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A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population

8 Jun

A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population is the latest in a long series of studies purporting to show a link between vaccines and the rise in autism prevalence. Like many of these studies, this one has major flaws. There was a time when I would take the effort to go through such studies in detail. There is enough bad in this one to take so long that I just can’t see taking the effort.

They claim that for every 1% increase in vaccination (defined in a very strange way, as you will see) their study shows that the autism rate (defined in an even stranger way) rises 1.7%.

Look at the title again: A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population

But, strangely enough, the author doesn’t study autism prevalence. Seriously. The author studies “To determine autism prevalence by U.S. state, the number of 8-year old students classified with either (1) autism or (2) speech or language impairments (speech disorders) was divided by the total number of 8-year-olds in the state.”. Yep, the author lumps autism with SLI. Consider, say, California in 2002 (one of the study years). There were 1,664 8-year-old students receiving services under the disability category “autism”. On the other hand, there were 22,702 8-year-old students in the SLI category. The autism data are basically swamped by the SLI data. Begs the question: what did the analysis show for autism alone? Could it have shown a protective effect of vaccination. Don’t get me wrong, the study isn’t strong enough to show a real association one way or another, but you really got to ask yourself why the author chose to bury autism this way.

In case you are wondering, the autism+SLI “prevalence” for California was about 5% for 8 year olds/3rd graders in 2001 (using 488.633 3rd graders)

Here is the abstract:

The reason for the rapid rise of autism in the United States that began in the 1990s is a mystery. Although individuals probably have a genetic predisposition to develop autism, researchers suspect that one or more environmental triggers are also needed. One of those triggers might be the battery of vaccinations that young children receive. Using regression analysis and controlling for family income and ethnicity, the relationship between the proportion of children who received the recommended vaccines by age 2 years and the prevalence of autism (AUT) or speech or language impairment (SLI) in each U.S. state from 2001 and 2007 was determined. A positive and statistically significant relationship was found: The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of AUT or SLI. A 1% increase in vaccination was associated with an additional 680 children having AUT or SLI. Neither parental behavior nor access to care affected the results, since vaccination proportions were not significantly related (statistically) to any other disability or to the number of pediatricians in a U.S. state. The results suggest that although mercury has been removed from many vaccines, other culprits may link vaccines to autism. Further study into the relationship between vaccines and autism is warranted.

Here are a few more important points from the paper:

1) They use the “prevalence” of autism or SLI from special education numbers. These data are just not reliable for this sort of work. This has been gone over and over. The best discussion of this is from Jim Laidler in 2005. US Department of Education Data on “Autism” Are Not Reliable for Tracking Autism Prevalence

2) Note that they use cohorts from the mid 1990’s, soon after autism was first added as a special education category. They are pretty much guaranteed that the “prevalence” they calculate will go up.

All they need is to link this to changes in the vaccine uptake. Easily done. The vaccine uptake rate is changing dramatically during the first couple years of the study. For example, Alabama goes from 46 to 76% in two years. Why is that? That brings us to point (3):

3) Here’s a trick bit: the author uses the vaccine schedule from 1995. A brand new vaccine schedule was rolled out and states and pediatricians picked it up over the next couple of years. Of course the vaccine uptake, by this measure, was low at the start.

Yes, they chose a very artificial measure of “vaccine rate” to insure that they had big changes in the “rate” during the study period.

How often do we hear SafeMinds (the author is a member by the way) ask “where’s the study of the vaccinated vs. unvaccinated?” Even when they have the data, they don’t do the comparison. They compare children who got the full 1995 schedule of vaccines vs. children who didn’t (missing one or more vaccines). My guess is there isn’t enough non-vaccinated data to make the study. But, that doesn’t explain why they went ahead with this really bad study.

How about a “too many too soon” study, comparing the total number of vaccines vs. autism rate? Again, not done in this study.

Of course the author is aware of the vaccinated/unvaccinated question. A few quotes from the paper:

A child who missed only one shot was different from a child who was completely unvaccinated, yet in this study both children were classified as not fully vaccinated.

and

A child who received all but 1 vaccination on time might be different from a child who received no vaccinations, yet both were in the group of children who did not receive timely vaccinations. Had the researchers examined fully vaccinated versus completely unvaccinated children, the results might have been different.

and

A follow-up study could investigate the prevalence of autism among unvaccinated children. Other children who typically are not vaccinated could be surveyed. These groups include the Amish and children served by Homefirst, a health clinic near Chicago (Eisenstein, 2009), as well as some homeschooled children or younger siblings of children with autism whose parents decided not to vaccinate.

“Eisenstien, 2009” is a link to the HomeFirst website, which includes unsupported claims. What is the point of a citation to an unsupported claim? For example, in the cited link, Dr. Eisenstein makes the unsupported claim:

“Since 1973, The Homefirst physicians have been offering vaccine choice and awareness Unlike most doctors, the Physicians of Homefirst are honored to serve your family if you give all some or none of the vaccines.

They have virtually no asthma, allergies, ADHD, ADD or Autism in their more then 35,000 un-vaccinated children. “

Where’s the data on how many of their patients have ADD, autism, or the other conditions? Also, I’ve seen the quoted number of “unvaccinated” at Homefirst vary through a very large range.

But back to the actual paper. What does the study claim as a result?

The results suggest that if a given U.S. state has a 1% higher vaccination rate than another U.S. state, then the state with the higher vaccination rate might have, on average, a 1.7% higher prevalence of autism or speech disorders.

Remember, this is using the strange definition of “vaccination rate” is how many children got the full series vs. how many missed any one or more vaccines.

Here you can see their data. Yes, “vaccination rates” and “autism or SLI rates” both go up with time. But it is how they go up that show us how bad this study is:

Take a close look at the vaccination rates for the first two years. That’s when there are the big increases. This is expected because, again, they measuring vaccination rates as the percentage of kids who got the full 1995 schedule, and they start in 1995 when the schedule was just introduced.

The autism/SLI rate, on the other hand, shows a slower, more steady increase (ignoring the noise).

Take a look at table 1. again. Take a look at the first couple of years in, for example, Alabama. The vaccination rate they quote increased from 46% (1995) to 65% (1996), rising again the next year to 76.5% (1997). What did the autism+SLI rate do? It went down.

Recall the result:

Further, if a given U.S. state decreases its vaccination coverage by 1% from one year to the next, prevalence of autism or speech disorders may, on average, fall by 1.7%. If 100% children received this series of vaccinations, the prevalence of autism or speech disorders would be 1.7%

Since the “vaccination rate” went up 20 points (from 46% to 65%), we would expect autism/SLI to go up a lot too: 0.34%, from 4.6% to 4.92%. You can see the same sort of trends in the first two years state by state–big increases in the vaccination rates, small or negative changes in the autism/SLI rates.

It’s only after many years go by that there are notable changes in the autism/SLI rates. Even then it isn’t consistent. Again, look at Alabama. Over the entire study period, the autism/SLI rate went down. Same for the next state on the list, Alaska.

The next state on the list (yes, it’s alphabetical) is one of the “winners” in the study. Autism/SLI rates went up notably over the study period, from 3.8 to 6.2%. But, strangely enough (if you believe the author that is) this didn’t happen for the cohorts which saw the big increases in vaccine rates. A big jump in autism/SLI rate is seen for the last year (a 0.8% jump), but this is for years when the change in vaccination rates was relatively modest.

To put it simply, the result of the study just doesn’t make sense given the data that we (and the referees who cleared this paper) can plainly see. This is a prime example of exactly the sort of paper that really has shown over the years the sort of intellectual dishonesty which has promoted the vaccine-epidemic notion.

Autism vs Symptoms of Autism Part II

25 May

If this is the case it is rather hard to see what we are arguing about. With all the semantic ingenuity in the world children on the autistic spectrum are surely autistic and so are children who have autistic behaviour.

So states John Stone on Age of Autism.

Its meant to point out to us the linguistic convolutions some people go to in order to seperate people who have autism and people who display autistic symptoms. We’re meant to roll our eyes on this stupidity.

But I can’t. Because its not stupid. Because there _is_ a difference between having enough of the symptoms to qualify for a diagnosis of autism and _not_ having enough of the symptoms of autism to qualify for a diagnosis of autism. In one scenario a person has autism as medically defined. In the other scenario, they don’t.

Far from John Stones ‘semantic ingenuity’, what we are in fact talking about is ‘semantic precision’. Lots of people display some of the symptoms of autism yet simply don’t have enough to get a diagnosis. This phenomenom has even got a name: Broader Autism Phenotype. In a paper from as long ago as 1997, the authors states:

Studies of families ascertained through a single autistic proband suggest that the genetic liability for autism may be expressed in nonautistic relatives in a phenotype that is milder but qualitatively similar to the defining features of autism.

Note the use of the word qualitatively there. In that, people with enough symptoms have autism share qualities with those who don’t.

Autism has a long and painful history of being sculpted into a set of beliefs that reflect the position of the believer rather than the objective truth of the matter. The thing is, we _have_ an objective (if medical) truth on the matter, its set down in the DSM or the ICD, pick your poison. John Stone is merely the latest in a long line of people who want autistic people to be ambiguous enough to reflect their beliefs. However, by its very definition, you cannot _be_ autistic (again medically speaking) if you don’t meet the criteria, or even _enough_ of the criteria.

I see nothing of semantic igenuity in this. Stone is, of course, attempting to whip up support for the latest terrible study – this one legal – that claims to have found 83 people compensated for autism via vaccine injury. When you apply John Stone et al’s loose, ambiguous definition of what autism medically is then they’re quite right. Thing is, I suspect I, John Stone and various others could all show _some_ symptoms of autism. Much trickier is to display _enough_ symptoms of autism to be diagnosed as autistic. Something I think about 1% of these 83 were. In other words, no different in amount than the rest of any other population.

David Geier ousted from autism commission

24 May

O’Malley ousts David Geier from autism commission is an article at the Baltimore Sun.

Appointee, who works at father’s practice that offers controversial autism treatment, charged with practicing without a license

Gov. Martin O’Malley removed David A. Geier from Maryland’s Commission on Autism on Friday, telling his one-time appointee in a letter that “you do not at the present time qualify to serve.”

O’Malley told Geier, who has only a bachelor’s degree, that he does not qualify under Maryland law to serve as a “diagnostician,” the title he held on the advisory commission. The governor also cited charges brought against him this week by the Maryland Board of Physicians.

More at the Baltimore Sun, including:

“I regret that you were not willing to withdraw from the Commission and that this action is therefore necessary,” the governor said.

Yes. He was asked to leave. He didn’t. Now he’s being told.

David Geier is part of the father/son team which has promoted the “Lupron protocol” as a therapy for autism. The idea was incredible (as in, not credible) from the start. Their practice appears to have been using false diagnoses of precocious puberty in order to apply Lupron, a drug which shuts down sex hormone production.

Personally, I find it very strange that David Geier was placed on the autism commission to begin with. He clearly lacks expertise or connection to the community (other than financially, of course). This is before one factors in the facts that his entire model of autism is wrong from the word go.

AutismOne, potentially the largest parent-convention promoting the bad science of the Geiers and others starts on the 25th (the day after this post goes live). Mark and David Geier are scheduled to speak. One could hope that AutismOne would pull these speakers. Instead, 2 days ago, they posted a new interview. Complete with the message:

“These top researchers are at the forefront of helping to treat the “Tough Cases”. The symptomology of Precoscious Puberty and its safe treatment for ASD.”

“Top Researcher”

“At the forefront”

“symptomology of precocious puberty”

This is a team that has been charged with serious ethical violations, including the misdiangosis of the “symptomology of precocious puberty”. This is a team which has failed time and again to produce quality research.

But, this is a team which promotes the vaccines-cause-autism hypothesis.

Safety of disable children apparently comes second to ideology for Autism One.

Sorry to have dropped my usual rather dry reporting, but this is just plain wrong. But, these are the people who gave Andrew Wakefield an award after he was found guilty of multiple ethics violations. What can we expect?

Study by NYU and PACE: another failure in obtaining ethical approval?

20 May

One issue that has come up more than once in autism research is the failure to obtain ethical approval for human studies research. Andrew Wakefield started his studies on autistic children before the Royal Free Hospital granted ethical approval. Mark and David Geier failed to obtain Institutional Review Board (IRB) approval before starting one of their studies. According to an article on neurodiversity.com:

None of the IRB members have declared expertise in the field of pediatric endocrinology. Whereas the IRB was registered in March 2006, the research described in the article was conducted between November 2004 and November 2005.

Not only did none of the members of the IRB have expertise in the field, the IRB included the researchers (Mark and David Geier), the mother of one of the children on the “Lupron protocol”, an attorney specializing in vaccine injury, and Anne Geier (wife to Mark, father to David).

Apparently following in these footsteps are the team who recently brought us a study purporting to show a high prevalence of autism amongst children compensated by the vaccine court (for more on this, see 2 ½ Studies: Autism Prevalence and the “Hidden Horde”). The vaccine-court study author list is Mary Holland, NYU School of Law, Louis Conte, Robert Krakow, and Lisa Colin. The study was published in the PACE Environmental Law Review. Further, “Pace Law School provided significant research support for this study” as noted in the footnotes of the paper:

* Mary Holland, Research Scholar and Director of the Graduate Legal Skills Program, NYU School of Law; Louis Conte, independent investigator; and Robert Krakow and Lisa Colin, attorneys in private practice. Pace Law School provided significant research support for this study. The authors thank former Environmental Law Dean Alexandra Dunn and law students Jillian Petrera, Kyle Caffrey, Sohad Jamal, Alison Kaplan, Georgine Bells, Jonne Ronquillo, Lisa Hatem, Allison Kazi and Adrienne Fortin. The authors also thank volunteers who worked under the direction of Louis Conte. For purposes of disclosure, Robert Krakow and Lisa Colin represent clients and have claims on behalf of family members in the Vaccine Injury Compensation Program.

Ken Reibel, journalist and proprietor of Autism News Beat has an article published today: Unanswered Questions from Pace Law journal study: Ethical Standards for Research on Human Subjects. He poses some very important questions:

1) Does the study methods meet the standards of “human subject” research?
2) Did NYU or PACE (or anyone else) obtain IRB approval?

The answers appear to be yes to the first, no to the second.

From Autism News Beat:

“Human subject” is defined by the DHHS as “a living individual about whom an investigator (whether professional or student) conducting research obtains data through intervention or interaction with the individual, or identifiable private information.”

and,

When asked if the Pace study had IRB approval, Pace Law spokesperson Lauren Rubenstein referred the question to the study’s co-author, Louis Conte. In an email, Rubenstein wrote “Louis Conte has told me that there was no human subjects research in this study.”

Which I interpret to mean that they don’t have IRB approval as they don’t believe they require it. My read is that, yes, they did require IRB approval.

It will be interesting to see what, if anything, comes of this. Will PACE and NYU investigate and let the public know if their people went ahead with human subject research without IRB approval?

For more details: Unanswered Questions from Pace Law journal study: Ethical Standards for Research on Human Subjects

Maryland Authorities Charge “Lupron Protocol” Promoters With Unprofessional Conduct, Unlicensed Practice of Medicine

20 May

The father-son team of Mark and David Geier have been charged with violations of medical practice. Mark Geier is a physician and his son, David, holds a bachelor of arts degree. Maryland Authorities Charge “Lupron Protocol” Promoters With Unprofessional Conduct, Unlicensed Practice of Medicine is the most recent post by Kathleen Seidel of Neurodiversity.com. This follows the suspension of Dr. Mark Geier (Maryland Medical Board Suspends Dr. Mark Geier’s License).

Ms. Seidel’s post follows her practice of a very thorough, well linked discussion of the topic. Here is her first paragraph (without links):

On Monday, May 16, 2011, the Maryland Board of Physicians charged Dr. Mark Geier with numerous violations of the Maryland Medical Practice Act, and charged his son, David Geier, with practicing medicine without a license. The charges come three weeks after the Board summarily suspended Dr. Geier’s license to practice medicine, in order to prevent harm to the many autistic children entrusted to his care. The suspension was upheld by a subsequent order issued by the Board on May 12, one day after a hearing at which Dr. Geier protested the suspension and submitted affidavits of support from the parents of seven of his patients. These included a statement from James B. Adams, Ph.D., a professor of engineering at Arizona State University who, like Dr. and Mr. Geier, has frequently exceeded the bounds of his academic specialty to conduct medical research premised on the discredited hypothesis that autism is a consequence of vaccine injury.

It is well worth the time to read the entire post: Maryland Authorities Charge “Lupron Protocol” Promoters With Unprofessional Conduct, Unlicensed Practice of Medicine

Childhood Vaccinations and ASD: No Relationship Between Number or Schedule of Vaccinations and Diagnostic Outcome or Severity

13 May

The International Meeting For Autism Research will be held in May. Abstracts for the conference are public now. One search that will be common amongst the online parent community is to see what research has been done on the question of vaccine causation.

Here is an abstract looking directly at the question. They compared siblings of autistics, children at risk for developmental delays and children expected to develop typically. They found–no evidence of increased risk from vaccination:

A. Margolis1, J. D. Jones2, A. Trubanova2, W. Jones2, K. Chawarska3 and A. Klin2, (1)Yale Child Study Center, Yale University School of Medicine, New Haven, CT, (2)Marcus Autism Center, Children’s Healthcare of Atlanta & Emory School of Medicine, Atlanta, GA, (3)Child Study Center, Yale University School of Medicine, New Haven, CT
Background: Recent increases in the number of recommended childhood vaccines have raised public concerns about the potential side effects of immunizations on children’s health. Because of the increasing prevalence of autism diagnoses over the last 15 years, this disorder, in particular, has become the focus of much of the attention and concern surrounding childhood vaccines. As a consequence of this debate, the use of childhood vaccines, especially the measles-mumps-rubella vaccine (MMR), has decreased significantly, and this decrease has led to numerous outbreaks in diseases previously prevented by vaccines. Furthermore, research addressing the relationship between vaccines and autism has relied primarily on retrospective population studies, with little power to determine the role of immunizations in individual outcomes.

Objectives: The primary goal of this study is to examine the relationship between the frequency and number of childhood immunizations and the subsequent likelihood of developing autism. In addition, this study aims to investigate the relationship between childhood vaccines and disorder severity in children who do go on to develop autism.

Methods: Immunization data were collected for 91 children divided among the following three groups: (1) siblings of children with an autism spectrum disorder diagnosis, (N =48; gender = 37M); (2) children at risk for developmental delays (N = 7; gender = 5M); and (3) children expected to develop typically (N = 36; gender = 19M). All children were at least 2 years of age when their immunization records were collected. Individual immunization data were recorded and then compared with diagnostic outcome and behavioral data.

Results: Tests of association and linear multiple regressions revealed that neither a greater number of childhood vaccines nor a higher rate of vaccination had a positive relationship with subsequent autism spectrum diagnosis (N=8; gender=7M) or disorder severity, which was assessed in all participants. In addition, comparison of immunization data to behavioral indicators at 2 years of age did not reveal any relationship between either higher frequency or greater number of childhood vaccines and subsequent negative behavioral outcomes. Likewise, neither vaccination with MMR nor the age of MMR vaccination was significantly related to outcome. Instead, because siblings of children with autism were less likely to be vaccinated according to the recommended schedule, both correlations and multiple regressions revealed a significant relationship between higher rates of vaccination and non-ASD behavioral outcomes.

Conclusions: These results suggest that childhood vaccines do not increase children’s risk of developing autism and do not exacerbate the disorder severity in children who are later diagnosed with autism. Children who receive a greater number of vaccines overall, who receive the MMR vaccine, or who receive immunizations at a higher rate, do not differ significantly on subsequent behavioral measures from children who receive vaccines on an alternative schedule or children who do not receive vaccines. Instead, the results of this study emphasize heritability in risk for autism, and also indicate that siblings of children with an autism diagnosis are less likely to be vaccinated, which actually increases their risk for contracting other illnesses.

Here’s an observation that has often been predicted: ” Instead, because siblings of children with autism were less likely to be vaccinated according to the recommended schedule, both correlations and multiple regressions revealed a significant relationship between higher rates of vaccination and non-ASD behavioral outcomes.” I believe this very point has been predicted by blogger Prometheus a number of times.

The study is relatively small in my opinion. With 91 participants, the number of autistics is likely small. Also, this will focus on familial autism. There may very well be a difference between the types of autism which run in families and that which is more sporadic.

Note–I originally posted this in April when the abstracts were first put online. They were online in error, as there was an embargo in place. The post was taken down at that time and I’ve now made it live again since the embargo is lifted.

So what do parents really think causes autism?

12 May

According to the MIND institute, presenting at IMFAR:

The two most common causes of autism cited among all parents was an environmental cause (51%) and/or a genetic cause (51%). Vaccines (22%) were the third most commonly believed etiological factor, followed by 20% of parents who did not know or have a guess as to what may cause autism.

This is an interesting set of results to me. I’m frequently told that the overwhelming majority of parents believe vaccines cause autism. Turns out less than a quarter do.

Also of interest was the following statement:

Vaccines are commonly cited as a cause by parents in all ethnic groups despite a clear lack of scientific evidence demonstrating a relationship between autism and either the measles, mumps, rubella (MMR) vaccine, or thimerosal containing vaccines

Wasn’t that long ago that autism anti-vaxxer supermo Rick Rollens was basically in charge of MIND. How times have changed.

PACE study confirms autism prevalence

11 May

The legal study published by anti-vaxxers and law students yesterday claims that 80 cases show definite autism. If we accept that as true (which I don’t, but there we go) this is an autism prevalence amongst the population of claimants of just over 3%. As we all know, a recent study puts the Korean prevalence as just under 3%. Close enough on behalf of the legal claims, when we allow for their dodgy definitions to be a match.

Or maybe we can be a little more exact. As Kim Wombles noted yesterday, 39 cases confirmed beyond parental anecdote equals a prevalence of 1.5%. Half a percentage over the UK official prevalence.

So what does this mean? It basically means that all things being equal, whichever prevalence figures you like to use (Korean or UK), this law study shows that amongst the population of claimants, there are no more autistic people than one would expect.

But surely, what we should be looking at is if vaccines caused autism in these cases?

OK, lets do that (thanks to Sullivan for spotting these):

From the paper:

[R]espondent’s report. . .suggests vaguely. . .that Kenny’s problems ‘can be attributed in part to other causes such as a family history of epilepsy, autism and tonsillar hypotrophy. . .Dr. Spiro did not even purport to know what did cause Kenny’s seizure disorder;? his basic point was that in his view the DTP did not cause it.”

From the case notes:

In this regard, respondent’s report (filed September 7, 1990) suggests vaguely (p. 5) that Kenny’s problems “can be attributed in part to other causes such as a family history [*18] of epilepsy, autism and tonsillar hypotrophy.” But in the attached expert report, upon which respondent based that assertion, Dr. Spiro candidly admitted (p. 2) that he can only “speculate” as to such possibilities. And certainly at the hearing, Dr. Spiro did not even purport to know what did cause Kenny’s seizure disorder; his basic point was that in his view the DTP did not cause it.

While Dr. Kaufhold notes Dr. Schmidt’s initial impression of infantile autism, she does not list autism among her impressions, but rather says Travis is significantly developmentally delayed to a degree not yet ascertained. Other medical personnel appear to use the term “autism” or “autistic” synonymously with “aphasia” or the absence of the ability
to speak. See, e.g., Pet. Ex. 7 at 148; Pet. Ex. 7 at 208; Pet. Ex. 7 at 393.

Here is an interesting statement:

While Dr. Schultz believes that Travis suffers from some autistic-like features, he does not now nor has he ever believed that Travis suffers from true autism.

In this case, Dr. Schultz is the doctor of the petitioner: Travis Underwood. Travis is child 7 in the PACE table. Here is how Holland et al. quoted that decision:

“In addition, respondent noted that Travis’ medical records indicate that he suffered from mental retardation and autism. These conditions, according to respondent, are not related to the residual seizure disorder.”

Dr. Schultz also said:

Moreover, Dr. Schultz testified that Travis is distinguishable from children with true autism because he (1) seeks affection; (2) makes eye contact; (3) doesn’t require sameness in routine as usually found with autistic children; and (4) doesn’t engage in twirling, flinging and other self-stimulatory behaviors to the same degree as autistic children.

So, next time someone tells you ‘autistic-like’ features or ‘features of autism’ are the same things as autism, tell them to look at the cases in question.

When the science fails you, turn to the legal option

10 May

A news conference today will confirm that autism/anti-vaccine groups have lost the scientific battle for the idea that vaccines cause autism as they turn to the legal battle instead.

…a new report in a New York law school journal, the Pace Environmental Law Review, could reignite the often-inflammatory debate over the issue. Based on a sampling of cases in which plaintiffs won settlements or awards in vaccine court, the authors found that many of the victims demonstrated evidence of autism – even though, perhaps as a legal tactic, their lawsuits emphasized other injuries.

Readers of this site might be forgiven for looking and yawning – here we go again. This is nothing but re-hash of already discussed material. But lets look at the main claim of this issue:

Of the 170 cases the report’s authors examined, 32, or 19 percent, provided documented evidence of autism or autism-like symptoms. The evidence in some cases included findings by the court that the children had autism, “autism-like symptoms” or “symptoms and behavior consistent with autism.” In other situations, third-party medical, educational or other court records confirmed an autistic disorder.

The report – at least in this news story – doesn’t seem to mention how many children were compensated for having autism. As we all kow ‘autism like symptoms’ or ‘symptoms and behavior consistent with autism.’ might be just that – but they are not autism. If they were I’m sure the court would’ve reported it.

And thats not all. Nobody seems to be giving an estimate for how many of these kids actual autism (not autism-like symptoms etc) was actually caused by an actual vaccine.

And thats *still* not all. One of the most problematic issues for this new ‘line of attack’ is this.

Daubert. This is the standard of science that should be used in legal cases. When Daubert is applied, the bottom line is that the best science must be applied. In _none_ of these cases was Daubert applied. In fact, in only one instance was Daubert applied – the Autism Omnibus hearings. And as we all know, they failed.

So here we have a fairly desperate roll of the dice. Eschewing science completely, the autism/anti-vaxxers have decided to turn their attention to the law. By muddying the legal waters, they are attempting to make it appear as if autism by any other name has been compensated in at least 19% of the cases they looked at.

The truth is, it hasn’t. The truth is that in no cases I can see has a case been established scientifically to show vaccines cause autism.

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.

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