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No, Wakefield’s Autistic Enterocolitis Does Not Exist

2 Sep

Listen to Andrew Wakefield talk for a while and he will tell you his work has been replicated. Usually claiming replicated multiple times and around the world. Since he says it, it gets repeated by his supporters in online discussions.

For those who get dragged into those discussions, here is another paper to reference. This one takes on the idea that there is a bowel disease specific to autism. Wakefield’s “autistic enterocolitis”

People have looked and, guess what, it isn’t there. Yes, autistics get bowel disease. Being autistic doesn’t prevent bowel disease. The fact that some do, indeed, get bowel disease isn’t what Wakefield claimed. He claimed a “new syndrome”.

It doesn’t exist.

Here’s the abstract. The group is reputable and, in fact, has expressed sympathetic views towards Wakefield.

Evaluation of Intestinal Function in Children With Autism and Gastrointestinal Symptoms.

Alterations in intestinal function, often characterized as a “leaky gut,” have been attributed to children who are on the autism spectrum. Disaccharidase activity, intestinal inflammation, and permeability were analyzed in 61 children with autism and 50 nonautistic individuals with gastrointestinal symptoms.

All patients had duodenal biopsies assayed for lactase, sucrase, maltase, and palatinase activity. Intestinal permeability was evaluated by rhamnose/lactulose test and measured by high-performance liquid chromatography-mass spectrometry. Intestinal inflammation was evaluated by fecal calprotectin and lactoferrin levels using enzyme-linked immunosorbent assay and histology.

Some children with autism had mild levels of mucosal inflammation on intestinal biopsy. Disaccharidase activity was not different in autistic and nonautistic individuals. Fecal calprotectin and lactoferrin were similar in both groups. Differences between lactulose and rhamnose recovery and lactulose/rhamnose ratio in urine were not statistically different in patients with and without autism.

The present study supports the observation that children with autism who have symptoms of gastrointestinal disorders have objective findings similar to children without autism. Neither noninvasive testing nor endoscopic findings identify gastrointestinal pathology specific to autism, but may be of benefit in identifying children with autism who have atypical symptoms.

If you are getting ready to write, “but they might not have seen enough kids to find one with autistic enterocolitis”, according to Wakefield, most of the kids his team tested had his “new syndrome”. If that were true, this team would have found it.

Add this to “MMR causes autism” as one of the failed ideas of Andrew Wakefield. Not that he will ever admit it.

By Matt Carey

Double checking Brian Hooker’s story in VAXXED

7 Jul

One of the arguments so often given for “vaccines cause autism” is that of “then why do so many parents tell exactly the same story?”

Well, they don’t. As we saw with JB Handley (Which is it, Mr. Handley?) even a single parent can shift and change stories over time. And he’s just one example. But we have also seen many times that once the stories we are told are compared to the facts, like say the medical records or videos in vaccine court, parent recollection is shown to be wrong.

Well, now we have Brian Hooker’s two stories. We have what he says in Vaxxed, and we have his recent vaccine court case. An in-depth legal analysis is provided by Prof. Dorit Reiss as BRIAN HOOKER’S VACCINE INJURY CLAIM DENIED BY NVICP.

From the video from Vaxxed, we hear Brian Hooker describe his son’s story starting at 3:26.

My son [SRH] was born in [month] of [year].

(home video with Brian Hooker saying: “[SRH] what does the cow say?”).

(second home video: Brian Hooker: “tweet tweet”, SRH vocalizes which parents interpret as “doggie”).

“Two weeks after his 15 month vaccines, then he lost all language. He lost all eye contact. You would pick him up and he would just hang limp.”

That’s pretty dramatic. And the sort of story that convinces many that, yes, indeed, vaccines might cause autism.

But ask this question, if this happened, why doesn’t Brian Hooker’s son’s medical record say anything like that?

From the Court’s decision, we see that the medical records show that Brian Hooker’s son was already delayed at 15 months. In fact, he was already showing signs of delays at 4 months. First, to be clear: Brian Hooker’s argument before the Court changed with time, and this can lead to some confusion. He first argued that one set of vaccines caused his child’s autism. When the Court informed Mr. Hooker that his cases was filed after the statute of limitations (filed more than 3 years from when the alleged vaccine injury occurred), Mr Hooker amended his complaint to add the claim that the 15 month vaccines (the ones he appears to be referring to in Vaxxed) “aggravated” the ASD as well. Since this event was later, it was not “untimely filed”.

In the end the court found that Mr. Hooker’s claims failed on their merits, so timely or untimely filed didn’t matter.

That all said, here’s an excerpt from the Court’s decision that discusses the 15 month vaccinations:

SRH received his 15-month well child examination on [DATE], and was found to be “healthy.” (Ex. 35, p. 13.) However, at this visit his developmental progress chart indicates that SRH had not achieved most of the expected milestones. (Id., p. 24.) His Denver II developmental progress chart indicates that he could not speak six words, could not run or climb stairs, could not remove garments or use a spoon, and could not stack two cubes, — indeed, he failed all but one of the developmental milestones for 15 months. (Id.) Following a physical examination of SRH, Dr. Heller-Bair administered the usually recommended vaccinations — i.e., DTaP #4, Hib #4, and OPV. (Id., pp. 13, 26.) (These vaccinations of [DATE], were the vaccinations that Petitioners now allege to have “significantly aggravated” SRH’s autism.)

OK, that’s the 15 month vaccination visit. But as to “two weeks after his 15 month vaccines” that Mr. Hooker describes in Vaxxed? What does the record show happened? The Court transcript reads:

Nineteen days later, on [DATE], both parents accompanied SRH to the pediatrician’s office, where she recorded that his temperature was 101.8°, and that both tympanic membranes appeared normal. (Ex. 35, p. 14.) She included the following description.

One-year-old with 1-day history of low-grade fever, irritability, decreased appetite, nasal congestion. Child has a history of recurrent ear infections. Is scheduled for typanostomy tube placement by Dr. Fong in about 4 days’ time. Mom is concerned that he may have an ongoing ear infection prior to surgery.

(Id.) No other recent symptoms were noted. Dr. Heller-Bair determined that SRH had a viral upper respiratory infection — in other words, “a cold” — and reassured the parents that he did not have an ear infection. (Id.)

Emphasis added. And now repeated: no other recent symptoms were noted. Not “he lost all language”. Not “he lost eye contact”. Not “he was hanging limp”.

As to signs of autism before the vaccines in question, we read this (Dr. Leventhal was an expert witness for the government):

Also included in Dr. Leventhal’s list of early symptoms of developmental disorders was another symptom particularly indicative of ASD — “evidence of language delay and reports of social interaction problems” at age 12 months. (Ex. C, p. 30, para. g.) Language delay and social interaction problems, are classic symptoms of autism.

Of course, many will discount this as coming from the government’s expert (even though he’s reporting the medical record).

So, what did the parents have to say?

Third, several representations by the Petitioners themselves indicate that SRH was suffering from developmental problems, likely early symptoms of his ASD, well prior to [DATE–about 15 months]. For example, SRH’s parents reported that at one year of age (about [DATE]), he seemed “delayed in interactive skills.” (Ex. 2, p. 46.) On [DATE], SRH’s parents reported that they had been worried about developmental delays “for about 6 months,” which would put the onset around [DATE–about 13 months]. (Ex. 6, p. 19.) And on occasions, SRH’s parents identified the onset of SRH’s developmental problems as occurring about the time of his MMR vaccination, which took place on [DATE–about 12 months]. (See Ex. 5, p. 30 (SRH lost eye contact “after his MMR shot”); Ex. 14, p. 38 (“delays, deterioration of verbal skills coincidental [with] MMR”)).

Emphasis in the original.

Parents reported loss of eye contact at about 12 months. But in Vaxxed Brian Hooker says his child lost eye contact two weeks after the 15 month vaccinations. So again we see that the stories don’t match up. And recall that Brian Hooker apparently didn’t mention this loss of eye contact to the doctor nor did the doctor notice 19 days after those 15 month vaccines.

Finally, it’s worth noting that pretty much the time that Vaxxed has been touring, Brian Hooker and the rest of those doing personal appearances have known that the Hooker case failed. And let’s not downplay this, the case was not even close. The Court decision includes in the conclusion:

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.

emphasis in the original.

The experts were quite wrong. The science was the same as was extensively argued in the Omnibus Autism Proceeding, and which failed to come close to being convincing then. The case history showed no sign of vaccine injury or developmental regression. On every count, Brian Hooker’s case failed. But we don’t hear that in the public talks. Why would Brian Hooker, Andrew Wakefield and the rest want to tell the public that not only are the “facts” in Vaxxed wrong, but the science had also been tested yet again and failed yet again? I mean, it’s not like they are calling this a “documentary” or anything. Except that’s precisely what they claim.

By Matt Carey

Sacramento County Schools “See” The Invisible Epidemic

5 Sep

At the end of this past week, California’s Sacramento Bee reports that “Autism rates quadruple in local schools over last decade“. The article, written by Phillip Reese, seems largely unremarkable. Even though headline is suggestive, there are no claims of “autism epidemic” that follow. In fact, Reese points out that:

Whether autism is actually more prevalent — as opposed to just more frequently diagnosed — is a matter of controversy.

From a scientific perspective, Reese definitely could have dug a lot deeper, but to a casual reader, the relevant facts seem pretty accurate, and a clear chart is provided.

The problem with an article like this, is that to a casual reader it may appear that there doesn’t seem to be any explanation in sight. “Autism is on the increase in Sacramento County Schools for the past decade”, and that’s that – “Why” is some sort of “controversy”, “some districts have more autistic students than others”, “here’s a chart”, and the article ends.

Did the Sacramento Bee miss an opportunity to carry their headline further, and expose an acutal “autism epidemic” in northern California schools?

Not surprisingly, Age Of Autism (always on the lookout for support of the notion that there’s been an autism “epidemic”) thought so. As it turns out, AoA resisted the urge to dig much deeper too. They were apparently satisfied to present a simple retort to the indication that whether or autism is actually more prevalent or more frequently diagnosed is “controversial”.

Seems the SacBee hasn’t read the study from their own state U that said, A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted – and the trend shows no sign of abating.

Emphasis AoA’s.

If you think the emapahsized quote above sounds more like a press release than an acutal study, you’d be correct. Does the quoted press release overstate the actual conclusions of the study?

I’ll let readers be the judge of that, here’s the actual study’s conclusion:

Autism incidence in California shows no sign yet of plateauing. Younger ages at diagnosis, differential migration, changesin diagnostic criteria, and inclusion of milder cases do not fully explain the observed increases. Other artifacts have yet to be quantified, and as a result, the extent to which the continued rise represents a true increase in the occurrence of autism remains unclear.

Emphasis mine.

As foreshadowed for us in the conclusion of the actual study, what other artifacts might there be, that have “yet to be quantified”? Big ones like changes in awareness or diagnostic substitution?

Let’s quantify one of those potential artifacts (diagnostic substitution) for the Sacramento County Schools data, shall we?

Here’s the data (available online to the public):

To sum things up, I think Reese’s article/blurb would have been more interesting, only requiring a few extra minutes (the data is already there, presented on the same page when looking up the autism numbers), if it had included information about other changes like the “more than offsetting decrease” of Specific Learning Disabilities over the same time period.

Tell us what you think? Could newspapers do better when reporting on autism data, or do they simply present what their readers are really looking for?

Additional reading on this subject:

California’s Invisible Autism Epidemic (Jan 2009)

California’s Invisible Autism Epidemic Continues (Feb 2010)

California’s Specific Learning Disabilities Counter Epidemic (Feb 2011)

Ageing in autism

6 May

A new paper highlights the issue with geriatric populations in autism.

At present, one of the major challenges is that the majority of the currently older individuals with ASD has not received a formal diagnosis of ASD, and this would be dif?cult to establish using the currently recommended diagnostic assessments, because for many of them, neurodevelopmental history would be hard to obtain. The diagnosis of ASD in children involves both the parents and the child contributing…

You see, nobody working the field of geriatric psychology has any doubt that there is a large population of autistic people within the geriatric population:

Many adult and older subjects with ASD remain undiagnosed and thus are largely unknown to specialist services. [M]any have survived childhood and adulthood by either being fully supported by their family or holding jobs in
protected environment, enabling them to function ‘normally’, and thus escaping the ASD diagnosis. In support for this are the three recent case reports on diagnosing older people with ASD indicating that the standard clinical screenings used in childhood had to be modi?ed and adapted for ?rst?time diagnosis of ASD in older individuals.

As also published recently, it is becoming clearer that there is in fact, no ‘autism epidemic’ and that, in point of fact, research shows:

…nearly one percent of Britons older than 16 years have autism, a rate that is similar to that seen in children. Younger people were no more likely to be affected than older ones, however, which would have been expected if the condition were truly on the increase.

So what can we take from this? Being who I am and having the interests I have I take two main things:

1) Vaccines haven’t caused an epidemic of autism because an epidemic of autism does not in fact exist.

2) There is a large amount of undiagnosed adults with autism who need our help now. They are in community homes (group homes I believe they are referred to as in the US) or living with very elderly relatives. The majority are in situations where their autism is not recognised and not diagnosed. How do we help them?

The University of Newcastle held a Workshop Meeting ‘to reach a consensus on he need for new initiatives in this area.’ and came away with the following points:

1 Prevalence rates of older people with ASD (a prerequisite for planning service needs and placements)
2 Determine life expectancy, behavioural changes and cognitive changes with ageing in ASD
3 Data regarding health problems common in ASD, clinical assessments and treatment of seriously medically ill and frail older individuals with ASD
4 Information whether and how the characteristic clinical symptomatology of ASD change with age
5 Problems diagnosing older individuals with ASD not known to services and development of diagnostic tools for this purpose
6 Diagnosing cognitive impairment and dealing with challenging behaviour in nursing homes
7 Increasing need for advocacy and mental capacity assessments
8 Need to identify services, support and resources for older people with ASD
9 Design of adequate environment for older individuals with ASD
10 Neuroimaging studies in older individuals with ASD
11 Biobanking facilities (cerebrospinal fluid, blood/blood derivates and brain donations) and facilitating research

We should all be aware of the needs of elderly autistic people and try and find a way to help I think. How we should do this is vital. The first step must be the recognition that the idea of an autism epidemic marginalises them.

UK Research places huge question mark over the autism ‘epidemic’

3 May

Just a quick couple of quotes as I’m in a rush.

Researchers found nearly one percent of Britons older than 16 years have autism, a rate that is similar to that seen in children. Younger people were no more likely to be affected than older ones, however, which would have been expected if the condition were truly on the increase.


And this – same source.

Fears that the condition is becoming more and more common in children have launched both researchers and parents on a fierce search for the underlying reasons.

So far those efforts haven’t paid off, however, and the much-reported claim that childhood vaccines could be the culprit has been widely discredited.

“None of them had been diagnosed (previously) with autism,” he said. “I think for me the issue is that people have been ignoring autism in adulthood and only focusing on children.”

93% of US parents trust vaccinations

19 Apr

“Celebrities have no expertise in childhood immunizations or infectious disease,” Freed said. “There is a danger in the media of putting up celebrities as experts on any topic for which they have an opinion, and giving them a platform to share their opinions that is presented as equal to true experts.”

In the first survey, published in the May issue of Pediatrics, researchers used data from a 2009 nationally representative sample of about 1,550 parents of children aged 17 and younger.

About 76 percent of parents said they trusted their child’s doctor “a lot,” 22 percent said they had “some” trust, while only 2 percent said they didn’t trust the doctor.

Parents also trusted other health-care providers and government vaccine experts, but not as much as doctors.

Two percent of parents said they trusted celebrities “a lot,” 24 percent said they trusted celebrities somewhat for vaccine information, and 74 percent said they trusted celebrities “not at all.” Women and Hispanics were more likely to trust celebrities.

A second survey by researchers from the U.S. Centers for Disease Control and Prevention published in the same journal used 2009 survey data from parents of children under the age of 6.

Nearly 75 percent of parents reported their youngest child had received all of the recommended vaccines; another 19 percent said their child would receive the vaccines.

About 79 percent of parents were either confident or very confident in vaccine safety, and about 80 percent said they thought vaccines were important for a child’s health.

But parents still have their concerns. About 22 percent somewhat or strongly agreed that they were concerned about “too many vaccines potentially damaging a child’s immune system,” according to the study.

When asked how many shots parents were comfortable with their child receiving in a single doctor’s visit, 42 percent said one to two; 34 percent said three to four; and 23 percent said “whatever the doctor recommends.”

The authors suggest that pediatricians listen to parents’ concerns and direct them to appropriate resources for information.

“It’s encouraging that in this survey the overwhelming majority said they will get all of their immunizations. That’s a wonderful thing,” said Dr. David Kimberlin, a professor of pediatrics at University of Alabama at Birmingham and a member of the American Academy of Pediatrics Committee on Infectious Diseases. “The noise out there that seems to question vaccine safety is increasingly being discounted and being discounted in a very public way.”


Vaccinated Children Not at Higher Risk of Infections or Allergic Diseases, Study Suggests

10 Mar

Seems German science has asked and answered the question everyone who believes vaccines damage the immune system wanted answering:

Do vaccinations put too much strain on or weaken children’s immune systems? Roma Schmitz and her colleagues from the Robert Koch Institute investigate exactly this research question in the current issue of Deutsches Ärzteblatt International.

Their data are based on the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS).

In their study, the authors compare the occurrence of infections and allergies in vaccinated and unvaccinated children and adolescents. These include bronchitis, eczema, colds, and gastrointestinal infections.

The evaluation showed that unvaccinated children and adolescents differ from their vaccinated peers merely in terms of the frequency of vaccine preventable diseases. These include pertussis, mumps, or measles. As expected, the risk of contracting these diseases is substantially lower in vaccinated children and adolescents.

California’s Specific Learning Disabilities Counter Epidemic

19 Feb

The U.S. and California Departments of Education recently released special education data (child counts) for the 2008-2009 school year. A particular focus in the media has been a tripling of the number of students who wear a special education label of “autism” in California.

Needless to say, some probably see this as confirmation of an “autism epidemic”. For a particularly myopic and emotional (anger and fear) interpretation of this recent news story, one need go no further than “Autism Epidemic” central (AoA) and read the data-free opinion piece by Anne Dachel.

For the bigger picture in California, a look at the actual data might be in order.

California Data

For those who may not be able to see the graph of the IDEA data that most closely represents the K-12 age group as a percentage of the resident population, receiving special education services for the last ten years in California: Autism has steadily increased from .13% to .64%, Specific Learning Disabilities has steadily decreased from 5.64% to 4.41%, and totals for all disabilities has remained flat at about 9.2%.

If you believe there’s been an “autism epidemic”, and that special education data from California proves that the schools are overwhelmed, here are a two questions for you:

1. What has caused the decrease in Specific Learning Disabilities (a decrease that more than offsets the increase in autism)?

2. If the special education totals remain unchanged, why are the schools “overwhelmed”?

Sloppy science – a perfect example of how the anti-vaccine crowd will listen to anything

11 Feb

Both Age of Autism and David Kirby have recently reported on a new review paper with Age of Autism describing it as ‘pretty interesting’ and David repeating a part of the abstract:

Documented causes of autism include genetic mutations and/or deletions, viral infections, and encephalitis following vaccination.

So, should we all in the skeptic camp be reaching for our humble pie and our knife and fork? Not exactly. Lets take a look at the contents of this paper. Lets start here:

The vaccine organism itself could be a culprit. For example, one hypothesis of the cause of autism is that the pertussis toxin in the DPT vaccine causes a separation of the G-alpha protein from retinoid receptors in genetically at-risk children (Farfel et al., 1999; Megson, 2000). The pertussis toxin creates a chronic autoimmune monocytic infiltration of the gut mucosa lamina propia and may disconnect the G-alpha protein pathways, leaving some G-alphamodulated pathways unopposed. In turn, the non-specific branch of the immune system is turned on and, without retinoid switching, cannot be down regulated.

Wow, blinded with the cool science yet? No, me neither. Go back to line one where it says ‘one hypothesis’. All that follows from that point is mere opinion. There’s no science to back it up.

Another organism of suspect is the live measles virus…

Yeah except its really not. The issues with the Wakefield hypothesis are so many and so thoroughly debunked, it really isn;t worth my time or yours going through them again and again.

There is evidence that Thimerosal (which is 49% ethyl mercury) is indeed harmful. Since the 1930s, Thimerosal has been extensively used as an antibacterial agent in vaccines (Geier et al., 2007). Thimerosal has been implicated as a cause of autism. Not only is every major symptom of autism documented in cases of mercury poisoning but also biological
abnormalities in autism are very similar to the side effects of mercury poisoning itself (Bernard et al., 2001)

Oh dear. Reliance on more thoroughly debunked rubbish in the form of well, anything by the Geier’s and the ridiculous Bernard ‘paper’. I’m happy to go through why these are rubbish but I think I’d be preaching to the converted.

The rest of the paper is a rogues gallery of debunked and fringe science. Helen Ratajczak cites the Geier’s numerous times, DeSoto and Hitlan, Nataf and Rossignol to name but a few. This isn’t a paper so much as an advert for the sort of poor science that was examined in the Autism Omnibus proceedings and roundly rejected by the Special Masters. For goodness sake, she even cites David Ayoub of the Black Helicopter infamy.

When it comes to this paper – handle with extreme caution. Its toxic rubbish.

GI and autism studies ‘none of these trials appeared to be of high quality’

8 Feb

A new paper is due out soon looking at the available literature on GI and autism.

The significance of the association between many gastrointestinal (GI) pathologies and autism has yet to be discovered. The aim of the present study was to review available evidence documenting any link between autism and GI histopathology in children

I’ve only got the abstract to go by but even that is fairly damning.

Eight studies have reported the histopathological features of the GI tract in children with autism and fulfilled inclusion criteria. In general, none of these trials appeared to be of high quality. Apart from intestinal lymphonodular hyperplasia, the majority of these findings were not consistent….GI pathological findings in children with autism have been inconsistent. The present available evidence does not support or refute a link between GI histopathology and autism in children. The significance of intestinal lymphonodular hyperplasia in these children is unknown.

I’m hoping to get the full paper soon. It would be interesting to know what these eight studies were.


Here’s the eight papers of low quality:

Furlano RI, Anthony A, Day R, et al. Colonic CD8 and gamma delta Tcell
infiltration with epithelial damage in children with autism. J Pediatr

Wakefield AJ, Anthony A, Murch SH, et al. Enterocolitis in children
with developmental disorders. Am J Gastroenterol 2000;95:2285–95.

Torrente F, Ashwood P, Day R, et al. Small intestinal enteropathy with
epithelial IgG and complement deposition in children with regressive
autism. Mol Psychiatry 2002;7:375–82. 34.

Ashwood P, Anthony A, Pellicer AA, et al. Intestinal lymphocyte
populations in children with regressive autism: evidence for extensive
mucosal immunopathology. J Clin Immunol 2003;23:504–17.

Ashwood P, Anthony A, Torrente F, et al. Spontaneous mucosal
lymphocyte cytokine profiles in children with autism and gastrointestinal
symptoms: mucosal immune activation and reduced counter regulatory
interleukin-10. J Clin Immunol 2004;24:664–73.

Wakefield AJ, Ashwood P, Limb K, et al. The significance of ileocolonic
lymphoid nodular hyperplasia in children with autistic spectrum
disorder. Eur J Gastroenterol Hepatol 2005;17:827–36.

Torrente F, Anthony A, Heuschkel RB, et al. Focal-enhanced gastritis in
regressive autism with features distinct from Crohn’s and Helicobacter
pylori gastritis. Am J Gastroenterol 2004;99:598–605.

14. DeFelice ML, Ruchelli ED, Markowitz JE, et al. Intestinal cytokines in
children with pervasive developmental disorders. Am J Gastroenterol

No surprises there.