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David Geier ordered to pay $10,000 for practicing medicine without a license

13 Aug

David Geier is the son in a father-son team which ran a clinic purporting to treat autism through such unproven and biologically implausible methods as chelation and lupron.  In addition, the team produced questionable quality research promoting the link between autism and vaccines.  While Mark Geier holds an M.D., David Geier holds no degree nor other qualifications in medicine.

The Maryland State Board of Physicians charged Mr. Geier with practicing medicine without a license and, recently, the board found him guilty and fined him $10,000. Mr. Geier has the right to appleal. More details can be found in the Board’s order.

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by Matt Carey

How Americans would slim down public education

12 Aug

With economic troubles in the U.S. and worldwide continuing for years, schools are facing tough decisions.  A recent survey, How Americans would slim down public education, in the U.S. taps into the public’s support for education in general and also for special education. 

With budget shortfalls predicted for schools (at least in the area I know best: California) people are thinking of how to react in case of budget shortfalls.  There is no support for increasing taxes to support schools, instead “dramatically changing how [schools] do business”:

End Business as Usual
Which would be the best approach for your district to take if it was facing a serious budget deficit?

48% Cut costs by dramatically changing how it does business.

26% Change as little as possible; wait for times to get better

11% Rely on tax increases

7%  Something else

8%  Don’t know

Which begs the question of how dramatic changes might affect special education.  While there is broad support for special education, there is a strong sentiment that there are children in special ed who do not belong:

When it comes to budget cuts, special education is not immune as far as most Americans are concerned. That’s not to say the commitment of Americans to educate children with special needs is waning—it’s not. But they have concerns about the growth, cost, and effectiveness of serving these kids well.

The overwhelming majority of the public, 83 percent, believes that “the public schools have a moral obligation to educate kids with special needs and learning disabilities, even if it’s more difficult and expensive to do so.”

76 percent believe that “too many students are being mislabeled as having special needs when they just have behavior problems or weren’t taught well in the first place.”

71 percent believe that special education programs should be “evaluated according to whether they help students learn—when students don’t learn, the programs should be replaced

The public is split on supporting the law’s provisions that cost should not be a factor in deciding a special education placement:

According to federal law, districts are required to provide special education services, but they are not allowed to consider the costs of those services. Do you think districts should be allowed to weigh costs when considering which special education services to choose, or do you think the law should be left as is?

44 Districts should be allowed to weigh costs when considering which special education services to choose

47 The law should be left as is

9 [Vol.] Don’t know

There is a lot more discussion in the report on ways schools could (e.g. cut pay, change retirement) and should not (e.g. lay off faculty) reduce costs. More can be found in the report.

Most people think that their schools are an asset to thrir community , but also that the schools have been hit hard by the recession and (77%) that the financial problems will last a long time.

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By Matt Carey

Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria

8 Aug

The proposed change in diagnostic criteria for autism (from DSM IV to DSM 5) has been a topic of much discussion. To put it mildly. Little, if any, data has been available on how this change may affect the adult population.

A recent study seeks to address that void:

Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria

Reseaerchers studied autistic adults with intellectual disability. They found that 36%  of their study population would lose their diagnosis under DSM 5.

The American Psychiatric Association is making changes in the autism spectrum disorder (ASD) criteria for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In order to examine potential effects of the changing of the criteria, 330 adults with intellectual disability (ID) from two developmental centers were examined. However, due to the fact that the DSM-IV-TR/ICD-10 Checklist does not contain one of the restricted behavior items listed in the current proposed DSM-5 criteria, 41 participants were eliminated from the study. An additional 62 individuals were randomly removed from the study so that no one group was 1.5 times larger than any other group. This left a total of 227 individuals. These individuals were divided into three groups: those who met criteria for an ASD according to only DSM-IV-TR criteria, those who met criteria according to the proposed DSM-5 criteria, and controls with ID not meeting ASD criteria according to either diagnostic system. After statistical analysis, individuals in the DSM-5 group evinced significantly greater overall ASD core symptoms than those in the DSM-IV-TR group or controls. In addition, those in the DSM-IV-TR group exhibited significantly greater overall ASD core symptoms than those in the control group. Furthermore, we found that the percentage of adults diagnosed with ASD declined by 36.53% when using DSM-5 as compared to DSM-IV-TR criteria. Implications of these findings are discussed.

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by Matt Carey

The 15-Year Fallout From One Man’s Lie About Vaccines

4 Aug

On the same day that Andrew Wakefield’s lawsuit against the BMJ, Brian Deer and Fiona Godlee was dismissed, The Atlantic has a piece: The 15-Year Fallout From One Man’s Lie About Vaccines . Who is the one man, and what is the lie? From The Atlantic:

Consider the widespread fear of childhood vaccinations. In 1998, the physician Andrew Wakefield published a study in The Lancet linking the measles, mumps, and rubella (MMR) vaccine to autism. This study has since been judged to be an ‘elaborate fraud,’ and Wakefield’s medical license has been revoked.

The consequences of Wakefield’s dishonesty would have been bad enough. But the legacy effect of other big lies has thus far made it impossible to remedy the damage he has caused. Given the fact that corporations and governments sometimes lie, whether to avoid legal liability or to avert public panic, it has become very difficult to spread the truth about the MMR vaccine. Vaccination rates have plummeted — especially in prosperous, well-educated communities –and children have become sick and even died as a result.

An unhappy truth of human psychology is probably also at work here, which makes it hard to abolish lies once they have escaped into the world: We seem to be predisposed to remember statements as true even after they have been disconfirmed.

Apparently The Atlantic didn’t feel the need to wait for a Texas Judge to rule before using Mr. Wkefield’s work as a prime example of a “big lie”.

The Atlantic is right. It is hard to spread the truth about MMR. Just check the comments for the article.

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by Matt Carey

Wakefield vs BMJ lawsuit dismissed on jurisdiction grounds

3 Aug

Andrew Wakefield’s lawsuit against the British Medical Journal (BMJ), Brian Deer and Fiona Godlee has been thrown out based on a lack of jurisdiction. Put plainly, he doesn’t have the standing to sue any of the parties involved as they are outside the U.S..

Had the lawsuit not been dismissed the BMJ team was prepared to fight the case on the facts. This is evidenced by vigorous response they made to the lawsuit, as well as supplemental filings.

Mr. Wakefield may have the opportunity to appeal the dismissal.

Mr. Wakefield’s home town newspaper, the Austin Statesman, has reported already on this in Wakefield can’t sue U.K. journal, editor and reporter in Texas

They write:

Godlee and Deer called the case frivolous and said it fit a pattern of Wakefield trying to silence his critics with lawsuits.

“We’re very pleased with the court’s decision,” said defense attorney Marc Fuller at Vinson & Elkins in Dallas. “We stood behind the reporting in the case, and from our perspective, it’s over.”

The comment above refers to previous attempts by Mr. Wakefield to sue Brian Deer. In one case, Mr. Wakefield dismissed his own lawsuit and was required to pay the legal fees for Mr. Deer. Had the current defamation case gone forward, Mr. Wakefield faced an anti-SLAPP motion based on a new Texas law which had the potential to cost Mr. Wakefield legal fees in this case. Based on the amount of documents supplied, the Texas suit has likely already cost a great deal of money, and was on track to be a very expensive endeavor. Mr. Wakefield may be fortunate to have gotten out early.

No comment yet on the Wakefield Justice Fund website. This site has not been updated a much anyway, so this is not surprising.

Since this is a dismissal on jurisdiction grounds, we do not have a ruling as to whether it is defamatory to call Mr. Wakefield a “fraud” or “fraudster” based on his research activities (such statements were part of Mr. Wakefield’s defamation suit), which resulted in his Lancet paper being retracted and which activities were deemed unethical by the General Medical Council.

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by Matt Carey

What projects are being funded in autism research? Part 2: Expanded Surveillance

3 Aug

At the IACC meeting OARC released it’s new IACC/OARC Autism Spectrum Disorder Research Portfolio Analysis Web Tool. There are many ways to explore what research is being performed. Since the CDC autism prevalence estimates get a lot of attention, it seemed valuable to see what is in the pipeline with them. The CDC estimates are made through ADDM, the Autism and Developmental Disabilities Monitoring Network, which is largely sites in various states working with the CDC, not the CDC itself.

One can search for ADDM for 2009 and 2010 projects.

In 2009 there were projects ongoing in Alabama, Arizona, Arkansas, Colorado, Florida, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah and Wisconsin, as well as the Metropolitan Atlanta Developmental Disabilities Surveillance Program/Autism and Developmental Disabilities Monitoring (ADDM) network – Georgia.

13 states plus the Metro Atlanta study.

The latest prevalence estimate report from the CDC included 14 sites: Alabama, Arizona, Arkansas, Colorado, Florida, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah, West Virginia, and Wisconsin. West Virginia appears to no longer be a part of the study.

In 2010 there were projects ongoing in 11 states plus the metro Atlanta site. Florida and Pennsylvania are no longer funded.

Now, here’s where it get’s interesting. At least to this reader. There are “expanded” projects in 2010:

Through surveillance of ASD among 4-year-old children, CDC can better understand the population characteristics of young children affected by ASDs and better inform early identification efforts.

Arizona, Missouri, New Jersey, South Carolina, Utah and Wisconsin are starting to count 4 year-olds as well as 8 year olds. This will be a good thing. As they say, this will inform early-intervention efforts. This will also benchmark 4 year olds, then (I assume) 4 years later find out what that same cohort looks like.

The CDC autism prevalence estimate reports find a large number of autistic students unidentified even at age 8. They are identified through the records review of the ADDM. This and other studies raise the question of what factors are involved with delays in autism diagnosis. A study is ongoing to answer just that question: Understanding the delay in the diagnosis of autism. The study has already resulted in numerous publications.

The Strategic Plan calls for even more expansion of the ADDM:

Expand the number of ADDM sites in order to conduct ASD surveillance in children and adults; conduct complementary direct screening to inform completeness of ongoing surveillance; and expand efforts to include autism subtypes by 2015.

Expanding to include adults is a good idea, but extremely tough. The current method uses educational and medical records of students. Obviously educational records will not be available for adults. This will make it difficult to make comparisons between adults and children in the same state. Most likely, the estimate will be lower than the actual autism prevalence in adults.

There is a study by the Mayo Clinic on adult autism prevalence and at least one more I am aware of.

Surveillance efforts are expanding into better identification of young children outside of ADDM. Two studies, the California Monitoring of Early Childhood Autism (CA-MECA) and the First Words Project: Implementing Surveillance to Determine the Prevalence of ASD project in Florida. Both are looking at young children (<4 years old) or infants (as young as 18 months). Both studies have been ongoing since 2006.

Studies are ongoing outside the U.S.. Including an Autism Speaks funded study in Kwa Zulu Natal (South Africa). KwaZulu-Natal (KZN) Autism Study will “…test how best to identify and assess children with ASD in the Zulu language and culture, explore the prevalence of autism in South Africa, and further explore the hypothesized relationship between autism and HIV infection.” The Korea Autism Study (also funded by Autism Speaks), which last year announced a prevalence of 2.62% using a whole-population screen, is ongoing.

Surveillance projects will generate questions, and that has definitely happened with autism surveillance work. Questions of why the estimated prevalences are increasing and why some groups are identified later than others are a couple of the big ones. Based on this quick look through the ongoing projects, there appear to be a number of projects in the pipeline which will probably shed some light on existing questions as well as spark new ones.

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by Matt Carey

Questions Surround Handling of Taser Assaults on Disabled Patients

1 Aug

This story is out of California. Specifically, the story “Questions Surround Handling of Taser Assaults on Disabled Patients” comes from the California Report, a public radio program.

Someone using a stun gun like a cattle prod assaulted a dozen patients at the Sonoma Developmental Center last fall, inflicting painful thermal burns on their buttocks, arms, legs and backs.

The center’s in-house police force, the Office of Protective Services, had a suspect from the start. An anonymous whistle-blower called a tip line in September 2011 and accused Archie Millora, a caregiver at the Sonoma center, of abusing several profoundly disabled men with high-voltage probes.

The parallels between this and the Judge Rotenberg Center are obviously going to be made. Except that this isn’t part of any sanctioned “therapy” and, unlike JRC, there is no constant video monitoring.

What does exist is an internal police force. Which “often fails to conduct basic police work”:

As part of an ongoing investigation, California Watch has detailed how the institutions’ internal police force, created by the state to protect the vulnerable residents at these state homes, often fails to conduct basic police work when patients are abused and harmed.

The full text of the story is online and the audio is here:

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by Matt Carey

Scarborough remarks unite much, but not all, of autism communities for a brief moment

26 Jul

Joe Scarborough is in the news. Yes, he works in the news, but he’s in the news for comments he made about the Aurora shooter:

“You have these people that are somewhere, I believe, probably on the autism scale, I don’t know if that’s the case here, but it happens more often than not, people that can walk around in society, that can function on college campuses, can even excel in college campuses, but are socially disconnected. I have a son who has Asperger’s who is loved by everyone in his family and who is wonderful, but it is for those that may not have a loving family and a support group and may be a bit further along on the autism spectrum, an extraordinarily frustrating, terrible challenge day in and day out. and so, I do think, again, I don’t know the specifics about this young man, but we see too many shooters in these type of tragedies bearing the same characteristics mentally.”

This has brought together various and disparate parts of the autism communities asking for a retraction. From the Autistic Self Advocacy Network (ASAN) to the Age of Autism blog. AoA even linked to a petition set up by Rachel Cohen-Rottenberg.

Such unity of voice should be telling Mr. Scarborough something.

I don’t think he got the message, though. In a follow-up to that statement, Mr. Scarborough wrote:

During a debate regarding the recent Colorado shootings, I suggested that the Aurora tragedy should make Americans focus more on mental health in this country. I also stated that my own experiences raising a son with Aspergers made me keenly aware of how important strong support systems are to those who might otherwise be isolated.
The growing Autism epidemic is a tremendous burden for children, parents and loved ones to endure. My call for increased funding and awareness for Autism and other mental health conditions was meant to support the efforts of those who work every day to improve the lives of Americans impacted. Those suggesting that I was linking all violent behavior to Autism missed my larger point and overlooked the fact that I have a wonderful, loving son with Aspergers. Perhaps I could have made my point more eloquently.
I look forward to continuing my work with wonderful organizations like Autism Speaks to provide badly needed support to millions of Americans who struggle with Autism every day

That nod to Autism Speaks brought on some criticism which demonstrates how this story shows the divisions within the autism communities even in this story.

Mediaite.com (a site I was previously unaware of) has at least three articles on the Scarborough story:

Autistic Journalist Demands Joe Scarborough Retract Comments Linking Autism To Aurora Shooting

Followed by these two with a partial focus on Autism Speaks:

Autism Speaks Whispers Response To Joe Scarborough’s Aurora Slur

and

First Autistic Presidential Appointee Lambastes Joe Scarborough And Autism Speaks

I thought I’d never heard of Joe Scarborough before. I forgot that he is or was a supporter of the thimerosal-causation idea and had interviewed Robert F. Kennedy Jr. on Kennedy’s “deadly immunity” articles (these ran in Salon.com and Rolling Stone. If you are unaware of Deadly Immunity, the piece had five corrections after being published and Salon has since retracted the article.

A comment from Joe Scarborough in that interview:

Maybe it’s five years from now. Maybe it’s 10 years from now. We are going to find out Thimerosal causes, in my opinion, autism.

It’s been more than five years since then and the support for the idea has only gotten worse.

I am actually somewhat surprised that Mr. Scarborough received such criticism from those promoting the notion of mercury causation.

For a brief moment, a call for respect for autistics trumped support for an old ally of the mercury causation movement.

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by Matt Carey

note: I made a few corrections, including changing the title, to this piece shortly after publishing it.

How Research into Chronic Fatigue Syndrome Turned into an Ugly Fight

24 Jul

Judy Mikovits is a researcher who, in recent years, has focused on chronic fatigue syndrome. In her work she published a paper potentially linking chronic fatigue syndrome to XMRV (Xenotropic murine leukemia virus-related virus). In her unpublished work, her team discussed the possibility that autism was also linked somehow to XMRV.

There has been much drama involving Judy Mikovits, her research and her former institution (the Whittemore Peterson Institute) over the last year.

The Daily Beast has an interview with Judy Mikovits. The first since the legal issues arose last year. How Research into Chronic Fatigue Syndrome Turned into an Ugly Fight. The interview gives her side of the story in much of the events. One can read them at the Daily Beast, but I’ll focus on this section here as it applies to the science involved:

Meanwhile, other research groups around the country were trying to replicate the 2009 results, but in the two years that followed, almost all had failed. The word “contamination” began to surface more and more frequently.

In the summer of 2011, Mikovits and her young lab assistant, Max Pfost, began poring through their notebooks, trying to find where such a contaminant might have entered their process.

In July, she says, she found it—an entry from March 2009 indicating that a culture of the XMRV virus had been placed into the same ice chest with the rest of the lab’s blood samples. Mikovits says she was out of town the day this occurred.

To this reader, this is a sign that the upcoming multi-center attempt to replicate the XMRV/chronic-fatigue-syndrome work is going to come out negative (like the multiple other XMRV/CFS studies published so far trying to replicate her work). There was contamination in her lab’s process.

This does not speak directly to the XMRV/autism work, but two papers have:

Lack of Infection with XMRV or Other MLV-Related Viruses in Blood, Post-Mortem Brains and Paternal Gametes of Autistic Individuals

PCR and serology find no association between xenotropic murine leukemia virus-related virus (XMRV) and autism.

So, we have an unpublished result supposedly linking autism with XMRV from a laboratory where the principle investigator is telling us there was a contamination issue and two papers saying there is no detectable link?

While I doubt the XMRV/autism story will die out completely, it strikes this observer that it’s time to look elsewhere for answers.

Joe Scarborough On Autism Remarks: ‘Perhaps I Could Have Made My Point More Eloquently’

24 Jul

Joe Scarborough is a talk show host. One who yesterday made a comment about autism and the type of people who do things like the Aurora Colorado shooting.

In regards to the Aurora Colorado shooting incident, he made the following comment:

“You have these people that are somewhere, I believe, probably on the autism scale, I don’t know if that’s the case here, but it happens more often than not, people that can walk around in society, that can function on college campuses, can even excel in college campuses, but are socially disconnected. I have a son who has Asperger’s who is loved by everyone in his family and who is wonderful, but it is for those that may not have a loving family and a support group and may be a bit further along on the autism spectrum, an extraordinarily frustrating, terrible challenge day in and day out. and so, I do think, again, I don’t know the specifics about this young man, but we see too many shooters in these type of tragedies bearing the same characteristics mentally.”

Which has had quite a backlash from the autism communities. Yes, various and disparate segments of the autism communities are complaining about the statement.

Today he has tried to clarify his position (from a story: Joe Scarborough On Autism Remarks: ‘Perhaps I Could Have Made My Point More Eloquently’)

During a debate regarding the recent Colorado shootings, I suggested that the Aurora tragedy should make Americans focus more on mental health in this country. I also stated that my own experiences raising a son with Aspergers made me keenly aware of how important strong support systems are to those who might otherwise be isolated.
The growing Autism epidemic is a tremendous burden for children, parents and loved ones to endure. My call for increased funding and awareness for Autism and other mental health conditions was meant to support the efforts of those who work every day to improve the lives of Americans impacted. Those suggesting that I was linking all violent behavior to Autism missed my larger point and overlooked the fact that I have a wonderful, loving son with Aspergers. Perhaps I could have made my point more eloquently.
I look forward to continuing my work with wonderful organizations like Autism Speaks to provide badly needed support to millions of Americans who struggle with Autism every day.

Is this in response, at least in part, to the Change.org petition Joe Scarborough, MSNBC: Retract your statements about autism and the Colorado shooting? That petition has gathered nearly 5,000 signatures in a day.

If this is the sort of criticism Mr. Scarborough is trying to deflect, I suggest he may have to work a bit harder to quiet the critics.

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By Matt Carey

note: I edited this shortly after posting to finish the incomplete first paragraph.

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