Archive | April, 2009

Bernadine Healy gets it wrong

17 Apr

Following Bernadine Healy’s April 14th post in USNews, Orac dealt her a dollop of respectful insolence which is a very good read, as are the comments.

However, I wanted to do a kind of accounting on Healy’s post, to see just how firm a grasp on the whole situation she has. So, lets start.

McCarthy and Carrey and two colleagues from the autism advocacy group she founded, Generation Rescue…

Oops. Sentence two, first error. McCarthy did not found Generation Rescue, JB and Lisa Handley did.

…and parents are raising legitimate concerns, yet unanswered…

I have been on the front line of this debate for the last six years. Once upon a time the question ‘do vaccines cause autism’ _was_ a legitimate one to ask. But that question has been asked and answered. Since about 2003/4 there have been _no_ legitimate concerns raised by parents or anyone else. The MMR question has turned out to be both a con and the result of bad science. The thiomersal question is just a defunct hypothesis, given that thiomersal was largely removed from vaccines by 2002 and yet autism rates continue to climb. Despite desperate attempts to rebrand the autism/vaccine question (aka when you know you’re right and yet turn out to be wrong, know you’re right with something else) into questions about greening vaccines when simple searching reveals that newborns contain most vaccine ingredients either naturally or via breast feeding. Or the hellacious vaccine schedule despite the fact that the UK for example has a higher rate of autism (1 in 100 vs 1 in 150) but a lower amount of vaccinations.

This controversy might be resolved if we can focus on a few big questions, with an open mind…

Mistake number three. There is no controversy. In the field of _science_ asking the _scientific question_ ‘do vaccines cause autism’, there is no controversy at all. What there is is a very good and well executed media campaign to manufacture one. However, the facts remain the facts – no vaccine, no vaccine ingredient and no vaccine schedule either solely or together cause autism. There is simply no sound science to support that set of ideas. If there is a controversy it is how the media continue to let people stoke the fire of this idea.

Influenza vaccine, mandated here starting at age 6 months…

Mistake number four. As far as I can tell, the flu vaccine is not mandatory in the US. Certainly this article covering the 2008/09 flu season states:

It will not be mandatory for every child to have the flu shot…

Onward.

…a study from Canada last year found that delaying the diphtheria, tetanus, and pertussis vaccination just a few months decreased by 50 percent the risk that a child develops asthma…

Mistake number five. This has absolutely no bearing an autism. The article is entitled ‘The Vaccines-Autism War: Détente Needed’. Not ‘vaccines, asthma, maybe other stuff as and when I think of it-autism war’. As such this strawman argument has nothing to do with autism.

(Side note: Healy says we should read two doctors thoughts on the pros and cons of a flexible vaccine schedule. It maybe will come as no surprise that the doctor who thinks the US needs a flexible vaccine schedule is ‘Vice chair, Section on Complementary and Integrative Medicine’ of the AAP).

The goal is to get all kids appropriately vaccinated…

Mistake number six. The organisation Healy references at least twice, Generation Rescue, have this on the front page of their Facebook Group

“I found that the whole vaccine business was indeed a gigantic hoax…” –Dr Kalokerinos MD June 1995

“There are significant risks associated with every immunization and numerous contraindications that may make it dangerous for the shots to be given to your child…” — –Dr. Robert Mendelsohn MD, pediatrician

Onward again.

…Hannah Poling, for example, who has an underlying mitochondrial disorder and developed a sudden and dramatic case of regressive autism after receiving nine immunizations, later determined to be the precipitating factor…

Mistake number seven. Nowhere, repeat, nowhere has it been published that Hannah Poling’s vaccines were the ‘precipitating factor’ in her autism. If anyone thinks that it has been published I would like a link to that document. I’ve been asking for this for over a year now and no one has ever managed to show me where this is stated.

What _has_ been said is that following her vaccines hannah showed ‘features of autism’. As I have said numerous times, ‘features’ of autism is not interchangeable with autism. If it was, then the medical report co written by four doctors including Hannah Polings father Jon Poling would have simply said ‘autism’. In fact, this medical case study listed a number of symptoms (over 20) of which only three were found on the DSM (IV) (the official diagnosis for autism). She may well have been autistic and she was determined to have been vaccine damaged but that does not automatically mean one caused the other and in fact by the lack of any of the many other symptoms needed to reach a diagnosis of autism, we can see that they were not.

Amd again, onward:

Other children may have a genetic predisposition to autism, a pre-existing neurological condition worsened by vaccines, or an immune system that is sent into overdrive by too many vaccines, and thus they might deserve special care. This approach challenges the notion that every child must be vaccinated for every pathogen on the government’s schedule with almost no exception…

Not exactly any mistake here but this is very misleading. Its well know _already_ that some kids _do_ have conditions that are not amenable to vaccines. Less than 30 seconds of searching the CDC website led me to the appropriate information. I think it is incredibly disingenuous and very ignorant of Healy to comment in the manner she has.

Onward we trudge through the morass.

Paul Offit, an infectious-disease expert from the University of Pennsylvania who has been a frequent spokesman and adviser on vaccine policy (and by his admission has become wealthy by developing the now mandated rotavirus vaccine)

Mistake number eight. The Rotavirus vaccine has never been mandated anywhere that I can see.

So this is Dr Bernadine Healy, a scientist with 125 records in PubMed. Impressive until you realise that, just like this, they are 125 blog entries from US News. That means we can say that on average Healy has got 1,000 mistakes into PubMed.

Good going Bernadine.

Powerful Autism public service announcement

16 Apr

Autism Steals….

Autism leaves an empty shell…

These are autism myths. This public service announcement is a good video to show people to address these (and other) myths–it is professionally done and carries a simple yet powerful message.

ASAN worked with the Dan Marino Foundation and Kent Creative to develop the PSA.

Leave the old stereotypes behind.

Very well said.

[edit]
Ari Ne’eman is correct–there is a national discussion on autism, and it is happening without the autistics. That is wrong.

Here is the captioned version (thanks codeman38!)

http://www.overstream.net/swf/player/oplx?oid=udtvrbt0rlao&noplay=1

Polly Tommey Woo-ing Gordon Brown

15 Apr

Polly Tommey was due to see Prime Minister Gordon Brown today after a successful billboard campaign, costing a reported £500,000, that invited Gordon Brown to meet with her if he wanted to save £508 million pounds. Ms. Tommey’s son is autistic and she is concerned that there is a terrible fall off in provision and support when you transition from school to adult services. She wants the government to invest in autistic people and her message is that appropriate support will save the government money by lifting autistic people out of benefits and into paid employment. As she says in her press release:

“We want better support, we want politicians to engage with us and we want the acknowledgement and support that our children deserve as fully contributing members of society.”

This is all very admirable. But Dr Michael Fitzpatrick has written An Open Letter to Gordon Brown in which he questions how she expects to achieve her aim.

In her campaign posters, Mrs Tommey, whose 12-year-old son Billy is autistic, offers to save the UK government £500 million a year by helping people with autism to get jobs. But it is not clear from the posters how she thinks this can be achieved. However, The Autism File, the magazine she edits, focuses on two issues: supporting the campaign led by the former Royal Free Hospital researcher Andrew Wakefield against the MMR vaccine and promoting ‘unorthodox biomedical’ treatments for children with autism.

The main point that Dr Fitzpatrick makes is that if her message to the prime minister is the same as the one she promotes in The Autism File she would be well advised to think again. He ends thus:

If she wants better provision of diagnostic, supportive and educational services, she might consider adding her energies to the long-running campaigns of the National Autistic Society and others, currently focused on the Autism Bill.

Ms Tommey’s supporters have been quick to respond. At The Age of Autism, Teri Arranga accuses Dr Fitzpatrick of carrying out an inquisition against the Autism Trust and quotes Trust Chairman. Oliver Jones who responded to Dr Fitzpatrick as follows:

I am both shocked and astounded having read your open letter on the Internet this afternoon. How dare you act in such an ill informed manner about a campaign that I and many others have invested significant time and effort in – when you evidently have no idea about what we are actually focused upon.
I find it remarkable that a professional person can take such an aggressive stance as you have done about The Autism Trust’s campaign without having the decency or following proper protocol by making contact with any of the Trustees and specifically myself to determine the objectives and intent of our forthcoming meetings.

The tone of the article is plain. The Autism Trust is trying to improve services and quality of life for autistic people in the UK and Dr Fitzpatrick is misrepresenting their aims and undermining their efforts because he resents Ms Tommey’s support for biomedical interventions. Having read the Autism Trust’s lengthy press release I agree with Dr Fitzpatrick.

“A Personal Campaign”

The press release is clear that this is Ms Tommey’s “personal campaign.” She wishes to speak to Gordon Brown “on behalf of the thousands of mothers of children with autism in the UK.” It repeats that this is “Her campaign” and highlights her role as Editor-in-Chief of The Autism File.

Credibility

Ms Tommey obviously has a lot of business acumen and is an astute campaigner who is adept at using the media to position herself “as one of the leading figures in autism in the UK.” But, as Dr Fitzpatrick points out, her support for discredited notions about MMR and autism and her promotion of unproven treatments do call her credibility into question. This is underlined by errors in the press release. Ms Tommey claims that:

autism numbers have increased dramatically in the last twenty years from 1 in 10,000 in 1988 to 1 in 100 today.

As long ago as 1966 Lotter established a figure of 4 in 10000 for severely autistic children. When Wing and Gould examined the broader autistic spectrum in 1979 they found 20 in 10000. The present figure of 100 in 10000 includes people without significant cognitive impairments who were only added to the diagnostic criteria in 1994.

But Ms Tommey uses these false figures to argue that we face a fresh challenge as for the first time a significant number of adults enter the system. This is a direct contradiction of the NAS I Exist campaign which has successfully persuaded the government that generations of autistic adults have been ignored. The NAS is continuously engaged in discussions with government ministers and officials to get a commitment to action based on the provisions of the Autism Bill which enjoys unprecedented support amongst MPs.

Centres of Excellence

The Centres of Excellence proposed by the Autism Trust seek to provide residential communities in rural locations that provide a “safe haven” for autistic adults. They hope that such centres will provide support for autistic adults in the community, setting up in business or becoming self employed. But most people live in urban settings so it hard to envisage how they will benefit. And despite Mr Jones’ protests it is clear that the Autism Trust is as committed as Ms Tommey is to nonsense cures and treatments. Each centre of excellence will feature a wellness centre offering all manner of quackery including homeopathy, chelation and hyperbaric oxygen therapy, as well as training centre and a conference centre promoting these “biomedical interventions.”

I think that Mr Jones’ complaints against Dr Fitzpatrick are disingenuous. If anything Dr Fitzpatrick should be taken to task for failing to mention the Autism Trust in his open letter. At a time when service providers are moving away from the model of self contained autism communities in favour of closer integration of services within everyday society the Autism Trust proposes to build a worldwide network of such communities.

They expect local authorities to fund places in their residential homes while they are free to develop profitable spin offs promoting quackery. Or, as they describe it in their financial model:

The capital development and business operating model will depend on the facility mix and local partners – as well as the engagement and support available from local and national government. A mix of charitable status and commercially self-standing models will be explored in each location.

Danger

The greatest danger is not that Ms Tommey and the Autism Trust are going to persuade the government to follow their lead. But by muddying the waters with their campaign they may give the government an excuse to back pedal on existing commitments while they consult with this self appointed autism constituency. The best way forward is to get behind the NAS campaign and keep up the pressure for the provisions of the autism bill to become law.

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Michael Fitzpatrick misrepresented by Age of Autism

15 Apr

Hardly news I suppose but on AoA yesterday Michael Fitzpatrick was misrepresented by someone called Teri Arranga.

Starting off by referring to Mike as a ‘backwoods doctor’ – something of an anti-British slur since Mike is a GP in London (I guess London is a backwoods now to AoA?) she soon went on to pretty much rant incoherently, built a few strawmen and finished off by quoting some other guy also ranting incoherently.

According to Arranga

…backwoods doctor Michael Fitzpatrick blasted Polly Tommey, founder of The Autism Trust, for the current campaign that seeks better supports and services for autistic individuals in the UK…

Hardly. Here’s what Mike led with:

In response to her ‘Dear Gordon’ billboard advertising campaign (see below), you have invited the British autism campaigner Polly Tommey to discuss her campaign with you on Wednesday 15 April. However, in the interests of children and families affected by autism, I hope that you will refuse support for her key activities – upholding discredited links between vaccines and autism and recommending unproven and untested fringe treatments.

Blasting? Good grief, where do these fragrant middle class ladies live? Its a statement of fact followed by a wish. None of it isn’t factual and its pretty much polite and to the point.

The fact is that the Autism File _is_ Tommey’s key activity. The other fact is that it is distinctly pro-extreme biomed and upholds links between key anti-vaccine researchers such as Andrew Wakefield. But Arranga sees some more blasting:

Fitzpatrick also blasted The Autism File magazine for including information about vitamins (oh, mercy me) and advertisements from “suppliers of biomedical products” (though none of them as lofty as Merck/Vioxx and Eli Lilly like Fitzpatrick’s cronies’ medical journals), among other things.

What escapes Arranga’s attention is that vitamins used as part of a quack ‘treatment’ for autism is both physically damaging (back in 2006 Mary Megson reported on the case of an autistic boy who was hospitalised by a DAN! doctor following an overdose of vitamins) and damaging to the future of autism research. Oh, mercy me indeed.

But no, Mike mentions the vitamins in passing. Arranga somehow neglected to mention the 15 page feature on Andrew Wakefield in the current issue of Autism File. It is peppered with ads for treatments from various biomeddlers.

Then we get to the ‘undermining’.

Fitzpatrick is trying to undermine the efforts of Polly and The Autism Trust to improve quality of life for autistic individuals and their families, many in woeful situations of deprivation and stress….Polly Tommey will be having meetings with members of the Prime Minister’s team in advance of the promised meeting with Prime Minister Gordon Brown himself. For Fitzpatrick to try to undermine this and to try to deny a charity the ability to do that on behalf of suffering individuals in a country deluged by autism is outrageous.

You can almost see the smoke coming out of Arranga’s ears. And for what? This is nothing but a strawman. Nowhere I can see is Mike saying Tommey shouldn’t go for her meeting with Gordon Brown. And nowhere I can see is Mike saying Tommey shouldn’t do the great things described. What he _is_ saying is that Brown should be very careful about the sort of things coming out of Tommey’s mouth about vaccines, treatments and cures. She is, on these issues, a know-nothing and I think it is absolutely correct for Mike to speak up for the autistic people and parents of autistic people who have no interest in the poor science peddled by Tommey’s publication.

Then after the strawman comes the conspiracy theory, this one bizarrely roping in Brian Deer for some totally mystifying reason:

If it threatens the Deer/Fitzpatrick camp when we want to get better services and supports for 1 child in 60 in the UK and their families, then we have touched a nerve. For example, how can trying to get decent housing and family supports threaten Deer and Fitzpatrick’s current repertoire of witch hunting? Why are they so scared that they would resort to petty tactics?

I mean, huh??? Can’t these people read? And whats this 1 in 60 number? The prevalence for autism in the UK is about 1 in 100. Weird.

Also frothing over in indignation is Oliver Jones, Chair of Autism Trust. He is ‘shocked’ _and_ ‘astounded’ (less caffeine feller):

How dare you act in such an ill informed manner about a campaign that I and many others have invested significant time and effort in – when you evidently have no idea about what we are actually focused upon

Oliver – it seems Mike has a very clear idea. Once again, at no point did Mike say that Tommey shouldn’t meet with Brown or discuss her campaign. He is merely pointing out that Tommey is someone with some decidedly odd ideas about autism treatment and that Brown should show these ideas – if they happen to be raised – the door. He also quite rightly points out that if Tommey is really serious about getting better services and education she should join NAS and support their already existing campaigns in these areas. I’m sorry Autism Trust but the phrase ‘showboating’ does spring inexorably to mind.

Their closing paragraph is genuinely amusing:

Secondly, in respect of Michael Fitzpatrick’s ill-informed letter, we would recommend that we should not seek to highlight this man in the eyes of the UK government, but, instead, we should recommend that people write to him directly. People like Dr Fitzpatrick – like Brian Deer – should simply not be allowed to undermine genuine initiatives such as Polly’s – we cannot allow this censorship.

Yeah, damn that censorship Mike (and Brian Deer again???) -how could you dare to voice your concerns and opinion in a public way? Why couldn’t you just shut up?? Oh wait…isn’t that….censorship…d’uh.

AoA have suggested 2 letter writing campaigns. The first is to deluge Mike’s inbox with emails from AoA readers. The second is to flood the PM with emails supporting Tommey.

Thats fine. But Tommey and AoA should know that a second email campaign is now under way. I’ll ask my readers here to contact Number 10 by writing an email to Gordon Brown c/o Katie Martin (Press Office in Downing Street) on email kmartin@no10.x.gsi.gov.uk or to Michael Ellam (Director of Communications in Downing Street) on email mellam@no10.x.gsi.gov.uk.

I’ll be writing as the parent of a severely autistic child to express my support of Mike’s points regarding Tommey’s beliefs. I hope you will too. And note that AT is an international organisation – US citizens are valid contributors also.

It’s different for girls

13 Apr

One of the puzzling things about autism has always been the disparity between the sexes.  Boys have always been more susceptible than girls. This is not in itself unusual. There are gender differences affecting a whole range of conditions and, if this New York Times article is correct, men frequently come off worse.

But if boys are more susceptible you might have assumed that as the severity of the condition increase this disparity would become more marked. In fact you would have assumed wrong. According to this source:

The greater severity and lower frequency of autism in females has been cited as evidence for a multifactorial polygenic mode of inheritance with differential loading by sex, which predicts greater severity in the less frequently affected sex.

Greater severity is usually taken to include severe cognitive impairment as well and the greater the degree of cognitive impairment the closer the ratio between boys and girls.  But there are problems with this model. David Skuse has argued that the association between cognitive impairment and autism is not because they share a common cause but simply because if you have both conditions you are more likely to be seen by a clinician and get a diagnosis. More able people may be just as autistic but have coping strategies that enable them to avoid a diagnosis.  And if girls have better coping strategies than boys they will be disproportionately overrepresented amongst autistic people without cognitive impairment who are missed by the system.

Last week Woman’s Hour broadcast a segment on Asperger syndrome took up this argument and suggested that there may be as many girls as boys on the spectrum. Most of them are not getting a diagnosis because they present in ways that are unfamiliar to clinicians who are used to seeing the condition in boys. The programme is no longer available but Sunday’s Observer carried a two page spread on the same story.

Experts like Judy Gould and Tony Attwood cited by the Observer still believe there is a gender difference but they estimate that it is only 2.5:1. Asperger girls may be more passive than boys. They do not assert their difference or draw attention to themselves. Instead they observe and copy other people’s behaviour. Their special interests may be intense but are also likely to be more socially acceptable; reading fiction, following soaps, celebrity culture – the sort of thing that lots of other girls do – and so they do not stand out.

Conformity comes at a cost. The Observer quotes Tony Attwood’s estimate that 20% of anorexic girls are undiagnosed autistics. Then there is self harm and other evidence of psychological stress. There are important differences between men and women. They need to be understood and respected. But it does not help autistic women if autism is described as an extreme male brain syndrome. The Observer ends by quoting professor David Skuse who believes that:

if we can prove the ratio of boys to girls is as high as many of us suspect, it would be as significant a milestone in this field as the discovery that the condition is on a spectrum.”

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The Somali Minnesotan Autism Epidemic

13 Apr

One of the most intriguing scenarios to pop up from the so-called autism epidemic happened in Minnesota in the US. It was noted that there were what seemed to be disproportionately high numbers of second generation Somali children in Minnesotan schoolrooms. Of course, this was immediately latched on to by the usual suspects, despite the caution issues by health authorities that until proper epidemiological studies had been done it would be impossible to say whether this really was a cluster worth investigation or just a coincidence.

On the 31st March, the Minnesota Dept Health released the study. Its a fairly substantial read. One thing immediately struck me about this:

Administrative prevalence of Somali children, ages 3 and 4, who participated in the MPS ECSE ASD programs was significantly higher than for children of other races or ethnic backgrounds

OK so this is what the families were saying. But there’s an extreme note of caution that should be noted here. This is basically CDDS all over again. Just like some believed that an increasing number of reports to CDDS meant that there was an autism epidemic and just as CDDS said there reports really shouldn’t be used to study these things, MDH are also saying:

Because of the study’s limitations, it is not proof that more Somali children have autism than other children…

This is a vital point. Back in 2005, James Laidler made the clear point that Department of Education data on autism are not reliable for tracking autism prevalence.

Sadly, the new Age of Autism editor, Abdulkadir Khalif, either misunderstood or elected to ignore this issue when he said:

It was obvious from the numbers that the issue of prevalence has finally been settled, and that there definitely is a cluster of autism in Minneapolis

It is clear from the report that Khalif has grossly overstated the case. Firstly, the issue of prevalence is far from settled. MDH seem to be solely using educational data which, as pointed out by Laidler, is not reliable for tracking autism prevalence. Indeed the phrase ‘administrative prevalence’ used by MDH reflects this. ‘Administrative prevalence’ refers solely to numbers of kids in educational programs. This is a clear distinction from ‘prevalence’ which is the proportion of individuals in a population who suffer from a defined disorder. Using only educational data gives a distorted picture.

As has been shown, the USDE data on autism are at odds with studies of autism prevalence, largely because the criteria used by the school districts (the source of the USDE data) to categorize children as autistic are neither rigorous nor consistent. They are inconsistent over time, as are the medical criteria, and are inconsistent from region to region. The USDE data are not reliable for tracking the prevalence of autism, and they in fact never were meant to fill this need.

Secondly Khalif uses the word ‘cluster’ whereas the MDH report does not use it at all. And it is not a word that should be used in such a throwaway fashion – it has a distinct epidemiological meaning.

So clearly, contrary to Khalif’s assertion that the issue of prevalence has been settled, it has not. Contrary to his statement that there is a cluster, there has been no such epidemiological assessment or statement.

Here are some more quotes from the MNH report that Abdulkadir Khalif either chose to ignore or never actually read:

The fact that a child is participating in an ASD early childhood program is an indicator of educational need, but that child may or may not have a medically diagnosed ASD.

Further, Minnesota’s public school open enrollment policy allows children to attend special education programs in school districts where they are not residents. This raised the question of whether participation rates for Somali children might appear higher than the participation rates for non-Somali children because of an influx of Somali children who are not residents of the Minneapolis school district attending MPS ECSE programs for ASD.

Data on variability of ASD prevalence by race, ethnicity, and SES is limited and inconclusive, and apparent differences between racial and ethnic populations may largely be due to differences in case finding and service provision.

Across all assumptions and ASD program types, administrative ASD prevalence estimates for Somali children were uniformly higher than the U.S. parental reported ASD prevalence, but most of the 95% confidence intervals corresponding to the administrative prevalence estimates for Somali children contained the value of the U.S. parental reported ASD prevalence estimate – suggesting that the 2005-2006 administrative ASD prevalence for Somali children might be no different from what would be expected in the U.S. population of children ages 3 and 4 based on parental report.

So what does this mean?

It means that there are no firm answers and that Khalif is simply wrong to assert that there are.

Its always been one of the great puzzles to me that a section of (mostly) parents who demand accurate answers fast cannot seem to understand that there _are_ no accurate answers until the science – proper science – has been done. And that takes time. What legacy do these parents want to leave the autism community? Fast inaccurate mistakes? Or well planned and rigorous science that helps build the growing knowledge we already have?

California tries to win back “stay put”

13 Apr

Parents, of course, have the primary responsibility to provide for the needs of their children. But, children and adults with special needs often require more than their parents can provide, and that’s where government agencies are supposed to help out.

In California, the Regional Centers manage government sponsored services for those with exceptional needs up to age 3. At age 3, the school districts take over as the lead agency, with the RC’s taking a secondary role.

That is, of course, if all goes according to plan.

What if a school district is swamped or for any other reason isn’t prepared to take over? What happens to the child’s services?

Up until a couple of years ago, the child would stay in the same services until the school district and parents could work out the new plan. This was called “stay put”. A family could say, “Hey, look, you aren’t prepared to take on my kid’s services in the school, so we are going to ‘stay put’ with the services we have until this gets worked out”. During ‘stay put’, the district pays for the same services the RC was paying for until age 3.

Then came a change to IDEA, the Individuals with Disabilities in Education Act. Stay put was lost.

Yeah, parents can pay out of pocket while going through a dispute process. That is, parents with the money to do so. The dispute process, at best, take a few months.

This didn’t happen without a lot of activism to try to keep “stay put”. So far, it hasn’t reinstated “stay put”, but there is hope. State Assembly Bill AB1124 is in process.

There is a hearing on this with the Education Committee, this Wednesday (April 15).

This is a proposed California Law, but, let’s face it, setting the precedent that stay put needs to be in place could help people throughout the US. For Californians, now would be a good time to contact your assembly person about this. If your assembly person is on the Education Committee, now is a REALLY good time to contact him/her.

Speaking clearly

12 Apr

The Canadian Journal of Medicine have an interesting article by MacDonald and Picard pleading for clearer language to be used by academics. In
particular they note the potential for different audiences to make
different conclusions from the 2001 Institute of Medicine report
looking at the relationship between MMR vaccine and autism.

The conclusion in the executive summary of the 2001 Institute of Medicine report about the relation between the measles–mumps–rubella vaccine and autism provides an excellent example of potentially confusing academic language. This conclusion was carefully crafted in precise academic language — so precise that, depending on the reader, different conclusions can be drawn. The academic involved in vaccine research, familiar with the scientific principle that the null hypothesis cannot be proven, would conclude that this report does not find evidence that the measles–mumps–rubella vaccine causes autism. A health care worker reading this same statement may not be sure what to make of it: maybe the vaccine causes autism in some children, just not often. The politician may wonder whether supporting public programs for measles–mumps–rubella vaccination at this time is justified. The journalist may reasonably interpret the conclusion as saying that the vaccine is a cause of autism, albeit an infrequent one. The antivaccine lobby, for its part, would be delighted that this respected academic body has given support to its claims that the vaccine can cause autism.

Go and have a read, and compare the actual IOM conclusion with
MacDonald and Picard’s proposed conclusion. Their arguments have
merit, particularly when it comes to the media interpretation of study or report findings. However, I’m not so sure about the anti-vaccine movement, who will deliberately misrepresent studies to prove the complete opposite of what they say, but we can at least stop giving them easy ammunition with which to dupe others.

Omnibus Expert: Patricia Rodier

10 Apr

Autism just plain isn’t mercury poisoning. When can we move on?

Even some of the people who loudly promoted the mistaken idea that “autism is just a misdiagnosis for mercury poisoning” have backed off. But, the groups that promote autism as vaccine injury are packrats: once they’ve collected an idea, bad or not, they won’t ever let it completely go.

Some of you will be thinking, dang, another mercury post. I agree, there are a lot of good arguments against blogging about the mercury-autism connection any more. For one, it gives the idea press that it just doesn’t deserve.

I do think this is worth posting about, though. “This” is the expert report from Dr. Patricia Rodier, submitted to the Autism Omnibus Proceeding. In a single document, we now have an expert on both mercury toxicology and autism. Not faux experts, or worse, businesspeople and public relations people, but an actual, bone fide expert in both fields. I.e. we have a good document to give to people who are being snowed under by the misinformation campaign promoting autism as mercury poisoning.

When Patricia Rodier testified in the Autism Omnibus Proceeding, I was very impressed–and I blogged it right away. I remember at the time telling a friend that it was good to finally see someone officially debunking things like Sally Bernard et al.’s paper, Autism: a novel form of mercury poisoning. My friend pointed out that any college freshman in science (and most not in science) should be able to tear that “paper” apart.

Unfortunately, “should be able to tear the paper apart” isn’t enough. Many people don’t have the time and/or energy. So, many people still think that paper is valid. Let’s face it, that “paper” should have been retracted by the authors long ago, but they still soldier on with the “autism is mercury poisoning” message.

Dr. Rodier’s qualifications are quite good. Her summary is quite good:

As a research scientist who has studied both the toxic effects of methylmercury in animals and autism in children and animal models, I believe I am qualified to evaluate the scientific merit of the allegation.

She may be the only person in the world who has studied both mercury toxicity and autism.

What does she think? In a nutshell:

My conclusion is that the allegation has no scientific support and is highly improbable

Dr. Rodier notes that the comparison that autism and mercury poisoning appear similar isn’t even close.

In othcr words, because the symptoms of methylmercury poisoning
are not similar to those of autism, the authors have tried to construct a new, hypothetical kind of mercury poisoning from symptoms of toxicity of other mercury species and symptoms never reported for any kind of mercury exposure. The hypothesis is not based of facts; instead, the facts are being selected, manipulated, and shaped to fit the hypothesis. The hypothesis is then offered as evidence. But hypotheses are not evidence.

Ouch. Ouch, that is, if you are someone promoting autism-as-mercury-posinong.

Dr. Rodier can back up her words, as we discussed in the previous blog post. But, let’s say that again, Dr. Rodier uses research based facts, not manipulated hypotheses, to come to her conclusion.

I need to get a clean copy of that document, one that looks as good as the information it contains. That document needs to get into the hands of people being lured by the pseudo scientists promoting autism as mercury poisoning.

Thank you, Dr. Rodier for putting yourself on the line to testify. Thanks also to the HHS for allowing these reports to be made public.

All change

9 Apr

A new design (more a realign than a redesign really) for LBRB and the alteration of some functionality.

The biggest change in functionality is that from now on you’ll be offered the chance to sign in to comment. In order to make this as easy as possible I’ve signed up with the RPX service which allows LB/RB to offer you several easy passwordless ways to comment. If you have a Facebook, GMail, Yahoo, Flickr etc etc account then you no longer need to do anything but click. This does not store your passwords anywhere, its simply an easy way for technology to talk to each other to make life easier for you the user. If you’re still not happy with that you can still elect to sign in anonymously. The biggest advantage for LB/RB for doing this is making the site harder to spam.

The biggest change in interface is I guess the ad placeholders. LB/RB has to bow to the inevitable and do all it can to get some money through the door. But please rest assured the ads will be vetted and will not feature anything contrary to the editorial direction of this site. Its the first time in its nigh on 6 years online adverts have been placed. A necessary evil I guess.

If you have a Gravatar your goods will be displayed 🙂 If you don’t – go get one!

Its been made easy for you to add LB/RB to various Social Networking apps and sites. If we’ve missed one out your want to see please contact us.

Efforts have been made to make the site work primarily on Firefox, IE6, 7 and 8, Opera, Chrome and Safari. There are still some very minor niggles in IE6 but mainly we’re good to go. I’m also aware that Archives aren’t available right now.

You might also note that there is no search box. There’s a reason for this 🙂 keep watching the top right column just above the block of four ads.

Go and play with it, you won’t break it and if you do or you find a bug please contact us.

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