The autism ‘epidemic’ no more

17 Aug

OK, so its well known to LBRB readers that I don’t think its ever been scientifically established that there has been such a thing as an autism epidemic but even so, looking at why autism numbers have changed over a certain period of time – the period of time people believe is part of the ‘epidemic’ – should be a good way to determine what contributed to that time periods rise in autism.

So thats what Peter Bearman did. Summed up well in this weeks New Scientist, Bearman’s study offers the first look at what actually did cause the ‘epidemic’.

Better diagnosis
Diagnostic changes are the most important influence. After 1987, the definition of autism used in California was broadened several times. Bearman and his colleague Marissa King examined the medical records of around 7000 Californian children with autism and found that one in ten had initially been diagnosed with mental retardation. Extrapolated to the state as a whole, they estimate that this change in diagnosis created almost 5000 extra cases of autism between 1993 and 2005, or 26 per cent of the increase of recorded over that period.

Greater awareness
Social influence accounts for another big chunk of the overall increase. Parents are more aware of the disorder than they used to be, and so those whose children who have mild forms of autism have become more likely to seek out diagnosis.

Bearman and his colleague Ka-Yuet Liu quantified this effect. They first estimated how the chances of a child being diagnosed with autism increase if he or she lives close to a child that has already been diagnosed. They then plotted the addresses of children with and without autism in California to calculate the number of children who had grown up close to a child diagnosed with the condition. They were then able to calculate the fraction of extra cases that would have been diagnosed as a result of social interactions. They put this figure at 16 per cent.

Older parents
The final contribution to the rise in diagnoses comes from demographics. Couples in California are having children later in life, as they are in much of the rest of North America and Europe. That is pushing up autism rates, because autism is triggered by genetic mutations that older parents are more likely to pass on to their children.

Bearman and King calculated that these older parents are responsible for 11 per cent of the extra autism cases.

So these total 53% of the so-called ‘epidemic’. What about the missing 47%? Well, Professor Roy Grinker says:

Autism used to be highly stigmatised, in part because it was thought to be due to poor parenting. The removal of that stigma has made doctors and parents more willing to recognise the disease, which will have contributed to [some of] the extra cases…This and other social causes, together with uncertainty in the number of cases that can be attributed to the factors already studied by Bearman, could account for much or all of the unexplained half

But note Grinker doesn’t say it definitely does. This is because he knows as a careful scientist it hasn’t been looked at.

So what can we take from Bearman’s work? In my opinion we can take the fact that as soon as the questions regarding non-environmental causes were actually looked at and studied, there were numerical values that could be applied to their contribution. There are other non-environmental causes which Bearman didn’t look at which would probably be found to contribute to the other half.

What about the alleged environmental causes? It would not surprise me in the least if it were found that there were some. But as to what they are, the environmental lobby are still so hung up on vaccines they don’t seem to want to look at other possible environmental issues. Maybe its time they dropped the vaccine nonsense and got involved in some decent research. Just a thought.

35 Responses to “The autism ‘epidemic’ no more”

  1. stanley seigler August 17, 2010 at 16:34 #

    AAIDD F.Y.I., July 2010, Vol.10, No.7, by the American Association on Intellectual and Developmental Disabilities

    CENTERS FOR DISEASE CONTROL HAS NOT OVERESTIMATED THE PREVALENCE OF AUTISM SPECTRUM DISORDERS IN THE UNITED STATES, REVEALS THE FIRST EVER ANALYSIS OF THE CENTER’S RECORDS-BASED TRACKING SYSTEM: A first ever evaluation of the Centers for Disease Control’s (CDC) tracking system used to estimate the prevalence of Autism Spectrum Disorders (ASDs) has revealed that the system is not likely over-estimating the prevalence of ASDs in the United States, and most children found to have an ASD by a clinical examination were also detected by the tracking system. The evaluation is published as an article titled, “Evaluation of a Records-Review Surveillance System Used to Determine the Prevalence of Autism Spectrum Disorders” in the June 22nd online issue of the Journal of Autism and Developmental Disorders. Read an abstract. An average of 1 in 150 children is affected by an ASD in the United States. Also in autism news, the world’s largest DNA scan by UCLA researchers for familial autism has uncovered new genetic changes in children with autism that are often not present in their parents. Identified in less than 1 percent of the population, these rare variants occur nearly 20 percent more in children with autism. Read more.

  2. brian August 17, 2010 at 16:58 #

    It’s interesting to compare the results from two different groups of investigators in this area. As you noted, Bearman et al. explain ca. 26% of the apparent increase in ASD as associated with the additional diagnosis of ASD diagnosis in children already diagnosed with mental retardation; 16% with social influence, and 11% with older parental age at conception: Bearman explains 53% of the “epidemic” with these few factors. Like Bearman, Herz-Piccioto and Delwiche also analyzed the California Department of Developmental Services data set; they showed that about 62% of the apparent increase in ASD was associated with changes in diagnostic criteria, inclusion of “milder” cases, and younger age at diagnosis, but they did not examine the effects of social influences or parental age (which in Bearman’s analysis accounted for 27% of the apparent increase) or increased awareness of ASD in the medical community.

    Although (since there’s some overlap here) it’s not clear how to reconcile these results, it is clear that most of the apparent increase in ASD is explained by just a few factors.

    Joseph explains the Hertz-Picciotto and Delwiche results here:

  3. passionlessDrone August 17, 2010 at 17:22 #

    Hello friends –

    I’ve got big problems with assigning any level of certainty to these numbers; and especially the idea that we can add them up to arrive at anything meaningful.

    For example, better diagnosis is largely a function of greater awareness; does anyone out there really think the GIS scatterpoint study finding ‘social proximity’ contributing to 16% of our increase really excluded all of the 26% of the better diagnosis cases? If not, we need to bring out numbers downward from 53%.

    Likewise, I like the proposed mechanism behind older parents, but this doesn’t do anything to argue against a true increase, in fact, just the opposite. An aging parent population argues in favor of a real increase, one that is initially environmentally generated, though the presumed acting force is genetic (or epigentic).

    But just like our interplay between better diagnosis and spatial proximity, we had some older parents in the past; some of them accumulated mutations and had their children inappropriately diagnosed as MR, or didn’t get any diagnosis at all due to ‘poorer awareness’. Therefore, unless we have some good reason to believe that our 11% of older parents value has been analyzed such that these values represent only children that didn’t get misdiagnosed, or undiagnosed, we must further downgrade our 53% ‘value’.

    Other analysis of California data set found a much more modest effect of older parents:

    Based on the first examination of heterogeneity in parental age effects, it appears that women’s risk for delivering a child who develops autism increases throughout their reproductive years whereas father’s age confers increased risk for autism when mothers are <30, but has little effect when mothers are past age 30. We also calculated that the recent trend towards delayed childbearing contributed approximately a 4.6% increase in autism diagnoses in California over the decade.

    Clearly, we have much to learn before anyone should believe the hype of the title of the original paper, “Autism explosion half explained, half still a mystery” This is a good example of bad journalism based on a half baked house of cards. Boo!

    – pD

  4. Kev August 17, 2010 at 17:45 #

    pD, I don;t think anyone (or at least me) is assigning stone cold certainty to anything. As I understand it, science just doesn;t work that way.

    With respect I think you’re being too literal – or at least assigning literality to these numbers. As Brain above you points out, reconciling Bearman’s numbers with others is difficult.

    However, what _isn’t_ difficult is seeing the larger picture – that the ‘epidemic’ is largely a function of social factors rather than an epidemic in the sense of the words as it has been played thus far by certain people – a scary, vaccine driven event causing untold legions of autistic children.

  5. Laurentius Rex August 17, 2010 at 21:56 #

    Only one thing to say, and whether I say it or not you know what it is:


  6. Barbara August 17, 2010 at 23:20 #

    There are several other factors that have not been addressed by this study, but which play a major part. One is the inclusion of Asperger’s Syndrome in the diagnostic criteria, from 1993/4. Another is the diagnosis of adults on the spectrum which, in the time I’ve been researching (13 years) has become very significant, including among them, those who were once diagnosed with schizophrenia in the past, and those who are the parent of a child on the spectrum.

    When women finally get diagnostic criteria which apply to them, rather than the ‘gendered’ criteria we now have, there will be a further increase. Both Kanner’s and Asperger’s subjects had very many spectrum mothers. Asperger recognised the genetic link – Kanner guessed it wrongly because he was under the influence of psychodynamic cultural imperatives. Autism is not ‘extreme male brain’, it’s just perceptual processing bias which leads to an alternative cognitive style and is ungendered.

    Almost all the families I’ve dealt with in my research, including a family of 13 children, two of 6, three of 5, several of 3, have been mothered by perfectly capable and loving AS mothers, all of whom remain undiagnosed.

  7. livsparents August 17, 2010 at 23:22 #

    The one thing I consider a major factor in autism diagnosis that is somehow passed aside is the significant social changes that the Americans With Disability Act caused. Before AWDA, what motivation did a parent have to recieve an ‘official’ diagnosis for their autistic child, especially one that was able to function in a school environment? They may have been struggling, but since there was a lack of motivation to help in the school districts, there was not much a parent could do.

    The AWDA changed that paradigm. Now parents had a great reason to go to a pediatric neurologist (or to the Regional Centers) and recieve a diagnosis for their child. Even parents of children formerly diagnosed as MR had reasons to have their children reevaluated.

    It just seems to me that these ideas are not really fully fleshed out…and could quite possibly be one of the primary reasons for a significant rise in autism rates. My only flaw is the fact that AWDA is just one country. Does anyone know if/when there were significant disability-rights changes in Europe or other parts of the world around the same timeframe?

  8. Barbara August 17, 2010 at 23:44 #


    I have to say that I’m more than disappointed that Grinker, someone I have previously held in very high regard, refers to autism as a ‘disease’.

    I find that deeply offensive and more to the point, totally inaccurate. I believed he knew better than to throw that mud (I say that rather than s**t as I am respectful of this board’s sensibilities).

    I am gobsmacked.

  9. Barbara August 17, 2010 at 23:56 #

    “Does anyone know if/when there were significant disability-rights changes in Europe or other parts of the world around the same timeframe?”

    Not in the UK. We’ve always ignored/been ignorant of ASCs, unless accompanied by significant intellectual impairment. Yet all research shows that the core characteristics in ASCs, sensory perceptual issues, are not LESS significant in Asperger’s Syndrome, than they are in ‘classic’ ho hum autism. They are THE SAME in levels of intensity and frequency.

    This misunderstanding continues. My PhD thesis confirms that there is no real understanding of ASCs in the UK’s educational provision.

  10. stanley seigler August 18, 2010 at 00:30 #

    [drone say] “I’ve got big problems with assigning any level of certainty to these numbers; and especially the idea that we can add them up to arrive at anything meaningful…Clearly, we have much to learn before anyone should believe the hype.”

    [savannah fr another LBRB thread say] “While it [90% dx] might be promising, I do want to point out that at a 40 point sample, it is hardly definitive or near a point where it could be used in diagnosis. Much much more research- including a much larger sample- would need done before we approached that point.”

    [Dwight F fr another LBRB thread say] “You can indeed have meaningful standard deviation calculations from only 10 subjects. The level of certainty isn’t as high but it is quite acceptable, and successful, for exploratory studies looking for potential avenues of investigation. A LOT DEPENDS on how things are structured.”

    thanks to the scientists on this blog…i’m beginning to believe all autism science, behavioral science is: promotional science (hype), as ms dawson implies…or is it punch and judy blogging as L. Rex say…

    what’s a non scientist parent to believe…indeed a lot depends…hope i dont mix apples/oranges and throw out the baby…

    stanley seigler

  11. Kev August 18, 2010 at 07:30 #

    Barbara – I doubt he did. It was almost certainly the journalist.

  12. Joseph August 18, 2010 at 16:30 #

    It should be noted that Dr. Bearman is not doing an exhaustive survey of all possible contributing factors, nor can he.

    For example, they quantified the effect of geographic proximity to other autistic children. But they didn’t measure other possible means of information diffusion, like co-workers, relatives, the media and the internet.

  13. Barbara August 18, 2010 at 17:30 #

    @ Joseph: Agree completely. Of those you cite, I think the internet is perhaps the most important. I’ve seen the ‘internet effect’ hugely in the 13 years I’ve been researching autism.

    @ Kev: As a freelance journo myself, it’s pretty bad form to include material within apparent quotes or indents that the interviewee hasn’t actually said.

  14. Chelsea August 18, 2010 at 23:27 #

    I was hoping that with this poster, I would have beaten a dead horse by now. Perhaps now it is getting close 🙂

  15. RAJ August 19, 2010 at 17:51 #

    The definition of autism has become increasingly ambigous over time. The very narrow DSM-III (1980) definition of a pervasive lack of responsiveness to other people (Social indifference) has evolved into an ambigous DSM-IV (1994) very broadly defined qualitative impairment of social reciprocity.

    Current ASD definitions (DSM-IV-TR 2000) consist of twelve isolated symptoms, not one of which is specific to autism.

    The actual startling rise in autism prevelance can be ‘carbon-dated’ if you will to 1994 and the introduction of DSM-IV (1994) and ICD-10 (1994) version.

    It is impossible to solve a problem that is without a clear definition.

  16. stanley seigler August 19, 2010 at 19:18 #

    [raj say] The very narrow DSM-III (1980) definition…[vs]…the introduction of DSM-IV (1994) and ICD-10 (1994) version.

    is there a study of increases based on DSM-III 1980…to this non scientist this would seems indicate startling rise or lack thereof…apples to apple thing…if such study does not exist…why not…

    was 1980 the first DSM defination…in days of yore (circa late 60s, 70s) you just knew it when you saw it…i doubt there has been a startling rise in 60/70s autism.

    stanley seigler

  17. RAJ August 19, 2010 at 20:46 #

    is there a study of increases based on DSM-III 1980…to this non scientist this would seems indicate startling rise or lack thereof…apples to apple thing…if such study does not exist…why not…

    was 1980 the first DSM defination…in days of yore (circa late 60s, 70s) you just knew it when you saw it…i doubt there has been a startling rise in 60/70s autism.

    Two studies that might interest you. Actually one is a review of the DSM definitions over the years beginning with the DSM-III (1980) very narrow definition:

    Another is a review of all prevelance studies over many decades:

    Hope this helps.

  18. RAJ August 19, 2010 at 20:55 #


    PS No studies using DSM-III (1980) narrow definition have been published this decade. It would be interesting though.

  19. stanley seigler August 19, 2010 at 21:19 #

    [raj say] Two studies that might interest you. Actually one is a review of the DSM definitions over the years beginning with the DSM-III (1980) very narrow definition:

    thanks will save me a lot time…fist because i dont know what i’m looking for…OTOH i probable have more time than you

    in any event thanks and when i win the lotto will pay you for your excellant research

    stanley seigler

  20. stanley seigler August 20, 2010 at 18:19 #

    [raj say] No studies using DSM-III (1980) narrow definition have been published this decade. It would be interesting though.

    closest i’ve seen to a comparision study,PERHAPS USING SAME CRITERIA is an article quoting CA Dept of Developmental Services (DDS) stats:
    [clip, quotation marks my add] Ten years ago in January 1995, DDS reported that during the Fourth Quarter of 1994 the system added 142 new cases of “full syndrome autism”. Today, ten years later in January 2005, DDS reports that during the Fourth Quarter of 2004 there were 807 new cases added to the system. Ten years ago California’s developmental services system had a total of 5,775 cases of “full syndrome autism” in it’s entire system. Ten years later in January 2005, there are now 26,578 cases of “full syndrome autism” in the system. In California’s developmental services system, 8 out of 10 persons with “full syndrome autism” are between the ages of 3 and 17 years old….7 out of 10 under the age of 14. [end clip]

    unable to determine “full syndrome autism” dx criteria or if same criteria used in 4th quarter 1994 and 4th quarter 2004…ie, where when DSM-III (1980) or DSM-IV (1994) used…if used.

    DDS tightened requirements (myopic cost cutting) to qualify for services in 2003…thus eliminating service to approximately 400 on the spectrum annually…which reduces number incidents on DDS records post 2003…also;

    quality of dx-es is questionable…eg, as mentioned a regional center (state funding agency) PhD psychologists spent 45 mins with my daughter said she was not autistic…she is non verbal classic kanner autistic. all said;

    the vast differences (5,775 v 26,578) indicate a significant increase. call it what you want.

    stanley seigler

  21. Barbara August 20, 2010 at 19:50 #

    Non-verbal is not a Kanner issue. Read his papers. Only 1 of his 11 original subjects was totally non-verbal, Herbert, and he did OK for himself. Your daughter may have other problems. What are they?

    ‘Classic’ Kanner’s is so badly understood, in all literature, including the diagnostic criteria.

    People seem to have lost the ability to go back to basics and look at what was said, very clearly, in 1943.

  22. stanley seigler August 20, 2010 at 22:07 #

    [barbara say] Non-verbal is not a Kanner issue

    This important why…didn’t mean to imply it was a kanner issue…was describing my daughters issues: autism AND non-verbal…most of her 30 some peers (same programs over the years) she grew up with are non-verbal and autistic.

    [barbara say] Your daughter may have other problems. What are they

    no problem, but why asked…as mentioned on another LBRB thread: my daughter was dx-ed as autistic (no retardation) by psychiatrists and neurologists at emory (atl, GA-usa); at ucla and cedars (lalaland, CA-usa) and by pro bona beverly hills psychiatrist…no other dx-es.

    ucla psychiatrist was appalled at funding agency’s psychologist dx that she was not autistic.

    [barbara say] Classic’ Kanner’s is so badly understood…

    as are many autism/behavioral issues

    [barbara say] People seem to have lost the ability to go back to basics

    back to basics a step forward…would clarify epidemic question…in days of yore (circa mid 60s and 70s) there was no widely publicized spectrum.

    Apologies for bringing kanner up…seems to have detracted from the epidemic issue…

    stanley seigler

  23. Barbara August 20, 2010 at 23:13 #

    There could be oral dyspraxia. Has this been investigated? Check it out via David Eastman. That case is worth a look.

    Back to basics means that it was already signposted by Hans Asperger that this was a genetic issue.

    We HAVE to get back to basics.

    Asperger says that in EVERY case he noted a parental genetic issue. He checked out 400 of these cases. All of them took us to genetic issues arising from the early 1900s and before.

    So what does that say?

  24. stanley seigler August 21, 2010 at 00:02 #

    [barbara say] There could be oral dyspraxia. Has this been investigated? Check it out via David Eastman. That case is worth a look.

    THANKS!! will do…but will have to commit sucide if i’ve missed this for 40 some years of my daughter’s life…amazing how she seems to forgive me all my stupid mistakes…think it called unconditional love.

    also angry no one has mentioned this before and we have been to some prestigious groups.

    [barbara say] So what does that say?

    for one thing it says we know the cause of autism in many/most…

    moving off epidemic topic…but on verbal ability topic…and may give someone hope.

    Off Topic:
    My brother, 57, started to talk when he was 50…it means that persons with autism can learn to write and communicate even in their 50’s…I [Jeanette] have written some of this at one of our websites: under Jim’s Story. I hope this gives parents and siblings hope and if it helps even one other person, that would be wonderful

    Barbara, all your comments very interesting…again, THANKS

    stanley seigler

  25. Chris August 21, 2010 at 17:37 #


    There could be oral dyspraxia.

    That is what my son was diagnosed with nineteen years ago. It was interesting to learn about, and how some medical professionals actually did not believe it existed. A parent of another dyspraxic child who moved up from Los Angeles told me that a UCLA neurologist he son saw was one of those.

    My son’s special ed. preschool teacher told me that they started their program on speech development after they were getting children enrolled in the deaf and hard of hearing program who could not speak, but could hear. She also said that less than twenty years before children who could not speak were considered mentally retarded and institutionalized. This also happened to deaf children.

    I used to be very active in the Apraxia-Kids online community between 1998 and 2005, and I have never heard of David Eastman. Who is he? (because my Google-fu failed me!).

  26. Barbara August 21, 2010 at 18:53 #


    David Eastman was a Canadian man with oral dyspraxia who became a poet. His mother, who helped him read and communicate wrote a book about him and his poems were published after his death from a tragic drowning accident. He remained nonverbal until the day he died. Here’s something about/by him:

    “You don’t know how lonely it is
    I feel it every day
    I appreciate what you’ve done
    Just help me find my way”

    Quote from
    David W. Eastman

    An accident claimed David’s life at the age of 25. David, a non-verbal, autistic adult will be remembered by his poetry which gives insight into the thoughts and feelings of a person with autism.

  27. Chris August 21, 2010 at 19:12 #

    Thank you. Ah, so young! He died the year my son was born.

  28. Donna August 24, 2010 at 23:46 #

    I’ve read that being firstborn is a risk factor for autism. Would the trend towards smaller family size contribute to growing autism numbers?

  29. David N. Andrews M. Ed., C. P. S. E. August 28, 2010 at 21:20 #

    Stanley Seigler: “ucla psychiatrist was appalled at funding agency’s psychologist dx that she was not autistic.”

    As am I, Mr. Seigler. As am I.

    Barbara may be onto something with the dyspraxia notion. A number of types of dyspraxia can impact on communication skills, including oral/verbal dyspraxia. For what it’s worth, I think that would be useful for you to follow up. As does Barbara, I dare say.

  30. David N. Andrews M. Ed., C. P. S. E. August 28, 2010 at 21:25 #

    Barbara: “My PhD thesis confirms that there is no real understanding of ASCs in the UK’s educational provision.”

    This would be interesting to see, even in summary. My own observations regarding my own experiences and those of my two Asperger-autistic nephews suggest that I will most likely agree with your findings.

  31. Barbara August 28, 2010 at 22:23 #

    Hi David – it’s good to ‘see’ you again! As you know, I have a deep respect for your astoundingly analytic mind, and your ability to cut to the chase! Here is my Abstract. I’ll tell you more if you want to contact me at the Uni, but do it quickly. My viva is in 3 weeks, and my email addy there probably runs out at the end of September. The address is

    How can autistic intelligence be recognised and accommodated within
    an inclusive education framework?

    The aims of this study were twofold and integrated. The first was to explore whether Hans Asperger’s expression ‘autistic intelligence’ was a valid concept. The second was to discover whether this theorised cognitive style could be accommodated within what is called an ‘inclusive’ education framework. Four children on the autism spectrum, in mainstream schools, their parents and their teachers, were interviewed in a phenomenological case-study approach, to analyse their beliefs and understandings about autism.

    Data analysis showed that parents and students in particular believed that autistic intelligence involved a cognitive style which seemed biased towards perceptual information processing. It tended, they said, to have sensory elements which impacted upon engagement and learning, and appeared to give rise to some social difficulties. These in turn were thought to impact upon their emotional well-being. Students and parents reported bullying and
    exclusion, as evidenced in recent national surveys. All students clearly described themselves as ‘different’ in terms consistent with the concept of autistic intelligence. These findings reflect the developing theoretical and cognitive neuroscience consensus supporting a probable Local Processing Bias (LPB) as being a key element in defining core characteristics of autism.

    Additionally what is thought to be an inclusive framework was perceived to be failing these students. The difficulties in obtaining educational support were believed, by students and their parents, to be obstructive. Another area of concern was the use of unqualified teaching assistants as the principal educational intervention.

    The bio-psycho-social theoretical framework of this study enabled a striking finding: that while students readily identified their difference, teaching staff consistently rejected it. They appeared to believe that to acknowledge difference means to label,negatively. What the learners perceived as their identity was thereby discounted.

    Ultimately this educational attitude fails to give due respect to the nature of autistic intelligence and denies these students their right to be fully included in the current educational system.

  32. stanley seigler August 31, 2010 at 15:09 #

    a second opinion, more mis-dxs:

    In the following presentation Dr. Shankardass says, “research shows that almost 50% of children diagnosed with Autism are actually suffering from hidden brain seizures.”

    Aditi Shankardass: A second opinion on learning disorders by Ted Talks June 20, 2010.

    Developmental disorders in children are typically diagnosed by observing behavior, but Aditi Shankardass knew that we should be looking directly at their brains. She explains how a remarkable EEG device has revealed mistaken diagnoses and transformed children’s lives.

    stanley seigler

    ps. THANKS to ARC-CA for the video lead.


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