Why the next CDC autism rates spells bad news for the mercury hypothesis

22 Mar

A recent article on Disability Scoop discussed an upcoming CDC autism report. The MMWR’s(Morbidity and Mortality Weekly Reports) from the CDC have been one of the standards for autism prevalence for years. Each CDC prevalence estimate is calculated for a group of 8 year olds born in a certain year. For example, the last estimate was “Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, United States, 2006” for children born in 1998.

Every time a new CDC autism MMWR has come out, the prevalence estimates are higher. Every timer there are groups that point to the rising number of vaccines and mercury exposure from those vaccines. People point out that there is a correlation between mercury exposure (thimerosal) and the autism rates. The MMWR’s so far have been all for children born in the 1990’s, a period when the number of vaccines and the thimerosal exposure from those vaccines was increasing.

Here are the autism prevalence estimates from recent CDC reports:

2006 (birth year 1998) 9 per 1000
2004 (birth year 1996) 8 per 1000
2002 (birth year 1994) 6.6 per 1000
2000 (birth year 1992) 6.7 per 1000

Following this trend, the next report will be for children born in 2000, age 8 in 2008. From the perspective of testing the vaccine hypothesis, in particular the mercury/thimerosal hypothesis, this is the start of a new era. In 1999 the AAP recommended that thimerosal be removed from vaccines. By 2001, all infant vaccines with the exception of influenza were produced only in thimerosal-free versions. This means that children born in 2000, the cohort the CDC will likely report upon, received, on average, a lower exposure to thimersal than the previous groups.

If the mercury hypothesis were correct (and there already a great deal of evidence to say that it is *not* correct) the autism rate should go down. At the very least, it should stay the same as the group before–about 0.9%.

Of course we will hear claims like “but not all the thimerosal containing vaccines were gone for this group” and “but what about the influenza vaccine?” and more obvious excuses in case (at it seems likely) the prevalence goes up again.

All of these avoid the fact that the average thimerosal exposure will be much lower for this group than the previous (1998 birth year) group. The excuses amount to…well…how about a visual?

With thanks to Reuters for the image I am using.

Yes, goal posts will move. Nice idea putting them on wheels. Could save a lot of effort, but those promoting the mercury idea are already used to moving goalposts.

And what if the CDC also reports on birth year 2002 (they have reported two birth cohorts at the same time in the past)? Those goalposts might to have to move quite a bit.

Now consider a different perspective. Consider that each CDC report has been an undercount. They don’t do a “whole population” survey like was done in Korea recently. They don’t test all children, they rely upon records already in existance. The last CDC report found that about 23% of the children identified as autistic in the study did not have a diagnosis before the study. Clearly the United States has not been identifying all the autistics in the population. Given this, the rising autism prevalence estimates (and, yes, they are *estimates*) could be seen as an accomplishment. This is a position put forth by Prof. Richard Grinker. The rising prevalence estimates reflect a the U.S. getting better at identifying the autistic students in our schools.

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36 Responses to “Why the next CDC autism rates spells bad news for the mercury hypothesis”

  1. Julian Frost March 22, 2012 at 06:36 #

    That picture says it all. Thanks for the giggle Sullivan.

  2. RAJensen March 22, 2012 at 16:07 #

    The prevalence rates for narowly defined autism hasn’t changed in twenty years 0.2% (20/10,000). the increase is in the more broadly defined cartegory. The lead editor of DSM-IV, Allen Fracis, has attributed the so-called false autism epidemic to the diagnostic crteria introduced with DSM-IV (1994) He has also stated that the field trials of DSM-IV failed to predict the fasle epidemics of autism, attentional disorders and bi-polar disorders. He has now concluded the the introduction of DSM5 will dramatically reduce prevelance rates for ASD with the removal of Asperger Syndrome and PDD/NOS.

    http://www.huffingtonpost.com/allen-frances/dsm-5-will-lower-autism-r_b_1240016.html

  3. McD March 22, 2012 at 23:26 #

    I too think the broadening criteria has a lot to do with the increase, but I just followed Sullivan’s link to the 2006 report and found this in the discussion:

    The widening of diagnostic criteria over time to include persons who are more mildly affected has been suggested frequently as a factor influencing increases in ASD prevalence (2,3,37–39). Although not a perfect indicator of degree of impairment severity, the broader spectrum might be represented by children who received a diagnosis from a community professional of a broader ASD subtype (i.e., Asperger disorder, PDD-NOS, or ASD or PDD, broadly defined) compared with autism (autistic disorder). However, in this analysis, a clear shift was not identified from 2002 to 2006 in the use of the more broadly defined ASD diagnoses. In fact, for several sites, increases were recorded in the use by community professionals of the autism diagnosis rather than the other ASD diagnoses. Another indicator of identifying children on the more mild end of the spectrum would be a differential increase in prevalence among children with borderline or average to above-average cognitive functioning. Although the overall pattern among these higher cognitive functioning groups indicated substantial increases in ASD prevalence, increases also were observed among children with cognitive impairment. Increases varied across sites, and a clear pattern did not emerge that would permit attributing the majority of the increase in ASD prevalence to the use of the broader ASD spectrum.

    The actual figure was 47% receiving an actual autism (not AS, PDD-NOS etc) diagnosis. Although I note that it was a records search and they were looking for kids who had EVER received an autism diagnosis. Which is different to a snapshot of 8 year-olds at the age of 8.

    The thing is that the main effects of the shift in diagnosis appear to have happened some time ago. The DSM IV came out in 1994. We are still now seeing smaller incremental increases in autism prevalence. In addition to shifting diagnosis, younger age at diagnosis, and the usual suspects, this could also be consistent with some cases of autism having genetic/epigenetic/prenatal causes associated with adverse pregnancy/infant mortality outcomes, which are alleviated by improvements in modern medicine – gradually improving the survival rate of the more vulnerable babies. Not all, but a proportion. It would be interesting to see if the proportion of autistics who were premies or multiple births increases.

    If the new results for the 2000 and 2001 cohort show a plateau or increase, and not the predicted drop, the anti-vax movement cannot co-opt the shifting diagnosis argument; the CDC are showing that its effects are less evident over time while prevalence still increases.

  4. Roger Kulp March 23, 2012 at 04:04 #

    Just curious if they count those who were diagnosed as adults?They should be counted,too.

    • Sullivan March 23, 2012 at 19:15 #

      Roger Kulp,

      the CDC counts are always for 8 year olds from a given birth year. I don’t think the US has done an adult prevalence study. The UK did an adult study http://www.time.com/time/health/article/0,8599,1927415,00.html

      Adults are much harder to get a good count on. With kids they have access to records for most of the kids in a given area and birth year. It isn’t an ideal method as there are a lot of opportunities for kids to be missed. It is a lot cheaper than a whole-population study, though.

  5. RAJensen March 23, 2012 at 09:21 #

    Many individuals currently diagnosed with PDD/NOS or Asperger Syndrome would most likley qualify for the new DSM5 diagnostic category of Social Communication Disorder. Why not just rename Social Communication Disorder, Asperger Syndrome which might resolve some of the complaints about Asperger Syndrome being removed entirely from DSM5.

  6. Liz Ditz March 23, 2012 at 20:44 #

    We’ve already found the new goalposts, it’s the evil aluminum. That’s my prediction of what the “autism is vaccine injury” gang are going to claim.

  7. RAJensen March 24, 2012 at 11:09 #

    McD;
    There are two population based studies that examined the longitudinal outcome of infants born extremely pre term or positive for extremly low weight deliveries.

    Johnson et al examined the records of all extremly pre term births in the UK and Ireland and reported that 16 of the 307 survivors, 8%, had an ASD diagnosis.

    http://www.ncbi.nlm.nih.gov/pubmed/20056232?

    Pinto-Martin et al (2011) assessed the long term outcome of infants with extremly low birth weight, less than 2000 grams, 31 of 623 had been diagnosed with autism, a prevelance of 5%.

    http://pediatrics.aappublications.org/content/early/2011/10/14/peds.2010-2846.abstract

    Both of those studies hilight the risk associated with other studies examining the longterm outcome of children with a specific pre, peri or nenatal event first reported by Stella Chess in her seminal article ‘Autism in children with congenital syndrome’. 243 children diagnosed with congenital rubella syndrome were placed under her care at New York University hospital, 18 of the 243 children wer given a psychiatric diagnosis of autism or atypical autism which represented 7.4% of total cases. The prevelance of autism in each of these studies is statistically significant compared to CDC estimates of autism prevelance of 1/110.

    http://www.springerlink.com/content/j25pqu8546115m47/

  8. Harold L Doherty March 25, 2012 at 23:49 #

    Thank you for analyzing that CDC report BEFORE it is available and BEFORE you have read it Sullivan. Always nice to see demonstrations of your scientific method. Great to see you and Liz Ditz display your animosity toward any exploration of the many possible environmental causes or triggers of autism disorders. If only the tobacco industry had your services available to prevent that whole lung cancer scare thingy. And the two of you might also have been able to prevent that whole scare about lead in pipes, gas and children’s toys. Maybe the two of you could have prevented all that fuss about lead pollution in the Roman Empire, the Middle Ages and the Industrial Revolution too.

    http://www.ncbi.nlm.nih.gov/pubmed/17379271

    • Sullivan March 26, 2012 at 18:11 #

      “Great to see you and Liz Ditz display your animosity toward any exploration of the many possible environmental causes or triggers of autism disorders”

      Perhaps you should actually read this blog, rather than go based on your prejudices. You might learn something here. This is where you can read, for example, that the funding levels for environmental and gene/environment interaction causality combined are higher than those for pure genetics. Have been for years. If I read your blog, will I still see you holding on to the old idea that purely genetic research outstrips other areas? My assumption is yes. Feel free to point me to posts of yours that are up to date on that.

      When was your most recent article quoting Bernadine Healy? I recall you were very fond of quoting her. She was part of “The Advancement of Sound Science Coalition”, a group paid by the tobacco industry after her stint at the NIH. I find it ironic for someone to try the “tobacco science gambit” who has no problem promoting someone who played an active part in tobacco science as a credible source of information.

      Mr. Doherty, do you never speculate? Is there nothing in your writing which is not founded in established? For example, have you speculated on what might happen with the DSM V? Or have you waited for it to come out and the results be published? Of course you speculate. But based on your comment I am not allowed to? Again, ironic.

  9. Roger Kulp March 26, 2012 at 04:37 #

    RAJensen,each section of the spectrum has it’s own “sub spectrum” of its own,great differences from patient to patient,putting aside autoimmune,and other medical issues,putting aside hearing or visual impairments,putting aside seizures,it is sometimes hard to tell where “autism” ends and other “comorbids” begin.Personality disorders.psychotic symptoms,learning disabilities/disorders,etc. end and the “autism” ends,and this other stuff begins.I have a diagnosis somewhere in between Asperger’s and Autistic Disorder.Journals and textbook articles tell me this is PDD-NOS,but when I was diagnosed,NVLD and personality disorders were also factored in to determine disability.All of my autoimmune diseases,and the fact I am 80% blind in my left eye were not.I was considered seriously disabled by these few things alone.

    I realize I am an extreme case of a newlt identified,possibly rare subtype,and most (?) people “just” have an ASD,but if “autism”,or ASD is to be the main diagnosis,there ought to be some way of determining disability in such cases,in relation to the whole spectrum,if that makes any sense.

    • Sullivan March 26, 2012 at 21:16 #

      Roger Kulp,

      “I realize I am an extreme case of a newlt identified,possibly rare subtype,and most (?) people “just” have an ASD,but if “autism”,or ASD is to be the main diagnosis,there ought to be some way of determining disability in such cases,in relation to the whole spectrum,if that makes any sense.”

      I don’t know if anyone can say if most autistic people “just have an ASD”. Autism is for the vast majority still idiopathic, the underlying reasons for the autism is not known. For conditions known to have a high risk of autism, there are other areas of difference and disability.

      Consider Down syndrome. It is well accepted that in addition to the cognitive differences found commonly within the Down syndrome population, there are multiple other conditions, involving the heart and other areas of the body. It is more than reasonable to expect (as it is already demonstrated in many cases) that the underlying etiology for autism will also affect systems other than the brain.

  10. RAJensen March 26, 2012 at 12:09 #

    Roger,
    I agree autism is not ‘just’ a disorder of the brain. This is seen in the severe genetic syndromes where autism is a whole body syndromic condition that effects the development of multiple organs and had multiple co-occuring disabilites.
    Virtually all of the severe genetic syndromes with co-occuring autism rates far greater than population prevelance exhibit mutiple congenital anomiles and medical problems:

    http://ghr.nlm.nih.gov/condition/22q112-deletion-syndrome

    http://ghr.nlm.nih.gov/condition/1p36-deletion-syndrome

    http://ghr.nlm.nih.gov/condition/rett-syndrome

    http://ghr.nlm.nih.gov/condition/down-syndrome

    The severe genetic syndromes are a sub-group and the etiology is known. Almost all cases, except for Fragile X, are not inherited and are caused by de novo sperm or egg mutations.

  11. Alex March 27, 2012 at 05:08 #

    I wish everybody would stop singling out this ingredient or that. The risk lies solely in the administration of numerous toxins and poisons that are whipped up in a tube and then injected repeatedly into a small child’s body. Not every being has the the capacity to this on. Look at the awful consequences to over hundreds of thousands of girls and even 47 deaths from Gardasil. Let’s discover a way to safely screen children and adults to make sure they can withstand the injection whatever it may be. And let’s everyone get along.

  12. Chris March 27, 2012 at 07:34 #

    Alex, please give us the evidence about those toxins. Which ones are more dangerous than tetanospamin? List them and include the title, journal and date of the studies that they are more dangerous than the toxins created by the diseases.

    Look at the awful consequences to over hundreds of thousands of girls and even 47 deaths from Gardasil.

    Citation needed. How many two to three year olds get a Gardisil vaccine (age is commonly the time autism is diagnosed). Do not say “VAERS” unless you can tell us what you must read and understand before entering the official VAERS database.

  13. Lawrence March 27, 2012 at 10:31 #

    @Alex – one of those “47” deaths was a girl killed in a car accident. How exactly did the vaccine cause a car crash?

  14. Harold L Doherty March 27, 2012 at 22:21 #

    Sullivan the comments on my blog about the DSM-5 are based on the actual published proposed DSM-5. You are speculating about data you haven’t even seen.

    I do not understand why you and other regulars on this blog are opposed to environmental autism research. A genetic/environmental interaction paradigm of understanding likely causes of autism disorders has been largely accepted by credible authorities. Frankly your opposition to exploration of environmental triggers of autism disorders seems irrational.

    • Sullivan March 28, 2012 at 00:05 #

      I haven’t read your blog. Have you seen the DSM V data (i.e. the Volkmar paper)? It just came out. It says that the groups most impacted by the DSM V are those with higher cognitive abilities. That PDD-NOS and Asperger syndrome would like see a large part of the population lose their diagnoses. Is this what you wrote about? Based on your comments I’ve stumbled upon elsewhere on the web, I doubt it.

      “I do not understand why you and other regulars on this blog are opposed to environmental autism research”

      Once again, since you clearly didn’t understand this the last multiple times this has been discussed. I am not. Hence the comment that you don’t read this blog. You base your opinions on assumptions. I expect that in a few months you will come back and once again tell me what I think, having not absorbed this statement nor what is written on this blog. Environmental risk factors have been studied since, what, the 1970s? Patricia Rodier gave a nice rundown of the possible environmental risk factors identified so far in her Omnibus testimony. Should I provide you with a link to my summary on this blog?

      What is your position on the funding levels for environmental vs. gene/environment vs. purely genetic? Are you still quoting Irva Hirtz-Picciotto’s incorrect statement or are you basing your position on actual data?

      One reason I rarely respond to you is that you are so clearly building straw man arguments. Tell me, what is irrational, my non-opposition to the exploration of enviornmental causes of autism or your refusal to read what I have been writing for years? It is easy to fight the straw man. Why are you taking the easy way out?

      For example–you have deftly dodged commenting on what happens if the next prevalence estimate comes out with a higher rate. It’s easier to attack the writer with straw man arguments than to engage in the discussion.

      The next prevalence estimate is out soon. I’m willing to bet it will be higher than the last. This cohort has a lower thimerosal exposure than the previous one. Once again, we are seeing one leg of the mercury hypothesis get pulled out. Not that there really is any leg left.

      • Sullivan March 28, 2012 at 19:04 #

        Harold L Doherty,

        are you equally annoyed with the organizations who (if their numbers are accurate) are breaking the embargo on the prevalence estimates–and are doing so for publicity and political gain?

  15. Harold L Doherty April 2, 2012 at 17:55 #

    Sullivan

    If I understand correctly you have been appointed as a parent representative to the IAAC? If that is true it is a sad day for those who recognize that autism disorders are just that … disorders … and who advocate for research into the environmental causes and triggers of autism and into possible treatments and cures.

  16. Lawrence April 3, 2012 at 10:37 #

    @Harold – you just proved that you haven’t read a single thing that Sullivan has written here. Good job.

  17. Science Mom April 3, 2012 at 15:02 #

    are you equally annoyed with the organizations who (if their numbers are accurate) are breaking the embargo on the prevalence estimates—and are doing so for publicity and political gain?

    Nope, crickets from Harold on that front. But I see he can’t resist a churlish insult about your IACC appointment. Harold, it’s too bad and requires a level of maturity and honesty that you don’t possess that you couldn’t just wait and see how this new committee performs before spewing your bitterness.

  18. Harold L Doherty April 3, 2012 at 15:15 #

    Science Mom thank you for the silly insults, the unsubstantiated allegations and the incredible hypocrisy. There is ample evidence on this forum of how “Sullivan” will perform and what positions he will take on the IACC.

    It is a sad day for people interested in finding causes,treatments and cures for autism disorders when Sullivan and other ideologues are appointed to the IACC.

    Professor Simon Baron-Cohen stated several years ago that genetics are not a complete explanation for autism disorders. He pointed to the fact that in cases involving identical twins where one twin was diagnosed with autism it did not always occur that the other identical twin also had an autism disorder diagnosis. Baron-Cohen stated clearly that environmental factors must be involved. There are other authorities in the past few years which also point to a genetic environmental interaction model as the most likely basis of autism causation. Yet, this forum and Sullivan continuously promote the archaic pure genetic model embraced by “Neurodiversity” advocates AND those whose books are promoted on the left hand side of this “autism” blog.

    Have a good day “Science” Mom.

  19. Lawrence April 3, 2012 at 15:56 #

    @Harold – once again, you show your ignorance of what Sullivan has actually written. You seem to be wearing, not only blinders, but also shades over your eyes with a rote script written on them.

    Environmental factors include many areas – concentrated “in-utero” and plenty of work is going on in those areas, which Sullivan himself has stated.

    So why don’t you read for a change & take off those blinders, you’re just making yourself look more foolish.

  20. Tom April 3, 2012 at 16:44 #

    “There is ample evidence on this forum of how “Sullivan” will perform and what positions he will take on the IACC.”

    Didn’t you just take Sullivan to task for speculating about the CDC prevalence data?

  21. Anne April 3, 2012 at 17:13 #

    Hi, Harold, could you please link to examples of where “this forum and Sullivan continuously promote the archaic pure genetic model?” Thanks.

  22. Science Mom April 3, 2012 at 19:15 #

    Science Mom thank you for the silly insults, the unsubstantiated allegations and the incredible hypocrisy. There is ample evidence on this forum of how “Sullivan” will perform and what positions he will take on the IACC.

    Actually Harold, my insults are on point as opposed to your wild speculations and baseless accusations of hypocrisy. Speaking of which, you would do well to address your substantiated hypocrisy by condemning the parties you sympathise with for breaking a press embargo to suit their own misguided ideological purposes.

    It is a sad day for people interested in finding causes,treatments and cures for autism disorders when Sullivan and other ideologues are appointed to the IACC.

    Careful how you use “ideologue” as a pejorative. Again, your ranting about what or what not this committee will achieve is baseless speculation and pure rancor.

    There are other authorities in the past few years which also point to a genetic environmental interaction model as the most likely basis of autism causation. Yet, this forum and Sullivan continuously promote the archaic pure genetic model embraced by “Neurodiversity” advocates AND those whose books are promoted on the left hand side of this “autism” blog.

    Pure bollocks! Not only are neurodiversity and acceptance of a multiple causation model NOT mutually exclusive but you still fail to provide a single example of any contributor of this blog who eschews that. Try getting it through your head that environmental just doesn’t mean vaccines.

    • Sullivan April 4, 2012 at 05:46 #

      I am very much reminded of years back when commenters would tell me about how my experiences and opinions were suspect because I was the parent of a “high functioning” kid. I’ve never understood where this idea came from as I wasn’t discussing my kid and the reality was that my kid is not what people call “high functioning”. I finally had to break the privacy of my family a little to correct that mis-impression.

      Now there’s the myth that I oppose research into environmental causation. Here is a discussion of the Columbia group’s paper on the increased autism risk from short interpregancy intervals (possibly an environmental cause). Is there language there antagonistic to the idea? And then there’s my supposed adherence to the idea that autism is purely genetic. Here are discussions of autism twin studies–the Stanford study that made the news last year, an earlier study from Columbia, and, in the same article, a discussion of the twin study from the U. Wisconsin. These twin studies showed a lower concordance than previously estimated, indicating less heritability than previously thought.

      I don’t recall reading anyone else write online about the Columbia twin study, or the Wisconsin twin studies–both of which showed a moderate concordance (i.e. lower than previously discussed) and both of which discussed the limitations of the older twin studies–and I wrote about them well before the Stanford “California Autism Twin Study” was published.

      I invite critics to quote where in those discussions is my supposed position that autism is purely genetic? For example, how exactly does one gather that from a my conclusion about the Coulumbia twin study:

      This study has the possibility to have a major impact on autism causation research. I would not be surprised at all if this ends up as one of the papers highlighted by the IACC for the year. I’m certain that this paper will be brought up in online discussions for some time to come, what with the very different estimate of twin concordance than previously quoted.

      On environmental causation, below are a few examples of previous articles. Some of which I have noted in previous discussions with Mr. Doherty in striking down his straw-man argument.

      Here is my article on Rodier on Bernard et al. and environmental causes of autism. (this was within my first 15 articles written for Left Brain/Right Brain, by the way).

      Here is an article on a talk Tom Insel gave at NIH called “demystifying autism“. He discussed the California Autism Twin Study before it was released. I’ll highlight one line from my article:

      Dr. Insel uses the term that the burden of proof is on those who would say that the increase is not “real”. I would put it differently—that given the lack of definitive information on the causes of the rise, we should continue to look for possible environmental causes

      How, exactly, is a call for a continued effort into possible environmental causes of autism something that will result in a “sad day for those who advocate for research into environmental causes”?

      As I’ve noted in previous discussions with Mr. Doherty on the question of whether I oppose environmental causation research: I have written about the fact that funding for environmental and gene-environment causation research funding combined is higher than the funding for pure genetic research (and provided links in previous discussions about the straw-man argument Mr. Doherty has presented). I’ve done this while writers claiming to support environmental causation research have not. I have done this without criticizing the decision to devote high levels of funding to those areas (other than to point out that I wish more funding was devoted to issues involving adult autistics).

      There is also my article The myth that the IACC doesn’t support environmental causation research and US plan for autism research: focus on environmental causation re-emphasized in which I stated “Many have claimed that this blog is somehow against environmental causation research. Again, this is clearly not true.” Another article, IACC calls for $175 million in autism and the environment research.

      I welcome someone pointing out where someone might interpret my stance in those articles is antagonistic towards environmental causation research.

      I am sure that with over 1,100 articles here on Left Brain/Right Brain, there are things people can find where I’ve made mistakes or where my viewpoints have evolved. But I stand by my stance on environmental causation research and on the genetics of autism. My positions are clear and defensible while Mr. Doherty’s criticisms are vague and not substantiated, despite numerous requests add provide facts.

      (note, I edited this comment for clarity shortly after publishing it)

      • Sullivan April 4, 2012 at 06:24 #

        I have mentioned this before, but it seems worth noting again: we participated in a clinical trial. I am sure the researchers involved would not share Mr. Doherty’s opinion that I am anti-treatment.

        Also, I have posted announcements about clinical trials on this blog.

        What I have not done is support “therapies” which are untested and not based on an accurate understanding of autism. Being critical of, say, using industrial chelators as “supplements” (which was bad on so many levels) is not “anti-treatment”.

  23. brian April 3, 2012 at 20:12 #

    Professor Simon Baron-Cohen . . . pointed to the fact that in cases involving identical twins where one twin was diagnosed with autism it did not always occur that the other identical twin also had an autism disorder diagnosis.

    Honestly, Harold, do you not understand that “identical” twins are not in fact genetically identical?

    Nonetheless, in decades of association with other geneticists as an undergraduate, graduate, and postdoctoral student of genetics and as a scientist I haven’t met another geneticist who didn’t understand that genes are affected by the environment (you might, for example, read the 1965 Nobel Prize lecture by Jacques Monod based on his work ca. 1951), so I don’t think that a “pure genetic model” for autism that ignores environmental influences was ever on the table, except perhaps in the minds of those who are ignorant of genetics.

  24. McD April 3, 2012 at 22:39 #

    Harold, It’s just crazy. I really enjoy reading your blog and fully support your efforts to dispel anti-ABA rantings. I am fighting a similar battle in my country.

    But you seem to have some crazy idea that not buying into the anti-vax meme means a person is automatically in the “it’s all genetic” camp (if there really is such a thing), and anti-treatment. That is so wrong.

    One reason we are having so much trouble getting evidence-based behavior therapy here is that it is often adopted by anti-vaxers who lump it in with junk therapies like chelation and secretin. At ABAI last year, practioners attending the ethics lectures for their registation credits were left in no doubt that jumping into bed with the bio-med crowd (one large ABA provider was called out) was a serious ethics breach. The basis for this was supporting the promotion of unscientific therapies which waste parents time and money

    So I have to say, after enjoying seeing your website a few years ago, then seeing you turn up here as an anti-vaxxer, accusing sullivan of adopting a position he clearly does not hold, I was quite disappointed.

    All “sides” have had to amend their positions as the evidence came in over the years. Some people had to admit that behavioral treatment does reduce symptoms of autism and improve outcomes. Some other people had to admit that it wasn’t the vaccines. Everyone has to admit the evidence shows that a complex interaction of genetic, epigenetic and (unknown)environmental factors are involved in the majority of idiopathic autism cases. (Only 5 known teratogens cause autism, all in the first trimester of pregnancy.)
    http://www.ncbi.nlm.nih.gov/pubmed/20087185

  25. Science Mom April 4, 2012 at 15:09 #

    Sullivan, you may wish to keep your last two comments handy to remind Harold the next time he plays that card.

    Harold, the ethical and honest response to Sullivan would be, “I apologise, I was wrong about your stance.” But I suppose that isn’t going to happen given the caveats of ethical and honest attached.

  26. Chris April 4, 2012 at 16:31 #

    We recently went over with the doctor specializing in genetics for our son’s heart anomaly. There are eighteen known genes that cause the abnormal muscle growth that cause 80% of this condition. Our son is in the 20% of those where none of these sequences are found.

    All we know is that it is a gene sequence that is not yet known, and his sample will be used in combination with others in his situation in the future. But the sample will be anonymous and we will not be told what happens.

    She did keep asking us if we wanted a more thorough genetic analysis done to see if he known causes of his other issues (history of seizures, learning issues, autistic like behaviors). We declined because it would not really provide us any real information to help him. I think she wanted us to pay for the full genetic scan, which would be three times more than the limited one he had.

    Though he will be asked to come in to give blood samples for future genetic research that will involve looking into if certain gene sequences are prevalent in those that have issues with both neurology and cardiology (like Down Syndrome, but less obvious than an extra chromosome). That all depends on their research funding.

    We have no idea why his genetics are the way they are. There is not enough family history to point to a pattern (various adoptions that were not recorded, and other issues involving multiple families that kept moving west). I am guessing it could be a de novo mutation by some environmental cause before or shortly after conception. Though I’m thinking more along the line of cosmic rays, or one of the miniature black holes that flew through our computer lab causing the VAX computer to shut itself off (that was about as good a story as we could come up with twenty five years ago, in a darkened cool room that would just suddenly go quiet and darker as the monitors went blank, and yes, we were joking).

    In short: It is complicated, there are no simple answers.

  27. Chris April 4, 2012 at 16:33 #

    Comment in moderation. Short version: genetic testing of son brought up more questions than answers (abnormal heart anatomy). That is because there are no simple answers, because it is very complicated.

  28. Anne April 4, 2012 at 17:02 #

    Well, it looks like Harold was talking out of his nether regions again. As a lawyer he knows that he has to back up his assertions with evidence, which he has failed to do. Harold, if you have some objection to Matt serving on the IACC for idealogical reasons, just say so. No reason to misrepresent his position.

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