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Autistic Ape? He’s charming and wonderful and we love him, but he is different

15 Apr

“He’s charming and wonderful and we love him, but he is different”. So says a researcher discussing Teco, a Bonobo in an article by Sarah DeWeerdt at the Simons Foundation SFARI blog. Here are the first couple of paragraphs:

Similarities between us and our closest ape relatives — chimpanzees and bonobos — have shaped our understanding of what it means to be human. The latest surprise is Teco, a young bonobo who shows behaviors that look suspiciously similar to those associated with autism.

Teco is the son of Kanzi, a 30-year-old bonobo whose use of symbols to communicate with humans made him famous. The two live with five other bonobos at the Great Ape Trust, a nonprofit research institute in Des Moines, Iowa, that is the site of a long-term study on ape language and culture.

Is Teco something akin to autistic? There’s really not enough information in the article to say, but it is still an excellent read.

Federal government denies Oregon waiver on special education cuts

15 Apr

In the US the Federal Government pays a part of the costs of special education. They are committed to pay 40%, but typically have spent about 17%. If a state reduces special education spending, the federal matching funds are also reduced. That is, unless the state is granted a waiver. So far the federal government has been granting the states waivers as they ask for them. In other words, the states cut special ed funding, but the government doesn’t cut the amount they pay in.

That’s what’s happened until now. Oregon has been denied a waiver. In Feds say Oregon must boost special education funding or face sanctions, Oregonlive.com points out:

The U.S. Department of Education has denied Oregon’s request to reduce special education funding in light of budget cuts and will cut more than $15 million federal funding to schools if the state doesn’t reverse course.

States lose federal special education money if they lower their contribution to those programs without a waiver. Oregon Department of Education officials sought the federal waiver, saying the state faced declining revenue projections throughout the summer, forcing the department to reduce the amount of money supporting special education programs.

But the federal government didn’t see things the same way. U.S. Department of Education officials say Oregon needs to tap into its reserves and return special education funding to 2009-10 levels. If it doesn’t, the federal government will reduce its contribution to the state by $15.7 million for the 2011-12 school year – a direct reduction to local school district budgets.

I am very mixed on this. Yes, I think the federal government should try to push states to maintain special ed funding. Unfortunately, this could cost an additional $15.7M to the state’s special education budget.

Studies on the autism-vaccine hypothesis

15 Apr

Below is a collection of studies which the American Academy of Pediatrics put together on the autism/vaccine question. Why bring this up now? Because with the indictment of Poul Thorsen, I’ve read a number of comments where people are claiming that he worked on the study that debunked the connection. Hardly. Going through these quickly, I find 2 articles that Poul Thorsen worked on (the two Madsen studies). No one has made a credible claim that even the studies Mr. Thorsen worked on are tainted.

The comparison to Andrew Wakefield has already been made. Mr. Wakefield promoted the idea that the MMR vaccine caused autism, and was later was found guilty of a number of ethical lapses in his research efforts. The major difference between Wakefield and Thorsen is this: Wakefield was wrong. His assertion that the MMR was related to autism causation when he stated: “…but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.” It was a statement not even supported by his own paper (even if it hadn’t been based on fraudulent research), much less has ever been supported by research by any other team. By contrast, the work that Mr. Thorsen worked on has been replicated.

Lack of Association Between Measles-Mumps-Rubella Vaccination and Autism in Children: A Case-Control Study
Budzyn D, et al. The Pediatric Infectious Disease Journal. Vol. 29, No. 5, May 2010
Researchers in Poland compared vaccination history and autism diagnosis in 96 children with autism, ages 2 to 15, as well as 192 children in a control group. For children diagnosed before a diagnosis of autism, the autism risk was lower in children who received MMR vaccine than in nonvaccinated children. A similar result was achieved for the single-antigen measles vaccine.
AUTHOR CONCLUSION: The study provides evidence against the association of autism with either MMR or a single measles vaccine.
http://www.ncbi.nlm.nih.gov/pubmed/19952979

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study
Hornig M et al., PLoS ONE 2008, 3(9): e3140 doi:10.1371/journal.pone.0003140
Researchers looked for measles virus in the guts of 25 children with both autism and gastrointestinal disorders, and another 13 children with the same gastrointestinal disorders but no autism. The virus was detected in one child from each group.
AUTHOR CONCLUSION: This study provides strong evidence against association of autism with persistent measles virus RNA in the gastrointestinal tract or with measles, mumps and rubella (MMR) vaccine exposure.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0003140

Measles Vaccination and Antibody Response in Autism Spectrum Disorders
Baird G et al., Archives of Disease in Childhood 2008; 93(10):832-7
Case-control study of 98 vaccinated children aged 10-12 years in the UK with autism spectrum disorder (ASD) and two control groups of similar age: 52 children with special educational needs but no ASD and 90 children in the typically developing group. No difference was found between cases and controls for measles antibody response. There was no dose-response relationship between autism symptoms and antibody concentrations.
AUTHOR CONCLUSION: No association between measles vaccination and ASD was shown.
http://tinyurl.com/dn6yy8

MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan
Uchiyama T et al. Journal of Autism and Developmental Disorders, 2007; 37(2):210-7
Study of 904 patients with Autism Spectrum Disorders (ASD). During the period of measles, mumps and rubella vaccine (MMR) usage, no significant difference was found in the incidence of regression between MMR-vaccinated children and nonvaccinated children. Among the proportion and incidence of regression across the three MMR-program-related periods (before, during and after MMR usage), no significant difference was found between those who had received MMR and those who had not. Moreover, the incidence of regression did not change significantly across the three periods.
AUTHOR CONCLUSION: The data do not support an association between MMR and autism.
http://tinyurl.com/6c6o4r

No Evidence of Persisting Measles Virus in Peripheral Blood Mononuclear Cells from Children with Autism Spectrum Disorder
D’Souza Y et al. Pediatrics 2006; 118(4):1664-75
Peripheral blood mononuclear cells were isolated from 54 children with Autism Spectrum Disorders (ASD) and 34 developmentally normal children, and up to 4 realtime polymerase chain reaction assays and 2 nested polymerase chain reaction assays were performed. No sample from either ASD or control groups was found to contain nucleic acids from any measles virus gene. In the nested polymerase chain reaction and in-house assays, none of the samples yielded positive results. Furthermore, there was no difference in anti-measles antibody titers between the autism and control groups.
AUTHOR CONCLUSION: There is no evidence of measles virus persistence in the peripheral blood mononuclear cells of children with ASD.
http://tinyurl.com/dcb79o

Immunizations and Autism: A Review of the Literature
Doja A, Roberts W. The Canadian Journal of Neurological Sciences 2006; 33(4):341-6
Literature review found very few studies supporting an association between vaccines and autism, with the overwhelming majority showing no causal association between the measles, mumps and rubella (MMR) vaccine and autism. The vaccine preservative thimerosal has alternatively been hypothesized to have a possible causal role in autism. No convincing evidence was found to support an association between the vaccine preservative thimerosal and autism, nor for the use of chelation therapy in autism.
AUTHOR CONCLUSION: With decreasing uptake of immunizations in children and the inevitable occurrence of measles outbreaks, it is important that clinicians be aware of the literature concerning vaccinations and autism so that they may have informed discussions with parents and caregivers.
http://tinyurl.com/ddnqq7

Pervasive Developmental Disorders in Montreal and Quebec, Canada: Prevalence and Links with Immunizations
Fombonne E et al. Pediatrics. 2006; 118(1):e139-50
Study of thimerosal and measles, mumps and rubella (MMR) vaccine uptake in 28,000 Canadian children born between 1987 and 1998, of whom 180 were identified with a pervasive developmental disorder.
AUTHOR CONCLUSION: The data rule out an association between pervasive developmental disorder and either high levels of ethyl mercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose MMR vaccinations.
http://tinyurl.com/5c27nu

Is there a ‘regressive phenotype’ of Autism Spectrum Disorder associated with the measles mumps-rubella vaccine? ACPEA Study
Richler et al. Journal of Autism and Developmental Disorders. 2006
A multi-site study of 351 children with Autism Spectrum Disorders (ASD) and 31 typically developing children used caregiver interviews to describe the children’s early acquisition and loss of social-communication milestones. For the majority of children with ASD who had experienced a regression, pre-loss development was clearly atypical.
AUTHOR CONCLUSION: No evidence that onset of autistic symptoms or of regression was related to measles, mumps and rubella vaccination.
http://tinyurl.com/66gtk2

Relationship between MMR Vaccine and Autism
Klein KC, Diehl EB. The Annals of Pharmacotherapy. 2004; 38(7-8):1297-300
Ten articles that specifically evaluated the possible relationship between the measles, mumps and rubella (MMR) vaccine and autism were identified. Review articles, commentaries, and evaluations of a link between gastrointestinal symptoms in autistic children and MMR immunization were excluded.
AUTHOR CONCLUSION: Based upon the current literature, it appears that there is no relationship between MMR vaccination and the development of autism.
http://tinyurl.com/chdjrk

Immunization Safety Review: Vaccines and Autism
Institute of Medicine, The National Academies Press: 2004
The IOM’s Committee on Immunization Safety Review was convened in the fall of 2000 to provide an independent review of increasingly prominent vaccine safety concerns. The 15 committee members with expertise in pediatrics, internal medicine, immunology, neurology, infectious diseases, epidemiology, biostatistics, public health, risk perception, decision analysis, nursing, genetics, ethics and health communications analyzed over 200 relevant studies.
AUTHOR CONCLUSION: The committee rejected a causal relationship between the MMR vaccine and autism as well as a causal relationship between thimerosal containing vaccines and autism.
http://books.nap.edu/catalog.php?record_id=10997#description

No effect of MMR withdrawal on the incidence of autism: a total population study
Honda H et al, Journal of Child Psychology and Psychiatry 2005 June; 46(6):572-9
Study examined incidence of Autism Spectrum Disorders (ASD) to age 7 for children born between 1988 and 1996 in Yokohama, Japan. The measles, mumps and rubella (MMR) vaccination rate in Yokohama declined significantly in the birth cohorts of years 1988-92, and no MMR vaccines were administered in 1993 or thereafter. In contrast, cumulative incidence of ASD up to age 7 increased significantly in the birth cohorts of years 1988 through 1996 and most notably rose dramatically beginning with the birth cohort of 1993.
AUTHOR CONCLUSION: MMR vaccination is not likely to be a main cause of ASD, and cannot explain the rise over time in the incidence of ASD. Withdrawal of MMR in countries where it is still being used cannot be expected to lead to a reduction in the incidence of ASD.
http://tinyurl.com/d8f3lg

No evidence for links between autism, MMR and measles virus
Chen W et al, Psychological Medicine 2004 April;34(3):543-53
Study compared 2,407 persons with autism born between 1959 and 1993; to 4,640 Down syndrome subjects born between 1966 and 1993.
AUTHOR CONCLUSION: No increased risk of autism was found following exposures to wild measles and vaccinations with monovalent measles, and Urabe or Jeryl-Lynn variants of measles, mumps and rubella (MMR) vaccine.
http://tinyurl.com/5msou2

Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta
DeStefano F et al. Pediatrics 2004; 113(2): 259-66
Study compared ages at first measles, mumps and rubella (MMR) vaccination between children with autism and children who did not have autism in the total population and in selected subgroups, including children with regression in development.
AUTHOR CONCLUSION: Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (ie, 24 months).
http://pediatrics.aappublications.org/cgi/content/abstract/113/2/259

MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study
Smeeth L et al. Lancet 2004; 364(9438):963-9
Matched case-control of 1,295 people born in 1973 or later who had first recorded diagnosis of pervasive developmental disorder while registered with a contributing general practice between 1987 and 2001. Controls (4,469) were matched on age, sex and general practice. 1,010 cases (78.1%) had measles, mumps and rubella (MMR) vaccination recorded before diagnosis, compared with 3,671 controls (82.1%) before the age at which their matched case was diagnosed,
AUTHOR CONCLUSION: Data suggest that MMR vaccination is not associated with an increased risk of pervasive developmental disorders.
http://tinyurl.com/8wlhfj

Prevalence of Autism and Parentally Reported Triggers in a North East London Population
Lingam R et al. Archives of Disease in Childhood. 2003; 88(8):666-70
Study of reported age of onset of Autism Spectrum Disorder (ASD) among 567 children in northeast London born between 1979 and 1998. The age at diagnosis of ASD was estimated to have decreased per five-year period since 1983, by 8.7% for childhood autism and by 11.0% for atypical autism.
AUTHOR CONCLUSION: The data suggest that a rise in autism prevalence was likely due to factors such as increased recognition, a greater willingness on the part of educators and families to accept the diagnostic label, and better recording systems. The proportion of parents attributing their child’s autism to MMR appears to have increased since August 1997.
http://adc.bmj.com/cgi/content/abstract/88/8/666

A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism
Madsen KM et al. New England Journal of Medicine. 2002; 347(19):1477-82
Compared relative risk of Autism Spectrum Disorder (ASD) in children vaccinated with measles, mumps and rubella (MMR) vaccine and unvaccinated children born in Denmark between 1991 and 1998. Of the 537,303 children in the cohort, 82% had received the MMR vaccine. Researchers identified 316 children with a diagnosis of autism and 422 with a diagnosis of other ASDs. There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autism.
AUTHOR CONCLUSION: This study provides strong evidence against the hypothesis that MMR vaccination causes autism.
http://tinyurl.com/5eob5k

Neurologic Disorders after Measles-Mumps-Rubella Vaccination
Makela A et al. Pediatrics. 2002; 110:957-63
Study of 535,544 1- to 7-year-old children who were vaccinated between November 1982 and June 1986 in Finland.
AUTHOR CONCLUSION: Data do not support an association between measles, mumps and rubella (MMR) vaccination and encephalitis, aseptic meningitis or autism.
http://tinyurl.com/6ybfjr

Relation of Childhood Gastrointestinal Disorders to Autism: Nested Case Control Study Using Data from the UK General Practice Research Database
Black C et al. British Medical Journal. 2002; 325:419-21
Nested case control study of 96 children diagnosed with autism and 449 controls. The estimated odds ratio for a history of gastrointestinal disorders among children with autism compared with children without autism was 1.0 (95% confidence interval 0.5 to 2.2).
AUTHOR CONCLUSION: No evidence was found that children with autism were more likely than children without autism to have had defined gastrointestinal disorders at any time before their diagnosis of autism.
http://tinyurl.com/csudoy

Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study
Taylor B et al. British Medical Journal. 2002; 324(7334):393-6
Population study of 278 children with core autism and 195 with atypical autism, born between 1979 and 1998. The proportion of children with developmental regression (25% overall) or bowel symptoms (17%) did not change significantly during the 20 years from 1979, a period which included the introduction of measles, mumps and rubella (MMR) vaccination in October 1988.
AUTHOR CONCLUSION: Data provide no support for an MMR associated “new variant” form of autism with developmental regression and bowel problems, and further evidence against involvement of MMR vaccine in the initiation of autism.
http://tinyurl.com/6oqsfc

No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism
Fombonne E et al. Pediatrics. 2001;108(4):E58
Study compared 96 children with a pervasive developmental disorder (PDD) born between 1992 and 1995 and who had received the measles, mumps and rubella (MMR) vaccine, to PDD patients who did not receive MMR.
AUTHOR CONCLUSION: No evidence was found to support a distinct syndrome of MMR-induced autism or of “autistic enterocolitis.” These results add to the largescale epidemiologic studies that all failed to support an association between MMR and autism at population level. These findings do not argue for changes in current immunization programs and recommendations.
http://tinyurl.com/5adckj

Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study from the Vaccine Safety Datalink Project
Davis RL et al. Archives of Pediatric and Adolescent Medicine. 2001;155(3):354-9
A case control study of 155 persons with inflammatory bowel disease with up to five controls each. Neither past vaccination nor age at vaccination with other MCV was associated with increased risk for Crohn’s disease, ulcerative colitis, or IBD. Risk for Crohn’s disease, ulcerative colitis, or IBD was not elevated in the time immediately following vaccination with either vaccine.
AUTHOR CONCLUSION: Vaccination with MMR or other MCV, or the timing of vaccination early in life, did not increase the risk for IBD.
http://archpedi.ama-assn.org/cgi/content/abstract/155/3/354

Time Trends in Autism and in MMR Immunization Coverage in California
Dales L et al. Journal of the American Medical Association. 2001; 285(9):1183-5
Scientists looked for correlation between increases in the rate of autism diagnoses and increases in the rate of measles, mumps and rubella (MMR) vaccination in children born between 1980 and 1994.
AUTHOR CONCLUSION: These data do not suggest an association between MMR immunization among young children and an increase in autism occurrence.
http://jama.ama-assn.org/cgi/content/abstract/285/9/1183

MMR and autism: further evidence against a causal association
Farrington CP, et al. Vaccine. 2001; Jun 14; 19(27):3632-5
Data from an earlier measles, mumps and rubella (MMR) vaccine study (Taylor et al, 2000) were reanalyzed to test a second hypothesis.
AUTHOR CONCLUSION: Results provide further evidence against a causal association between MMR vaccination and autism.
http://tinyurl.com/5lb3w7

Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis
Kaye JA et al. British Medical Journal. 2001; 322:460-63
Study compared prevalence of measles, mumps and rubella (MMR) vaccination among children in the United Kingdom to rising prevalence of autism diagnoses for children.
AUTHOR CONCLUSION: The data provide evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time.
http://www.bmj.com/cgi/content/full/322/7284/460

Further Evidence of the Absence of Measles Virus Genome Sequence in Full Thickness Intestinal Specimens from Patients with Crohn’s Disease
Afzal MA, et al. Journal of Medical Virology. 2000; 62(3):377-82
Study of specimens of macroscopically inflamed and normal intestine along with mesenteric lymph nodes from patients with Crohn’s disease. None of the samples examined gave any evidence of the persistence of measles virus in the intestine of Crohn’s disease patients.
AUTHOR CONCLUSION: The study supports previous findings produced by this laboratory and others using highly sensitive measles virus specific PCR diagnostic technology.
http://tinyurl.com/aoec5b

Absence of Detectable Measles Virus Genome Sequence in Inflammatory Bowel Disease Tissues and Peripheral Blood Lymphocytes
Afzal MA et al. Journal of Medical Virology. 1998; 55(3):243-9
Study looked for measles virus in 93 colonoscopic biopsies and 31 peripheral blood lymphocyte preparations, examined and obtained from patients with inflammatory bowel disease (IBD) and noninflammatory controls.
AUTHOR CONCLUSION: Measles virus was not detected using this method.
http://www.ncbi.nlm.nih.gov/pubmed/9624614

Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association
Taylor B et al. Lancet. 1999;353 (9169):2026-9
Researchers looked for a change in trend in incidence or age at diagnosis associated with the introduction of measles, mumps and rubella (MMR) vaccination to the United Kingdom in 1988. The study identified 498 cases of autism (261 of core autism, 166 of atypical autism, and 71 of Asperger syndrome) in children born in the UK since 1979. There was a steady increase in cases by year of birth with no sudden “step-up” or change in the trend line after the introduction of MMR vaccination. There was no difference in age at diagnosis between the cases vaccinated before or after 18 months of age and those never vaccinated. There was no temporal association between onset of autism within 1 or 2 years after vaccination with MMR. Developmental regression was not clustered in the months after vaccination.
AUTHOR CONCLUSION: Data do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.
http://tinyurl.com/5bgvwg

No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-year Prospective Study
Peltola H et al. Lancet. 1998; 351:1327-8
Prospective study of 3 million adverse events in temporal relation to MMR vaccine. A form was filled and posted to the data collectors, followed by another form with further information 2-3 weeks later. Researchers traced subjects who developed gastrointestinal symptoms or signs lasting 24 hours or more at any time after MMR vaccination (apart from within the first hour). Researchers also checked hospital and health center records or interviewed the local public-health nurses.
AUTHOR CONCLUSION: Over a decade’s effort to detect all severe adverse events associated with MMR vaccine could find no data supporting the hypothesis that it would cause pervasive developmental disorder or inflammatory bowel disease.
http://www.freenetpages.co.uk/hp/gingernut/lancet/Finland%20May%201998.pdf

Exposure to Measles in Utero and Crohn’s Disease: Danish Register Study
Nielsen LL et al. British Medical Journal. 1998; 316(7126):196-7
Investigators identified 472 women aged 15 to 43 years who had been admitted with measles between 1915 and 1966. Thirty-three were pregnant: 11 developed measles during the first trimester, 9 during the second, 6 during the third, and 9 had exanthema less than 14 days after delivery. Of the 26 offspring identified (including one set of twins), four died, one in infancy. The diagnoses of the other three, who died as adults, did not suggest inflammatory bowel disease. Among individuals still alive (median age 51.4 (36-79) years) none were registered as having Crohn’s disease or inflammatory bowel disease.
AUTHOR CONCLUSION: Exposure to measles in utero does not seem to be strongly associated with the development of Crohn’s disease later in life.
http://www.bmj.com/cgi/content/short/316/7126/196

U.S. Court of Federal Claims decision in Omnibus Autism Proceeding
On Feb. 12, 2009, the “vaccine court” ruled in three test cases on the theory that MMR vaccine and the vaccine preservative thimerosal are linked to autism. The court found the scientific evidence is overwhelmingly contrary to this theory.
http://www.uscfc.uscourts.gov/node/5026

Studies looking at thimerosal:

Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism
Price C et al., Pediatrics. Vol. 126 No. 4 October 2010, pp. 656-664
Researchers reviewed managed care organization records and conducted interviews with the parents of 256 children who were verified to have ASD according to a standardized personal evaluation. Children with ASD were further categorized as having autistic disorder or ASD with regression. Another 752 children without autism, matched to the ASD children by birth year, gender and managed care organization, were also studied. For none of the autism outcomes was prenatal or early life receipt of thimerosal-containing vaccines and immunoglobulins significantly greater among children with ASD than among children without ASD.
AUTHOR CONCLUSION: These results add to the evidence that thimerosal containing vaccines do not increase the risk of autism.
http://pediatrics.aappublications.org/cgi/content/full/126/4/656

Continuing increases in autism reported to California’s developmental services system: mercury in retrograde
Schechter and Grether, 2008, Archives of General Psychiatry. 65(1):19-24
Study analyzed autism client data from the California Department of Developmental Services between 1995 and 2007. Even though thimerosal was absent from scheduled childhood vaccines after 2002, cases of autism continued to climb quarter by quarter.
AUTHOR CONCLUSION: The California DDS data do not show any recent decrease in autism in California despite the exclusion of more than trace levels of thimerosal from nearly all childhood vaccines. The data do not support the hypothesis that exposure to thimerosal during childhood is a primary cause of autism.
http://www.ncbi.nlm.nih.gov/pubmed/18180424

Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines
Pichichero, et al., Pediatrics. Vol. 121 No. 2, 2008, pp. e208-e214
Study assessed blood mercury levels of 216 healthy children prior to immunization with thimerosal-containing vaccines, and 12 hours to 30 days after. The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30.
AUTHOR CONCLUSION: The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.
http://pediatrics.aappublications.org/cgi/content/full/121/2/e208

Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years
Thompson, et al. 2007, New England Journal of Medicine. 357:1281-1292
Study compared early exposure to thimerosal-containing vaccines to 42 neuropsychological outcomes in 1,047 children between the ages of 7 and 10 years. Exposure to mercury from thimerosal was determined from computerized immunization records, medical records, personal immunization records and parent interviews.
AUTHOR CONCLUSION: The study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.
http://tinyurl.com/5ndvpe

Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations
Fombonne, et al., Pediatrics. Vol. 118 No. 1, 2006, pp. e139-e150
Quantified thimerosal and measles, mumps rubella (MMR) vaccine uptake in 28,000 Canadian children born between 1987 and 1998, of whom180 were identified with a pervasive developmental disorder.
AUTHOR CONCLUSION: The data rule out an association between pervasive developmental disorder and either high levels of ethyl mercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measlesmumps-rubella vaccinations.
http://tinyurl.com/5c27nu

Immunization Safety Review: Vaccines and Autism
Institute of Medicine, The National Academies Press: 2004
The IOM’s Committee on Immunization Safety Review was convened in the fall of 2000 to provide an independent review of increasingly prominent vaccine safety concerns. The 15 committee members with expertise in pediatrics, internal medicine, immunology, neurology, infectious diseases, epidemiology, biostatistics, public health, risk perception, decision analysis, nursing, genetics, ethics and health communications analyzed over 200 relevant studies.
AUTHOR CONCLUSION: The committee rejected a causal relationship between the MMR vaccine and autism as well as a causal relationship between thimerosal containing vaccines and autism.
http://books.nap.edu/catalog.php?record_id=10997#description

Thimerosal Exposure in Infants and Developmental Disorders: A Retrospective Cohort Study in the United Kingdom Does Not Support a Causal Association
Andrews N et al., Pediatrics. Vol. 114 No. 3, 2004, pp. 584-591
Study analyzed thimerosal exposure and possible development delays in 109,863 children born in the United Kingdom from 1988-97. Exposure was defined according to the number of DTP/DT doses received by 3 and 4 months of age and also the cumulative age-specific DTP/DT exposure by 6 months.
AUTHOR CONCLUSION: With the possible exception of tics, there was no evidence that thimerosal exposure via DTP/DT vaccines causes neurodevelopmental disorders.
http://tinyurl.com/7rvj6m

Autism and thimerosal-containing vaccines: Lack of consistent evidence for an association
Stehr-Green P et al., American Journal of Preventive Medicine. 2003; 25(2):101-6
Study compared the prevalence/incidence of autism in California, Sweden and Denmark from the mid-80s to the late 90s with average exposures to thimerosal containing vaccines. In all three countries, the incidence and prevalence of Autism Spectrum Disorders began to rise in the 1985-1989 period, and the rate of increase accelerated in the early 1990s.
AUTHOR CONCLUSION: The data is not consistent with the hypothesis that increased exposure to thimerosal-containing vaccines is responsible for the apparent increase in the rates of autism in young children being observed worldwide.
http://www.ncbi.nlm.nih.gov/pubmed/12880876

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data
Madsen et al., Pediatrics; Vol. 112 No. 3, 2003, pp. 604-606
Analyzed data from the Danish Psychiatric Central Research Register recording all psychiatric admissions since 1971, and all outpatient contacts in psychiatric departments in Denmark since 1995. There was no trend toward an increase in the incidence of autism during that period when thimerosal was used in Denmark, up through 1990. From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal.
AUTHOR CONCLUSION: The discontinuation of thimerosal-containing vaccines in Denmark in 1992 was followed by an increase in the incidence of autism. The data do not support a correlation between thimerosal-containing vaccines and the incidence of autism.
http://tinyurl.com/5omq4u

Association Between Thimerosal-Containing Vaccine and Autism
Hviid et al., Journal of the American Medical Association, 2003; 290(13):1763-6
Study of 467,000 children born in Denmark between 1990 and 1996 compared children who were vaccinated with a thimerosal-containing vaccine to children who received a thimerosal-free formulation of the same vaccine. The risk of autism and other autism spectrum disorders did not differ significantly between children vaccinated with thimerosal-containing vaccine and children vaccinated with thimerosal-free vaccine.
AUTHOR CONCLUSION: The results do not support a causal relationship between childhood vaccination with thimerosal-containing vaccines and development of autistic-spectrum disorders.
http://tinyurl.com/5rtzjd


Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association
Heron et al., Pediatrics. Vol. 114 No. 3, 2004, pp. 577-583
The researchers monitored the thimerosal exposure of more than 14,000 children born in the UK between 1991 and 1992. The age at which doses of thimerosal-containing vaccines were administered was recorded, and measures of mercury exposure by 3, 4 and 6 months of age were calculated and compared with measures of childhood cognitive and behavioral development covering from 6 to 91 months of age.
AUTHOR CONCLUSION: No convincing evidence was found that early exposure to thimerosal had any deleterious effect on neurologic or psychological outcome.
http://pediatrics.aappublications.org/cgi/content/abstract/114/3/577

Additional studies looking at vaccine safety:

On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes
Smith M and Woods C, Pediatrics. Vol. 125 No. 6 June 2010, pp. 1134-1141

The study of data on more than 1,000 children born between 1993 and 1997 looked at their vaccination schedules up to 1 year of age, and studied their performance 7 to 10 years later on 42 different neuropsychological outcomes. Timely vaccination was associated with better performance on numerous outcomes. The less-vaccinated children did not do significantly better on any of the outcomes.
AUTHOR CONCLUSION: This comparison of children vaccinated on time with children whose vaccinations were delayed or incomplete found no benefit in delaying immunizations during the first year of life. For parents who are concerned that children receive too many vaccines too soon, these data may provide reassurance that timely vaccination during infancy has no adverse effect on long-term neuropsychological outcomes.
http://pediatrics.aappublications.org/cgi/content/abstract/125/6/1134

A Systematic Review of Secretin for Children With Autism Spectrum Disorders

15 Apr

The journal Pediatrics has a series of articles out recently on autism therapies. All are review articles: discussions of previous papers rather than new research. One topic that was covered was secretin. I don’t hear much about secretin now, but it was a big event in the 1990’s. Last I checked (which was some time ago) many alternative medical practitioners in the Defeat Autism Now group still were prescribing it. The Autism Research Institute’s webpage still has a prominent link to “The Use of Secretin in Autism: Some Preliminary Answers “, an article from 1998.

A number of studies have been performed on the use of secretin, including randomized control trials (RCT). There is enough data that the authors of this review were able to make a rather definitive statment: not only is there no evidence of having an imact.

CONTEXT: As many as 1 in every 110 children in the United States has an autism spectrum disorder (ASD). Secretin is 1 of many medical treatments studied for treating the symptoms of ASDs, but there is currently no consensus regarding which interventions are most effective.
OBJECTIVE: To systematically review evidence regarding the use of secretin in children with ASDs who are aged 12 years and younger. METHODS: We searched the Medline, PsycINFO, and ERIC (Education Resources Information Center) databases from 2000 to May 2010 and reference lists of included articles. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings on the basis of predetermined criteria.
RESULTS: Evidence from 7 randomized controlled trials supports a lack of effectiveness of secretin for the treatment of ASD symptoms including language and communication impairment, symptom severity, and cognitive and social skill deficits. No studies have resulted in significantly greater improvements in measures of language, cognition, or autistic symptoms when compared with placebo; study authors who reported improvement over time did so equally for both the intervention and placebo groups.
CONCLUSIONS: Secretin has been studied extensively in multiple randomized controlled trials, and there is clear evidence that it lacks benefit. The studies of secretin included in this review uniformly point to a lack of significant impact of secretin in the treatment of ASD symptoms. Given the high strength of evidence for a lack of effectiveness, secretin as a treatment approach for ASDs warrants no further study.

Here is the conclusion of the paper:

Previous studies have demonstrated that secretin is not effective for improving language, cognition, behavior, communication, autism symptom severity, or socialization skills. The strength of evidence for this lack of effectiveness is high. With 7 randomized controlled trials with fair- to good quality scores and 1 case series that contributes to this evidence base, future studies are unlikely to change the estimate of effect for this treatment. Further studies of secretin in children with ASDs are not warranted.

This is pretty strong: “Further studies of secretin in children with ASDs are not warranted”

The IACC’s commitment to environmental causation research

14 Apr

The Interagency Autism Coordinating Committee (IACC) met on Monday. I was unable to listen to much of it, although I did get to hear most of the presentation by Joseph Piven. His talk was about the Infant Brain Imaging Study:

Infant Brain Imaging Study (IBIS) Network

Joseph Piven, M.D.
Sarah Graham Kenan Professor of Psychiatry, Pediatrics, and Psychology
Director, Carolina Institute for Developmental Disabilities
Director, Neurodevelopmental Disorders Research Center
University of North Carolina at Chapel Hill

There are some very interesting results coming out on onset of brain overgrowth and timing of onset of autistic symptoms.

There was also, as you might imagine from the title of this post, some reference to environmental causation research. As in, promoting the notion that the IACC hasn’t and doesn’t support environmental causation research. This is far from the truth. Strangely, one doesn’t find news on the research going into environmental causation on the blogs which focus upon environmental causation. One can find it here, though. For example:

US plan for autism research: focus on environmental causation re-emphasized

US proposes $154M in new autism research projects

Poul Thorsen indicted

14 Apr

Poul Thorsen, a Danish scientist who worked on many subjects including autism prevalence, was indicted in the United States today, the Atlanta Business Chronical reports. The article, Dane indicted for defrauding CDC, notes:

A Danish man was indicted Wednesday on charges of wire fraud and money laundering for allegedly concocting a scheme to steal more than $1 million in autism research money from the Atlanta-based Centers for Disease Control and Prevention.

Poul Thorsen started his association with the CDC as a visiting researcher. Later he moved to Denmark and Aarhus University.

According to the news article, Mr. Thorsen was using his position to create fraudulent invoices, and got his university to pay funds into his personal accounts in the US.

Mr. Thorsen worked on many projects. Most pertinent to this blog are his group’s efforts on autism epidemiology. These include works on MMR vaccines and thimerosal (e.g. A population-based study of measles, mumps, and rubella vaccination and autism and Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data )

No charge has been made about the quality of these research projects or the conclusions drawn. However vaccine-causation advocates have been promoting the Thorsen case as part of their efforts.

Make no mistake: if guilty Poul Thorsen has committed very serious crimes. As a taxpayer, of course I am upset that this man might have stolen taxpayer money. As an autism parent, I can say without reservation that if found guilty Mr. Thorsen should be sentenced to the maximum sentence. The damage to the reputation of the research community which has sought to answer the questions of vaccine causation. A million dollars is a lot of money, but it is small change compared to the potential damage that might be caused .

Autistic community concerned about Robert MacNeil’s upcoming PBS special “Autism Today”

13 Apr

The PBS NewsHour has a series airing soon on autism. I’ve discussed this, including some reservations I have about the program, here on LeftBrainRightBrain. The Autsitic Self Advocacy Network (ASAN) has put out a press release about the upcoming program “PBS NewsHour Special “Autism Today” Leaves Out Key Stakeholders, Relies on Old Stereotypes”

PBS NewsHour Special “Autism Today” Leaves Out Key Stakeholders, Relies on Old Stereotypes

WASHINGTON, DC (April 11th, 2011) – In the midst of autism awareness month, early questions are emerging about next week’s PBS NewsHour six-part special about the autism spectrum. The highly promoted series – titled “Autism Today” – is generating controversy from an unexpected source: Autistic people themselves. Today, the Autistic Self Advocacy Network (ASAN) released a statement expressing concern over the failure of NewsHour co-founder and reporter Robert MacNeil to interview representatives of any organizations run by Autistic adults and the presence of concerning stereotypes about Autistic Americans in the promotional material.

“We are very concerned about the upcoming NewsHour special,” said ASAN President Ari Ne’eman, “While we will obviously be judging the final product when it airs, it appears from the promotional material that no Autistic-run organizations were interviewed or consulted during its creation – and that the series may rely on erroneous and offensive tropes claiming that Autistic people are violent, less than human and incapable of empathy.”

Early promotional material from PBS show that while MacNeil interviewed many parents, physicians and educators for the series, no organizations run by Autistic adults themselves were consulted or approached. In fact, no information exists as to whether or not Mr. MacNeil interviewed any Autistic people during his reporting about the autism spectrum.

“As an Autistic young adult, I am concerned about how this upcoming PBS series may misrepresent me and my disability,” said 17-year old Autistic high schooler Lydia Brown of Melrose, Massachusetts. “I want journalism that addresses the systemic problems behind the challenges I and other autistic people face instead of reporting that plays into the popular media’s misleading and harmful stereotypes about Autistic people.”

In an interview about the series on PBS.org, MacNeil stated his feeling that Autistic Americans lack “the most human thing we have, which is our ability to look into each others eyes and feel that other person’s existence and what might be going on in their mind, and to empathize with them.” Later during the interview, MacNeil made unsupported statements suggesting that Autistic adults are disproportionately and randomly violent as compared to the general population.

“We urge PBS to work with the Autistic community to review the series prior to airtime to correct any errors of fact or ethics,” said Ne’eman, “Furthermore, let me take this opportunity to invite Mr. MacNeil to meet with representatives from the community of Autistic adults. I think he’d find it very educational. It is our sincere hope that PBS does not exclude this perspective in future programming about the autism spectrum.”

The Autistic Self Advocacy Network (ASAN) is the nation’s leading advocacy organization run entirely by and for Autistic adults and youth. ASAN’s supporters include Autistic adults and youth, cross-disability advocates, family members, professionals, educators and friends. ASAN was created to provide support and services to individuals on the autism spectrum while working to change public perception and combat misinformation by educating communities about persons on the autism spectrum. The organization’s activities include public policy advocacy, community engagement to encourage inclusion and respect for neurodiversity, quality of life oriented research and the development of Autistic cultural activities and other opportunities for Autistic people to engage with others on the spectrum.

Alabama given permission to cut special education funding

13 Apr

We’ve discussed it before: some states are starting to ask for waivers from the federal government to allow for reductions in special education funding. From Al.com: Federal goverment to let Alabama cut spending for special education. Here’s the first few paragraphs:

WASHINGTON — Ala­bama is one of a handful of states given permission to cut spending on special ed­ucation this school year, a rare concession from Wash­ington for states facing se­vere shortfalls in their state budgets.

State education officials had asked to spend $9.2 mil­lion less on education pro­grams for disabled children than last year, a 1.45 percent drop.

In a response letter dated Thursday, federal education officials said they were will­ing to waive the insulation that special education pro­grams normally have from cutbacks because the reduc­tion was a fraction of the cuts made to the rest of the education budget.

Alabama reduced its over­all spending on education by 8.41 percent in the 2010-11 fiscal year — 8.46 percent in elementary and secondary education.

The federal governement will give the same amount to Alabama for special education:

If the waiver had been rejected, Washington would have reduced the amount of money it sends to Alabama for special education next year by $9.2 million. Washington said it expects Alabama to spend about $635 million on special education in the 2011-12 year, which would have been the budget before the waiver was granted.

Best image from an iPad-autism blog post

12 Apr

If you don’t regularly read the Liv’s Journey blog, it’s well worth taking a look. The blog has some great insights and a great sense of humor. Case in point: The Case FOR iPads Being a Miracle Device for Children with Autism. Posted in response to a post here on LeftBrainRightBrain: Wired: iPads Are Not a Miracle for Children With Autism, it takes a long look at the iPad. What made me snort aloud what this graphic:

I don’t know if he lifted it from someplace or created it himself (I didn’t find it with a quick google search). But it shows the humor of the blog. The real meat is in the actual posts, which are very well thought out and presented.

Reassessing the role of mitochondrial DNA mutations in autism spectrum disorder.

12 Apr

Autism and mitochondrial medicine have become a very hot topic in recent years. What the connections are between autism and mitochondrial disorders has yet to be clarified. Mitochondria are little structures within cells that produce much of the energy required. Mitochondria have their own DNA (mtDNA) in addition to the nuclear DNA (nDNA) of the cell. nDNA is what most people think of when we hear “genes” or DNA. Given the focus on mitochondrial dysfunction and autism, it is natural to consider the question: are there mutations in the mtDNA which increase the risk of autism?

A new paper takes a look at the question. They studied 148 patients with ASD and found, well, no support for a link to mtDNA mutations. Here is the abstract:

BMC Med Genet. 2011 Apr 6;12(1):50. [Epub ahead of print]
Reassessing the role of mitochondrial DNA mutations in autism spectrum disorder.
Alvarez-Iglesias V, Mosquera-Miguel A, Cusco I, Carracedo A, Perez-Jurado LA, Salas A.
Abstract
ABSTRACT:
BACKGROUND: There is increasing evidence that impairment of mitochondrial energy metabolism plays an important role in the pathophysiology of autism spectrum disorders (ASD; OMIM number: 209850). A significant proportion of ASD cases display biochemical alterations suggestive of mitochondrial dysfunction and several studies have reported that mutations in the mitochondrial DNA (mtDNA) molecule could be involved in the disease phenotype.

METHODS: We analysed a cohort of 148 patients with idiopathic ASD for a number of mutations proposed in the literature as pathogenic in ASD. We also carried out a case control association study for the most common European haplogroups (hgs) and their diagnostic single nucleotide polymorphisms (SNPs) by comparing cases with 753 healthy and ethnically matched controls.

RESULTS: We did not find statistical support for an association between mtDNA mutations or polymorphisms and ASD.

CONCLUSIONS: Our results are compatible with the idea that mtDNA mutations are not a relevant cause of ASD and the frequent observation of concomitant mitochondrial dysfunction and ASD could be due to nuclear factors influencing mitochondrion functions or to a more complex interplay between the nucleus and the mitochondrion/mtDNA.

PMID: 21470425 [PubMed – as supplied by publisher]Free Article

This is consistent with previous studies, as noted in a recent review article which was itself summarized at The Thinking Person’s Guide to Autism by Emily Willingham as Mitochondrial Disease and Autism: Linked?

Ms. Willingham noted there:

Thus, tracking down mitochondrial dysfunction in the context of ASD to a specific mutation has remained an elusive goal. Two scenarios are likely for this lack of mutational findings: (1) there are mutations, but we just haven’t found them yet; or (2) the environment is largely responsible for any mitochondrial dysfunction that abnormal marker levels might indicate.

This paper is available as a free manuscript online. Here is the

Although it is widely accepted that some forms of ASD appear concomitantly with the impairment of mitochondrial energy metabolism, there are reasons to believe that the cause of these mitochondrial disorders does not systematically rest on mutations or variants in the mtDNA molecule. Pathogenic mtDNA mutations have been reported in ASD patients, but this seems to be the exception rather than the rule. It is more likely that the real causes of mitochondrial deficiencies in some ASD cases are due to the intervention of several nuclear factors acting alone (additively or epistatically) or through a complex interplay with mtDNA variants. For the time being, while the cause for mitochondrion dysfunction in ASD remains unclear, there is no reason to indicate systematic screening for mtDNA mutations in ASD patients unless a mitochondrion disorder is suggested by a clear phenotype.

What is also interesting to me is the table of characteristics of the study subjects. In particular, there is a big difference in the percentage with epilepsy and dimorphism between adults and children:

Mitochondrial dysfunction is listed as mild and somewhat infrequent (about 10%). Not the very high prevalences of mitochondrial dysfunction that some have suggested are present in autitics. This does beg the question: should this genetic study be performed on those with some measure of mitochondrial dysfunction?

This doesn’t mean that mitochondrial dysfunction isn’t an important area for autism research, or that a genetic study such as this shouldn’t be done on a larger group with some measure of mitochondrial dysfunction.

Of course it would be great to hear that there is something definitive in this study. As in, “this is it!” rather than “this probably isn’t it”. Mitochondrial DNA mutations “probably isn’t it” when it comes to the etiology of ASD in most people.

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