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Hey Amazon, here’s another autism-treatment book to consider delisting

15 Mar

As the parent of an autistic child, let me start by saying “Thank You, Amazon, for removing books with harmful fake autism treatments from your offerings.” Seriously. One great example is Kerri Rivera’s book on using bleach to “treat” autism.

For readers who don’t know about this, here’s an article on Disability Scoop: Amazon Yanks Books Touting Autism ‘Cures’.

That said, there are many more books that you should consider removing. One that comes to mind is The Autism Book: What Every Parent Needs to Know About Early Detection, Treatment, Recovery, and Prevention (Sears Parenting Library).

As of right now, still for sale on Amazon.com.

This is by Dr. Bob Sears. As part of the Sears family, he may seem to have some credibility. Or you just missed it.

Dr. Bob promotes chelation, among other dubious ‘treatments’. Here is but one paragraph from his book:

Here’s a page by the Mayo Clinic on autism and chelation. It starts with this line:

Chelation therapy is not an effective autism treatment, and it may be dangerous.

Among the other questionable therapies you can find in his book are antiviral treatments, hyperbaric oxygen therapy and IV immune globulins.

If you are serious about removing books that promote potentially dangerous therapies, consider removing this one.


By Matt Carey

Anti vaccine activists are angry about a new study…and they didn’t even bother to read it

14 Mar

This is a big piece of what the “vaccines-cause-autism” idea is built on. Really bad analyses. Another study shows up showing that vaccines don’t cause autism. People immediately jump to give talking points to their community: “ignore this study! In fact, it’s just another conspiracy to defraud you!!!!!”*

But they know from history, their community doesn’t check. They don’t test whether the talking points hold up. Either that, or they really are this bad at simple math.

One reason I slowed down a lot on writing debunks of the “vaccines cause autism” community is that it’s very repetitive. It only takes a few minutes to see where they make their mistakes. I admit, I have the training and the time to do that checking, but it leaves me wondering. As in, it’s hard to not ask: “are they really this bad at science? Are they so biased they don’t know they are wrong? Or, are they lying?” I don’t know. What matters most is they are wrong. I am grateful that I had the time to spend checking their claims and was able to not get sucked into that world.

That intro aside, there was a recent study that, once again, shows that the MMR vaccine doesn’t increase autism risk. 21 years since Wakefield’s junk study and we are still spending time and money countering his misinformation. When you look at what the autism community needs, it’s just sad to see resources used this way. But I get it. The anti-vaccine community is doing real harm (note the rise in measles in the US and elsewhere). But, dang, I’d like more work done to help my kid.

So, what’s this new study? Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study. With the conclusion:

The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. It adds to previous studies through significant additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases.

Thanks for doing this, but, again, the results are not surprising in the least.

Naturally this brought about a big response from the anti-vaccine community. The go-to place for defense of “vaccines cause autism” used to be the Age of Autism blog. I went there and found they just recycled a piece from a guy named James Lyons Wieler. Apparently he was once a scientist, but he now seems to be a guy asking autism parents for money to write bad articles about how vaccines cause autism. In this case has found the “Smoking Gun” for why the MMR study is so wrong.

(1) The smoking gun is the study-wide autism rate of 0.9-1%. The rate of ASD in Denmark is 1.65%. Where are the missing cases of ASD? Given past allegations of this group’s malfeasance and fraud, the rest of the study cannot be accepted based on this disparity alone: the study group is not representative of the population being studied.

Clearly they must be fudging the data!!!!!

This appears to have become the talking point that the anti-vaccine community is passing around. It was picked up by Brian Hooker. He wrote “A Scientist’s Rebuttal to the Danish Cohort Study“:

1. Children were notably missing from the study sample:

First and foremost is the underascertainment of autism cases within their data sample. The study authors used Denmark population registries of children born in Denmark of Danish-born mothers which should reflect the current reported autism incidence in Denmark at 1.65% (Schendel et al. 2018, JAMA). However, the autism incidence within the sample of the Hviid et al. paper is 0.98%, meaning that approximately 4,400 autistic children are missing from this study. The authors do not discuss the discrepancy in the number of cases.

Again, his number 1 point, the missing children!

Even JB Handley (remember him? Yes, he’s back) wrote about this. Focusing his whole piece on this “missing” group in the MMR study: New Danish MMR study shows autism rate of 1 in 100—CDC should rush to Denmark!

2. The most compelling data in the study will never get covered: why is the autism rate in this study only 1 in 100?

Here in the U.S. we’re at 1 in 36! Shouldn’t CDC researchers rush to Denmark to figure out why their autism rate is so much lower than ours? For every 1,000 Danish kids, only 10 have autism. But here in the U.S., we have 28 per 1,000, that’s 177% more autism! I thought Paul Offit wanted everyone to believe the autism rate was the same everywhere? What gives?

Hold on to your seat, Handley. It’s about to get discussed.

I had thought I’d take the easy route and just email the study author for an explanation. That could have answered the big question for Handley, Weiler, and Hooker. But that would take a day or two to get a response from Denmark. Why not just, you know, read the paper? Or, just the introduction?

Under the “Abstract” section of the MMR paper, which has the “missing” autistic kids and a lower prevalence rate:

Participants: 657 461 children born in Denmark from 1999 through 31 December 2010, with follow-up from 1 year of age and through 31 August 2013.

Under the methods section for the earlier Denmark paper, which has the higher prevalence rate:

All live births in Denmark between 1980 and 2012 were identified in the Central Person Register and followed through 2016 for an ASD diagnosis

It’s not that hard to compare the two studies.

One study looked at Danes born from 1999 to 2010. And took data from 2013. This is the MMR study.

The other study looked at Danes born from 1980 and 2012. And took data in 2016.

Apples, meet Oranges.

Seriously, people are surprised that they came to different answers as to the overall prevalence? I mean, this is your “smoking gun”? This is the best the “vaccines cause autism” community can do? If nothing else, one study took data later than the other. You are the “it’s an epidemic!” team, surely you accept that the autism rate is higher in the later dataset.

But, hey, this didn’t take the full 5 minutes I allocated to check the claims of this “smoking gun” against this new study. I still had 4.5 minutes.

So, let’s see if the data really are compatible. Can we take the data from the prevalence study and get the same number as in the MMR study? Yes, I’m a geek and this is what I do. But we just saw that 2 Ph.D.’s (Hooker and Wieler) and a business guy (Handley) didn’t think to do that. Is it really that hard? (I do wonder how Handley made money. Seems like he must have relied on someone else to do the numbers.)

I just wrote about the autism prevalence study: Yes, there are a lot more adult autistics than commonly thought. The real question is what we do with this information. I have the graph from the prevalence study, so I ran the numbers quickly. If we limit ourselves to the autistics in the MMR study (born 1999 to 2010) and take data in 2013, we get a prevalence value of 1.02%.

1.02% using the prevalence study. Compared to 1% in the MMR study.

They are the same. No “malfeasance”. No “fraud”. No “discrepancy”. And, Mr. Handley, no evidence you can use to blame the HepB vaccine for autism.

Now for the dull part. Here’s my math.

Step 1: I digitized the graph. The red points are where I took prevalence data from the graphs. Each line represents 2 birth years, so I took points where for the age of the average kid in each cohort in 2013.

Here’s the summary table from those data points.

I did this fast. Let me know if I made a mistake. That’s why I’m showing my work. It’s not precise because, well, it’s done by hand. Also, there’s the fact that the MMR paper was for kids born from 1999 to 2010. The prevalence study has kids grouped by 2 years. So I have data for 1998-99 where I only really want 1999. It’s good enough. The “age in 2013” is what the digitizer gave me for the datapoint positions I chose. I can’t get exactly, say, 10.5. But, again, it’s good enough.

Anyway, there’s no “smoking gun” as James Lyons Weiler says. There aren’t children “notably missing” as Brian Hooker claims. And the “most compelling data” according to JB Handley is just that he can’t read a scientific paper.

This is a big piece of what the “vaccines-cause-autism” idea is built on. Really bad analyses. Another study shows up showing that vaccines don’t cause autism. People immediately jump to give talking points to their community: “ignore this study! In fact, it’s just another conspiracy to defraud you!!!!!”*

But they know from history, their community doesn’t check. They don’t test whether the talking points hold up. Either that, or they (people like Handley, Hooker and the rest) really are this bad at simple math.


By Matt Carey.

*Yeah, you guys are pushing a conspiracy theory. I know you like to say “oh, he called us conspiracy theorists, therefore we don’t have to listen to him.” Surprise me. Grow a backbone and defend the points in this commentary rather than either (a) ignoring it or (b) dismissing it because I pointed out that you are claiming scientists conspired to fool the world.

Yes, there are a lot more adult autistics than commonly thought. The real question is what we do with this information.

13 Mar

What if I told you that there are a lot more autistics born in the 1980’s than 1 in 10,000. And this isn’t me saying “it’s almost certainly true”. This is fact. I’d hope that one of your first reactions would be, “what should we do with this information to make life better for autistic people?”

Hang around online autism discussions, especially those involving causation, and you will undoubtedly read someone claiming “back in the 1980’s, the autism rate was 1 in 10,000.” People base this on studies done back in the 1980’s and they assume or assert, “nothing has changed since then”. Which is odd, since a whole lot has changes in autism understanding since the 1980’s.

What if I told you that there are a lot more autistics born in the 1980’s than 1 in 10,000. And this isn’t me saying “it’s almost certainly true”. This is fact. I’d hope that one of your first reactions would be, “what should we do with this information to make life better for autistic people?”

If your first reaction was, “this can’t be true. There’s an autism epidemic because of vaccines or some other pet causation theory”, you have your priorities in the wrong place. If you think you are an autism advocate, you aren’t.

Back to the recent study. When I read a recent study from Denmark, I was amazed. No exaggeration, I was amazed to see data so clearly showing that the autism prevalence for autistics born in the 1980’s is much higher than previously reported. I say this with apologies to the study authors, because there’s a lot more in this study. That said, there is also the trend of prevalence* with time. It’s, well, amazing. The study is Cumulative Incidence of Autism Into Adulthood for Birth Cohorts in Denmark, 1980-2012. Basically, the authors mined the Danish Central Person Register for people with autism diagnoses. Here’s the graph from that study (click to enlarge):

There is a phrase for a certain type of graph in my work: spaghetti plots. This isn’t quite that complicated, but it is complicated enough to take some time to walk through. So let’s take that time. Basically, each line shows show data for people born in a given 2 year period as a function of their age. The bottom line, for example, shows data for people born in 1980-81. The data is basically what the autism prevalence would be if someone had reported it in the year for that age.

Let’s take a few examples. Again, for that bottom line (people born in 1980-81). At age 10, the autism prevalence is about 0.02%. So, if you had asked in 1990 (when these autistics were 10), “what’s the autism prevalence for 10 year olds in Denmark”, you’d have been told 0.02%. 2 in 10,000. And if you never looked again, that’s what you’d think the autism prevalence is for people born in 1980. Which is exactly why you hear, “the autism prevalence back in the day was 1 in 10,000.” No one looked again.

But now we have more data. Let’s look at, say, age 20, which would be about year 2000. By this point, the autism prevalence has risen to about 0.13% (about 1 in 800). That’s 6 times larger than when this group was 10. This doesn’t mean that more people “became” autistic. No, it means that people previously undiagnosed were identified. By the time this group was 35 years old (about 2015), the autism prevalence was 0.33% (about one in 300). That’s 16 times larger than when they were 10.

I digitized the data for the 1980-81 group and plotted it. If I get time I’ll make a better graph. It isn’t 100% precise, but here’s that graph (click to enlarge):

Let’s say again what we see here:

1) the autism ‘rate’ for Danes born in 1980-81 is not 1 in 10,000, it’s about 1 in 300. Getting comparable to the autism ‘rates’ reported today.
2) the majority of these autistics were not identified until they were older than 10 years old.
3) the autism ‘rate’ is still climbing today. Yes, they are still diagnosing people well into adulthood.

Now, consider some of the other data in the study. For example, Danes born in 2000-01 had an autism prevalence in 2016 of 2.8%. With no sign of a plateau. When those Danes were 8 years old, their autism prevalence was about 0.77%. Yes, it climbed by a factor of 3+ from age 8 to age 16.

Another way to look at this is: people have been diagnosed throughout the lifespan. And this is still going on.

We’ve only looked at a small subset of the data in this study, but we have to ask ourselves what do we do with these results? I know what I think we need to do:

First, we have to accept that many autistics were not diagnosed when they were children. The autism prevalence in the adult population is much higher than the old data would suggest. It may be (probably is, in my view) close to or the same as the prevalence in children.

Second, we have to accept that the autism prevalence in children is likely higher than what is being reported today. The 2.8% reported for one birth cohort in Denmark is basically the same as that reported in the highest estimates in the U.S.. And there was no sign that this Danish value is the maximum value that will be seen for that cohort, or any other.

Third, and here’s where we need actual action, not just a change in beliefs. If we believe that the supports, services and therapies autistics deserve are different than those targeting other disabilities (which I firmly believe), we should be working harder to diagnose those as yet undiagnosed. This goes for young children as well as adults.

Third, and here’s where we need actual action, not just a change in beliefs. If we believe that the supports, services and therapies autistics deserve are different than those targeting other disabilities (which I firmly believe), we should be working harder to diagnose those as yet undiagnosed. This goes for young children as well as adults.

I am the parent of an autistic teenager. There’s a lot of advice (good and bad) on how to support autistic children. But there’s very little on autism specific supports for adults. And this hasn’t really changed in the past decade or more. One way to get real information is to take a look at what has worked and what has failed for autistic adults. Besides helping those adults and other autistic adults (a good cause in itself), it helps pave the way for the autistic kids coming of age. Well, you know what? It’s hard to do those sorts of studies if we don’t even identify who is and who isn’t autistic in the adult population.

As a final aside, consider the CDC autism prevalence estimates. They use a very different methodology than in this Danish study, which will introduce some differences in the results. That said, the CDC focuses on children 8 years old. The CDC team had good reasons to choose 8 years old, but let’s look at some of the data from this recent Danish study and ask what this tells us about the CDC data. For people born in 2000-2001, the Danish autism prevalence is be about 0.77% at age 8. One might say, “Hey, the CDC autism prevalence for 8 year olds born in year 2000 is 1.13%. Autism is more prevalent in the U.S. than in Denmark.” People making this sort of comparison often then try to fit this into their own favorite causation theory. As in, “Denmark gives fewer vaccines, so vaccines cause autism!”. But, wait. The autism prevalence for Danes born in 2000 is actually 2.8%, well over double the CDC estimate for US kids born in 2000. Makes the comparison of CDC numbers to others a bit of an apples and oranges story.

More to the point, consider graphs of CDC prevalence vs. time. It goes up and up, doesn’t it? Kids born in 2004 have a higher autism prevalence than those born in 2000, right? But if you’ve missed a bunch of the kids because you looked at 8 year olds and many kids aren’t identified by then, can you really say that the number of autistic kids has gone up?

Another way to say this: the CDC data are good for what they are. What they aren’t is an actual census of the fraction of kids who are autistic in any given birth year. Trying to say, “there’s an epidemic” from these data just can’t be done.

But that’s getting off the topic. As I noted above, the real question with these data are not “how do they fit into the failed idea that [exposure x] causes autism”. The real question is, what do we do with the knowledge that there are a lot of autistic adults? That there are a lot of kids, younger and older, who aren’t diagnosed accurately? That autism gets diagnosed through the lifespan? I’ve pointed out what I think above. We act on the data. We do what we should be doing: try to use this information to make life better for all autistics, be they young or old, diagnosed or not.


By Matt Carey

*note–I am not an epidemiologist. Rather than try to keep bouncing between “incidence”, “cumulative incidence” and “prevalence”, I will use the terms more loosely than an epidemiologist would.

Neurodiversity

5 Mar

Simply put by example: I feel that my kid shouldn’t have different rights or be afforded less respect just because of disability. Yes, my kid needs a lot of support. Yes, my kid is different. No, my kid shouldn’t have to trade rights away for that support. No, difference doesn’t mean less.

What does neurodiversity mean to me? It strikes me odd that I am often told what the term means, usually by people who have it completely wrong and who don’t want to listen. So, I thought, why not put it into words.

Note that like many terms, others may see neurodiversity differently than I do.

That all said, let’s start with the difference between “neurodiversity” and “the neurodiversity movement”.

Neurodiversity is the fact that we don’t all think the same. Different people have different neurologies, hence we have a diversity of neurologies.

A lot of people use “neurodiversity” in place of “the neurodiversity movement”. As in when I read “I don’t believe in neurodiversity”. Again, what neurodiversity is is a fact, one obvious to anyone in the autism communities. Or should be.

So, what is this neurodiversity movement, then? For me, it’s simple–the effort to advocate for equality and respect for people of various neurologies.

Simply put by example: I feel that my kid shouldn’t have different rights or be afforded less respect just because of disability. Yes, my kid needs a lot of support. Yes, my kid is different. No, my kid shouldn’t have to trade rights away for that support. No, difference doesn’t mean less.


By Matt Carey

MMS, Miracle Mineral Solution, CD, Chlorine Dioxide…call it what you will, it’s abusive and it’s fake medicine

3 Jan

I’ve written a few times about MMS. Rather than the long articles on specific topics, I feel it’s appropriate to make a simple, short statement:

MMS, aka Miracle Mineral Solution, aka CD, aka chlorine dioxide is bogus. It’s junk. Worse than that, it’s abusive. Yes, you will find segments of the autism-parent community who promote and use it. But that doesn’t make it actually useful, nor does it make it OK to use.

Here’s the thing–it’s a bleach solution. The idea that this can work to “detoxify” or “kill parasites” is just flat out wrong.

The Autism Research Institute (ARI), a group which has promoted unproven alternative treatments for autism throughout its history, has this to say:

Given these issues, we advise against using MMS at this time. We hope parents will remain critical of unsubstantiated claims that children have recovered or greatly improved in the absence of objective proof. We also strongly encourage any parents who choose to administer MMS to their children to report it to their physician so that side effects can be monitored.

If a group such as ARI, a group favorable to alt-med, comes out with such a strong statement, you know it’s time to question the “scientific” claims and testimonials.

As to why I call this abusive? Used as an enema (one method strongly promoted by MMS activists) it causes people to pass the lining of their intestines. You can find pictures of these “worms” on the web, where people claim they have killed a parasite. (This is just the worst use of MMS. Taken orally it is still abusive).

Again, from the ARI:

The mucous threads that children expel during MMS treatment, which have been touted as worms (though laboratory analysis does not support this claim), are the body’s method of protecting itself from induced oxidative stress in the lower digestive tract equivalent to the mid-day sun in its ability to produce severe sunburn.

Seriously, what else can one call pushing chemicals into disabled children’s digestive tracts until they start passing tissues? Yes, parents subjecting their children to this are not doing so with the intent to abuse, but they are being fooled into a harmful act.

Since I keep getting commenters on this blog defending this practice, I felt the need to make this short and clear statement. MMS is bogus. It’s harmful.

Just don’t do it.

By Matt Carey

Here’s one part of Brian Hooker’s “reanalysis” that shows just how cynical the anti vaccine movement is

18 Dec

When my kid was diagnosed autistic I started reading research papers (I am a Ph.D. researcher by profession) and the raw data. One thing that struck me immediately was the fact that minority children are much less likely to get a diagnosis than white kids. And minority kids are diagnosed later.

This inequity really bothers me. Accurately identifying the needs of a disabled child can focus the appropriate therapies and supports on that child. The need to rectify this inequity is 100% accepted within the autism advocacy and research communities.

This inequity poses a problem to people who claim that autism is an “epidemic”. If we are not identifying all the autistics in any given group (we aren’t), autism prevalence numbers are inaccurate. Being inaccurate, how does one compare, say, one CDC prevalence number with one 2 years later and claim a “real” increase?

One can’t. Plain and simple.

So, for years, groups like those promoting the idea that autism is caused by vaccines have not only ignored this inequity, they have actively denied it. They are stuck between accepting that the data can’t show an epidemic, or accepting that minorities have some sort of protection from this supposed “autism as vaccine injury”.

When was the last time you read something from, say, the Age of Autism blog or Andrew Wakefield calling for efforts to end this inequity? You haven’t. They don’t do it. When have you heard from someone like Brian Hooker that we should study minority populations to see what “protects” them from “vaccine injury”? You haven’t.

Who is Brian Hooker? Brian Hooker is a parent of an autistic child. Brian Hooker strongly believes that vaccines cause autism. He can back this up with his observations of his child’s development. Observations which are contradicted by his child’s medical records. I discussed this before as Double checking Brian Hooker’s story in VAXXED. A Special Master (a judge in the vaccine court) put it very strongly:

After studying the extensive evidence in this case, I am convinced that the opinions provided by Petitioners’ experts in this case, advising the Hooker family that there is a causal connection between SRH’s vaccinations and either the initial causation or aggravation of SRH’s ASD, were quite wrong.

In the original, the Special Master emphasized “quite wrong“.

So, we have someone who believes vaccines cause autism to the point of ignoring the facts in front of him.

A few years ago Mr. Hooker “reanalyzed” some data from an old CDC study, suggesting that evidence showed that the MMR vaccine might increase risk in African American boys. That was discussed in great detail here and elsewhere. (for example: Brian Hooker proves Andrew Wakefield wrong about vaccines and autism and MMR, the CDC and Brian Hooker: A Guide for Parents and the Media).

Mr. Hooker’s study was retracted. In the research world thats a big deal. As in, embarrassingly bad.

Recently, as in 4 years after his original study, Mr. Hooker republished his “reanalysis”. In the Journal of American Physicians and Surgeons. I’d be completely embarrassed to have a paper in that journal, to be blunt. A lengthy discussion of this reappearance of the study can be found at Respectful Insolence as Brian Hooker’s antivaccine pseudoscience has risen from the dead to threaten children again.

Let me just focus on how Mr. Hooker, in my view cynically, abuses the African American community in order to attack vaccines. From the website of an organization Mr. Hooker belongs to (the ironically–to be polite–named “Children’s Health Defense”), we read this:

Main Points from Reanalysis:

The rate of autism diagnoses has increased alarmingly in the U.S., and is about 25 percent higher in black children. Boys are far more likely than girls to receive this diagnosis.

This is not only wrong, it’s wrong in a way that points to incredible dishonesty.

This first point is that autism is about 25% higher in black children. A “main point from the reanalysis”.

Tell me, when you read that did you think, “this study found that autism is more prevalent in African American children”? If so, you were misled. The 25% higher prevalence is from a different study than Hookers. And that other study says something completely different.

From the Hooker study:

However, one study showed that prevalence of autism in African-Americans was approximately 25% higher than that of whites when the data were adjusted for socioeconomic factors[7].

Reference [7] is Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a U.S. cross-sectional study.

The Socioeconomic Equality study states:

Also notable is that, although the overall ASD prevalence was higher among non-Hispanic White and Asian children than among non-Hispanic Black or African-America and Hispanic children, when the results were stratified by SES, we saw that the racial/ethnic differences in prevalence varied by SES (Table 3). The lower prevalence among non-Hispanic Black or African-American and Hispanic children was seen only in the low SES category, and the fact that more non-Hispanic Black or African-American and Hispanic children live in poverty contributed to the lower overall prevalence among these groups.

Emphasis mine. Overall ASD prevalence was lower for African American children. Not 25% higher. This lower prevalence was due to lower socioeconomic status. I.e. poverty.

Want to see this a different way? Here’s a figure from the paper (click to enlarge):

The overall prevalence in White non-Hispanic kids was 6.9/1000. For black non-Hispanic kids it was 5.7/1000. About 20% lower. Not 25% higher as Mr. Hooker claims.

Fewer African American kids are getting autism services. Not because they aren’t autistic, but because their poverty keeps them from getting a diagnosis.

This is something we should be working towards fixing. No question. But don’t look to the anti-vaccine community to care or act. It’s an inconvenient fact for their epidemic story.

I guess he has such a low level of respect for the people in his own community (those who believe vaccines cause autism), that he thought no one would check this.

By the way, this paper isn’t the only one that shows a lower autism prevalence among African Americans. You know those CDC autism prevalence reports that come out every two years? Every single one has reported a lower prevalence among African Americans. Every one.

Here’s a line from the latest report:

Previous reports from the ADDM Network estimated ASD prevalence among white children to exceed that among black children by approximately 30% in 2002, 2006, and 2010, and by approximately 20% in 2008 and 2012.

When I saw the claim on Hooker’s organization’s website I figured he must have cherry picked a study that shows what he needed to make his story work. It’s just such common knowledge in the autism community that African Americans get diagnosed less frequently. It’s in every CDC report. I didn’t know he wasn’t cherry picking, he was just misrepresenting the study entirely.

I discuss this as a scientist. He “misrepresented the study”. My father had a word for that sort of behavior: lying.

OK, Brian. You’ve read the studies and decided to do nothing about the fact that many autistic African American kids aren’t getting identified and getting appropriate services. I get that, you have your own cause. But, really, is that community so much of a nothing to you that you can just use them like this? I ask rhetorically. You and your community have always acted with callous disregard.

I once had hope that as it because completely obvious that you and your community were wrong (and that was many years ago), you’d join the actual autism community and put your advocacy to use. I now know that will never happen. And, frankly, we don’t need dishonest people.


By Matt Carey

Why autism at 2.5% isn’t surprising.

29 Nov

Let’s get one thing out right away–autism prevalence studies undercount. Not all autistics are diagnosed. That’s just a fact. Consider the recent CDC study. They look at school and medical records. In many cases, they find children are autistic based on their records–but the schools and doctors hadn’t diagnosed those children.

Combining data from all 11 sites, 81% of boys had a previous ASD classification on record, compared with 75% of girls (OR = 1.4; p<0.01).

Yeah, more than 20% of the kids counted in their prevalence had no diagnosis. They and their families didn’t know.

And, if there isn’t enough in the records to show a kid is autistic? That kid gets uncounted altogether.

So, when people look at the CDC prevalence estimates from over the years and cry “epidemic”, well, there’s a reason why those people usually have some causation theory that they believe in. The irony is that they are usually wrong that their theory needs an epidemic to support it. But, heavily biased people are not usually the best sources of reliable analyses.

What would be a better method of counting how many autistics are in a population? Sounds obvious–test all the kids in a given population. Equally obvious–this is a much more expensive and difficult task. One such study was published in 2011. Yes, 7 years ago. In Prevalence of autism spectrum disorders in a total population sample, the autism prevalence in Korea was found to be 2.63%. A study performed in South Carolina and reported at IMFAR last year found a prevalence of 3.62%.

This all said, we had another autism prevalence come out this week–The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children. This study found a prevalence of 2.5%.

Now here’s a nice thing about this recent study–OK, two nice things. First, they don’t just look at kids of one age. Second, you can obtain the data. Which I did. Let’s look at the autism prevalence broken down by birth year.

Do you see autism prevalence increasing with birth year? I don’t. I see some scatter, but in general the autism prevalence is about 2.5% from birth year 2000 to 2010. For what it’s worth–the scatter is due to the small numbers of kids in each year making the value uncertain. It’s statistical noise.

If you are wondering about how the autism prevalence drops off above birth year 2010, keep this in mind: kids aren’t diagnosed at birth. In the CDC study, 1/2 of the kids didn’t get diagnosed until after 52 months (4 years 4 months) of age. For this type of reason, the more recent study didn’t count kids under 3 years of age.

People are very fond of graphing autism prevalence data from various years and claiming these are accurate, full counts of autism prevalence (they aren’t) and, from that, claiming an epidemic. Here are the CDC data:

The numbers go up. Steadily up. I’d have to be a total denialist to not see that as evidence of an epidemic, right?

Consider this–the CDC autism prevalence for birth year 2000 is 1.1%. The study just out gives an autism prevalence more than double that (2.9%). For the same birth year. Both are good studies, for what they are. Both are limited. But, for one thing, the CDC study was performed in 2008. 10 years ago. Since then a lot has changed. For one thing, the kids got older and had more chances to get diagnosed. They didn’t just suddenly become autistic in the past 10 years.

So, yeah, we have an autism prevalence estimate of 2.5%. I’m not surprised and I’m not taking this as evidence of an epidemic.

The unfortunate thing in this discussion is that with all the work in this study, all the potential for advocacy, the only number that usually gets discussed is the overall prevalence. Watch the video abstract (which I can’t get to embed). One of the authors goes into a lot of detail about the other findings. Findings I hope to discuss soon.

//players.brightcove.net/1327978102001/rkA3rSifl_default/index.html?videoId=5839990273001

By Matt Carey