Blockchain Papers

Hussain Noori

NEUROUNBOUND is a whitepaper and manifesto proposing a free, decentralized, and borderless research and educational ecosystem designed specifically for neurodivergent minds — individuals with ADHD, AuDHD, and Autism. Rather than replicating conventional academic structures, this framework is built around hyperfocus, non-linear reasoning, and proof-of-creation rather than standardized testing or rote memorization. Main Goal: To design an alternative educational and research model that removes the structural, sensory, and social barriers neurodivergent individuals face in traditional institutions, while channeling their cognitive strengths toward solving complex real-world problems across five core domains: Medicine & Neuroscience, Technology & Computing, Environment & Climate, Economy & Financial Systems, and Politics & Governance. Intended Audience: Neurodivergent students, independent researchers, educators, and institutions interested in inclusive, non-traditional models of education and talent development; also relevant to policy researchers and organizations working on neurodiversity, alternative credentialing, and decentralized education. Key Contributions / Outcomes: A four-stage adaptive admissions framework (Neurotype Verification, Hyperfocus Portfolio, Asynchronous Sandbox Challenge, Zero-Masking Async Interaction) designed to reduce social and sensory friction in evaluation. An educational methodology centered on "Proof of Creation" (a Magnum Opus artifact) rather than lectures and standardized grading. A self-sustaining funding and talent-retention model based on IP commercialization, open-source grants, and industry innovation contracts. This document is published as a formal, timestamped declaration of authorship and prior art for the NEUROUNBOUND concept, structure, and terminology, licensed under CC BY-NC-SA 4.0.

Sofia Sakka, Nikolaos Pavlidis, Vasiliki Liagkou, Ioannis Panges · 7 authors

The growing influence of technology in the healthcare industry has led to the creation of innovative applications that improve convenience, accessibility, and diagnostic accuracy. However, health applications face significant challenges concerning user privacy and data security, as they handle extremely sensitive personal and medical information. Privacy-Enhancing Technologies (PETs), such as Privacy-Attribute-based Credentials, Differential Privacy, and Federated Learning, have emerged as crucial tools to tackle these challenges. Despite their potential, PETs are not widely utilized due to technical and implementation obstacles. This research introduces a comprehensive framework for protecting health applications from privacy and security threats, with a specific emphasis on gamified mental health apps designed to manage Attention Deficit Hyperactivity Disorder (ADHD) in children. Acknowledging the heightened sensitivity of mental health data, especially in applications for children, our framework prioritizes user-centered design and strong privacy measures. We suggest an identity management system based on blockchain technology to ensure secure and transparent credential management and incorporate Federated Learning to enable privacy-preserving AI-driven predictions. These advancements ensure compliance with data protection regulations, like GDPR, while meeting the needs of various stakeholders, including children, parents, educators, and healthcare professionals.

Ahmethan Turan, Mehmet ya, Ertan lmaz, M. Munir Syam AR

Objective: Cryptocurrency trading has become widespread in recent years with developing technology and ease of use. As this is similar to gambling and pathological trading, this can produce an addiction. In this study, we aimed to examine the relationship between use of cryptocurrencies and ADHD symptoms, quality of life and sleep quality among university students. Methods: In total 921 university students were included in this study. All participants answered the sociodemographic data form, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), 36-Item Short Form Survey (SF-36) and Pittsburgh Sleep Quality Index (PSQI) using the online questionnaire method. Cryptocurrency users additionally responded to Problematic Cryptocurrency Trading Scale (PCTS). Results: In the cryptocurrency users’ ASRS scores were significantly higher (p<0.001), all SF-36 scores were significantly lower (for mental health subscale p=0.034, for other subscales p<0.001) in except SF-36 bodily pain scores, PSQI global scores (p<0.001) and subscales scores were found to be significantly higher (for sleep latency subscale p=0.013, for sleep disturbances subscale p=0.041, for other subscales p<0.001). Among those who cryptocurrency user, positive significant relationship was found between male gender, gambling, smoking and psychiatric history and PCTS scores (p=0.017, p=0.002, p=0.029, p=0.011 respectively). Conclusion: Cryptocurrency users have shown more ADHD symptoms, lower sleep quality and lower quality of life than non-users. Cryptocurrency use is common among university students and it should not be overlooked that it can evolve into behavioral addiction.

Clare Dyer

The metaverse and non-fungible tokens (NFTs) were some of the hottest tech terms in 2021, according to a Google Trends search. Our review aims to describe the metaverse and NFTs in the context of their potential application in the treatment of mental health disorders. Advancements in technology have been changing human lives at an ever-increasing pace. Metaverse, also known as the three-dimensional (3D) internet, is the convergence of virtual reality (VR) and physical reality in a digital space. It could potentially change the internet as we know it, with NFTs as the key building blocks in the new expansive virtual ecosystem. This immersive 3D virtual world boasts the features of the real world with the added ability to change the surrounding environment according to individual needs and requirements. VR, augmented reality (AR) and mixed reality (MR) have been employed as tools in the treatment of various mental health disorders for the past decade. Studies have reported positive results on their effectiveness in the diagnosis and treatment of mental health disorders. VR/AR/MR have been hailed as a solution to the acute shortage of mental health professionals and the lack of access to mental healthcare. But, on the flip side, young adults tend to spend a significant amount of time playing 3D immersive games and using social media, which can lead to insecurity, anxiety, depression, and behavioural addiction. Additionally, endless scrolling through social media platforms negatively affects individuals9 attention span as well as aggravating the symptoms of adolescents with attention deficit hyperactivity disorder. We aimed to explore the ramifications of expanding applications of the metaverse on mental health. So far, no other review has explored the future of mental health in the context of the metaverse.

Sadia Suhail Usmani, Medha Sharath, Meghana Mehendale

The metaverse and non-fungible tokens (NFTs) were some of the hottest tech terms in 2021, according to a Google Trends search. Our review aims to describe the metaverse and NFTs in the context of their potential application in the treatment of mental health disorders. Advancements in technology have been changing human lives at an ever-increasing pace. Metaverse, also known as the three-dimensional (3D) internet, is the convergence of virtual reality (VR) and physical reality in a digital space. It could potentially change the internet as we know it, with NFTs as the key building blocks in the new expansive virtual ecosystem. This immersive 3D virtual world boasts the features of the real world with the added ability to change the surrounding environment according to individual needs and requirements. VR, augmented reality (AR) and mixed reality (MR) have been employed as tools in the treatment of various mental health disorders for the past decade. Studies have reported positive results on their effectiveness in the diagnosis and treatment of mental health disorders. VR/AR/MR have been hailed as a solution to the acute shortage of mental health professionals and the lack of access to mental healthcare. But, on the flip side, young adults tend to spend a significant amount of time playing 3D immersive games and using social media, which can lead to insecurity, anxiety, depression, and behavioural addiction. Additionally, endless scrolling through social media platforms negatively affects individuals' attention span as well as aggravating the symptoms of adolescents with attention deficit hyperactivity disorder. We aimed to explore the ramifications of expanding applications of the metaverse on mental health. So far, no other review has explored the future of mental health in the context of the metaverse.

Xin Wang, Haojun Wang, Jianping Chai, Jiawei Li

Abstract We proposed a decentralized cryptocurrency protocol named proof of activity and stake in which participants have no admittance threshold and communicate in peer-to-peer network. Our protocol adopts the idea of stakeholders in proof of stake and combined it with the propagation activity to replace the resource-costly proof of work. It is also proposed to solve the contradiction of security and throughput, which discouraged the promotion of blockchain applications. With analysis of security assurance and performance, proof of activity and stake is proved to be robust and economical against double spending attack.

Sean Braithwaite, Ethan Buchman, Ismail Khoffi, Igor Konnov · 7 authors

In Tendermint blockchains, the proof-of-stake mechanism and the underlying consensus algorithm entail a dynamic fault model that implies that the active validators (nodes that sign blocks) may change over time, and a quorum of these validators is assumed to be correct only for a limited period of time (called trusting period). The changes of the validator set are under control of the blockchain application, and are committed in every block. In order to check what is the state of the blockchain application at some height h, one needs to know the validator set at that height so that one can verify the corresponding digital signatures and hashes. A naive way of determining the validator set for height h requires one to: (i) download all blocks before h, (ii) verify blocks by checking digital signatures and hashes and (iii) execute the corresponding transactions so the changes in the validator sets are reproduced. This can potentially be very slow and computationally and data intensive. In this paper we formalize the dynamic fault model imposed by Tendermint, and describe a light client protocol that allows to check the state of the blockchain application that, in realistic settings, reduces significantly the amount of data needed to be downloaded, and the number of required computationally expensive signature verification operations. In addition to mathematical proofs, we have formalized the light client protocol in TLA+, and checked safety and liveness with the APALACHE model checker.

Kristie Trousdale, Joyce Martin, Laura Abulafia, Claire Barnett · 5 authors

Since the government action on the removal of lead from gasoline in the 1970s, children's environmental health research and policy measures have expanded greatly. Education and outreach campaigns urge parents to ensure their homes are lead free and to check for the presence of radon, mold, and other potential environmental hazards. However, children also spend a good portion of their days in school environments, with the conditions of many schools being so poor that Lloyd Kolbe, founding and former director of the U.S. Centers for Disease Control and Prevention's (CDC) Division of Adolescent and School Health, has referred to them as “America's largest unaddressed children's health crisis” (Healthy Schools Network, 2005, p. ii.).According to 2008 National Center for Education Statistics (NCES) data, there are approximately 132,000 public and private schools in the United States, employing over 7 million adults and enrolling 56 million children (NCES, 2008). Twenty percent of the U.S. population attends elementary and secondary schools, many of which are very densely occupied (U.S. Environmental Protection Agency [EPA], 2002).In 2006, a national collaborative report entitled Lessons Learned (Healthy Schools Network, 2006) estimated that 32 million U.S. children were at risk due solely to school conditions. These conditions include the presence of old and peeling paint, asbestos, mold, poor indoor air quality, and pesticides, as well as possible preexisting on-site or off-site contamination. According to the EPA (2002), one half of U.S. schools have indoor environmental quality problems. Indoor concentrations of pollutants are commonly three to five times higher than outdoor concentrations due to chemicals found in some conventional cleaning products, improper cleaning procedures, defective or ineffective climate control (HVAC) systems, interior finishes, exterior pollutants, personal care products, and renovation projects (EPA, 2002). Contamination is portable as well and can be brought inside from outdoor exposures.Childhood exposures to environmental toxins have been associated with various cognitive and behavioral impairments, immune dysfunction, adverse reproductive and developmental effects, cardio-respiratory illnesses, and cancer (Greater Boston Physicians for Social Responsibility [GBPSR], 2000; Landrigan, Needleman, & Landrigan, 2002; Rudant et al., 2007; Salam, Li, Langholz, & Gilliland, 2004). One out of every 10 school-aged children, or over 6.7 million children under 18 years of age, has asthma, and between 1977 and 1994 the number of children in special education increased 191% (Akinbami, 2006; American Lung Assocation, 2009; GBPSR, 2000). The prevalence of diagnosed learning disabilities, autism spectrum disorders, and attention deficit hyperactivity disorder in children has increased dramatically nationwide (GBPSR, 2000). Environmental contaminants, especially those that affect indoor air quality, have also been linked to increased allergies and sensitivities, rashes, headaches, and other symptoms, often referred to as sick building syndrome (EPA, 2008).Environmental toxic exposures have also been linked with decreased IQ. One study reported that, on average, a 1-µg/dL increase in blood lead results in a decrease of 0.46 IQ points (Canfield et al., 2003). This rate of decline in intellectual functioning appears even greater (1.37 IQ points lost per 1-µg/dL increase in blood lead) among children with blood lead levels below, rather than above, the CDC recommended level of 10 µg/dL (Canfield et al., 2003). Taking into account this increased effect at lower body burdens, more children may be at greater risk of harm from lead exposure than previously believed.Lead has been relatively well researched with regard to its adverse effect on IQ. Yet, other toxicants and combinations of chemicals have also been associated with lowered cognitive functioning. For example, a 2009 Columbia University study found that exposure to polycyclic aromatic hydrocarbons, chemicals released into the air from burning of coal, diesel, oil, gas, and other substances, such as tobacco, can also inversely impact IQ in the developing brain. Schools that have idling buses or are close to major highways may have higher levels of polycyclic aromatic hydrocarbons in the indoor air (Perera et al., 2009).Researchers have found that lowered IQ, even by just a few points, negatively impacts an individual's future earnings (Schwartz, 1994). Other hidden expenses of unaddressed children's environmental health concerns include parents' lost wages due to medical and therapeutic expenses and missed work and the costs to school districts and taxpayers of postconstruction remediation efforts, which often far exceed the costs of precautionary or proactive measures (Center for Health Environment and Justice [CHEJ], 2005). Additonal expenses may arise from lawsuits brought against school districts by affected families. Indeed, the adverse effects of childhood environmental exposures, such as lead poisoning–induced aggression and violence, affect society as a whole. It is estimated that anywhere from $4.6 to $18.4 billion in costs of neurobehavioral disorders alone in the U.S. are attributable to environmental toxicants (Landrigan, Schechter, Lipton, Fahs, & Schwartz, 2002).Between 1976 and 1994, the average blood lead levels of U.S. children plunged from 16 µg/dL to 3.2 µg/dL, primarily as a result of the removal of lead from products such as gasoline and paint in the 1970s (Gilbert & Weiss, 2006). Grosse, Matte, Schwartz, and Jackson (2002) estimated that U.S. preschool-aged children in the late 1990s had IQs that were, on average, 2.2–4.7 points higher than they would have been had their blood lead distribution matched that observed among U.S. preschool-aged children in the late 1970s. Each 1-point increase in an individual's IQ has been associated with a 1.76% to 2.37% increase in future earning potential, and the researchers estimated that the economic benefit for each year's cohort of 3.8 million 2-year-old children ranged from $110 billion to $319 billion (in 2000 dollars; Gross et al., 2002). This represents a truly significant public health triumph in the United States, yet the problems of lead exposure continue to persist for many children. The CDC estimates that there remain approximately 310,000 children aged 1–5 years with BLLs greater than 10 µg/dL, the upper limit of what is considered an acceptable level, which is arguably too high (CDC, 2005; Gilbert & Weiss, 2006).Although adults also work in school environments, the deleterious health impacts of environmental hazards may be greater for children. The unique physical and behavioral characteristics of children as well as the paucity of research, policy, and regulation with regard to school environments and children's health underscore the need to recognize and address school children as a particularly vulnerable population.Children are not “little adults,” and, therefore, assessments of their exposures to, and outcomes resulting from, environmental toxicants using adult-based toxicological models are insufficient. Children breathe more, eat more, and drink more per pound of body weight than adults, increasing their risk of exposures. Their behaviors also expose them to more possible contaminants (e.g., hand-to-mouth behaviors, more time spent on the ground), and they cannot always identify and protect themselves against hazards (Guzelian, 1992; National Research Council, 1993).Not only are children generally exposed to toxins at higher levels than adults, they may also absorb the toxins more readily than adults, placing them at even greater risk of harm. The efficiency of detoxification and elimination of toxins from the body may differ in children and adults. For example, young children may lack sufficient amounts of a key enzyme needed to metabolize and excrete a particular contaminant quickly, resulting in longer residency time of the contaminant in the body, leading potentially to greater toxicity and harm.Children's organ systems continue developing through early childhood and are, thus, more vulnerable to adverse effect. Longer exposures to some toxins, such as those experienced since early childhood, leads to greater body burdens, with potentially more detrimental health outcomes. Those with existing disabilities may be more vulnerable, both with regard to exposure and absorption, and, thus, at even greater risk.Public sector employees (including teachers and others working within the public school system) in 25 states are protected from environmental and occupational hazards through state-adopted, Occupational Safety and Health Administration (OSHA)–approved standards. All but 4 of these states also provide protection to private sector employees, such as private school staff and administrators (Healthy Schools Network, 2005). Injured workers may also be eligible for, and receive, worker's compensation, sick leave, union support, and access to U.S. Department of Health and Human Services–funded occupational health clinics; they may also be able to switch their job locations. Thus, there exists protection for some of the adults employed in schools in the United States.However, OSHA standards do not exist for any of the children attending these schools who are exposed to the same environmental hazards and are more vulnerable to their effects. In addition, chemical regulations under the Toxic Substances Control Act (TSCA) of 1976 in the U.S. do not guarantee adequate protection to children because they are based upon risk assessment models derived from adult populations and other inherently limited assumptions (Environmental Working Group [EWG], 2005).Whereas the health effects of some contaminants, such as lead, tobacco, and asbestos, have been well studied, barely any of the approximately 80,000 chemicals inventoried by the TSCA have been fully tested for their impacts on human health (U.S. General Accounting Office, 2005). In fact, only 7% of the 2,863 most commonly used chemicals have undergone complete toxicological testing, and few of these have been studied for neurodevelopmental effects (EPA, 1998).Research of children's environmental health issues at school is either minimal or nonexistent. In fact a seemingly noncontagious outbreak of rashes in 2001–2002, which affected approximately 1,000 children in 27 states, could not be meaningfully investigated due to the lack of baseline data of children's environmental health measures at schools (Healthy Schools Network, 2005).The National Institute for Occupational Safety and Health (NIOSH) performed a workplace evaluation of a school near “ground zero” in New York City and found evidence of new-onset diseases among school staff. However, no agency offered a similar service for students, including children with special needs, in the dust-contaminated school (Bartlett & Petrarca, 2002). Furthermore, had any investigations been conducted, meaningful assessment would have been difficult due to the lack of any baseline data on students' health.A NIOSH Healthy Hazard Evaluation (HHE) evaluates worker health and safety on site based on previous and current individual medical conditions. The same type of evaluation could have been done for school children but was not, thus depriving children (who outnumber adults in schools), their families, schools, IEO sciences, and NIOSH of important information. Children are the work product, or “output,” of schools, so not having any assessment of them erodes the educational mission.Some environmental concerns, such as the prevention of urban sprawl, the creation of walkable and bikable communities, the need for safe routes to school, and the selection of a locale conducive to high-performing schools, are often considered when choosing a school site; however, the presence of on- or off-site sources of pollution are usually not considered. This is mainly due to considerations of land cost and availability (CHEJ, 2005). School districts seek out inexpensive land due to declining school budgets and rising, unfunded mandates, such as the No Child Left Behind Act (legislation enacted in 2002 that ties federal funding for schools to states' performances in standards-based assessments). Contaminated land is inexpensive because it is unsuitable for housing and most types of businesses.Availability of land is another factor in site selection. School districts in rural areas look to site schools on inexpensive, unused agricultural land, which is often contaminated with pesticides, whereas urban school districts, limited in their siting choices due to the shortage of undeveloped land, often turn to sites on or near abandoned landfills or abandoned industrial sites, such as brownfields, or near heavily polluting industries (CHEJ, 2005). Furthermore, urban school districts, motivated to save money or to devote greater percentages of their budgets to hiring highly qualified teachers and improving schools' technology and curriculum, may be unwilling to invest in proper clean up of contaminated sites. There are 1,100 public schools, and over 600,000 students attending public schools, within half a mile of contaminated sites (CHEJ, 2005). This issue directly affects children's health, especially low-income and non-White children, who may have less access to health care and who have higher rates of asthma and lead poisoning (CHEJ, 2005).According to a 50-state siting laws survey detailed in a 2005 report entitled Building Safe Schools: Invisible Threats, Visible Actions, only 10 states have laws that prohibit the siting of a school on or near sources of pollution or other environmental hazards (CHEJ, 2005). These hazards include sites affected by air, motor vehicle, and rail traffic; sites near utility transmission lines; sites impacted by air and noise pollution; sites where hazardous or solid waste was disposed; and sites especially vulnerable to natural hazards, such as flooding or earthquakes.The report indicated that only 6 states require environmental investigation of potential school sites, such as the preparation of Phase I or Phase II environmental assessments or environmental impact statements for school projects. A Phase I environmental assessment is a cursory evaluation of the site, in which surveyors check for obvious of hazards, such as those that can be or Phase II assessments would be based on the of a Phase I assessment and would of site (e.g., Environmental impact statements or the and environmental effects of a such as the building of a school, and states require public or public school sites, and states require or the creation of school siting report also that states have no laws that either prohibit or the siting of a school on or near or environmental hazards and that states do not require school districts to potential school sites for the presence of pollutants or other environmental hazards or to environmental impacts associated with potential school toxicants at contaminated sites include such as lead, and such as and from and gasoline and from at which often at sites where has been in and many more (CHEJ, of the most lead and are and IQ (U.S. Agency for Toxic Substances and Disease IQ leads to cognitive and attention and is linked to behaviors, and and also affect the are also both associated with adverse reproductive effects, and in is associated with are also of cognitive functioning in children, more on its health effects are needed is a need for school siting laws that would siting on or near sources of environmental hazards and require investigation and assessment of hazards on potential school sites or impacts to future of proper clean and of contaminated and public in siting of a siting is in public education is also to a siting The of laws and federal on school siting is not In addition, chemical are and often not well by the Thus, parents and school may often be of on-site the need for a educational as of the safety data by a cleaning do not always provide complete on the health hazards of the and are not at for products & cleaning products may and that affect the the such as and and & Landrigan, 2006; et al., 2006; 2002; & et al., U.S. National 2000). commonly found in such as and have been linked with as have some found in such as and including of Occupational and Environmental 2000; et al., 2000; & 1994). and found in cleaning products also are associated with 2000; & chemicals are commonly found in cleaning products and can be to the human body in very The and many of the of other body systems the of chemical to on into the and also can either from to their proper or and with the either important are and adverse health outcomes may The are in cleaning and found in care products and and found in and 2000; et al., 2006; et al., 2005). conventional cleaning chemicals and some less toxic 2005 the public schools a cleaning policy (Environmental Institute New York an the of cleaning products and the New York for public and private schools similar in and a in New to of states had cleaning In addition, many school districts have to or have cleaning even in the of and cleaning not only on the of toxic chemical but for the of more and the of proper for the cleaning staff. cleaning both for and for cleaning (e.g., and are A and human and environmental health its to In a cleaning the of cleaning can be with just one the number of chemicals in and and are also to their conventional in such as care and and indoor air cleaning include on proper and the of the cleaning products, as well as on and chemical these would be in a where the of is another important of cleaning The of and may be of & can be with and be to clean to and to in areas such as those areas by regulations and those where body may be and can most and may be for points, rather than to a cleaning need only their to a free of cleaning products on to staff and a by products and to based on the unique of the For schools that to the of a cleaning an evaluation of the current products, and used on site be conducted, and baseline such as the number of to the be Schools may also to an environmental health and safety to staff other than and to and schools would policy that would staff and However, it is most important that schools it is to a cleaning school an for a number of various and are and within school and and areas may also and among and other educational within schools (Healthy Schools Network, 2006). associated with include the of diseases from and allergies and asthma by and and to some or (EPA, from and may also physical hazards to (EPA, However, conventional control may hazards of their is often the of prevention and control in U.S. schools, and are used on school to control and are to and and and are often to enzyme or (EPA, are potentially toxic to children, and adults. Indeed, with the EPA are not to be safe for human health (Landrigan, Needleman, & Landrigan, 2002). of the enzyme in pesticides, in and in against remain in children through at 7 et al., Thus, this of to school-aged children as well as the of in a to regulation rather than a more precautionary have not been tested by standards and are commonly the complete of each at 10 years University Furthermore, most in have not been tested for their health effects on children (Landrigan, Needleman, & Landrigan, toxicological found that many harm the developing and as resulting in and and many are or (Landrigan, Needleman, & Landrigan, 2002). human health problems associated with exposure include and upper and even and in et al., 2005; for exposure to some has also been associated with health such as childhood such as and developmental and behavioral and disorders & & Rudant et al., 2007; Salam, Li, Langholz, & Gilliland, Weiss, & no federal regulations exist for in schools, the EPA that schools to the risk of exposure to children. is a and usually less for within schools, it not of A school of including the and of when However, a on measures and toxic such as to sources of and for within school and school include the and are at from and in and are either or and are and at a and are by the of each and are is and of at a are times the rather than one the or is to and rather than of are used when are needed (EPA, can and have been found as far as from the of for 2003). Thus, of particularly for schools near agricultural is also and be school schools to their school and and and provide when are used in the United are densely and often and by or budgets are often the to be when budgets In to poor availability of school sites and the lack of research and policy these unaddressed health hazards to the need to for school sites, and schools need to the and of the schools an environmental health to report on conditions and to provide to and the of school projects and the public to protect to from and air out areas to to such as to cleaning and to and clean out such as the National and primarily by the National Institute of Child Health and Human exposures in and Health by the a to these exposures. that and federal a for children's health at by the

Anastasia Antoniadis, Steven G. Gilbert, Michele Wagner

You have accessThe ASHA LeaderFeature1 Sep 2006Neurotoxicants: Environmental Contributors to Disability in Children Anastasia Antoniadis, Steven G. Gilbert, and Michele (Gagnon) Wagner Anastasia Antoniadis Google Scholar More articles by this author , Steven G. Gilbert Google Scholar More articles by this author and Michele (Gagnon) Wagner Google Scholar More articles by this author https://doi.org/10.1044/leader.FTR2.11132006.6 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Speech-language pathologists and audiologists continue to be challenged by increasing numbers of children on their caseloads who present with a variety of developmental and learning disabilities of unknown or undetermined origin. Apart from the budget and service delivery concerns associated with larger caseloads in schools, parents and professionals alike seek explanations for why so many of our children are receiving diagnoses such as attention deficit hyperactivity disorder or those under the autism spectrum. Recent research reveals that exposures to neurotoxicants such as lead, mercury, and pesticides can have a particularly detrimental impact on brain function and in turn lead to the expression of learning and developmental disabilities, including speech, language, and hearing disorders (Miller & Snow, 2004; Schettler, Stein, Reich, Valenti, & Wallinga, 2000). The complex interaction of genetics and the environment during windows of vulnerability may lead to the expression of various disabilities. These environmental contributors to disability are often the least appreciated yet the most preventable. Children are uniquely susceptible to hazardous environmental exposures-they are not little adults (National Academy of Sciences, 1993). Exposures that occur before conception and continue through late adolescence can cause or contribute to disease and can disrupt development, learning, and behavior. For example, a child’s biological system is still developing: pound per pound they eat, drink, and breathe far more than adults and their behavior, such as crawling on the ground and putting their hands in their mouths after touching the floor, results in higher toxic exposure. Metabolism of many compounds, even common ones such as caffeine, is limited during the first six months of life, making them more vulnerable. In comparison to adults, children have periods of rapid brain growth in utero and during the first few months of life through puberty and up to 20 years of age when the brain reaches its maximum weight. The greatest neurological difference between adults and children includes the immaturity of the blood brain barrier, which is not fully developed until after 6 months of age. Rigid and predictable periods of nervous system cell proliferation, migration, and differentiation create windows of vulnerability for the young brain. These two features combined make the young brain a less stable organ and a more culpable target of toxicity when compared to the adult counterpart. To date, most learning and developmental disability groups have focused on identifying affected children and getting them the services they need-something that is, of course, very important. However, there is a parallel need for prevention of exposures that lead to or exacerbate these disabilities. Prevention of communication disorders has always been a part of the scope of practice for SLPs and audiologists. Science typically can’t identify a single chemical “cause” of a developmental or learning disability. There are hundreds of neurotoxicants and suspected neurotoxicants in production that have not been thoroughly tested for adverse health effects. Given the knowledge and experience we have gained about developmental effects of neurotoxicants, we have an ethical responsibility to protect our children (Gilbert, 2005). Therefore environmentalists and public health officials are beginning to adopt the “precautionary principle” with regard to chemical exposures. The precautionary principle states: When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically. In this context the proponent of an activity, rather than the public, should bear the burden of proof. The process of applying the precautionary principle must be open, informed, and democratic and must include potentially affected parties. It must also involve an examination of the full range of alternatives, including no action. (Science and Environmental Health Network, 1998). Lead Exposure Lead provides an important example of hazardous environmental exposures that may lead to disabilities because it is the most researched neurodevelopmental toxicant. Lead exposure in schools can occur through older drinking water systems with leaded pipes or from cracking and peeling paint that produces lead dust. This lead dust may be inhaled or inadvertently ingested by children, teachers, and administrators alike. More recently lead has been found in children’s jewelry, school lunch boxes, and even candy. Lead has an affinity for the central nervous system (CNS) and it deposits in bone as a substitute for calcium. Very high lead levels in blood can result in encephalopathy; very low levels can result in cognitive impairment and behavioral difficulties. In 1979 Herbert Needleman published a research paper that found an association between lead levels in teeth and difficulty following classroom instruction, unruly behavior, greater distractibility, and reduced auditory and verbal processing (Needleman et al., 1979). Lesser known CNS effects from lead include hearing and balance (Bhattacharya, Shukla, Bornschein, Dietrich, & Keith, 1990). Although blood lead levels in children and adults have been declining over the past 30 years, deterioration or renovation of homes and complexes constructed prior to 1980 can result in exposure to contaminated paint chips or dust. Lead-tainted soil can persist as long as 2,000 years and contaminated house dust remains a significant source of lead exposure for children in urban communities (Koger, Schettler, & Weiss, 2005). Children also may be exposed through inhalation of lead dust from home renovation or take-home occupational exposures of adults in the household. Poor academic performance and low intelligence test scores have been associated with even low lead levels (Needleman et al., 1979). Long-term follow up of children with early childhood exposures reveals the irreversibility of lead’s effects on cognitive and behavioral impairment (Needleman, 1998). These studies have been substantiated elsewhere (Schwartz, 1994). Recent evidence suggests that lead exposure below the current Centers for Disease Control and Prevention standard of 10 µg/dL blood lead level results in cognitive deficits (Lanphear et al., 2005). The effects of a developmental disorder last a lifetime with societal costs measured in the billions of dollars (Landrigan, Schechter, Lipton, Fahs, & Schwartz, 2002). Prevention of childhood lead exposure at home and school is the best course of action to protect the potential of our children. Pesticide Exposure Over the years, many schools have relied on pesticide applications to control pests. However, recent research reminds us that pesticides are poisonous and many are neurotoxicants. Exposure to pesticides is linked with cancer, birth defects, and most notably, neurological and behavioral disorders. There is a movement across the nation to eliminate pesticide use at schools to manage pests and this safer alternative is called Integrated Pest Management (IPM). IPM is a method of pest control that emphasizes prevention of pests and allows the use of “least toxic” pesticides when necessary to protect human health. IPM is a shift in thinking to prevention in the first place. It eliminates the cause of pests by minimizing their access to food, water, and hiding places. Many schools are finding that implementing IPM as an “ounce of prevention” can save time and money with the added benefit of being safer for children’s neurological development and the environment. Recent examples include the Seattle, WA IPM policy (www.seattleschools.org/area/facilities/IPM/IPM.htm) and the Pennsylvania IPM policy (http://paipm.cas.psu.edu/schools/PSBApolicy.html). A good place to find more information and resources on an IPM program for schools is the Safer Pest Control Project (http://spcpweb.org) based in Chicago, IL. This project conducts site assessments, workshops, and ongoing technical assistance and maintains a speaker’s bureau that travels the surrounding states educating school administrators, homeowners, and even garden clubs on IPM implementation. The project also has a 12-minute video available for purchase entitled, “Integrated Pest Management in Schools: A Better Method.” See The ASHA Leader Online for more resources. Elemental Mercury Exposure Elemental mercury exposure in schools occurs from broken thermometers and thermostats, spills from improperly stored or handled mercury in the chemistry lab, and accidents when using mercury in the science lab for experiments. In 2004, six Environmental Protection Agency (EPA) regional offices responded to mercury spills that included 12 emergency removals from schools. EPA cleanup costs for elemental mercury in 2004 ranged from $1,000 to $200,000 per school. Elemental mercury is most toxic in its vapor form. It slowly vaporizes at room temperature and more quickly when heated. Children exposed to elemental mercury can be seriously poisoned by breathing in the invisible vapor. Elemental mercury vapor, like lead, is a well-known neurotoxicant that can disrupt normal brain development in the child and fetus. Children exposed to elemental mercury for long periods of time may have trouble learning in school, and exposure to mercury can result in communication and learning disabilities that may be irreversible (Skavroneck & Stenstrup, 1998). The EPA has developed a program, with funding, to help schools get rid of elemental mercury and many other harmful chemicals that could adversely affect children’s health. The Schools Chemical Cleanout Campaign (SC3) was started in 2004 to help schools remove potentially harmful chemicals, conduct chemical management training for lab instructors, and raise national awareness of the issue of chemicals in schools (see the Resources online for more information.) Understanding the role that exposures to neurotoxicants play in the etiology of communication disorders in our most vulnerable of populations-young children-is an important landmark because many of these exposures are either preventable or amenable to change. Through self-directed learning, SLPs and audiologists become better prepared to serve as important members of the health profession/research team. Education regarding children’s environmental health will enable the practicing SLPs and audiologists to provide parents with information using brochures and Web site information about exposures commonly found in their child’s environment. Partnerships with the Learning and Developmental Disabilities Initiative (LDDI) and its member organizations will afford researchers in the field of communication disorders opportunities to forge into new territory, taking into consideration the possible role of neurotoxicant dose and timing on the nature of hearing loss, language delays, and a host of other communication disorders in children. Educators and public health professionals can make powerful partners in taking action at local, state, and national levels to prevent exposure to neurotoxicants that lead to learning disabilities. Keeping Children Safe from Pesticides Pesticides are poisonous chemicals used in schools and around school grounds to kill weeds, insects, rodents, and fungus. Children are more vulnerable to the adverse effects of pesticides because of their smaller size, their organs still being under development, and they eat and breathe more relative to their body weight. For an adult or child, pesticide exposure is unwelcome and increases the risk of adverse health effects. Our children have a right to an environment that ensures that they have the best opportunity to reach and maintain their potential. The health effects of pesticides are well established; after all, they are designed to kill. Pesticides can affect a child’s nervous system, respiratory system, endocrine function, and some are even linked to cancer. Pesticide exposure in schools can be reduced or even eliminated by establishing an Integrated Pest Management (IPM) program. For example, in Seattle, WA a public committee was established by the Seattle School Board to examine pesticide use and consider establishing an IPM policy. The Seattle School Board adopted the following policy: It is the policy of the Seattle School Board that students and staff have a right to a healthy learning and working environment. The District will work to achieve this, in part, by reducing and eliminating the use of pesticides and other toxic chemicals through the use of Integrated Pest Management in buildings and grounds programs, as set forth in the attached procedures. The goal of this policy is to create and maintain sustainable, healthy school environments by using methods that emphasize protection of children’s health and use of ecologically sound practices, in order to achieve long-term prevention and suppression of pest problems. The above policy statement was supported by a more detailed operating procedure that outlines an IPM approach. These changes in management practice were not expected to increase costs while the use of chemicals is being reduced or even eliminated. In some cases less toxic chemicals were substituted for more toxic pesticides. More information on developing an IPM policy for your school can be found at Washington Toxics Coalition (www.watoxics.org) and School Pesticide Reform Coalition (www.beyondpesticides.org/toxicfreeschools/index.htm). Focus on Divisions Division 2, Neurophysiology and Neurogenic Speech and Language Disorders, focuses on professional and research topics related to normal neurophysiology and to the diagnosis and treatment of neurogenic disorders in adults and children. The Division offers affiliates the opportunity to earn CEUs through self-study of the publication, Perspectives (published four times annually); an exclusive e-mail list and Web forum; and other benefits. Learn more about Division 2. ASHA Resources Prevention of Communication Disorders Position Statement Prevention of Communication Disorders Tutorial Prevention Curriculum Guide for Audiologists and Speech-Language Pathologists provides training modules on prevention principles and practices. Manual for Instructors - Volume 1. Includes course outline, learning objectives, discussion points, activities, and overheads (Item #0112355) Manual for Students - Volume 2. Includes course outline and learning objectives (Item #0112356) Readings on Prevention - Volume 3. Includes more than 60 articles referenced in Volume 1 plus ASHA policy documents on prevention (Item #0112357) References Bhattacharya A., Shukla R., Bornschein R. L., Dietrich K. N., & Keith R. (1990). Lead effects on postural balance of children.Environmental Health Perspectives, 8, 35–42. CrossrefGoogle Scholar Gilbert S. G. (2005). Ethical, legal, and social issues: Our Children’s Future.NeuroToxicology, 26, 521–530. CrossrefGoogle Scholar Koger S. M., Schettler T., & Weiss B. (2005, April). Environmental toxicants and developmental disabilities: A challenge for psychologists.American Psychologist, 60(3), 243–255. CrossrefGoogle Scholar Landrigan P. J., & Carlson J. E. (1995). Environmental policy and children’s health.The Future of Children, 5, 34–52. CrossrefGoogle Scholar Landrigan P. J., Schechter C. B., Lipton J. M., Fahs M. C., & Schwartz J. (2002). Environmental pollutants and disease in American children: Estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.Environmental Health Perspectives, 110, 721–728. CrossrefGoogle Scholar Lanphear B. P., Hornung R., Khoury J., Yolton K., Baghurst P., Bellinger D. C., et al. (2005). Low-level environmental lead exposure and children’s intellectual function: An international pooled analysis.Environmental Health Perspectives, 113, 894–899. CrossrefGoogle Scholar Miller E. and Snow N. (2005, Nov.) Safeguarding our children at home: Reducing exposures to toxic chemicals and heavy metals. Washington, DC: ZERO TO THREE: National Center for Infants, Toddlers, and Families, 26–32. Retrieved July 6, 2006 fromhttp://www.iceh.org/pdfs/LDDI/ZeroToThreeArticle2005_11.pdf. Google Scholar National Academy of Sciences. (1993). Pesticides in the diets of infants and children. Washington, DC: National Academy Press. Google Scholar Needleman H. L. (1998). Childhood lead poisoning: The promise and abandonment of primary prevention.American Journal of Public Health, 88, 1871–1877. CrossrefGoogle Scholar Needleman H. L., Gunnoe C. E., Leviton A., Reed R., Peresie H., Maher C, & Barrett P. (1979) Deficits in psychologic and classroom performance of children with elevated dentine lead levels.New England Journal of Medicine, 300, 689–695. CrossrefGoogle Scholar Schettler T., Stein J., Reich F., Valenti M., & Wallinga D. (2000). In harm’s way: Toxic threats to child development. Cambridge, MA: Greater Boston Physicians for Social Responsibility. Google Scholar Schwartz J. (1994). Low-level lead exposure and children’s IQ: A meta-analysis and search for a threshold.Environmental Research, 65, 42–55. CrossrefGoogle Scholar Schwartz J., & Otto D. (1991). Lead and minor hearing impairment.Archives of Environmental Health, 46, 300–305. CrossrefGoogle Scholar Science and Environmental Health Network. (1998, Jan.). Wingspread Statement on the Precautionary Principle. Retreived June 21, 2005, from www.sehn.org/precaution.html. Google Scholar Skavroneck S., & Stenstrup A. (1998, Oct.). Mercury: In your community and the environment. Retreived June 7, 2006, from Wisconsin Department of Natural Resources Web site:www.epa.gov/glnpo/bnsdocs/merccomm/. Google Scholar Author Notes Anastasia Antoniadis, is an early intervention consultant at the Pennsylvania Training and Technical Assistance Network in King of Prussia, PA. Antoniadis, who is an SLP, also earned a master’s in public health from Temple University and has presented on the topic of children’s environmental health issues to early intervention audiences. Contact her by e-mail at [email protected]. Steven G. Gilbert, is director of the Institute of Neurotoxicology & Neurological Disorders in Seattle, WA, and an affiliate associate professor, department of environmental and occupational health sciences, University of Washington. His book, A Small Dose of Toxicology-The Health Effects of Common Chemicals was published in 2004 (www.asmalldoseof.org). Contact him by e-mail at [email protected]. Michele (Gagnon) Wagner, is the former director of the Environmental Health Initiative with the American Association on Mental Retardation. She holds a master’s in public health with a concentration in environmental health. Contact her by e-mail at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 11Issue 13September 2006 Get Permissions Add to your Mendeley library History Published in print: Sep 1, 2006 Metrics Current downloads: 633 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2006 American Speech-Language-Hearing AssociationLoading ...

Susan Boswell

You have accessThe ASHA LeaderSchool Matters1 Nov 2005U.S. Supreme Court Hears Special Education Case on Burden of Proof Susan Boswell Susan Boswell Google Scholar More articles by this author https://doi.org/10.1044/leader.SCM.10152005.1 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In The U.S. Supreme Court heard oral arguments on Oct. 5 to determine whether the family or the school district bears the burden of persuasion at a due process hearing in establishing that an Individualized Educational Program (IEP) is appropriate. The case, Schaffer v. Weast, is among a handful of special education cases to reach the nation’s highest court. The case could shift the balance of power between parents and districts in IEP meetings and shape the outcome of due process hearings for decades to come. Schaffer v. Weast is the result of a seven-year battle that began when Jocelyn and Martin Schaffer requested an eligibility evaluation for their son Brian for special education services in middle school. Brian attended a private elementary school but struggled as the result of an auditory processing disorder, attention deficit hyperactivity disorder, a learning disability, and a speech-language disorder. Meanwhile, the parents also applied for his admission to another private school. Montgomery County Public Schools (MCPS) offered an IEP that included 15.3 hours of special education in inclusion classes and 45 minutes of speech-language treatment each week at a local middle school. The parents objected to the IEP, saying that it proposed a less intense program with a higher teacher-student ratio than the original private school where Brian was failing. The parents placed Brian in a private school and requested a due process hearing seeking tuition reimbursement. The administrative law judge deemed both sides equally balanced and called the issue of burden of proof “critical” to the case. Several years later, Brian attended a learning center at a MCPS high school under a different IEP where he graduated in 2003. He is now a junior at a small East-coast college. Inside the Courtroom The plaintiffs argued that if parents are required to carry the burden of proof, they will be less able to challenge districts over the appropriateness of an IEP. MCPS argued that placing the burden of proof on school districts would make the IEP presumptively invalid and result in costly litigation, diverting scarce resources away from all children. “I have never seen a case where a private party coming in and challenging government action does not have the burden of proof,” Justice David Souter said. Other justices questioned the legislative history, legal precedents, and state law relating to burden of proof. They noted that the statute does not just cover the initial IEP, and questioned which party has the burden of proof when the parents agree to the initial IEP and then contest it, or when discipline issues arise. William Hurd, of the law firm Troutman Sanders in Richmond, VA who represented the Schaffers, focused on the disparity in knowledge between the district and the parents. “If you let the school district slide by without being accountable, they’re likely to be less thorough in preparing their IEPs,” Hurd said. In questions to the school district’s attorney, Gregory Garre, of Hogan & Hartson, the Supreme Court focused on the number of times the district initiates due process hearings in comparison to the parents and which party goes first in the proceeding. The justices also explored whether the allocation of burden of proof should be determined by state legislatures, the courts, or the U.S. Department of Education (ED)-and whether the Supreme Court needs to decide at all. But as the arguments came to a close the discussion focused on a single issue-money. “Is there more litigation in states that have burden of proof on the school system? Is it more expensive?” Justice Ginsburg asked of David Salmons, assistant to the solicitor general. Salmons provided supporting comments because the United States reversed an earlier position and sided with the school district in a recent amicus brief. “In the largest volume of hearings, is the burden on the school and is there an explosion of litigation?” asked Justice Stevens. Hurd noted that the cost of due process litigation averages about $22 per child if spread among all 6 million children receiving special education services in the United States. Chief Justice John Roberts excused himself from the case. Although he did not provide a reason, he likely did so because the school district is represented by his former firm, Hogan & Hartson. Rallying for a Cause Outside the courtroom the case was overshadowed by the emotionally charged assisted suicide case, Gonzalez v. Oregon, which asked whether the federal government can prevent doctors from helping terminally ill patients take their own lives. Amid a throng of media and demonstrators dressed in black were about 30 parents and students representing grassroots advocacy groups in Montgomery County carrying colorful signs. “The burden of proof should be on the person writing the IEP. In Montgomery County, parents have to sue the school system to get the right to learn to read,” said Joan Sablaka, one of the 1,200 members of the MCneeds, a nonprofit advocacy organization for families and co-chair of the Montgomery County special education advisory committee. Montgomery County spends more money than any other Maryland county on special education, noted Bob Astrove, another MCneeds parent. “There are zero dollars in the budget for this Supreme Court case, and funding will come out of special education services. Clearly, the school system should have to show that what they’re proposing will benefit the child,” Astrove said. More than 20 disability organizations and nine states filed briefs in support of the Schaffers. Hawaii (joined by Alaska, Oklahoma, and Guam), the ED, the United States government, and the Council of Great City Schools filed briefs in support of MCPS. The Court has until the end of the term in June 2006 to render a decision. The case is Schaffer v. Weast, No. 04-698. Visit the Wrightslaw Web site for background on the case. Author Notes Susan Boswell, an assistant managing editor of The ASHA Leader, can be reached at [email protected]. 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David Collier, Sarah Curran, Philip Asherson

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