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Internet survey shows high autism rate in unvaccinated children

31 Aug

Informal surveys are fraught with problems. There can be all sorts of biases. Many ways for the data to be skewed one way or another. A great example of this was the Generation Rescue phone survey. The results were all over the map, and clearly flawed. Many of the results pointed to higher autism rates in partially vaccinated over fully vaccinated children.

That was four years ago. Recently an internet survey was undertaken to explore vaccine questions. The survey results can be found on the site vaccineinjury.info. People with agendas certainly can do surveys, but they shouldn’t be surprised when their agendas are pointed out. I won’t go into the survey or results in detail. I have a suspicion the results will be analyzed elsewhere. Rather, let’s just look at the autism results.

Here is the age distribution of the (mostly) children reported on in the study. Very skewed towards the very young.

Here is the distribution of an age distribution of the fraction of kids in each group reported to be autistic (click to make bigger)

If you are wondering, “did they just publish a graph showing high autism ‘prevalences’ in unvaccinated kids?”, you are correct. They are showing that in some age groups the fraction of unvaccinated autistic kids is about 2%. The current prevalence estimate for the U.S. and the U.K. is about 1%.

Do we really want to put any weight on this result? No, not really. It is a nicely packaged internet survey, but it is an internet survey after all. Can we speculate a little as to what this means? Sure. It could mean that the groups that were recruited for this survey included more families with autistic children. Given the high recurrence risk of autism (i.e. the high chances that a younger sibling of an autistic kid would be autistic) it is not only reasonable, but predicted, that such a survey might show a high fraction of autistic kids.

Keep something in mind–the number of autistic kids is small. If I did the math correctly, there are only 37 autistic kids total. [edit to add–this is incorrect. There are 44. I left out two age groups in my total] That means big uncertainties (error bars) in the “results”. Results which, as we’ve already discussed, are pretty skewed just by the design and limitations of the survey.

Must be unexpected for the people doing the survey. Rather than show a low autism prevalence, they show a high one. For those who claim (sometimes over and over) that there are no unvaccinated autistic kids, here is another piece of evidence that they are wrong.

It’s clear enough that even commenters at the Age of Autism blog have noticed it. From “Sarah”:

Help! What am I doing wrong trying to read these graphs? The one titled autism in UNVACCINATED children shows autism percentages above the commonly accepted level in vaccinated children, but in the full study, which also shows a similar graphic, they say only 4 children in the study had severe autism. Are the graphs supposed to be the levels in vaccinated children? What am I missing here? Does this study show higher rates of autism among the unvaccinated?

Yes, Sarah, you are seeing correctly. The study shows higher rates of autism amongst the unvaccinated. That’s what the >1% values for ages 3-12 means when compared to the 1% value currently reported for the United States.

And, you can see people trying to “interpret” these results in interesting ways:

Sarah, I see 0.57% for autism roughly half of the rate seen in vaccinated children.
Note also that many who are not vaccinating are doing it because they have a child with autism already and these families have an increased likelihood of another child having autism as well. These numbers could be much lower in a larger survey and the cases are less severe as noted already. I hope this helps.

Yes, if you want to water down the results by averaging, including infants too young to be reliably diagnosed, you can get a lower prevalence. Of course, to do that one has to ask: what is the prevalence of diagnosed autism amongst infants? We don’t know.

The website notes:

Due to the fact that the majority of children in the survey are between 0 and 2 years of age and some diseases generally do not appear in this age group, the results are subdivided into different age groups (click on the graphic). Information about country, gender, age, age distribution, breastfeeding, preferred tretment[sic] can be found here.

And they are correct. There are no autistic kids in the age 0-2 group reported. Looking at just the ages 3-18 kids, there are 4326 kids, making a “prevalence” of 0.85, if you want to average. That would be within the error bars of the current autism prevalence estimate in the U.S..

As I’ve noted, the Age of Autism blog has already discussed this (thanks to those who sent me the link). I doubt this will get much play from these groups as the results are really not good from their point of view.

Effects of intranasal oxytocin on social anxiety in males with fragile X syndrome

30 Aug

There have been a few papers in the recent past on oxytocin and autism. Oxytocin is a hormone and is considered to have a rule in social cognition. Fragile-X is a syndrome which results in autism or autistic-like symptoms. As such, it isn’t surprising that someone has looked into oxytocin and Fragile-X.

This study comes out of Stanford University. Effects of intranasal oxytocin on social anxiety in males with fragile X syndrome. It is very small with only 10 subjects starting the study (only 8 completed the study). Eye contact is tracked. This is not what I would consider a great parameter to track, but it is measurable. In addition, heart rate and salivary cortisol were monitored. These are measures of excitability/anxiety. They found no effect on heart rate and some other measures. Cortisol levels went down and eye contact went up.

Again, it is small study so it is difficult to

Here is the abstract:

Fragile X syndrome (FXS) is a rare inherited genetic disorder causing severe intellectual disability and autistic-like symptoms. Individuals with FXS, males in particular, often exhibit extreme eye gaze avoidance and hyperarousal when they encounter stressful social situations. We investigated whether oxytocin (OT), a hormone with prosocial and anxiolytic effects, could alleviate symptoms of social anxiety in this population. A randomized double-blind placebo-controlled single-dose trial was performed with intranasal administration of placebo, 24IU OT and 48IU OT. Measures of eye gaze frequency, heart rate, respiratory sinus arrhythmia (RSA), heart rate variability (HRV) and salivary cortisol were obtained during a structured social challenge conducted 50min following OT administration. Ten low-functioning males with FXS (aged 13-28 years) traveled to Stanford for the initial visit: 8 completed the study. Eye gaze frequency improved significantly in response to the 24IU OT dose and salivary cortisol levels decreased significantly in response to the 48IU OT dose. There was no effect of OT on heart rate, RSA or HRV although individual plots of the heart rate data suggested that OT increased heart rate in some participants and decreased heart rate in others. These findings suggest that intranasal administration of OT may ameliorate some symptoms of social anxiety in patients with FXS. Further double-blind placebo-controlled studies of OT, conducted in combination with behavioral treatment programs, may be warranted

The Autism Speaks Book List

29 Aug

I want to like Autism Speaks. I really do. I know some very good people working with Autism Speaks. From a very practical standpoint, they are one of the biggest autism organizations and I need them to be doing good.

Unfortunately, sometimes Autism Speaks does things which I really find difficult to support. Recently, I pointed out that Autism Speaks is sponsoring a conference by the National Autism Association. This conference will be hosting Andrew Wakefield to speak. In my view, Mr. Wakefield is a person whose damage to the autism communities can not (and should not) be minimized. Even though Autism Speaks isn’t directly hosting Mr. Wakefield, I feel that it would be good and appropriate to withhold sponsorship of such an event.

During the discussion of that article I decided to search for how Autism Speaks discusses Mr. Wakefield on their website. The Autism Speaks website is a resource for many families looking for information. I found that Autism Speaks has a book list in their Resource Library (Family Services » Resource Library » Books) and this list includes “Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy”, Mr. Wakefield’s account of the events surrounding the loss of his medical license.

Frankly, I find this a poor resource for autistics, families, well anyone looking for accurate and useful information. Shannon Rosa did what I should have done and contacted Autism Speaks for comment and reported the response the comments here.

Kim, you are awesome. And I agree, working towards real change is hard; it requires a lot of processing power, a lot of reflection, a lot of synthesis, a lot of perseverance—and an eye on long-term as well as short-term goals.

Re: listing Callous Disregard, Autism Speaks pointed me to their resources section’s legal disclaimer:

“Autism Speaks maintains the Family Services Resource Guide as a service to families as a reference tool. Every effort is made to ensure listings are up-to-date. Autism Speaks does not endorse or claim to have personal knowledge of the abilities of those listed. The resources listed on this page are not intended as a recommendation, referral, or endorsement of any resource or as a tool for verifying the credentials, qualifications, or abilities of any organization, product or professional. Users are urged to use independent judgment and request references when considering any resource associated with diagnosis or treatment of autism, or the provision of services related to autism.”

But I still think including Callous Disregard reflects badly upon them, and have said so. The conversation continues.

Since that time two small changes have occurred to that page. First, a disclaimer was added (it wasn’t there before, as the Google cache version confirms). The disclaimer:

Autism Speaks does not provide medical or legal advice or services. Rather, Autism Speaks provides general information about autism as a service to the community. The information provided on this website is not a recommendation, referral, or endorsement of any resource, therapeutic method, or service provider and does not replace the advice of medical, legal, or educational professionals. Autism Speaks has not validated and is not responsible for any information or services provided by third parties. You are urged to use independent judgment and request references when considering any resource associated with the provision of services related to autism.

I agree…to a point. Autism Speaks can’t be responsible for everything said in every resource. However, Mr. Wakefield was found guilty of dishonesty and unethical behavior in his research activities involving autistics. Even if one believes Mr. Wakefield’s account (which is clearly contradicted by the facts), it doesn’t give any real information of value to, say, a family with a new diagnosis. Autism Speaks can and does make a distinction of what books to host. You won’t find “The Empty Fortress” by Bruno Bettleheim on the list (surprisingly enough, it is still in print).

The second change to the Autism Speaks books resource page? The link has been removed to “Callous Disregard”. The book is still listed, but there is no link to the publisher’s site any longer.

The vaccine-autism notion has caused a great deal of harm to the autism communities. So much time and money has been thrown at researching the supposed epidemic of vaccine-induced autism. Much more to the point for an organization like Autism Speaks: this idea has caused a great deal of harm to families, a great deal of pain and, most importantly, a great deal of unwarranted and sometimes dangerous medicine to be practiced on autistics. This is why I would go further than to question why Autism Speaks lists a book by someone proven dishonest and unethical. I would ask why continue to give support to ideas whose time has clearly passed.

For example:

Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy
by David Kirby

David Kirby’s book was speculative at best when written. It is now very clearly false. Thimerosal did not cause an autism epidemic. And why list this under the subheading “Medical, Biomedical, Diet Interventions”? Mr. Kirby isn’t anything close to a medical professional and the book is more of a speculative thiller involving conspiracies which didn’t occur to cover up a mercury-induced epidemic that didn’t happen. Here’s the blurb for Evidence of harm:

Evidence of Harm explores the heated controversy over what many parents, physicians, public officials, and educators have called an “epidemic” of afflicted children. Following several families, David Kirby traces their struggle to understand how and why their once-healthy kids rapidly descended into silence or disturbed behavior, often accompanied by severe physical illness. Alarmed by the levels of mercury in the vaccine schedule, these families sought answers from their doctors, from science, from pharmaceutical companies that manufacture vaccines, and finally from the Center for Disease Control and the Food and Drug Administration-to no avail. But as they dug deeper, the families also found powerful allies in Congress and in the small community of physicians and researchers who believe that the rise of autism and other disorders is linked to toxic levels of mercury that accumulate in the systems of some children.

An important and troubling book, Evidence of Harm reveals both the public and unsung obstacles faced by desperate families who have been opposed by the combined power of the federal government, health agencies, and pharmaceutical giants. From closed meetings of the FDA, CDC, and drug companies, to the mysterious rider inserted into the 2002 Homeland Security Bill that would bar thimerosal litigation, to open hearings held by Congress, this book shows a medical establishment determined to deny “evidence of harm” that might be connected with thimerosal and mercury in vaccines. In the end, as research is beginning to demonstrate, the questions raised by these families have significant implications for all children, and for those entrusted to oversee our national health.

Other books of a questionable nature:

What Your Doctor May Not Tell You About(TM) Children’s Vaccinations
by Stephanie Cave

This is a book which links vaccines to autism using, for example, the incorrect comparison of mercury poisoning symptoms to autism, and gives the Wakefield (called “One of the most prominent researchers in MMR vaccine research) hypothesis for MMR causing autism.

Another example from the Autism Speaks book list:

The Age of Autism: Mercury, Medicine, and a Man-Made Epidemic
by Dan Olmsted, Mark Blaxill

This is another in the series of books making the link between autism and mercury. On the one hand, it is nice for Autism Speaks to host a link to a book by people who are such harsh critics of Autism Speaks. But, why be polite when the book is a failed hypothesis wrapped in a bad understanding of science?

Another book:

Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children
edited by Louise Kuo Habakus, MA, and Mary Holland, JD

Amongst other topics discussed, this book includes a chapter which is basically a summary of “Callous Disregard”. I know this is getting repetitive, but Autism Speaks could do families a service by steering them away from this.

The book list is long. No one will agree with all the books listed as being accurate and valuable. I have no problem with that. I do feel that some level of screening is being done and more should be done. A new family deserves better than to waste their time, money and emotions on the failed ideologies of the past decade. They are, after all, trying to perform a service with this book list. I am only asking that they follow through on the spirit of this. Perform a service. Pointing them at sources of misinformation is no service. Disclaimers don’t change that.

Aging in Autism Spectrum Disorders: A Mini-Review

27 Aug

I am both encouraged and saddened by this recent paper. Encouraged that someone is taking up the topic of aging and autism. Saddened because there is very little work out there so far. The paper is from the MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK.

Here is the abstract

This article addresses an important and barely researched topic: what happens to children with autism spectrum disorders when they grow old. We review the small published literature on aging in autism. We then consider the relevance of research on ‘neurotypical’ aging in core domains of autistic impairment: social cognition, executive function, cognitive style and memory. Research themes from the study of normal aging, including cognitive reserve, compensation, quality of life, loneliness and physical health are of relevance for future research on autism. Studies of aging in autism will be important not only to plan appropriate services, but also to shed light on the full developmental trajectory of this neurodevelopmental condition, and perhaps provide clues to neuropathology and etiology.

“barely researched topic”

I hope that (and lobby for) a change in this. I will not be here to support my child through old age. Even if I were, I could really use some help in understanding what is going on.

Adverse Effects of Vaccines: Evidence and Causality

26 Aug

The United States Institute of Medicine (IOM) has just published a lengthy report, Adverse Effects of Vaccines: Evidence and Causality.

The short summary, via Reuters, is: “the big take-home message is that we found only a few cases in which vaccines can cause adverse side effects, and the vast majority of those are short-term and self-limiting.”

As to autism? There are two main theories of autism and vaccines: MMR and Thimerosal. The autism and MMR theory is one of the most studied and most clear. The committee found that the research “Favors Rejection”. As in,

The committee concluded the evidence favors rejection of five vaccine-adverse event relationships. These include MMR vaccine and type 1 diabetes, DTaP vaccine and type 1 diabetes, MMR vaccine and autism, inactivated influenza vaccine and asthma exacerbation or reactive airway disease episodes, and inactivated influenza vaccine and Bell’s palsy. The evidence base for these conclusions consisted of epidemiologic studies reporting no increased risk; this evidence was not countered by mechanistic evidence

The epidemiological evidence says there is no increased risk. There is no good mechanism known or postulated whereby MMR could cause autism.

Thimerosal is barely mentioned in the report, with only 7 mentions. As far as autism+thimerosal is concerned, the IOM reviewed the literature years back and found no evidence of a link. Since that time, the evidence has grown greater against a link and thimerosal has been removed from the routine pediatric vaccine schedule (e.g. Price et al. Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism
and, while not specific to autism, Thomson et al. Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years)

Previous IOM reports on Thimerosal: Immunization safety review: Thimerosal -containing vaccines and neurodevelopmental disorders.

Previous IOM report on vaccines and autism (especially MMR and thimerosal): Immunization safety review: Vaccines and autism.

I expect much criticism to be focused on the IOM from some circles. The arguments will likely focus on “look at all the vaccines which have not been specifically studied in relation to autism”. It is a semi valid point. The problems with the argument are many, but include: what mechanism is there for these vaccines to cause autism? (Too many too soon is a slogan, not a scientific argument). Without a mechanism, and without some sort of data showing a possible link, there is such a low possibility of finding anything that resources are best spent elsewhere. In addition, the studies to date give a reasonable proxy for vaccine exposure: the more thimerosal an infant was exposed to, the more vaccines. Thimerosal exposure becomes a proxy for the number of vaccines. It has been shown (multiple times) that there isn’t an increased risk for autism with thimerosal.

Lastly, if you read the criticisms claiming “but they’ve only studied one vaccine and one ingredient”, watch for the intellectual honesty. That’s the part where the critic admits that “they’ve only studied one vaccine and one ingredient, and they found that those don’t increase the risk of autism“. Most critics in this field are cake-eaters. They want their cake (the argument that the studies have only looked in depth at MMR and thimerosal) and they want to eat it too (by denying the results of those studies). It’s predictable.

Prevalence and Correlates of Autism in a State Psychiatric Hospital

24 Aug

I’ve said it before: I really like David Mandell’s work. He and his team take on some very important and tough questions. I am very concerned about the lack of information on autistic adults. We don’t know an accurate prevalence. Without study ongoing into the needs of autistic adults, those of us with autistic children will face a

That’s why I like studies like this one: Prevalence and Correlates of Autism in a State Psychiatric Hospital.

This study estimated the ASD prevalence in a psychiatric hospital and evaluated the Social Responsiveness Scale (SRS) combined with other information for differential diagnosis. Chart review, SRS and clinical interviews were collected for 141 patients at one hospital. Diagnosis was determined at case conference. Receiver operating characteristic (ROC) curves were used to evaluate the SRS as a screening instrument. Chi-squared Automatic Interaction Detector (CHAID) analysis estimated the role of other variables, in combination with the SRS, in separating cases and non-cases. Ten percent of the sample had ASD. More than other patients, their onset was prior to 12 years of age, they had gait problems and intellectual disability, and were less likely to have a history of criminal involvement or substance abuse. Sensitivity (0.86) and specificity (0.60) of the SRS were maximized at a score of 84. Adding age of onset <12 years and cigarette use among those with SRS 80 increased specificity to 0.90 but dropped sensitivity to 0.79. Undiagnosed ASD may be common in psychiatric hospitals. The SRS, combined with other information, may discriminate well between ASD and other disorders.

For reference:

Sensitivity relates to the test’s ability to identify positive results.
Specificity relates to the ability of the test to identify negative results.

Identifying autistic adults is not easy. Prevalence studies are far more difficult than when working with students. But Prof. Mandell is out there, trying to find autistic adults. In this case, he found that in a given psychiatric hospital, about 10% of the patients were autistic. He is calibrating instruments (the SRS together with correlates like smoking, age-of-onset, ID) to provide for a fairly direct screening tool.

This is one type of work that needs to be done. I’m glad that Prof. Mandell’s group is out there doing it, but I hope that more groups pick this up in the future.

Controversial issues in hyperbaric oxygen therapy: a European Committee for Hyperbaric Medicine Workshop

22 Aug

After writing the post on the University of California HBOT paper (Brief Report: Hyperbaric Oxygen Therapy (HBOT) in Children with Autism Spectrum Disorder: A Clinical Trial) this new abstract came out: Controversial issues in hyperbaric oxygen therapy: a European Committee for Hyperbaric Medicine Workshop.

It covers a discussion of applications of HBOT which were not yet considered in their previous workshop. This includes autism as a condition to treat with HBOT. Their conclusion: rate HBOT for autism as “not-accepted”.

Every few years, the European Committee for Hyperbaric Medicine (ECHM) publishes its recommendations concerning the clinical indications for hyperbaric oxygen therapy (HBOT). The last recommendations were issued during the 7th European Consensus Conference on Hyperbaric Medicine in 2004. Since then, several publications have reported on the use of HBOT in some indications in which it has not yet been recommended routinely, namely aseptic bone necrosis, global brain ischaemia and autism. Patients or their families push physicians and staff of hyperbaric facilities to use hyperbaric treatment regardless of the quality of the scientific evidence. Therefore, the ECHM Workshop “Controversial issues in hyperbaric oxygen therapy” was convened as a satellite meeting of the 2010 European Underwater and Baromedical Society Annual Scientific Meeting in Istanbul, Turkey in 2010. For each topic, a set procedure was used: first came a general report by specialists in the topic, incorporating a review of current pathophysiological, experimental and clinical evidence. Then, there were reports from hyperbaric facilities that had gained clinical experience in that condition, followed by a general discussion with specialists present in the audience. Finally, statements regarding each topic were proposed and voted on by the audience and these were presented to the ECHM Executive Board for consideration and possible approval. In conclusion, the use of HBOT in femoral head necrosis will be proposed during the next ECHM Consensus Conference to become an ‘accepted’ indication; whilst the use of HBOT in global brain ischaemia and autism should retain its current ECHM recommendations, that it should be ‘optional’ and ‘non-accepted’ respectively.

Brief Report: Hyperbaric Oxygen Therapy (HBOT) in Children with Autism Spectrum Disorder: A Clinical Trial

22 Aug

Hyperbaric Oxygen Therapy (HBOT) is a popular offering in the alternative medical community. It is a therapy that has proven and approved uses (most notably treatment for decompression sickness or carbon monoxide poisoning). It has been proposed as a therapy for autism, and there is already a mixed body of literature on the subject, most with small and/or uncontrolled studies. The most recent study found no benefit.

Another study has now been released, this time from the University of California (UC San Francisco and UC Davis). Brief Report: Hyperbaric Oxygen Therapy (HBOT) in Children with Autism Spectrum Disorder: A Clinical Trial is a small, uncontrolled study. The measure of benefit, at least by the abstract, is the CGI-I (Clinical Global Impression, Improvement scale), which is not particularly objective. Measures of cytokine levels were made, and no changes were observed. So, if any behavioral changes were derived from the HBOT, they were not correlated with cytokine levels.

We sought to determine whether HBOT leads to parental reported behavioral changes and alterations in cytokines in children with ASD. Ten children completed 80 sessions of HBOT and all improved by 2 points on the clinician-rated CGI-I scale (much improved) as well as several parent-completed measures of behavior. The lack of a control group limits the ability to determine if improvements were related to HBOT. Enrolled children did not exhibit abnormal cytokine levels at baseline and no significant changes in mean cytokine levels were observed. Although this study was limited by the small sample size and by the variable nature of cytokines, we found no evidence that HBOT affects cytokine levels or that cytokine levels were associated with behavioral changes.

In general, not a particularly strong study. I’ll note that UCSF’s recent MB12 study put a rather positive spin on a negative result. The fact that these researchers rated the children as improved is not really impressive to me. We don’t need more weak studies on alternative medicine. Those will never really answer any questions.

Teaching Medical Students About Disability: The Use of Standardized Patients.

20 Aug

If you haven’t heard about “standardized patients” before, they are an interesting (and important) part of medical training. Basically think of an actor (often literally an actor looking for some extra money) who portrays a patient with a given malady. He may or may not give all the information needed to the doctor in training. As in, “I’m coughing a lot lately” without saying “I smoke three packs a day”.

How can a doctor learn about the special needs of patients with disabilities? Especially those which may not be obvious, or those which make it difficult to obtain information from the patient? In Teaching Medical Students About Disability: The Use of Standardized Patients the authors consider programs which use standardized patients (SP’s) with disabilities and those portraying disabled subjects.

Standardized patients (SPs), now a mainstay of the undergraduate medical education experience, are beginning to play larger roles in helping students build competencies to better serve patients who have disabilities, in educating students about the lived experiences of persons with disabilities, and in testing students’ understanding of disability-related issues. In this article, the authors discuss several U.S. training programs that involve SPs who have disabilities or SPs who do not have disabilities but who portray patients who do. The authors review the goals of each program (e.g., to provide students with opportunities to gain experience with patients with disabilities), describe their commonalities (enhancing students’ interview skills) and differences (some programs are educational; some are evaluative), and summarize the evaluative data of each. The authors also explore the benefits and challenges of working with SPs with disabilities and of working with SPs without disabilities. Finally, they consider the practical issues (e.g., recruiting SPs) of developing and implementing such programs.

Honestly, I haven’t read the full paper. I’ve been putting off writing about this until I find the time, but that hasn’t happened and I find the subject too interesting to let it just fall by the wayside. I am encouraged to think that training programs include disability in their SP’s, and hope that is is more the rule than the exception.

Loving Lampposts: now on Netflix

19 Aug

Been putting of watching Loving Lamposts, Todd Drezner’s film? Well, it’s now available for streaming on Netflix (possibly for DVD delivery too, I can’t tell for sure).

I discussed the film a number of times when it was released (Loving lampposts, Loving Lampposts: synopsis and director’s statement, Loving Lampposts video clips, and, after I was provided with a review DVD, Loving Lampposts, a review.)

Here are a couple of clips from the film:

Loving Lampposts Clip#1 from Cinema Libre Studio on Vimeo.

Loving Lampposts Clip #3 from Cinema Libre Studio on Vimeo.

In his recent Huffington Post article,Labeling Autism And Creating Community, Mr. Drezner takes on some of the questions posed by the proposed DSMV criteria for autism. Specifically, will some people lose their autism labels, and what does this mean.

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