a house in Marietta and Nate is talking up a storm. He understands the idea of "zero", I'll have to start working on negative numbers soon :).
Three mile island just put up the job postings for a new class in January 08. Its a fun job and great money.
From John Gemmer, Class of 2006
Hi Dr. Nolan,
I just wanted to let you know that I passed my qualifying exams at the
I believe that huge amount of my success during my first year is due to the excellent undergraduate education I received at Millersville.
From John Gentile, Class of 2005
I decided to leave John W Hallahan High mainly because of the travel. I am now at Villa Joseph Maire High School. I get to teach all physics here. I have 2 honors classes and 3 academic physics classes. This is an improvement from the load I had at Hallahan. I saw that Dr. Cooney retired. We use his book for AP physics which I will be teaching next year.
From Tom Herr, Class of 1991
Thanks so much for having us in [Physics 231] lecture last week; my students have plans for college and hopefully that includes Millersville physics. They have picked up on optics rather quickly and we'd like to sit in on an optics class. I see they are 3 hour periods and I think teenagers may be a little hard pressed to sit for that length of time, so perhaps the first hour or so will suffice...
Thanks for having us in your optics class, the boys where impressed and we had a good discussion
From Lindsey Moll, Class of 2005
Dear Dr. Dushkina:
I would just like to thank you for writing/filling out a recommendation for me when I applied for the job with Osceola County, FL. I got the job teaching 9th grade Physical Science at Liberty High School.
Physical Science is the perfect blend for me to ease into my teaching career because it starts off with Chemistry, then it gets into Physics and ends with Earth and Space Science. So far the kids are a handful but this is probably the 5th time they have been moved around this year because of it being a new school and teachers are constantly being hired to fill different positions. As I said, I just wanted to thank you very much for your time and effort you put into helping me get this job with the reference you gave.
From David Parks, Class of 2005
I wanted to thank you for recommending that I apply to the Penn State engineering science and mechanics. I was accepted [for 2005] and am currently finishing my MS.
I have
There was also the problem of making the transducer broadband (it emits a pulse not CW) and coupling it acoustically to the NDE medium at high temps. I have solved all these problems but don't feel that I did anything really scientific. I am likely to go on for my
From Jim Ringlein, Class of 1986
I wanted to let you know I will be joining the North Museum as their curator of science this coming January. I am really excited about it! Of course this means that LCDS needs a replacement for me ( long term physics sub with possibility of permanent hire) for Jan. to June 2008. If you know of anyone who might be interested and qualified I can direct them to the right people. I am hoping to continue to work with you guys in the upcoming years...
From Arzie Yeater, Class of 2007
After exhausting all the certified candidates West York Area School District called me in to interview. I completed the three step interview in three consecutive days and they offered me the position. I happily accepted the position and will be teaching physics one and conceptual physics next year.
As the third physics teacher I will have an office but will be teaching in other people's rooms the good news is that the rooms are the physics rooms so I have lab space to work with. I haven't spoken to them about the pendulum yet but I am pretty sure they will like having it available. We will just have to make the space for it.
Thank you for everything through out my time at Millersville I know my students will be better off for it (even if they won't always agree).
From Tanya Benway, Class of 2006
I applied to TMI and I am almost through the training program to be an Auxiliary Operator. I started here in January. I only taught for a few weeks, but the school was not a good match for me. I spent more time with discipline issues and writing up absentee reports than I did teaching. I love it here at TMI, and at the end of July I will be joining Leah [galemore/gallek]on her shift.


text: Our work with children in Iraq Our children's charity in Iraq since 2014 At the end of 2016 SOS Children's Villages started a pilot project for women and children in northern Iraq. There are countless Yazidi women and children currently living in refugee camps in northern Iraq. They have been severely traumatised by their experiences. They have been attacked, displaced and abused by the Islamic State (Isis). The SOS Children's Villages project in the Khanke refugee camp aims to help children and families re-establish their lives and give them a future. Over a million internally displaced persons Yazidi children in the Khanke refugee camp in northern Iraq (Photo: Ralph Gladitz) The Republic of Iraq borders on Kuwait, Saudi Arabia, Jordan, Syria, Turkey, Iran and the Persian Gulf. The Autonomous Region of Kurdistan is located in the north of the country. Iraq is in a permanent state of crisis. According to the Fragile States Index, the country continues be in the 'very high alert' category, ranking number 11 after states like Afghanistan, Somalia and South Sudan. Due to ongoing conflicts in various parts of the country, over a million Iraqis have been displaced and have sought refuge in one of the three provinces of Kurdistan. In addition, the conflict in neighbouring Syria has led to an enormous influx of Syrian refugees, of whom 98% are now living in refugee camps in Kurdish administrative districts. Kurdistan and the Yazidi people The Autonomous Region of Kurdistan has a population of 5.5 million. Northern Iraq is the heartland of the Yazidis, an ethnic Kurdish cultural group. They practise the religion of Yazidism, an ancient Kurdish faith influenced by Zoroastrianism. Prior to August 2014 around 700,000 Yazidis lived in and around the city of Sinjar and in the mountain region of the same name; around 200,000 Yazidis have settled elsewhere in the world. Genocide and mass exodus Trauma therapy helps children to work through the horrific experiences. (Photo: Katharina Ebel) In August 2014 Isis began the occupation of the Sinjar region, triggering a Yazidi exodus from the area. The Jihadists started a violent process of ethnic cleansing amounting to genocide. Countless men and young people over the age of 14 were murdered; boys were captured and trained as child soldiers. Women were shot, raped, enslaved. The United Nations believes that Isis abducted around 3,500 Yazidis, mostly women and children, many of whom are still in captivity. In total, over 6,800 people were officially reported abducted. Around half have now returned, severely traumatised, or had their freedom bought. But many mothers are still waiting for their sons and husbands to this day. Countless families, particularly the children, experienced terrible traumas and suffer deeply as a result. SOS Children's Villages in Iraq SOS Children's Villages has begun an aid programme in the Khanke refugee camp near Dohuk. Trauma treatment of 800 children and young people. With the help of various techniques, severely traumatised victims of Isis learn how to regain control of their thoughts, emotions and reactions. Children are given intensive support and assistance over a number of months. Training local volunteers to become counsellors who can provide effective help for the children in coping with their terrible experiences. Professional training for 20 Iraqi psychologists in providing trauma therapy to children. Vocational training for 300 Yazidi mothers and young women. Widows who have lost their husbands acquire new prospects. SOS Children's Villages provides support for the women to earn a living. Play therapy activities which promote tolerance, communication and a sense of community amongst the children. An SOS Children's Villages' kindergarten in the Khanke refugee camp offers boys and girls a place to play and learn where they can experience normality and just be children. Reading and writing courses for adults and courses in hygiene, communication and imparting values. Mobile teams will in the future also reach children in hard-to-access areas and train teachers locally.