I was saddened to see a recent interview given by Tom Insel to the Age of Autism blog. Maybe he’s not a regular reader of that blog where his fellow scientst Paul Offit is regularly castigated in such personal and violent ways. Or maybe he is and doesn;t care. However the impression I get from Insel is that he’s a weak man who will say whatever it is the person he’s talking to wants to hear.
He certainly did this during his interview with David with statements as bizarre as:
As far as I can tell, the burden of proof is upon anybody who feels that there is NOT a real increase here in the number of kids affected…
In fact the oonly really accurate statement I found during David’s published highlights with Insel was Insel’s statement that:
I think I am arguing, probably, against the wave of the people that are in this field…
which is most definitely the truth. I can’t think of an autism epidemiology expert that has come out and said that there is definitely or definitely not an ‘epidemic’ of autism. And why? Because the science doesn’t exist.
Insel also seems to be infering that most people in the field believe there is one entity called ‘autism’ which is most certainly not true. A simple comparison between Rhett syndrome and all other known forms of autism would clearly show more than one type of autism. Insel doesn;t name names but I am at a loss to think of anyone else in the field who considers autism to be one entity.
He goes on to say that he finds it ‘believable’ that children can develop autism in the context of severe gut problems. Well, good for him. But ‘believable’ is not the same thing as ‘established’ or even ‘hypothetical’. Its one persons opinion.
All in all, this interview added little (if anything) to what we know about autism. But it did allow us to see Tom Insel in a certain light. Not a very good once in my opinion.
Left Brain Right Brain 
“Insel also seems to be infering that most people in the field believe there is one entity called ‘autism’ which is most certainly not true. A simple comparison between Rhett syndrome and all other known forms of autism would clearly show more than one type of autism. Insel doesn;t name names but I am at a loss to think of anyone else in the field who considers autism to be one entity.”
Would this also apply to neurodiversity types who continually use the term “autism” or “autistic” to refer to themselves,when they really mean “Asperger’s”,and say that those who have intellectual disabilities are not autistic,but “retarded”?
One quote that popped out at me was
“It’s quite believable to me that there are many children who develop autism in the context of having severe gut pathology, of having autoimmune problems, of having lots of other problems. And some of these kids really do recover.”
It sounds to me like the CDC is almost on the verge of admitting the “comorbid conditions”* that this blog,in particular,is so big on putting down,are a big factor in some cases of autism,and it’s about damn time.
Will neurodiversity do the same? Sure they will.If it’s one thing we’ve learned about you guys,is that,like a two-bit politician, you are a bunch of slippery chameleons,always ready to change your message whenever you think it suits you.Sort of like Ari Ne’eman has on his position that autism is a disability.
*And maybe biomedical treatments,too
When there are issues or controversies in a scientific field, NIH institutes usually hold meetings to review the state of affairs and seek guidance from experts. Insel would be well-served to call for such a meeting instead of shooting from the hip.
Roger – comorbid conditions have long been associated with autism (it’s what the word means), this blog has not ‘put them down’ as you say, and aspergers is increasing seen as a form of autism, if not one of the orignal forms.
You would do well with putting effort into learning the actual meaning of the words used by your opponents, and to stop your blithe baseless accusations against people who clearly know and understand more about this situation than you do.
Never mind, this post was quite amusing to write, shame you rarely deign to respond to points raised agianst you.
Roger…where to begin…my child is autistic, not Aspergers. My step-child is also autistic not Aspergers. My child also has learning difficulties – she’s still autistic. So please – take your ignorant presumption elsewhere.
Secondly, this was Tom Insel speaking. Not the CDC.
Lastly, I suspect a lot of us would change our minds if the science pointed that way. The ability to change ones mind is the sign of an open mind. You will never change your mind because it is a tightly shut.
Roger,
If the term autism bothers you in the context of someone in ND using it to describe the spectrum, why does it NOT bother you in the context of someone using ‘autism’ prevelence rates as an alarmist tool of a vaccine causation argument, when the entire spectum is clearly within those numbers?
Cocommittants are an area that clearly needs to be investigated, but not in the way that many would like it to be. The cart is clearly before the horse if the discussion is presented as ‘gut issues cause autism’ as it has been. To use another analogy, if there are fire safety hazards in a movie theatre, the solution is NOT to yell ‘FIRE’ in a darkened packed auditorium.
We need rational, systematic processes driving studies that will provide real answers; not alarming, baseless or grossly overinflated proclamations driving us to waste money to quell fears.
Great post, Kev. Sounds like the NIMH could use some message control.
I agree that Insel may have been overgeneralizing if his statements on “one autism” were in regards to researchers, but I’m not sure if he was completely inaccurate in regards to some of the conversations and perceptions about the nature of autism,
Reading the entire transcript, some statements made were,
“I tend to think of it more in the way we think of fever. I think this is a collection of many, many different disorders. And part of the reason why you see so much polarization in the community is because there is a tendency for people to think that their experience is the same as everybody else with a child with autism”
…
“So I don’t know if what we have here are 10 different disorders or 20 different disorders. What I think hangs up this field is the inability to indentify [sic] all these different autisms – and it’s very much where we were with infectious disease 100 years ago, before we knew how to break this down into multiple different disorders, different causes, different treatments. That’s why fever seems like the right analogy. In this context, I don’t think anyone would be able to argue very strongly that there is not some subgroup that’s going to be unrelated to genetics — like those kids who have Fragile X — and some subgroups that may be much cleaner on the genetic side, but will have some environmental exposure that triggers the disorder.”
I don’t think those are totally out of bounds in a condition that is diagnosed by observation of external behavior.
I heard Dr Insel speak at MIT a few weeks ago, and in his talk he mentioned that he thought there was a real increase in autism, and that the increase was very much like the increase that has been observed in children’s allergies, asthma and autoimmune stuff. He also said that he thought that the human microbiome project would be very important in understanding the causes of autism. He sees autism as a neurodevelopmental problem, something that happens over time, not something that occurs at a point in time. I think he is correct, and that low NO from the loss of my bacteria is important in both.
At his talk there were a couple of anti-vax people who monopolized the questions with angry diatribes against vaccines. The questioning had to be cut short because of the disruption of the anti-vaxers. Insel said (paraphrasing) that we have looked at vaccines and mercury, thimerosal is out of virtually all vaccines and there is no hint of a drop in autism rates. There are maybe 900 areas that need to be looked at. We have looked at vaccines, and vaccines are not the cause of a significant fraction of autism cases. There are 899 other areas that have not been looked at as intensively as vaccines have been looked at. We need to look at those areas. (/paraphrase)
When Dr Insel talks about “environmental effects”, he is not at all thinking about vaccines. He knows the science of vaccines and there isn’t any that connects vaccines to autism.
Dr Insel has a very sophisticated approach to neurological difficulties. Perhaps the most sophisticated of anyone I have heard speak or have read papers from. He wants the field to become more sophisticated, and he is working to make that happen. At his talk, he mentioned that James Simons asked him what he (Simons) should do to foster good work in autism, and Dr Insel said put together a multi-disciplinary team of very smart people working at depth and at the highest levels in each aspect of the chain of neurodevelopment, from genes to behaviors and everything in between, and have them all in one place and have them all work together. That is what Simons did at MIT. This is the only way to understand neurodevelopment and to eventually understand disorders of neurodevelopment.
The sophistication of the talks at MIT has gone up considerably in the past few years. There is real progress in the field in terms of gathering hints and pieces of what is going on. Real progress is being made, but real progress like this is highly non-linear. The way I see it, reliable facts are gathered and then hypotheses are made to connect those reliable facts together into a network. The more reliable facts that a hypothesis can connect together, the better the hypothesis is. When the hypothesis can connect all the reliable facts, then the field is mature and is well understood. This is a problem of percolation. The critical percolation threshold (where the network of connections first encompasses the entire fact-space) is a critical point, where the properties change exponentially as that point is approached. We are not there yet, but we are getting closer.
I wouldn’t rely on AoA for anything, certainly not for a reliable indication of what Dr Insel thinks or feels. He certainly knew who he was talking to, how the article would be slanted, who would read the article. He knows there is essentially no research benefit to looking at vaccines, mercury, aluminum, toxins, or any of the other biomedical crap that the curebies and quacks push. The research benefit is essentially zero, but if it keeps the curebies from threatening the real research through intimidation it might be worth it. Threats have driven people away from the field, and have caused people to not select the field in the first place. If that continues, progress will be slowed, and if there is too much, the understanding needed may never happen.