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Committee on Oversight & Government Reform, subcommittee hearing on autism

20 May

The U.S. House of Representatives, Committee on Oversight & Government Reform, Subcommittee on Government Operations held a hearing today: Examining the Federal Response to Autism Spectrum Disorders. That hearing was live streamed and the video is now available online:



Broadcast live streaming video on Ustream

The hearing focused on a recent Government Accountability Office report: FEDERAL AUTISM ACTIVITIES: Funding and Coordination Efforts.

IACC releases 2013 Strategic Plan Update

20 May

The U.S. Interagency Autism Coordinating Committee releases each year an update the Strategic Plan for ASD Research. This year’s update differs from previous years in that the format was more retrospective: an accounting of the changes in research and understanding in the past five years.

Below is the press release from the Office of Autism Research Coordination announcing the update:

2013 IACC Strategic Plan Update Provides Accounting of ASD Research Progress Over Last 5 Years (pdf-45KB)

The Interagency Autism Coordinating Committee (IACC) has released its 2013 Strategic Plan Update, which provides an overview of funding and scientific advances made in autism research since 2009, when the IACC Strategic Plan for ASD Research was first published. Approximately $1.5 billion has been dedicated to ASD research over the past 5 years through the combined efforts of U.S. government agencies and private organizations. The 2013 Strategic Plan Update describes funding trends and research advances that capture the significant progress that has been made in all seven critical research areas of the Strategic Plan over the past 5 years, providing an accounting for which funding and research goals have been achieved and identifying key areas where intensified efforts are warranted.

IACC Chair and NIMH Director Dr. Thomas Insel said, “The state of the science has dramatically changed in the ASD field over the last 5 years. The 2013 Strategic Plan Update provides an accounting of that change, through investments and the evolution of research since the 2009 publication of the original Strategic Plan. This investment has translated to progress in all seven research areas outlined by the Plan,” which include risk factors, treatments and interventions, services, lifespan issues, and surveillance and infrastructure.

Since the release of the first IACC Strategic Plan in 2009, scientific advances have been made in the understanding of the key windows of fetal and infant development, when changes in gene expression, brain architecture and behavior can be linked to the later development of autism, along with potential environmental contributors to ASD risk such as parental age, maternal health conditions and prematurity. Advances have also been made in the development of new and improved screening tools, demonstration of the efficacy of various early intervention strategies, and increased information about critical services gaps, such as transition and housing, as well as data supporting effective services strategies. Research infrastructure has also greatly expanded in the past 5 years, with shared data repositories providing an unprecedented opportunity for collaboration and large-scale data analysis.

In most research areas, including those where funding fully met recommendations, the Committee suggested that additional investment would be needed to fully achieve the aspirational goals of making appropriate diagnosis, intervention and services available to all individuals with ASD, including people of all ages, cultural groups and levels of ability.

The 2013 Update identified several overarching themes that have emerged and that the Committee felt were critical for accelerating the progress of ASD research in the next 5 years. These include:

Scaling up screening tools, interventions, and services approaches for transition from lab to community settings.
Promoting inclusion of research subjects from the full range of ASD disability, from all periods of the lifespan, and from underserved populations.
Translating “practice to research,” by encouraging study of current real-world practices to inform research studies.
Characterizing the heterogeneity of ASD, including genotypes, subtypes, and co-morbid health conditions, in order to develop a personalized medicine approach.
Leveraging existing infrastructure to increase research speed and efficiency.
Applying strategies from other fields to ASD research.
Standardizing the ways in which outcomes are measured in clinical trials and services research to determine the effectiveness of interventions and services.
In the 2013 Strategic Plan Update, the IACC provides the most detailed accounting to date, using both quantitative and qualitative data. This included review of detailed portfolio analysis data and the literature, as well as consultation with over 25 external experts and review of comments received from the public, to assess progress across all objectives and aspirational goals described in the Strategic Plan since its initial conception.

Overall, the Committee hopes that this latest IACC Strategic Plan Update will provide Congress, federal agencies, advocates, and people with autism and their families with helpful information about important research progress that has been made to date, as well as areas that need further attention, in order to support a robust research effort that will lead to enhanced interventions, services and opportunities for people with autism across cultures, across the full spectrum of ability, and across the lifespan.


By Matt Carey

note: I serve as a public member to the IACC but my comments here and elsewhere are my own

Hearing tomorrow on Examining the Federal Response to Autism Spectrum Disorders

19 May

The Committee on Oversight and Government Reform through the subcommittee on Government Operations will be holding a hearing tomorrow (May 20): Examining the Federal Response to Autism Spectrum Disorders

Testifying will be:

Thomas R. Insel, M.D.
Director, National Institute of Mental Health
Chair, Interagency Autism Coordinating Committee

Mr. Michael K. Yudin
Acting Assistant Secretary, Office of Special Education and Rehabilitative Services
U.S. Department of Education

Marcia Crosse, Ph.D.
Director, Health Care
U.S. Government Accountability Office

Likely this is based partly on the Government Accountability Office report last year: Better Data and More Coordination Needed to Help Avoid the Potential for Unnecessary Duplication and the introduction of the reauthorization bill for the Combating Autism Act.


By Matt Carey

Combating Autism Reauthorization Act of 2014

17 May

The text of the bill to reauthorize the Combating Autism Act is below.

A few notes:

The bill does include the “Combating” term that is the topic of controversy. This is contrary to what I wrote in my previous article on the reauthorization.

There are not two legislatively appointed representatives to the IACC as previously reported but four. Two from the House. Two from the Senate.

There is a strong emphasis on focusing on adult autistics. Consider the last section “REPORT TO CONGRESS ON DEMOGRAPHICS AND NEEDS OF ADULTS WITH AUTISM SPECTRUM DISORDER”

Much as I desperately would love to see this work done, I do not generally support legislative mandated research. This is a report to congress to inform them on an area which, frankly, they need to hear about.

The demographics and needs of autistic adults is a huge hole in the body of knowledge we have about autism. And while politically active groups are wasting their time and money on congressional hearings to validate their failed views on vaccines,


By Matt Carey
note: I serve as a public member to the IACC but all comments and views here and elsewhere are my own.

text of the proposed bill:

A BILL

To reauthorize certain provisions of the Public Health Service Act
relating to autism, and for other purposes.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Combating Autism Reauthorization Act
of 2014”.

SEC. 2. REAUTHORIZATION OF PROGRAMS RELATING TO AUTISM.

(a) National Autism Spectrum Disorder Initiative.–Part R of title
III of the Public Health Service Act (42 U.S.C. 280i et seq.) is
amended–
(1) by redesignating sections 399AA through 399EE as
sections 399BB through 399FF, respectively; and
(2) by inserting before section 399BB, as redesignated, the
following:

“SEC. 399AA. NATIONAL AUTISM SPECTRUM DISORDER INITIATIVE.

“(a) Establishment.–For the purposes described in subsection (b),
the Secretary shall designate an official within the Department of
Health and Human Services to establish and oversee a National Autism
Spectrum Disorder Initiative (in this section referred to as the
`Initiative’).
“(b) Purposes.–The purposes of the Initiative shall be–
“(1) to implement a strategic plan for the conduct of, and
support for, autism spectrum disorder research, taking into
account the strategic plan developed by the Interagency Autism
Coordinating Committee under section 399DD(b); and
“(2) to ensure that autism spectrum disorder research
programs and activities of the Department of Health and Human
Services are not unnecessarily duplicative of other Federal
research programs and activities.”.
(b) Developmental Disabilities Surveillance and Research Program.–
Section 399BB of the Public Health Service Act (42 U.S.C. 280i), as
redesignated, is amended–
(1) in subsection (a), by inserting “for children and
adults” after “reporting of State epidemiological data”;
(2) in subsection (b)(1), by striking “establishment of
regional centers of excellence” and inserting “establishment
or support of regional centers of excellence”;
(3) in subsection (b)(2), by striking “center to be
established” and inserting “center to be established or
supported”; and
(4) in subsection (e), by striking “2014” and inserting
“2019”.
(c) Autism Education, Early Detection, and Intervention.–Section
399CC(g) of the Public Health Service Act (42 U.S.C. 280i-1), as
redesignated, is amended by striking “2014” and inserting “2019”.
(d) Interagency Autism Coordinating Committee.–
(1) Appointment of members by congressional leaders.–
Section 399DD(c)(1) of the Public Health Service Act (42 U.S.C.
280i-2(c)(1)), as redesignated, is amended–
(A) in subparagraph (D), by striking “and” at the
end;
(B) by redesignating subparagraph (E) as
subparagraph (I); and
(C) by inserting after subparagraph (D) the
following:
“(E) one member appointed by the Speaker of the
House of Representatives;
“(F) one member appointed by the majority leader
of the Senate;
“(G) one member appointed by the minority leader
of the House of Representatives;
“(H) one member appointed by the minority leader
of the Senate; and”.
(2) Preventing duplication.–Section 399DD(b) of the Public
Health Service Act (42 U.S.C. 280i-2(b)), as redesignated, is
amended–
(A) in paragraph (5), by striking “and” at the
end;
(B) by redesignating paragraph (6) as paragraph
(7); and
(C) by inserting after paragraph (5) the following:
“(6) include in such strategic plan recommendations to
ensure that autism spectrum disorder research programs and
activities of the Department of Health and Human Services are
not unnecessarily duplicative of other Federal research
programs and activities; and”.
(3) Extension of sunset provision.–Section 399DD(f) of the
Public Health Service Act (42 U.S.C. 280i-2), as redesignated,
is amended by striking “2014” and inserting “2019”.
(e) Report to Congress.–Section 399EE of the Public Health Service
Act (42 U.S.C. 280i-3), as redesignated, is amended–
(1) in subsection (a), by striking “Combating Autism
Reauthorization Act of 2011” and inserting “Combating Autism
Reauthorization Act of 2014”; and
(2) in subsection (b)–
(A) in paragraph (1), by striking “provisions of
the Combating Autism Act of 2006” and inserting
“provisions of this part, section 404H, and section
409C”;
(B) in paragraph (2), by striking “provisions of
Combating Autism Act of 2006” and inserting
“provisions of this part, section 404H, and section
409C”;
(C) in paragraph (3), by striking “Combating
Autism Act of 2006” and inserting “Combating Autism
Reauthorization Act of 2011”;
(D) in paragraphs (4) and (5), by striking “over
the 6-year period beginning on” each place it appears
and inserting “since”;
(E) in paragraph (8), by striking “and” at the
end;
(F) in paragraph (9), by striking the period at the
end and inserting “; and”; and
(G) by adding at the end the following:
“(10) a description of the actions taken to implement, and
the progress made on implementation, of the strategic plan
developed by the Interagency Autism Coordinating Committee.”.
(f) Authorization of Appropriations.–Section 399FF of the Public
Health Service Act (42 U.S.C. 280i-4), as redesignated, is amended–
(1) in subsection (a)–
(A) by striking “399AA” and inserting “399BB”;
and
(B) by striking “fiscal years 2012 through 2014”
and inserting “fiscal years 2015 through 2019”;
(2) in subsection (b)–
(A) by striking “399BB” and inserting “399CC”;
and
(B) by striking “fiscal years 2011 through 2014”
and inserting “fiscal years 2015 through 2019”; and
(3) in subsection (c)–
(A) by striking “399CC” and inserting “399DD”;
and
(B) by striking “$161,000,000 for each of fiscal
years 2011 through 2014” and inserting “$190,000,000
for each of fiscal years 2015 through 2019”.

SEC. 3. REPORT TO CONGRESS ON DEMOGRAPHICS AND NEEDS OF ADULTS WITH
AUTISM SPECTRUM DISORDER.

(a) In General.–Not later than 24 months after the date of
enactment of this Act, the Comptroller General of the United States
shall complete a study and submit to the Congress a report on the
demographics and needs, if any, of individuals in the United States
with an autism spectrum disorder (in this section referred to as
“ASD”).
(b) Issues To Be Addressed.–The study and report under subsection
(a) shall–
(1) address the demographics of individuals with ASD making
the transition from a school-based support system to adulthood;
(2) address the needs, if any, of adults with ASD with
respect to–
(A) community integration;
(B) housing and residential supports;
(C) employment;
(D) transportation;
(E) vocational training and rehabilitation;
(F) continued education;
(G) health care and social services;
(H) speech therapy;
(I) public safety; and
(J) day habilitation activities, including those to
provide a safe, respectful, and stimulating environment
that allows participants to become active members of
their community;
(3) provide an overview of Federal, State, and local
government policies and programs, and any available private
(including private nonprofit) sector assistance, for addressing
the needs identified in paragraph (2); and
(4) provide policy recommendations to–
(A) improve outcomes for adults with ASD making the
transition from a school-based support system to
adulthood;
(B) enhance the effectiveness of the policies,
programs, and assistance described in paragraph (3);
(C) ensure integration of and collaboration among
services for addressing the needs of adults with ASD;
and
(D) encourage independent living, equal
opportunity, full participation, and economic self-
sufficiency.
(c) Survey.–
(1) In general.–In carrying out this section, the
Comptroller General shall conduct a survey of public and
private sector stakeholders on–
(A) the needs, if any, of adults with ASD;
(B) the services and resources available for
addressing such needs; and
(C) the effectiveness of such services and
resources.
(2) Stakeholders.–The stakeholders to be surveyed under
paragraph (1) include the following:
(A) Individuals from the business community
representing both large and small businesses.
(B) Institutions of higher education, community
colleges, vocational schools, and university centers
for excellence in developmental disabilities.
(C) Social service providers, including case
management experts and health care providers.
(D) Vocational rehabilitation experts.
(E) State and local housing departments and
nonprofit organizations that provide housing services
for individuals with disabilities.
(F) Individuals with ASD, parents of individuals
with ASD, and representatives from advocacy groups that
focus on individuals with ASD.
(G) Officials or employees of the Federal
Government responsible for overseeing disability
services at each of the following departments and
agencies:
(i) The Department of Health and Human
Services, including the Administration for
Children and Families, the Centers for Disease
Control and Prevention, the Centers for
Medicare & Medicaid Services, the Health
Resources and Services Administration, and the
Administration for Community Living.
(ii) The Department of Education.
(iii) The Department of Housing and Urban
Development.
(iv) The Department of Labor.
(v) The Department of Justice.
(vi) The Department of Transportation.
(vii) Any other Federal departments and
agencies determined appropriate by the
Comptroller General.

More autism parents believe the “will of God” is behind autism than vaccines

15 May

Why is so much attention and so much money spent on genetics and autism? How about 75.8% of autism parents think that genetics is involved with autism. How many believe in vaccine causation? 41.8%. Less than half. 42% is a sizable minority, but less than the fraction who felt the will of God was involved (46.3%). Parents with a child who regressed were much more likely to endorse vaccines as a possible cause.

What do autistics think? I’ve never seen a study where someone asked.

So often in the online discussions I’ve been told, “well, if you had ever spoken with a parent of a child with autism you’d think differently”. This happens after making it clear that I do not subscribe to the vaccine-induced-autism-epidemic notion. Many people take it as a given that autism parents all think that vaccines are behind the increase in diagnoses. But as we see, that’s just not the case. In fact, the majority of parents don’t endorse vaccine causation. The study I’m referring to is being presented at IMFAR this week: Regression in Children with ASD: Associations with Parents’ Beliefs about Causes of ASD. The abstract is below.

To pull one line from the abstract: “The five causes that families most frequently endorsed were genetics (75.8%), child’s brain structure (59.7%), will of God (46.3%), toxins found in vaccines (41.8%), and environmental pollution (37.4%). ”

It would be interesting to see how the statements are phrased. Saying, “genetics may be involved with autism” is different than “genetics was involved with my child’s autism”.

Here’s the abstract:

Background: Parent-reported developmental regression occurs in an average of one-third of children with autism spectrum disorder (ASD). While prospective, clinician-rated studies detect higher rates of skill losses, understanding parent perception of this phenomenon is valuable, as it may subsequently color parents’ thoughts about ASD and decisions they make on behalf of their families. Limited data suggest that parents who observed regression in their children were significantly more likely to believe that external factors—most often vaccines—caused ASD (Goin-Kochel & Myers, 2005). Fears about immunizations causing autism is now one of the leading reasons behind a growing trend of delayed or refused vaccine uptake (Offit, 2008), which has important public-health ramifications (e.g., increased disease outbreaks). Understanding more about how regression shapes parents’ beliefs and actions is key to developing targeted education efforts.
Objectives: (a) To provide descriptive information about regression status across three related samples; (b) To assess parents’ degree-of-agreement with various potential causes of ASD; and (c) To determine whether child history of regression is associated with beliefs about causes of ASD.

Methods: Data were analyzed for children with ASD (probands; N=2758; M age=9 years, SD=3.6 years, range=4—17.9 years) who participated in the Simons Simplex Collection (SSC). Regression was defined according to the Autism Diagnostic Interview—Revised (ADI-R), with rates of language and social-skill losses calculated for the full SSC sample; SSC probands from the Baylor College of Medicine (BCM) site (n=203); and a subset of BCM probands who were recontacted for additional data collection (n=68), including parents’ beliefs about causes of ASD via the Revised Illness Perception Questionnaire (IPQ-R; Moss-Morris, et al., 2002). Frequencies of agreement/disagreement with possible ASD etiologies were calculated for the IPQ-R’s 21 closed-ended items about potential causes. Qualitative analyses were used to categorize parents’ open-ended rankings of their top three beliefs about causes of ASD. ANOVA’s were conducted to determine whether parents’ degree-of-agreement with various etiologies differed according to their child’s regression status.

Results: Regression rates were only slightly higher in the BCM samples: full SSC=29.5%, full BCM=34%, recontacted BCM=35.3%. The five causes that families most frequently endorsed were genetics (75.8%), child’s brain structure (59.7%), will of God (46.3%), toxins found in vaccines (41.8%), and environmental pollution (37.4%). Parent-provided causes were organized into 10 categories, with genetics/heredity being first-ranked among the largest proportion of parents (42.6%); however, external factors were ranked (i.e., 1st, 2nd, or 3rd) by nearly 84% of families as causing ASD. Parents who reported regression in their children were more likely to agree with “toxins in vaccines” (F[1,66]=3.74, p=.05) and “environmental pollution” (F[1,66]=3.25, p=.07) as causes.

Conclusions: Findings support an association between parent-reported regression in children with ASD and parental endorsement of vaccines/external mechanisms as causing autism, even within this small subsample. That so many also endorsed “will of God” may reflect potential geographical and/or cultural differences within the BCM subsample. Replication of this study at other SSC sites will elucidate varying belief patterns by locale for targeted education efforts.

This isn’t the first of these studies. I’ve seen ~20% and ~40% as the fraction of autism parents who subscribe to vaccine-causation in studies before.


By Matt Carey

More embarrassment from faux autism advocates

13 May

There are groups, some within the autism communities and some external, who are doing the autism communities harm. Ironically they think they are helping, leading, changing the world. Many of these groups and people adhere to the idea that the rise in autism diagnoses is due to vaccines. Yesterday I wrote about how individuals from these groups have stooped so low as to threaten high school student filmmakers (Faux advocates embarrass the autism communities by attacking high school students and their film project). Today I’m sadly writing about another embarrassing incident: making a statement by photoshopping an important statement by Michelle Obama

In case you haven’t seen it, the First Lady of the United States, Michelle Obama, posted this picture to Twitter (click to enlarge):

MO_Nigeria_Tweet

Ms. Obama is referring to the mass abduction of girls from their school in Nigeria.

The Nigerian abduction story has been in the news for some time and Ms. Obama’s statement garnered a great deal of attention. And with good attention sometimes comes bad. Consider this effort by the faux autism advocate community: (click to enlarge)

AnotherBadPhotoshop

Yes, the faux autism advocates decided to try to get some attention for themselves using Ms. Obama’s picture. In case you are wondering, yes I mean attention for themselves. Consider the statement Ms. Obama publicized: “Bring Back Our Girls”. Simple. Direct. Calls for action. Now consider the statement by the faux autism advocates. Long and doesn’t actually call for real action. Read it again if you missed that. All the action they call for is to call autism an epidemic and a crisis. They are calling for someone to accept their views on autism. They didn’t take the opportunity to say, oh, “We need more support”. “We have 1.2M people with great needs”. No. They called for attention for themselves and their agenda. And they did it in a way that reflects very poorly (to be polite) on the autism communities.

I’m not the only one who finds this effort by the faux autism advocates offensive. Consider these comments from the Canary Party’s (one of the faux autism advocate groups) facebook page:

I work with children who have Autism. I don’t know what to get mad at first. The photoshopping? The callous comparison? The horrible idea that children with a genetic disability are “missing”? The inability to understand what the word epidemic means? Revolting.

How sick and sad! This to me appears that you HATE autistic people- seeing how you view them as “missing” or “damaged” or “soulless”
The very fact you think it needs to be cured is disgusting!

Of the three autistic children I know, two are unvaccinated and they are siblings…this makes me think that autism is genetic and absolutely NOT caused by vaccines.

This is a really gross way to push your agenda…photo shopping a pic of the First Lady?! Insulting those with autism…just ick.

What a shameful way to promote your agenda… The Canary Party’s decision to photo shop this image in particular trivializes the real danger and terror that these young Nigerian girls are going through right now.

You can go to the Canary Party Facebook page and see that, yes, there are some comments supporting the picture. And, in some strange irony, advertisements for faux autism cures. Somehow this is a business opportunity for someone to put his wares in front of autism parents. But most of the comments are very critical of this photoshopped picture.

Let’s go through the faux autism advocate message. Let’s call the 1.2M autistics an epidemic. A crisis. That’s what they want. Not help. Not support for autistics. Labels. Consider this: they’ve been calling autism an epidemic and a crisis for many years. When has it ever helped?

Consider that number: 1.2 million autistics. There’s heavy irony in them using that number. 1.2M is based on an estimate of the number of autistic children in the US based on the recent CDC autism prevalence report. Somehow adults just don’t count to whoever did that photoshop. Also, 1.2M is an estimate assuming that the prevalence is flat among all children. Think about that. 1.2M is a number that basically assumes no epidemic in the past roughly 20 years.

This is an example of why I don’t consider these group and these individuals to be autism advocates but faux autism advocates. They are not helping. They are in the way.

Right now the estimate is that there are 1.2 million autistic children in the U.S.. The real number is almost certainly higher. And there are many more adults. When have these supposed autism advocates called for a real count of autistic adults in this country? The answer is that they haven’t. Such a count would likely give more data to counter their message of a vaccine induced epidemic. Ironically it would move us closer to actually determining if there is a real rise in the fraction of our population who are autistic. It would be a big step forward in understanding the needs of autistic adults. It would be a step towards learning what helped some autistics gain independence or greater independence. And what may have held some back. There’s so much we could learn. So much that frankly could help my kid. But instead we have people crying out for acknowledgement of their failed opinions, not real steps forward.


By Matt Carey

Faux advocates embarrass the autism communities by attacking high school students and their film project

12 May

Not all advocates in any given community will push for the same thing. That’s a given. But within the autism communities we have groups who pretend to speak for all of us and who have been throwing their efforts away for well over a decade. I’m speaking of course about those fixated on vaccines. Not even vaccines as a hypothetical risk factor for autism, but vaccines in general. Attacking vaccines and spreading misinformation about vaccines has nothing to do with autism. Now we can add: attacking high school film makers has nothing to do with autism advocacy.

Emily Willingham covers this well at Forbes.com: High School Students Under Attack For Vaccine Documentary. Shot of Prevention also talks about it at Invisible Threat Filmmaker Discusses Journalistic Integrity and Respectful Insolence as Antivaccine activists bully high school filmmakers over a student documentary about vaccines (plus more).

In short, a group of high school students have a film called “Invisible Threat”. The students are from Carlsbad High School Television. Here’s the trailer:

Invisible Threat Trailer from CHSTV Videos on Vimeo.

Unfortunately for the faux autism advocates (and others who attack vaccines) “Invisble Threat” is getting a lot of visibility for a student film. From Shot of Prevention: The Invisible Threat Is Coming to Our Nation’s Capitol.

On May 1st at 10am, Every Child By Two and the Immunization Coalition of Washington, DC will host a special event which will serve as the official nationwide launch of the Invisible Threat movement. Since it is critically important for our elected officials to get the strong message that the public expects sensible, science-driven legislation when it comes to vaccines, we’ve invited them as our special guests. Now we are counting on you (and your friends, family and colleagues) to call, or email, your members of Congress this week to further encourage their attendance at the U.S. Capitol Visitor Center.

By flooding their offices with calls and emails between now and May 1st we can make it clear that pro-vaccine constituents have a voice, and that we stand firm against vaccine misinformation that is resulting in weakened public health policies, watered-down school vaccination requirements and the resurgence of deadly diseases!

Yes, legislators were invited to a screening of the film. A film which presents vaccines as life-saving and effective. But this is branded as “propaganda”. If you read the criticisms (say here and here) you see that apparently it’s inconceivable to these faux advocates that high school students could come to the conclusion that vaccines work. Instead this must be part of the entire imagined network of conspiracies that are behind vaccines.

Over the years I’ve come to believe that improbable as these conspiracy theories are, these people actually do believe them. (When someone sends you an email saying, in effect, “let me bully you or I’ll write an article that shows I’ll believe pretty much anything” and then does write that article, you have to accept that they believe what they write). So while their arguments are filled with misinformation, they may not be technically lies. But when they bully and harass, and bully and harass high school students, that’s something even they should know crosses the line. From Invisible Threat Filmmaker Discusses Journalistic Integrity:

“Almost three years ago an article in our tiny local newspaper mentioned our broadcast journalism club, Carlsbad High School TV (CHSTV) Films, was going to make a video clip about the immune system including how vaccines work. We hadn’t even started filming, yet the blogs prompted hundreds of ugly comments and calls. Yes, the anti-vaccine bloggers were harshly criticizing high school students doing an after school project sponsored by an unrestricted local Rotary grant.

Not knowing anything about vaccines, I thought there must be something shocking we were about to uncover about children being harmed and possible cover up. Now that was worth researching. However, the adult supervisors at CHSTV Films – the director (our broadcasting teacher) and the volunteer (PTA mom turned producer) – had a different reaction. They pulled the plug on the project, citing a concern for us teens after all the angry comments flooded in. They had no idea that this topic was so explosive. Due to the success of our previous films, we had other projects being pitched to us and the adults felt it best to avoid this headache.

Yep, they got attacked from the beginning. From Stop the Fear-Based Propaganda About Vaccines

According to Lisa Posard, a teacher at Carlsbad and producer of the film, once the anti-vaccine community got wind of the production through a small news article in a local paper, the threats and emails started and almost stalled their production. At a media call for the film, she confirmed that after the resistance they received from white-supremacists over their holocaust documentary, they considered abandoning the vaccine documentary all together.

The students pushed back, however, and would not give up their investigation. They have since produced a film that has been lauded by the Centre for Disease Control in Atlanta, Every Child by Two and the Children’s Hospital of Philadelphia. The film has become a standard educational tool at hundreds of health-care sites across the US and they are currently searching for a producer to release it commercially. These students will not give up.

And it continues.

It’s one thing to protest something, even when you are wrong. That I support. It’s another to threaten high school kids. When your tactics are being compared to those of white supremacists, you are causing harm. You are causing harm to the autism communities, to public health and more.

Let me put it simply. I stand apart from you. As a citizen, I stand apart from you. As someone interested in public health, I stand apart from you. As a parent, I stand apart from you. As the parent of an autistic child, I stand apart from you.

And I am far from alone. You think you are the leading edge fringe: those with vision. But you are just a garden variety fringe. Causing harm and making it hard for those of us who want a better future to accomplish our goals.


By Matt Carey

Eradicate Microglia to treat autism? No. No and No.

12 May

Long ago I gave up on countering the misinformation that comes from the blog “The Age of Autism”. Not that there’s no value to it, but there is greater value for me in other tasks. Once in a while something that comes up that just needs to be taken on. In this case an article: Will Eradicating Microglia and Stopping Neuroinflammation Help in Autism?

Let me get to the conclusion quickly: No. Eradicating a whole class of cells in the brain is a bad idea. Not just because such a statement is obvious, but because there are already cases of children being harmed by people “treating” glial cell activation (neuroinflammation).

To say it again, “eradicating” microglia is dangerous, would cause harm and is just an incredibly bad proposition.

Micrioglial activation in autistic brains was discovered by Carlos Pardo and his group at John’s Hopkins. The seminal paper, Vargas et al., Neuroglial activation and neuroinflammation in the brain of patients with autism, was published in 2005. The authors knew that the understanding was incomplete at the time and that there was a great potential for people to jump ahead to “treat” neuroinflammation based on this report so they put a FAQ online. In it they state:

If there is neuroinflammation in the brain of some autistic patients, is treatment with anti-inflammatory or immunomodulatory medications indicated?
At present, THERE IS NO indication for using anti-inflammatory medications in patients with autism. Immunomodulatory or anti-inflammatory medications such as steroids (e.g. prednisone or methylprednisolone), immunosupressants (e.g. Azathioprine, methotrexate, cyclophosphamide) or modulators of immune reactions (e.g. intravenous immunoglobulins, IVIG) WOULD NOT HAVE a significant effect on neuroglial activation because these drugs work mostly on adaptive immunity by reducing the production of immunoglobulins, decreasing the production of T cells and limiting the infiltration of inflammatory cells into areas of tissue injury. Our study demonstrated NO EVIDENCE at all for these types of immune reactions. There are ongoing experimental studies to examine the effect of drugs that limit the activation of microglia and astrocytes, but their use in humans must await further evidence of their efficacy and safety.

Since then the understanding of the role of microglia has broadened. It has been shown that microglia play a role in brain development. At an IACC meeting last year, Carlos Pardo commented:

And that is important to point out because it was believed that microglia may have been the bad actor of the immune system in the brain, and actually, in the past 3 or 4 years, we are learning more and more about the beneficial effect and the normal biological function that microglia have on synaptic plasticity and synaptic formation.

And I want to point out this issue because it’s extremely important for brain development and plasticity, that manipulating the immune system with medication probably is not the best avenue for management of autism.

It’s a very understated comment, but on that should be heeded. Dr. Pardo has continued to work on the area of neuroninflammation and autism, including this clinical trial of a treatment.

Sadly, this isn’t just countering a very bad hypothetical question posed by irresponsible people at the Age of Autism blog. As I’ve already noted, “treating” microglial activation has already caused harm. Also, there’s a group claiming that all autism is caused by microglial activation and that the treatment is to “inhibit” microglial activation. The group calls itself “stop calling it autism”.

Autism is caused by a medical illness in which the brain’s immune system (microglia) attacks the connections in the brain. This leads to developmental delays that can cause significant social, communication and behavioral problems.

Our approach to treat autism and enable recovery is to inhibit microglial activation, which from evidence is known to destroy brain connections affecting brain development and function.

We at SCIA have designed and published a treatment protocol centered on this

They list elsewhere on their site:

Treatments include:
1. Antiviral medications
2. Antifungal medications
3. Antibiotics
4. Medications and supplements to increase natural killer cell activity
5. Immunoglobulin Therapy
6. Medications to inhibit microglial activation and to reduce nitric oxide levels

That’s a nice “shotgun” approach to a topic they clearly don’t understand.

In addition to the above, I’ve seen individuals and groups promoting NSAID’s (Non-steroidal anti-inflammatory drug), steroids, ACTOS (a potent diabetes treatment that has been shown to increase cancer risk)

Dr. Pardo is giving a talk at IMFAR this week, the title of which seems very on-point: Immunological Disarrangements in ASD Are Associated with Biological Processes and Homeostatic Mechanisms in ASD Rather Than Autoimmunity or Pathogenic Inflammation. “rather than…pathogenic inflammation”. The abstract is still embargoed, but it seems like the understanding is indeed moving forward. But away from the understanding that the Age of Autsim blog and “Stop Calling It Autism” are espousing.

This is an area where people have jumped ahead of the understanding and harm is being done.

By Matt Carey

The largest autism science conference, IMFAR, starts this week

12 May

IMFAR, the International Meeting For Autism Research, is being held this week in Atlanta, Georgia. The schedule for the meeting is up, as is the list of talks (program). Abstracts are embargoed until Wednesday at 10am EST.

Here is a list of general topics for the conference:

Adult Outcome: Medical, Cognitive, Behavioral
Animal Models
Brain Function (fMRI, fcMRI, MRS, EEG, ERP, MEG)
Brain Structure (MRI, neuropathology)
Cognition: Attention, Learning, Memory
Communication and Language
Early Development (< 48 months)
Epidemiology
Genetics
Intellectual and Behavioral Assessment and Measurement
Invited, Keynote Speakers, Awards
Medical and Psychiatric Co-morbidity
Molecular and Cellular Biology
Other
Repetitive Behaviors and Interests
Services
Social Cognition and Social Behavior
Special Interest Groups (SIGs)
Specific Interventions – Non-pharmacologic
Specific Interventions – Pharmacologic
Technology Demonstration

I, for one, am very glad to see a focus on adults (<a href=”https://imfar.confex.com/imfar/2014/webprogram/Session3075.html“>three sessions) and on services (three sessions).

There is a session on Autism in Africa. There is very little information on this area.

There is a dearth of autism research on the African continent; this scientific panel session aims to highlight recent research progress addressing this gap. The panel includes scientific presentations from two sub-Saharan African countries, using a combination of qualitative and quantitative methodologies and reporting on both urban and rural African populations. Altogether, the findings from these studies highlight the major barriers to appropriate support for families of children with autism in Africa (including the severe shortage of diagnostic and educational services, lack of awareness about autism and its causes, and high levels of stigma), and report on a promising scalable model that can help tackle these problems by training frontline community-based health extension workers. The challenges and opportunities discussed in these presentations apply not just to the countries under study, but have relevance for the entire African continent and low/middle income countries elsewhere. During the panel discussion these common themes will be reviewed and priority areas for future research and opportunities for intervention will be highlighted, in order to facilitate future autism research, advocacy and capacity building efforts.

I was able to attend IMFAR in San Diego a few years ago with the aid of an Autism Science Foundation grant. It was a great experience and I wish I could attend this year. There is nothing like it for concentrated autism science.


By Matt Carey

On Andrew Wakefield and the use of the term “fraud” in the press

6 May

Andrew Wakefield has sent a threatening letter to Forbes and Emily Willingham claiming harm over their use of the word “fraud” in a recent article. I wrote about this recently but then thought, “I wonder how often the term ‘fraud’ shows up in the press. Here are some examples from a recent Google News search.

Vail Daily column: Vaccine: Not a 4-letter word

But before I continue, realize that a few years later Wakefield was found guilty of falsifying data in order to fit a desired conclusion and was stripped of his license to practice medicine. The hypothesis that MMR caused autism was declared fraudulent, and Wakefield is now living in Texas pushing homeopathic medicine (read: watered-down to the point it needs no FDA approval) to the gullible.

STONE: Vaccines save lives

First, let’s put to bed one of the more outlandish conspiracy theories brought on by the anti-vaccine movements that vaccines cause autism. Jenny McCarthy, fueled by a biased and fraudulent study in 1998 by Dr. Andrew Wakefield claiming autism was linked to the combined measles, mumps, rubella (MMR) vaccine, used her celebrity stature to “raise awareness” for parents to reconsider vaccines for their children.


LETHBRIDGE: The victory of reason over my vaccination fears

In retrospect, it was the correct decision. Wakefield’s work was later found to be fraudulent. His research practices were ethically dubious, he falsified data and failed to declare certain vested interests.

The vaccine and its controversy

The MMR vaccine became the centre of a controversy following claims (which were subsequently established as fraudulent) that the vaccine was responsible for causing Autism-spectrum disorders in children. The controversy was kicked off in 1998 by the publication of a paper by British surgeon Andrew Wakefield in the medical journal The Lancet. Investigations later revealed that Wakefield had multiple undeclared conflicts of interest, had manipulated evidence, and had broken other ethical codes. The Lancet paper was partially retracted in 2004 and fully retracted in 2010, and Wakefield was found guilty by the General Medical Council of serious professional misconduct in May 2010 and was struck off the Medical Register.

Collin Boots | Immune to reason
The Devil’s Advocate | The anti-vaccine movement, whether religious or secular, needs a dose of reality

Not only have countless follow-up studies directly contradicted this result, but The Lancet actually retracted the original article in 2010 when it was revealed to be fraudulent. Wakefield was also stripped of his medical license

Richard Feldman: Vaccines and autism: Numerous studies indicate no connection

British researcher Dr. Andrew Wakefield authored completely bogus research in 1998 that linked the measles-mumps-rubella vaccine to autism. His fraudulent research was finally exposed; he was completely discredited and lost his British medical license.

Don’t let parents opt out of ‘mandatory’ vaccinations

In 2011, the British Medical Journal published an investigative piece by Sunday Times reporter Brian Deer, debunking Dr. Andrew Wakefield’s vaccine/autism study as “an elaborate fraud.”

Only 12 children were studied. Doubts were raised about the manner in which they were recruited and the science with which the study was conducted.

As well, it was discovered Wakefield was on the payroll of a group that had launched a lawsuit against manufacturers of the MMR vaccine — and their claim would be based on his evidence.

What’s most shocking about this is that well-meaning, concerned parents around the world stopped vaccinating their children on the basis of this fraudulent study and Wakefield became the darling of the anti-vaccine activists movement.

Even though it’s been shown to be a giant fraud, there are those who still persist in parroting the untruths.

EDITORIAL: Vaccinate your children

Reasons vary. Some parents prefer a “natural immunity” to vaccine-acquired immunity; others believe vaccines overload a child’s immune system; others say we shouldn’t worry about diseases that have “disappeared.” Then there’s the Jenny McCarthy phenomenon. The former Playboy model has convinced some parents that vaccines cause autism. The one study that linked the measles-mumps-rubella vaccine to autism, by British doctor Andrew Wakefield in 1998, has been discredited as fraudulent, and the published paper was retracted. Autism rates are the same in vaccinated and unvaccinated children.

My position on immunization – Dr. Mark Fishaut

Editors of BMJ, the British medical journal, have even called the study “an elaborate fraud,” accusing author Andrew Wakefield of deliberately falsifying medical data.

Prevention is better than cure

It was also reported that his research methodology was questionable as patient data was manipulated to create the appearance of a link to autism. This conflict of interest plus the fraudulent research resulted in the withdrawal of Wakefield’s paper from The Lancet and revocation of his medical licence.

That’s, what, 10 examples in only the past few weeks?

None have any notation that Mr. Wakefield has contacted them. I have not heard of any such letters being sent other than the one to Forbes and the lawsuit instigated against Brian Deer and the BMJ.

Odd, isn’t it, that all of a sudden Mr. Wakefield decides to threaten one of the Age of Autism’s favorite targets and no one else?


By Matt Carey