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A bad day for antivaccinationists: Yet another study fails to support an association between vaccines and neurodevelopmental disorders

30 Sep

This blog entry first appeared at Respectful Insolence. It is reproduced here with permission.

A bad day for antivaccinationists: Yet another study fails to support an association between vaccines and neurodevelopmental disorders
By Orac.

I’m almost beginning to feel sorry for the mercury militia.

Think about it. They’ve been claiming for the past several years that the mercury in the thimerosal used as a preservative in childhood vaccines is a cause of autism. If you believe Generation Rescue, A-CHAMP, SAFEMINDS, and various other activist groups, vaccines are the root of all neurodevelopmental evil, culminating in what to them seems to be the most evil of evil condition, autism. Yet, in study after study in the new millennium, no correlation has been found to implicated their favorite bte noire thimerosal, which serves as a surrogate for their general dislike of vaccines in general.

It comes as no surprise, then, that A-CHAMP would want to launch a pre-emptive strike against a large study of thimerosal-containing vaccines that was published in the New England Journal of Medicine today. Blazing out of their website is the headline New CDC Study Falsely Claims Thimerosal is Safe

On September 27, 2007 the New England Journal of Medicine will publish a study entitled, “Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years.” For more than two years we at A-CHAMP have been hearing rumors of a new study that “exonerates” thimerosal, despite the fact that the study results were supposed to be kept strictly confidential.

Now the rumors have been turned into hype – another government funded study that tries to spin data and clear thimerosal of any suspicion of causing neurodevelopmental disorders. The study authors claim in their “Conclusions” that “[o]ur study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and neuropsychological functioning at the age of 7 to 10 years.”

The statement is plainly false. The study’s conclusions do not reflect the study’s data or the limitations of the study,

You’d think that at least A-CHAMP would correct that hanging comma at the end of the sentence there.

Sarcasm aside, the study’s conclusions do reflect the study’s data, quite well, as we will see, and A=CHAMP’s complaints boil down to the usual crank technique of cherry picking the evidence, combined perhaps with sour grapes. Let’s lay the abstract out for all to see before we look at A-CHAMP’s individual points:

Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years
William W. Thompson, Ph.D., Cristofer Price, Sc.M., Barbara Goodson, Ph.D., David K. Shay, M.D., M.P.H., Patti Benson, M.P.H., Virginia L. Hinrichsen, M.S., M.P.H., Edwin Lewis, M.P.H., Eileen Eriksen, M.P.H., Paula Ray, M.P.H., S. Michael Marcy, M.D., John Dunn, M.D., M.P.H., Lisa A. Jackson, M.D., M.P.H., Tracy A. Lieu, M.D., M.P.H., Steve Black, M.D., Gerrie Stewart, M.A., Eric S. Weintraub, M.P.H., Robert L. Davis, M.D., M.P.H., Frank DeStefano, M.D., M.P.H., for the Vaccine Safety Datalink Team

Background It has been hypothesized that early exposure to thimerosal, a mercury-containing preservative used in vaccines and immune globulin preparations, is associated with neuropsychological deficits in children.

Methods We enrolled 1047 children between the ages of 7 and 10 years and administered standardized tests assessing 42 neuropsychological outcomes. (We did not assess autism-spectrum disorders.) Exposure to mercury from thimerosal was determined from computerized immunization records, medical records, personal immunization records, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. We assessed the association between current neuropsychological performance and exposure to mercury during the prenatal period, the neonatal period (birth to 28 days), and the first 7 months of life.

Results Among the 42 neuropsychological outcomes, we detected only a few significant associations with exposure to mercury from thimerosal. The detected associations were small and almost equally divided between positive and negative effects. Higher prenatal mercury exposure was associated with better performance on one measure of language and poorer performance on one measure of attention and executive functioning. Increasing levels of mercury exposure from birth to 7 months were associated with better performance on one measure of fine motor coordination and on one measure of attention and executive functioning. Increasing mercury exposure from birth to 28 days was associated with poorer performance on one measure of speech articulation and better performance on one measure of fine motor coordination.

Conclusions Our 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.

It’s noted that a similar study looking at autism will be published next year. Of course, the fact that this study didn’t look at autism leaves the antivaxers a huge opening to say, “Well, yes, but you didn’t look at autism.” Never mind that there are now several studies that did look at autism and found no association between thimerosal-containing vaccines and autism. So what are the main complaints that A-CHAMP has about this study? Let’s take a look, starting with the first one:

The Study’s Claim of No Causality is Contrary to the Study’s Data. The study authors claim that the data disproves causality when in fact, several findings show a negative effect on neuropsychological functioning warranting more study. At least one such adverse association was also found to be associated with low dose thimerosal exposure in other studies. As with earlier studies hyped by vaccine promoters, the study is unable to prove or disprove causality. The blanket dismissal of the troubling neuropsychological outcomes in this study is disingenuous and misleading.

First off, the study didn’t claim that there was “no causality.” What it stated is exactly what you see in the Conclusions section: That the study does not support a causal relationship. There’s a difference there too subtle for the ideologues who wrote this press release to understand. It’s impossible ever to prove “no causality.” It is, however, possible to conclude from the data that the data does not support a causal relationship. Second, A-CHAMP is cherry picking associations here. It is true that there were some negative correlations found that achieved statistical significance. When running 42 tests, it would be shocking if there were not a few anomalous findings. What makes the study authors fairly confident that the findings are anomalous is that they were divided roughly equally in both directions, good and bad. Consequently, if A-CHAMP is going to insist that the correlation, for example, with increasing mercury exposure and poorer performance on the GFTA-2 measure of speech articulation test, then it must also accept the findings of a beneficial association between mercury and identification of letters and numbers on the WJ-III test, as there is no reason to reject it. Naturally, the mercury militia picks on the associations as being true that they want to be true and ignore the other associations, which, if true, would be arguments for including thimerosal in vaccines. It’s far more likely that all of them are just noise. Again, the reason that investigators can reasonably conclude that the associations found are most likely due to random chance is because of their random distribution between positive and negative.

Another complaint:

Children with autism were excluded from this study. The early media contacts we have received suggest that this study shows no association between thimerosal and autism. In fact, the study specifically did not look at children with autism as the sample size was too small and the testing is impossible to complete for the typical child with autism. The exclusion of children with autism from the study may have undermined the power of the study to draw any conclusions about thimerosal.

This is a really, really dumb statement. I’m sorry, but there’s no other way to put it. It just is. It’s like criticizing an apple for not being an orange. The explanation for this is right in the paper, “Since the CDC is conducting a separate case-control study of autism in relation to mercury exposure, a measure of autism was not included in the test battery.” Get it, idiots? A separate study is being done and the results will be reported in a separate paper! That renders this complaint utterly irrelevant. It’s nothing more than a red herring designed to fire up the faithful.

This complaint is not really stupid, but definitely overblown:

The Study’s Methodology has Serious Limitations Negating Any Conclusions Drawn. Major flaws that that causes a large underestimation of neurological adverse effects burden the study: 70% of the families recruited for the study failed to participate. This kind of bias in epidemiological studies is well known to distort even large studies of health effects…It is well established that people who choose to participate in this kind of study are probably very different than those who refuse to participate (the “healthy person” or “complier” effect); especially when the ones who refused to participate said they were too busy.

Simply put: if you have a kid with ADHD or mild ASD or other neurodevelopmental disorders, you are likely to be busier, more stressed, and less available than the mother of a healthy normal child. This phenomenon serves to amplify the effect of the “complier”, the ;healthy families,” – those who do cooperate with the study – confounding or confusing the study’s results. The cooperative parents included in the study were more likely to be those with relatively trouble-free kids

There’s no evidence that this sort of bias existed, and A-CHAMP conveniently omits other biases that might be result from such a selection bias. For example, it is also quite possible to argue that parents who think vaccines may have caused their child’s condition would be even more likely to want to participate in the study (self-selection bias), than parents whose children are normal or who don’t believe vaccines had anything to do with their child’s problems; they might have thought that it wasn’t worth their bother. It’s good of the antivaxers who have been championing the execrable telephone survey done by Generation Rescue to recognize that this sort of bias exists; too bad they only mention it when it suits their purposes (i.e., to trash a study whose results they don’t like) and ignore it when it doesn’t, for example when it calls into doubt the results of the Generation Rescue telephone poll.

In reality, the fact that only 30% of the families who were approached for the study agreed to participate is probably the most significant weakness of the study. The authors don’t try to hide it. Rather, they are right up front with it in the Discussion section, while at the same time pointing out that this is this possible bias was ameliorated by enrolling children on the basis of having received vaccinations without regard to the seeking of health care or having been given a neurodevelopmental diagnosis, as well as noting that many children weren’t enrolled because they couldn’t be located. Moreover, exposure information was obtained from many different sources. It also looked at prenatal exposure to thimerosal-containing vaccinations from vaccines that the mother might have had while pregnant.

Next complaint:

Vulnerable Children Were Excluded from the Study; Early Intervention Was Ignored. Children with a birth weight under 5 lbs. 8 oz. were excluded from the study further skewing the results, as these children are likely more vulnerable to thimerosal than larger babies. In addition, the fact that early intervention may have reduced deficits such as speech delay detected by neuropsychological testing of children aged 7-10 was not accounted for in the study results. There also was no analysis of combined prenatal and postnatal mercury exposures. Only 103 mothers who were exposed to mercury from prenatal immune globulins participated in the study, far too small a group for researchers to draw conclusions regarding the safety of thimerosal in these products.

This is a grab-bag of the specious and semireasonable. The reason for excluding low birthweight children was obvious: Such children are more likely to have neurodevelopmental problems completely independent from any external cause, such as thimerosal. Including preemies and lower birth weight children would only contribute to the background noise and make finding true associations more difficult. A-CHAMP should be glad that the investigators did that, given that it was almost certainly done to make the study more likely to find an association between vaccines and neurodevelopmental disorders. In addition, there is no evidence that low birth weight children are “more vulnerable to thimerosal.” Of course, once again, A-CHAMP fails to point out that the authors themselves pointed out the shortcoming in regard to not being able to account for interventions such as speech therapy. As for the whining about not analyzing combined prenatal and postnatal mercury exposures, that’s just a red herring; the study did test an a priori assumption of interaction between pre- and postnatal mercury exposure.

The rest of the complaints are the standard ones: Conflict of interest, for example, because several of the study’s authors had received funding from pharmaceutical companies. These potential conflicts of interest are clearly stated in the study. A-CHAMP also brings up a totally specious complaint of the study supposedly not accounting for “efflux” disorder (i.e., children who are allegedly “poor excretors” of mercury). Fortunately, Prometheus has provided a good explanation of what a crock that whole myth is, so that I don’t have to.

Of course, there is another reason, besides this study failing to show what the mercury militia wants it to, that there is such hostility here:

The politicization of the thimerosal issue has led researchers to take unprecedented measures. Unlike previous studies, the current study included more than a dozen outside consultants, including at least one advocate for families of children with autism. “We have really tried to make the entire process–from experiment design to manuscript review–as transparent as possible,” says Thompson. But that effort may not have made a difference in the long run. Sallie Bernard, executive director of Safe Minds, a nonprofit parents’ organization that focuses on the role of mercury in neurodevelopment disorders, consulted on the study but still takes issue with its findings. “All the studies, including this one have certain limitations in their design and their methodology,” she says.

Sour grapes, anyone? Ms. Bernard was a consultant on this study and helped contribute to its design! She apparently didn’t like the results that it was producing and decided to drop out and start criticizing it–even jumping the gun on the 5 PM embargo yesterday to do so! Indeed, she is listed on the study in a way that I’ve never seen before: as a “dissenting member.”

How many studies by mercury militia enablers Mark and David Geier include even a note of dissent?

Although this study is not without flaws, it nonetheless does not support a correlation between thimerosal-containing vaccines and the neurodevelopmental problems studied. Even better, the New England Journal of Medicine included two editorials along with the story. One editorial discussed the explosion of vaccine litigation that the now discredited thimerosal “hypothesis” has unleashed, immune to the findings of science. The second editorial is by Paul Offit (the Antichrist to antivaxers) and makes an excellent point about the unintended consequences of taking precautionary measures on the basis of little or no evidence:

On July 9, 1999, after much wrangling, the CDC and AAP decided to exercise the precautionary principle. They asked pharmaceutical companies to remove thimerosal from vaccines as quickly as possible; in the interim, they asked doctors to delay the birth dose of hepatitis B vaccine in children who weren’t at risk for hepatitis. A press release issued by the AAP revealed the ambivalence among its members: “Parents should not worry about the safety of vaccines,” it read. “The current levels of thimerosal will not hurt children, but reducing those levels will make safe vaccines even safer. While our current immunization strategies are safe, we have an opportunity to increase the margin of safety.” Critics wondered how removing something that hadn’t been found to be unsafe could make vaccines safer. But many parents, frightened by a sudden change in policy, reasoned that thimerosal was targeted because it was harmful — and their faith in the vaccine infrastructure was shaken. Doctors were also confused by the recommendation.

I could see how that would confuse parents and doctors. Offit concludes:

Despite several years of reassuring studies, the thimerosal controversy continues to be emotionally charged. Physicians, scientists, government policy advisors, and child advocates who have publicly stated that vaccines don’t cause neurologic problems or autism have been harassed, threatened, and vilified, receiving hate mail and occasionally death threats. The CDC, in response to planned protests at its gates, recently beefed up security and instructed personnel about how to respond if physically attacked.

During the next few years, thimerosal will probably be removed from influenza vaccines, and the court cases will probably settle down. But the thimerosal controversy should stand as a cautionary tale of how not to communicate theoretical risks to the public; otherwise, the lesson inherent in the collateral damage caused by its precipitous removal will remain unlearned.

Exactly. With the best of intentions, trying to be as “safe” as possible, the AAP and CDC unleashed a tsunami of fear of vaccines and laid the groundwork for pseudoscientists like Mark and David Geier to stoke the fears of mercury further with badly designed studies. This was an example of framing science at its worst.

In the end, it is always frustrating to watch how such studies are spun by antivaccinationists. Epidemiology is like that, though. It’s virtually impossible to conduct a cohort study like this without permitting significant shortcomings in it. The reason is that, unlike a bench experiment, the investigators can never control all the variables. Trade-offs are inevitably made, and rarely are there adequate resources to assure sample sizes large enough to be bullet-proof or to be able to account for all potentially confounding variables. No one study is ever sufficient to rule out correlations between undesirable outcomes and various compounds. However, as the weight of several studies starts to bear down on the problem, the preponderance of evidence must at some point be accepted, because we do not have unlimited resources to keep doing studies to answer the same question over and over and over again and every repeated study uses resources that could be used to study other potential causes and treatments for autism. This study happens to be one large and convincing chunk of that evidence, but it is not the only one. Coming next year, when the CDC releases a similar trial about autism, will be another. As Dr. Offit said:

In a new study, Thompson and his colleagues are taking another look at thimerosal exposure and autism. But for many, the question has been resolved. “This study is the third one of its kind. When the autism one comes out, it will be the sixth of its kind. They’ve all shown the same thing–that there is no significant correlation,” says Offit. “Meanwhile, the thimerosal question has diverted attention and resources away from the search for more promising leads on what causes autism. How many more studies will it take?”

That’s the difference between science and crankery. If this study had shown a clear and convincing correlation between thimerosal in vaccines and neurdevelopmental disorders, I would have accepted the results and perhaps started to change my mind. On the other hand, for cranks, no number of studies is ever enough to dissuade them from their beliefs. If God Himself were to come down from on high and design the absolutely perfect study, which when carried out showed no correlation between thimerosal in vaccines and neurodevelopmental disorders, the antivaccinationists would insist that it was flawed, that the investigators had conflicts of interest, and that it needs to be repeated until (although they would never admit this) it shows the results they want it to show.

In fact, expect just that. The CDC has pledged to make the raw data available to other researchers. I predict that, within a few months, a study by Mark and David Geier will use their trademark bad statistics and bad math to cook the numbers to make it look as though there are associations between thimerosal in vaccines and neurodevelopmental disorders that the CDC “covered up.”

Just wait.

ADDENDUM: Some more commentary on this study:

From Left Brain/Right Brain:

No, everything was fine and dandy as long as she [Bernard] was enjoying being fawned over as a “representative of the autism community” and a fellow-scientist instead of the commercial marketer she actually is. Here’s a clue, Sallie: If you’re going to play scientist, you have to follow the rules of science, and that means you stand by your results. You don’t get to say “heads I win, tails you lose” by waiting to see the outcome before deciding whether the study was any good.

And you really don’t get to have CDC at your beck and call, spend hundreds of thousands of taxpayer dollars to do a study to your specifications, then turn around and call them liars when you don’t like how it comes out.

And you, CDC? You’re not just a victim here. Every time you say “let’s do more research” or “we are examining this issue” in order to appease the mercury moms, you increase the chances that kids will go unvaccinated because you failed to give their parents confidence in the safety of vaccines. When you say a study is reassuring and then highlight what is virtually certain to have been a chance finding (a statistical association between higher thimerosal exposure and transient tics in boys) without making it abundantly clear that some false associations were inevitable given the study design, you defeat the purpose of doing the study.

From AutismVox:

Safe Minds, whose Executive Director, Sallie Bernard, was an external consultant and dissenting member of the study, put out a press release stating that the new study’s “draws a misleading conclusion.” But this statement is as “misleading” as the headlines cited above are about the study’s actual contents This only furthers the belief that–no matter how clearly it is stated and shown that there is no causal association between early exposure to thimerasol and later neuropsychological outcomes—a link between these has been firmly established in the public mind. And disputing that link will take more studies, more evidence, more efforts, and more self-scrutiny of why we believe what we believe.

From Autism Natural Variation:

The CDC study looked at 42 different outcomes, and determined multiple confidence intervals in each case, since different levels of exposure were tested. In total, I understand there were over 300 confidence intervals. Consequently, assuming the null hypothesis is correct, you should expect that an RR of 1.0 will be outside the 95% confidence interval in over 15 measures. What the study found was that in 12 measures there was an apparent protective factor, and in 8 measures there was an apparent risk factor. This is completely consistent with the null hypothesis. Therefore, the conclusion of the study, namely that the results of the same do not support a causal association between thimerosal-containing vaccines and neurological outcomes, is absolutely the correct conclusion.

From Arthur Allen on The Huffington Post:

Despite the wealth of data showing that vaccines do not cause autism, many parents continue to believe the theory. Jenny McCarthy, an ex-Playboy Bunny and TV personage, has been making the rounds of the media this week (Oprah, ABC, People magazine) to promote her book, in which she claims that her child was made autistic by vaccines but was “recovered” through alternative therapies.

A large CDC study comparing thimerosal exposure rates in autistic and non-autistic kids is due out around this time next year, as is an Italian study of the question. The data will probably duplicate the many previous studies that have shown no effect. The dogs may bark but the caravan moves on. Or is it the other way around

(The comments from die-hard antivaxers after Allen’s post are scary indeed.)

From Derek Lowe at In the Pipeline:

The director of SafeMinds, a group of true thimerosal believers if ever there was, actually was on the consulting board of this latest study. But she withdrew her name from the final document. The CDC is conducting a large thimerosal-and-autism study whose results should come out next year. Here’s a prediction for you: if that one fails to show a connection, and I have every expectation that it’ll fail to show one, SafeMinds will not accept the results. Anyone care to bet against that?

As a scientist, I’ve had to take a lot of good, compelling ideas of mine and toss them into the trash when the data failed to support them. Not everything works, and not everything that looks as if it makes sense really does. It’s getting to the point with the autism/thimerosal hypothesis- has, in fact, gotten to the point quite some time ago – that the data have failed to support it. If you disagree, and I know from my e-mail that some readers will, then ask yourself what data would suffice to make you abandon your belief? If you can’t think of any, you have moved beyond medicine and beyond science, and I’ll not follow you.

Commenting on David Kirby’s truly idiotic take on this study in The Huffington Post, Steve Novella at Neurologica:

What Kirby does is not just really dumb, it’s despicable. He cherry picks all the negative (meaning bad) neurological outcomes and pretends that the study shows a correlation (it doesn’t, when you look at ALL the data). He then tries to dismiss the positive (good) outcomes as absurd. He mockingly writes:

If they (the CDC) really mean that thimerosal increases IQ levels in males, then sign me up for a double-dose flu shot this year.

No, David, they don’t mean that. Not by any stretch of the imagination. It takes incompetent statistical analysis or the blindness of ideology to write something so ridiculous. What the CDC means is that the study does NOT show that thimerosal increases IQ, nor that it causes motor tics, or improve motor skills, or decrease language skills, or anything else. The study showed no correlations because it all averaged out as noise.

Steve, normally polite to a fault even with cranks, seems to be laying down a bit of the old Respectful Insolence(tm). I like it.

More Evidence for the Safety of Vaccines

29 Sep

This article was originally published at the NeuroLogica Blog and is re-published here with permission.

By Steven Novella, MD
NeuroLogica Blog

A new study just published in the New England Journal of Medicine, Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years, does not support a correlation between mercury in vaccines and neurological damage. It adds to the growing evidence that vaccines are safe and they do not cause neurological disorders. This study did not look at autism (a study that will be published next year looks, again, at vaccines and autism), but the mercury-causes-autism crowd are still unhappy with the results.

I have been following this issue closely for several years. Although my awareness of the issue goes back much farther, I started to seriously research the claim that the MMR vaccine, or that thimerosal in other vaccines, causes autism while researching an article on the topic for the New Haven Advocate. As a physician (a neurologist) and a skeptical activist I knew I had to get this issue right. I certainly did not want to falsely stoke the flames of public fear, nor did I want to cast myself in the role of denier.

Early on in my research I really did not know which way I was going to go with the issue. Should my bottom line be that there is real reason for concern here, that there is nothing to the claims, or that we really don’t know and will have to just wait for further research? But after reading through all the claims on both sides, and all the research, it was an easy call – vaccines, and specifically the MMR vaccine and thimerosal, do not cause autism, and the alleged autism “epidemic” is likely just an artifact. Those claiming there is a connection were drowning in conspiracy thinking, logical fallacies, and blatant pseudoscience. Meanwhile every piece of reliable clinical data was pointing in the same direction – no connection.

But still, while I was confident in my final conclusion, a small connection between mercury and autism that eluded the existing data could not be ruled out. Or perhaps there was an angle to the whole story that we were missing but would later come to light. I have had enough experience with scientific medicine to be humble in the face of the complexity of medicine and biology. The only rational position is to remain open to new data and new ideas. On this issue there was sure to be more studies in the future – and the ultimate test of the thimerosal-autism connection, the removal of thimerosal from the vaccine schedule, was yet to be seen. So I confidently plunked my nickel down and waited for the future to unfold.

Everyone likes being right, and sometimes this desire clouds our judgment. I have learned, therefore, how to cheat, which is to say how to always be right. All you have to do is say that your position is based upon the existing data, but is contingent upon the results of future studies. In other words, the “right” position is to change your final answer to accommodate new evidence as it comes in. Therefore the only “wrong” answer is to stick to your original position despite new evidence that contradicts it.

OK – so this is just restating how science is supposed to work, but it is amazing how many people forget to cover their behinds with this simple rule. Usually this is because they are not doing science – they are taking an ideological position, and ideology is inflexible. This is a huge advantage for science over ideology, and why, when science and ideology clash, science is almost always right.

In the case of vaccines and autism, since writing my first major article on the topic, the data has come in all consistent with my original position (so I get to be doubly right). Removing thimerosal from vaccines did not decrease the incidence of autism (or decrease the rate of increase in new diagnoses). And several new major studies came out all showing no association – not counting the utter crap being produced by the Geiers.

Enough had happened to warrant an update, so I jumped at the chance when Ken Frazier of the Skeptical Inquirer asked me to write an article on the topic. My article will be out in the next issue, along with a couple of smaller ones on the same topic, so take a look.

Alas, as is often the way in the world of science, my paper is outdated before it even goes to print. This new study, of course, will not be covered in the article. But that’s what blogs are for – instantaneous news and analysis.

Actually, several of my fellow science bloggers have already beat me to the punch. They cover the article, and the response to the article by the mercury crowd, in great detail, so I will not duplicate it here.

Orac at Respectful Insolence goes over the press release of A-CHAMP (one of the mercury militia) that attempts to dismiss the study. He shows that, while the study (like all studies) has its weaknesses, it does add significantly to the body of evidence showing that vaccines are safe. The complaints of A-CHAMP are either wrong, overblown, or inconsistent with their prior positions and shows that they are just trying to tear down the study at all costs.

For the record, I agree with Orac that the study is good enough that it’s conclusions add to the cumulative data on this topic, and that the weakest element of the study was the 30% compliance rate. In other words, only 30% of the subjects that they looked at for the study made it into the final analysis. This opens up the door for selection bias. Orac is probably correct that this bias would likely overestimate a correlation, not underestimate it, but you can never be sure with such things.

I will add that the 30% figure is not as bad as it first seems. The study reports:

Of 3648 children selected for recruitment, 1107 (30.3%) were tested. Among children who were not tested, 512 did not meet one or more of the eligibility criteria, 1026 could not be located, and 44 had scheduling difficulties; in addition, the mothers of 959 children declined to participate. Most of the mothers (68%) who declined to participate in the study and provided reasons for nonparticipation cited a lack of time; 13% reported distrust of or ambivalence toward research. Of the 1107 children who were tested, 60 were excluded from the final analysis for the following reasons: missing vaccination records, 1 child; missing prenatal records, 5; missing data regarding weight, 7; and discovery of an exclusionary medical condition during record abstraction, 47. Thus, 1047 children were included in the final analyses. The exposure distribution of the final sample was similar to the exposure distribution of the initial 3648 children selected for recruitment in the study.

So about 40% of those that did not make it into the final analysis simply could not be located – this is unlikely to represent a bias. But this is a small point.

Isles from Left Brain/Right Brain points out that Sallie Bernard (a believer in the mercury hypothesis) was consulted on the study design and execution and did not criticize its methods until after the results came back negative. That kind of behavior instantly sacrifices all your credibility in the science club.

Kristina Chew at AutismVox reiterates what I did above – that the mercury-causes-autism ideologues are always asking for more studies, but refuse to change their position when the studies they ask for come out. They are waiting for studies that show what they want them to show – we call that “cherry picking.”

The other side is busy too. David Kirby (a bad journalist who desperately wants to be a bad scientist), who wrote the book Evidence of Harm, published an article online in that absolute rag, The Huffington Post (to be fair, they also published this piece by Arthur Allen defending the paper’s conclusions). Kirby repeats all the same points in the A-CHAMP press release, but he emphasizes the fact that the study found some neurological symptoms that were higher in the subjects who received more thimerosal. Kirby proceeds to completely misinterpret the significance of this.

The study looked at 42 different outcomes, and set the p-value for significance at 0.05. A vague concept of basic math should be sufficient to see that some outcomes will reach significance by chance alone. The researchers arguably should have adjusted their statistics to account for the fact that they were looking at 42 variables – but instead they just looked at all the outcomes that were significant to see if there were any patterns or trends. What they found was that there were a few scores that were worse among those exposed to more thimerosal, but there were also a few scores that were better. There was a random distribution of positive and negative effects that essentially average out to no net effect. It’s all just noise. (Is there a small signal hiding in the noise? There could be – scientists have to be honest about that. But that doesn’t mean there is.)

What Kirby does is not just really dumb, it’s despicable. He cherry picks all the negative (meaning bad) neurological outcomes and pretends that the study shows a correlation (it doesn’t, when you look at ALL the data). He then tries to dismiss the positive (good) outcomes as absurd. He mockingly writes:

If they (the CDC) really mean that thimerosal increases IQ levels in males, then sign me up for a double-dose flu shot this year.

No, David, they don’t mean that. Not by any stretch of the imagination. It takes incompetent statistical analysis or the blindness of ideology to write something so ridiculous. What the CDC means is that the study does NOT show that thimerosal increases IQ, nor that it causes motor tics, or improve motor skills, or decrease language skills, or anything else. The study showed no correlations because it all averaged out as noise.

This is, by the way, the same mistake that astrologers make (remember that crusty pseudoscience?). They look at many variables then cherry pick the outliers. At best what this study might show is a possible correlation, but any such possible correlation would have to be corroborated by a later study (with fresh data) that looked specifically at that one variable.

So the pattern that I found when I first started looking at this issue – that all the reliable data was on the side of no correlation between vaccines or mercury and autism or neurological disorders – continues to hold up to new data. The other pattern I noticed – that those promoting a correlation were relying on bad science, logical fallacies, and ad hoc conspiracy claims – also continues to hold.

In the last few years every new study showed no correlation, and the mercury militia responded with abject nonsense and dismissal. This cycle seems to be repeating itself over and over, and this latest study is no exception.

CDC: “Thank you, Sallie, May We Have Another?”

27 Sep

A CDC study released yesterday found no evidence to 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.” In other words, vaccines don’t scramble your brain.

The study didn’t examine autism as an outcome, although that is almost certainly what it was intended to get at. Instead, it looked for whether children’s exposure to thimerosal before birth or in infancy had any relationship to their later performance on 42 standardized tests which one would expect to be affected by autism. For each of the 1,047 children in the study, the researchers assessed speech and language; verbal memory; achievement (letter and word identification); fine motor coordination; visuospatial ability; attention and executive function; behavior regulation; tics; and general intellectual functioning.

CDC tried so hard. They invited one of the queen mercury moms, Sallie Bernard of “SAFEMINDs,” to participate in the planning of the study. They brought on a panel of outside advisors. The team spent at least two years administering forty-seven separate tests to each of the children and analyzing and writing up the results. They printed every piece of data generated in a companion volume to the published study.

They got kicked in the teeth, but don’t feel bad for them. They should have known better.

The autism-vaccine contingent has responded by spluttering about the study not having been large or random enough, and by accusing the researchers of being biased and of ignoring important associations in the data. It’s no news that these people don’t believe anything that comes from CDC – they’ve said as much, very clearly. But one would think that if you let the antivaxers in on the process from day one, if you were totally transparent, they couldn’t object, could they? They’d have to see the light when the results came back and say, “Well! I guess it’s not the vaccines after all!”

CDC, if you really thought that would happen, you were so, so wrong.

The appearance is that Sallie Bernard was going along with all this up until the day the results came in and – shockingly! – showed thimerosal didn’t do one bit of harm. If she’d thought from the outset, as a SAFEMINDs press release now claims, that there weren’t enough kids in the study or the sampling were biased, does anybody think this gadfly would have nodded and smiled and gone right along with it?

No, everything was fine and dandy as long as she was enjoying being fawned over as a “representative of the autism community” and a fellow-scientist instead of the commercial marketer she actually is. Here’s a clue, Sallie: If you’re going to play scientist, you have to follow the rules of science, and that means you stand by your results. You don’t get to say “heads I win, tails you lose” by waiting to see the outcome before deciding whether the study was any good.

And you really don’t get to have CDC at your beck and call, spend hundreds of thousands of taxpayer dollars to do a study to your specifications, then turn around and call them liars when you don’t like how it comes out.

And you, CDC? You’re not just a victim here. Every time you say “let’s do more research” or “we are examining this issue” in order to appease the mercury moms, you increase the chances that kids will go unvaccinated because you failed to give their parents confidence in the safety of vaccines. When you say a study is reassuring and then highlight what is virtually certain to have been a chance finding (a statistical association between higher thimerosal exposure and transient tics in boys) without making it abundantly clear that some false associations were inevitable given the study design, you defeat the purpose of doing the study. People who understand statistics weren’t the ones who needed to be convinced thimerosal is safe; the antivax crowd will never be convinced no matter what. You needed to speak to the well-meaning parents who worry about the rumors they hear at playgroup, and not only did you give them something new to worry about and whiff the opportunity to show them that the likes of Sallie Bernard are all about the rhetoric – you managed to tee up for yet another round of Righteous Long-Suffering Parents vs. Heartless Government Scientists.

Haven’t you learned yet who wins that one? Or are you going to invite Sallie back for another round of research?

Postscript: More commentary on this study by Arthur Allen, Orac, Joseph, Interverbal, and Kristina Chew.

After Jenny and Oprah

23 Sep

And so, this was the week that the anti-vaccine/autism hypothesis got its first real airing in a public arena. Jenny McCarthy went on US TV and told her audience that her son was her science (quite possibly _the_ silliest thing on the show since Tom Cruise’s couch/brain malfunction).

I’m going to level with you here. I don’t really care too much about Jenny McCarthy spouting on about the evils of vaccines. She’s not the first and she won’t be the last. Despite the raptures the anti-vaccination people are having over her appearance she wasn’t on Oprah because of her vaccine ideas.

This is what bothers me: she was on Oprah because she was famous. It scares the _shit_ out of me that we can only apparently have a conversation about something after a celeb has let the light of their countenance shine down upon it.

The UK is just as ridiculous about this whole thing as the US. Its got to a stage whereby the subject under discussion doesn’t even seem to really matter to Joe Public – what seems to matter is that there’s a famous face pontificating on a subject that, in all honesty, they’ve probably only recently begun to get a firm grasp on themselves.

To put it another way, the Oprah show wasn’t about autism. It was about Jenny McCarthy. It was to sell copies of her book. Her appearance on People magazine is to increase book sales. Her upcoming appearance on Larry King is to increase book sales. None of it is about _autism_ . None of this will help the autism community. Even that subsection of the autism community who are anti-vaccine are kidding themselves if they think that after the dust settles on Jenny McCarthy’s book she will be around to lead them in their fight. Until its time for the sequel of course.

Is the autism community really so shallow that we are going into raptures because a celeb is speaking about a subject that vast majority of us could speak much more accurately and eloquently about? It seems some of us are.

In the meantime, whilst Jenny McCarthy is being lucratively controversial on Oprah, the vast majority of autistic kids are still not getting the right kind of educational placement. Whilst Jenny McCarthy’s Media Clean Up Crew are attempting hoover away every mention of her Indigo Children beliefs from the web lest they affect book sales, autistic adults are still struggling to get into appropriate work and living accommodations.

I would urge autism parents to spend the ten quid they were going to spend on Jenny McCarthy’s book on something that might actually help autistic people instead of helping line the pockets of Jenny McCarthy.

Why Aren’t You “Scared To Death”?

13 Sep

Do you miss Dan Olmsted’s writing? He now apparently showcases his version of scientific brilliance over at Rescue Host.

Recently, he tried to pass off the Flu shots and Chinese mercury hypothesis (which I thought was David Kirby’s, but I guess I was wrong) without much more than unfounded speculation and belief.

California, of course, is ground zero as we watch autism rates keep rising — even after mercury was “removed” from childhood vaccines starting in 1999 (the situation is much more complicated than that, since more and more pregnant women and younger and younger kids are getting mercury-preserved flu shots). So if you believe as I do that autism is fundamentally an environmental illness that whacks a subgroup of susceptible kids, mercury from China — or anyplace else — is every bit as important as mercury from vaccines.

I asked him the following in the comments:

If you wouldn’t mind Mr. Olmsted, take a look at a graph of the 3-5 year-old autism caseload cohort for the past 5 years.

Such a graph would include children born at the starting point of the “removal” in 1999 you mentioned. What do you see? Does the trend look linear to you?

Do you really believe there is combined flu shot uptake and airborne mercury data that would exactly and inversely match (in dose and effect, if any) the reduction the use of thimerosal in childhood vaccines in order to produce a trendline with an R-squared value of .9954 for this time period?

You can view such a graph here.

To which he replied:

An “R-squared value of .9954” is way beyond my non-scientific expertise. All I can say is that thimerosal use has actually been increasing in by far the most vulnerable group — pregnant women — and that at least some studies suggest that greater pollution directly correlates with a greater risk of autism. If the CDC had recalled all thimerosal-containing vaccines in 1999, we’d have a genuine “natural experiment.” But we don’t. Nor will the government study autism rates in never-vaccinated kids; the survey by Generation Rescue found ominous correlations between vaccines and NDs including autism, but it’s been widely ignored.

The survey by Generation Rescue? Right. Did he just make up that part about thimerosal use increasing in pregnant women? It kind of looked like it to me, so I asked and commented as follows:

What evidence do you have that thimerosal use actually increased in pregnant women for the period immediately following the “removal” of thimerosal from childhood vaccinations? (required to make your hypothesis work)

The majority of childhood vaccines were thimerosal-free or contain only trace amounts by 2002 (more on that below). Here’s flu shot uptake estimates for pregnant women for the three years that follow:

2002 – 12.4±3.9 %
2003 – 12.8±4.4 %
2004 – 12.9±5.0 %

Source

Note: there is an increase in the estimate for 2005, but children born in 2005 and later are not old enough to be reflected in the 3-5 year-old California autism caseload cohort yet. Additionally, estimates for 2006 were back down to 12.9 percent.

Source

Mark Blaxill and JB Handley showed up in the comments following that, and Olmsted apparently did not reply further. So the question of where Dan Olmsted might have found any data to make his Flu shots and Chinese mercury hypothesis plausible, will have to remain unanswered for now. But, while we’re on the subject of data-free gibberish, have a look at a piece of something posted by Dan Olmsted at Rescue Host on September 11th.

At some point, common sense has to prevail. For instance, let’s stipulate that better diagnosis accounts for a gargantuan 36 times more cases of bipolar disorder among kids over the past 10 years. That still would mean that the condition quadrupled in a decade — suspiciously, the same decade that autism, asthma, ADD, ADHD etc. soared out of sight. The deniers have to explain away every digit of that 40-fold number, because even a “mere” fourfold increase in the real incidence would be deeply disturbing. How can anyone be certain that one-tenth of that 40-fold increase isn’t actually real? And if they can’t be certain, why aren’t they scared to death?

Emphasis mine.

An appeal to “common sense” is a sure sign that what follows is probably not data that supports his hypothesis. Is common sense really the best way to arrive at correct answers about any subject for anyone, regardless of their background? What do statements like, “An ‘R-squared value of .9954’ is way beyond my non-scientific expertise”, tell us about the context to which Mr. Olmsted’s “common sense” might be reliably applied? Is autism epidemiology likely to be anywhere near Olmsted’s knowledge and expertise?

Sometimes common sense seems like a good way to operate, but the reality is that many things in science have quite complex answers. It’s also the case that science does not have all the answers (nor does it claim to). None of this will apparently stop Mr. Olmsted from forging ahead with assertion and anecdote in the rest of his post of course.

Did you catch this part of that paragraph above?

“…suspiciously, the same decade that autism, asthma, ADD, ADHD etc. soared out of sight.”

Did you see any real data or science whatsoever that actual autism prevalence “soared out of sight” in the past ten years? Me neither. So here you go any “Flu shot and Chinese mercury” proponents, now is your chance to post that real data or science in the comments – really, Mr. Olmsted needs your help if he’s to avoid the inevitable “You’ve got nothing!”. Either that, or get him a new hypothesis to work with (something with corroborative data preferred).

As for Mr. Olmsted’s final question in that paragraph, I’d like to answer it from one perspective.

We can’t be absolutely sure that there hasn’t been some real increase in autism prevalence, there might have been. To conclude that there has been a real increase in autism prevalence wouldn’t require much more than good data that shows it’s actually true. However, to conclude that there has been a real increase without supporting scientific evidence, but based on “stories”, is unscientific, if not a bit silly.

I can’t be absolutely 100% certain that an alien abduction has never occurred, but this lack of certainty does not translate to “therefore alien abductions are real”. I can’t be absolutely 100% certain that bigfoot doesn’t exist either, but again, that lack of certainty does not translate to “bigfoot is real”. I don’t live in fear of being abducted by aliens or encountering a hairy giant biped while on a hike with the kids, despite an abundance of “stories” about these things. I’m also not “scared to death” that there could indeed be an increase in the actual prevalence of autism. It is a possibility, but I have seen no evidence of it’s truth. I do see an increase in storytelling though.

JB Handley’s Emerging Hypothesis

9 Sep

The Handley’s are now proud parents to a third child. Many congratulations to them. I hope their daughter gives them as much pride and happiness as my two have given me over the years.

Of course, for JB, its all about the autism. And so, he details the steps the family took to ‘ensure’ this third child wasn’t autistic. Its, um, interesting reading.

First Brad reminisces about whats on the GR site:

It’s probably worth taking a quick step back. The Generation Rescue website spells out pretty accurately how we feel about the cause of
autism:

We believe these neurological disorders (“NDs”) are environmental illnesses caused by an overload of heavy metals, live viruses, and
bacteria. Proper treatment of our children, known as “biomedical intervention”, is leading to recovery for thousands.

Yeah, you do _now_ – it used to be:

It’s nothing more than mercury poisoning

And whilst Brad was happy to carry this simple message to the TV masses, he’s seemingly less happy to go back on and say, well no, I was wrong actually. Its in fact ‘overload of heavy metals, live viruses, and bacteria’. And as for ‘leading to recovery for thousands’…heh yeah, whatever.

But anyway, back to the Emerging Hypothesis of preventing autism. What has JB Handley come up with?

we began to develop a plan to prepare for life before and after birth that we believed would reduce the chances for another autistic child.

And what does this plan entail?

Early Preparation for Mom (prior to conception):

– Switching to a gluten/casein free diet
– Eating organic foods and avoiding all artificial colors, flavors, and preservatives
– Limiting sugar
– Focusing on gut health through a combination of anti-fungal treatment, beneficial bacteria re-population, and digestive enzymes
– Detoxifying the body through a combination of chelation and natural detoxification techniques like FIR sauna, NDF Plus, Zeolites, etc.
– Adding a pre-natal vitamin and B-12

During pregnancy:

– Maintaining all dietary approaches listed above
– Avoiding all vaccines
– Avoiding any environmental risks like lead paint, home construction, cleaners and solvents, chemicals, etc.
– Avoiding antibiotics except in life-or-death situations
– Avoiding x-rays and sonograms, unless high-risk birth issues exist
– Continuing supplementation of pre-natal vitamins, probiotics, digestive enzymes, and B-12
– Proper supplementation of mom’s methylation cycle based on genetics

After birth:

– Maintaining all dietary approaches and supplements listed above while breastfeeding
– Holding off on introducing solid-foods until at least 6 months
– Avoiding antibiotics for breastfeeding mom and baby except in life-or-death situations
– Avoiding any environmental risks like lead paint, home construction, cleaners and solvents, chemicals, etc.
– Supplementing baby with infant-safe probiotics
– Avoiding all vaccines for at least the first 2 years of life, and then taking extraordinary caution
– At the right time (typically 6 months or older), adding proper methylation cycle support
– At the right time, proper supplementation of Omega3-6-9
– Providing natural detoxification through things like Epsom salt baths

So mum has to go through an extremely rigorous program. What does dad have to do?

Nothing. Nada. Zip. Fuck all.

Children are, it seems, conceived solely by the female and thus the male’s biology plays no part. Or maybe JB just couldn’t stomach the thought that men’s sperm might play a role.

OK now, back on real street, lets look at a few things.

Firstly, this child is a third born female. Sibling risk of recurrence for autism with the previous birth of any child with autism is thought to be about 4.5% (the numbers are higher for families with a firstborn female with autism or more than one child with autism). That’s right, about 4.5%. That means that there is an approximately 95.5% chance, based on the available science, that a third child born into a family with one autistic child who is not a firstborn male, will not be autistic. Let’s say that again – a 95.5 % chance for non-autistic (maybe even higher if the child is female). From a purely statistical perspective, that’s a very high probability for a non-autistic child. (Source).

If this daughter _doesn’t_ end up being autistic, what do you think is more likely to be the reason? The +95% chance it wouldn’t have happened anyway? Or JB’s course of mummy purification?

The Myth of Recovery

1 Sep

Back in August of last year I wrote a blog entry about the Generation Rescue ‘recovery’ stories and how true recovery actually accounted for 5% of the stories on their website which I upgraded in May of this year when they redesigned their website. Their true recovery figure now stands at 7%. I even recounted how I sent my own daughters details to them under an assumed name using the exact truth about her state and condition which they duly published.

I was interested to come across some more fascinating dialogue between members of the Yahoo ABMD group – a group which believe mercury caused their kids autism and Biomed can help them. This is one of the oldest and most well regarded (amongst the mercury militia anyway) Yahoo groups.

The conversation began thusly:

From: Eva family
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Date: Mon, Aug 27, 2007 at 6:29 AM

the other thing that troubles me about all the “autism doctors” is that
no one seems to do any studies based on their patients. Some doctors
must have dozens of patients but there seems to be no published work
correlating their levels of minerals, reactions to diets, success of
treatments

…………

But in general J McC, Yasko etc, Buttar, the zeolite-people earn lots of
money and publish nothing except opinions………..followed by
anecdotal acclaim from those for whom they work and silent despair from
those for whom they don’t.

Being an experienced reader of the material on these groups, I silently commiserated with this poster as I waited for the inevitable flame fest. But it never happened. Here are some of th responses this post received from other ABMD members:

From: Laura K. Fischer
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Date: Mon, Aug 27, 2007 at 4:34 PM

Sally, this has always been a concern of mine also, I honestly don’t know whether some of these alternative doctors have any better of a percentage record in improvements then say some of the better mainstream neurologists prescribing meds or even in comparison to kids who only do therapy and educational intervention. Although I recognize that part of my skepticism probably stems from the fact that most of the kids I personally know who have done a lot of biomedical treatment (those in my local community) don’t seem to have improved any more rapidly than those who did not, there are a couple who are even worse off. There is no clear advantage that I have witnessed with my own eyes and it may be that it is because there is a tendency for many of these families to have used a couple of the same DAN doctors in this region, I recognize that this could be a contributor. But I do share your concern with this….Laura

From: Lawrence G. Leichtman, MD
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Date: Mon, Aug 27, 2007 at 6:40 PM

I have followed about 100 children with autism doing biomed. I have never seen a single “recovered” child if by recovered you mean normal though 8 of
the children were claimed to be recovered by their DAN doctors. I have wseen about 10-15% improved kids, some slightly and 10% of kids who were
actually worse from biomed. Of my patients using Yasko prescribed treatment alone I have seen 0 improvment out of 12 patients. I still don’t know what
works or why and this is after 10 years of doing this.

The response from Leichtman is a bombshell. If you do not recall the name, he is the doctor who was quoted in Dan Olmsted’s Age of Autism pieces as treating Amish kids (who never have autism – heh). According to his (anecdotal) opinion he has never seen a recovered child out of the 100 he has seen who have been doing biomed, even amongst those whose DAN! claimed they were recovered. Fascinating.

From: Gina Mouser
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Date: Mon, Aug 27, 2007 at 7:45 PM

We were seeing a very famous DAN dr. who told us that of all the 5000 plus
patients that the DAN doctor was treating, my son was the ONLY one that is
not improving.

Go figure..

Gina

This shed’s some light on the way DAN! quacks falsely inflate their patients parents with hope or a ‘convincing’ explanation. Except, judging by the tone of this email, this mum isn’t convinced.

One of the responders went on to question why Dr Leichtman was a member of the ABMD board if he didn’t believe in biomed. He reiterated his position and confirmed his belief that DAN! docs either lie or are mistaken:

I have seen positive results 10 to 15 percent is still better than 0. I just don’t believe in the total recovery claims as several of my patients were claimed to be recovered by their DAN doctors but they weren’t.

The original poster chimed back in later….

In the UK in education we have something called “value added” — this is the amount that a school has done for a child over and above what might have been expected by simple development. I would like to autistic children measured and placed at a point on a graph as they come into a
doctor (this is already done as I understand it) and then measured again after set periods. Over time that would set baselines and it would be
possible to see which doctors/treatments were giving “value added”.

I don’t understand why no one is doing this. Surely anyone genuinely “recovering” children would be all over us with data, analysis etc — so
that their achievements could be recognised, replicated and they (the doctor) could receive universal praise.

Quite. A point some of us have been making for quite some time.

Then of course, someone finally did play the PharmaShill card at Dr leichtman:

From: Marisha Taylor
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Date: Tue, Aug 28, 2007 at 3:12 PM

I think the “confusion” is coming from you trying to turn the outcome of the study to what “you” want it to be. You & the pharmaceutical
guys would get along great -how much are they paying you on the side? Thank God you are having problems getting it published – there is no
more space for flawed studies.

The most fascinating thing about this post was the speed and weight of the responses telling her to shut up. Not what I would be expecting at all.

As part of the responses Dr Leichtman dropped his second bombshell:

I don’t even understand what you are asking. Neurotypical is average for a child their age not with sensory issues, not with hyperactivity, not with behavioral disorders. I do not include those that I really don’t believe nor does my neurodevelopmentalist believe has autism despite coming in with that diagnosis. *I see plenty of children who come in with the diagnosis who don’t have it in the first place* so improvement or not may not be valid for their issues.

This was unbelievable stuff. Straight ‘from the horses mouth’ was the seconding of the opinions that a lot of us had held for years. That some ‘recovered’ kids were never really truly autistic to begin with. I would love to know if Leichtman ever saw the Berle’s.

Anyway, as I mentioned, when Leichtman was accused of being a Big Pharma shill, the entire group sprang to his defense, including Holly Bortfield, a well known mercury mom.

From: Holly Bortfeld
Reply-To: abmd@yahoogroups.com
To: abmd@yahoogroups.com
Cc: *******@aol.com
Date: Tue, Aug 28, 2007 at 3:24 PM

Wow, time to back off Marisha. Dr. L is a valued member of this list and you are out of line.

Bortfeld is a fascinating case. Later on in this discussion she says:

I know people who did only a few things and their kid is recovered and I know people who did EVERYTHING and their kid is still severe. While I do know some, they are very few in comparison, kids that are recovered. That sucks.

…………

I am thrilled for them, but my kid isn’t one of them (recovered) despite having the best of the DAN docs, virtually unlimited therapies and the “best” of everything, regardless of money, he’s still screwed up at 12 years old.

‘Screwed up’? Nice. This post was in response to the owner of the ABMD group’s post when she said:

I believe (and I’ am very cynical at this point) that most stories of “recovery” are the result of a misdiagnosis, or a mispresentation of
the facts for some financial gain.

Wow. Just….wow. These are incredible things for a ‘mercury militia’ group to be saying. If you only heard Gen Rescue etc you’d believe Brad’s oft-repeated claim of thousands of recovered kids. Its amazing to know that people of the same essential belief differ so wildly.

But back to Bortfeld’s screwed up non-recovered son. Her stance is peculiar given that, back in 2001, she was part of a discussion on the ABMD list during which she said:

Each time we deal with one of his medical problems, the features that gave him the autism label reduce. So in my mind, if we heal enough of his body, the autism dx won’t apply anymore. He went from severe (62 on the CARS) to mild (29 on the CARS) with diet and secretin. The last CARS they ran on him was a 22 so that technically doesn’t even qualify him for the autism label anymore (CARS is from 30-60) but I keep the label for services.

So which is true? That her son is ‘still screwed up’ and isn’t recovered? Or, back in 2001, that he doesn’t qualify for the autism label anymore? Interesting confirmation that Rescue Angels falsely hang on to diagnosis just to receive services as well.

I talked recently about denial. Is this discussion evidence of the rift in the mercury militia between those who have moved past most of their denial and those who can’t? Is it evidence that DAN! doctors know exactly how to play on the hopes and fears of these parents? I think so.

Acceptance not denial

22 Aug

Acceptance. It is a word that some use to describe their relationship with the reality of their children, or their own, autism. We accept the fact our daughter is autistic.

For people who claim to ‘fight autism’ this acceptance is a weak passivity. An act of giving in.

This, of course, is rubbish. Those who have accepted the reality of their own or their children’s autism know that the work starts right there. We do not attempt to carry on deluding ourselves and using quack treatments such as chelation etc as shields against the reality of who our kids really are.

Parents like Brad Handley of Generation Rescue claim at one point in time that:

“autism is a misdiagnosis for mercury poisoning…..The whole notion of autism is mythical. It didn’t exist before thimerosal in vaccines”

Source

and then later say:

The argument is being spun by focusing exclusively on a single ingredient used in vaccines, Thimerosal (which is made from mercury), while forgetting to mention a number of key points about the differences between the vaccine schedule of 20 years ago and today….Thimerosal is only one of the possible ways that the vaccine schedule could be the primary trigger behind the autism epidemic…

Source

are simply in denial. When their first belief is established to be untrue, they simply move on to another belief.

From the videos I posted a link to above, Brad is asked:

Q: This therapy (chelation) is it something he (Jamie) will be on the rest of his life?

Brad’s answer is:

A: Absolutely not. Its at maximum a two year process. Probably less.

As of next month, Jamie Handley will have been undergoing various treatments for three years. His story is not, as far as I can tell, listed anywhere as a ‘recovery’ story. He is still autistic.

Brad has made no effort to go back onto TV and explain this inconsistency. This is because he cannot. It is not explainable. I will be honest. Brad and I regularly exchange verbal barbs but I often feel sorry for the Handley’s. Because of their inability to accept the reality of their sons autism they have been unable to move on. They have instead – as I think is the case with a lot of the autism/vaccine parents – sublimated their failure to ‘cure/recover’ their kids in a proxy-fight with the ND’s, the CDC, the FDA – whatever.

I read a lot of blogs from the likes of Wade, Ginger, Kim Stagliano etc and whilst I often read about their anger and I often read about their love for their kids, I never ever read about them being happy. Do they love their kids? Of course they do. Do they enjoy their time with their autistic kids? I don’t know. I don’t think so.

There is a curious emphasis in a lot of these blog posts. Take Kim Stagliano’s most infamous blog entry – The Crappy Life of the Autism Mom – in which she says:

Recovering your kids doesn’t mean denying their value as people. To the contrary, it means we are willing to devote our lives, our savings, our sanity to their improved health, development and well being.

The jarring difference between stating that she is not denying their value and describing her life as their mum as crappy never occurs to her. It is also sad beyond belief that Stagliano feels that the measure of a persons value is the suffering of their parents.

Of course, the truth is that any decent parent will devote their lives, savings and sanity to their kids well being. That is not a situation that is the sole province of autism or even disability. Just parenting. However, I think that as well as lives, money and sanity, a parent should also invest respect and reality. Sublimating a continued tilting at the windmill of your child’s condition into an increasingly dirty and violent fight against a giant conspiracy is sad. Not sad in a sneering way but genuinely sad. It must be so miserable to be simply unable to accept the reality of the nature of your child.

This inability manifests itself in some strange ways. There have been a spate of articles fairly recently which examine the possibility that older parents are more likely to have autistic kids, or that autism might be due to a ‘corrupted’ (in the medical sense) gene. The outbursts these research papers have generated on EoH are amazing:

You forgot to mention that we’re damn old TESTOSTERONE-laden refrigerator mutant moms……………Here’s more from Autism Speaks funded research. So now the theory is it’s you damn old moms with your refrigerator mutant genes that causes autism. You are such horrible people. Tsk-tsk. Clearly, you aren’t feeling guilty enough, no matter how misplaced.

Any hypothesis which mentions or refers to parents is given equally short shrift. It doesn’t take much to work out why. Even when there is no hint of ‘blame’ (as in dear old Bettlehiem) to parents, any intimation that the genetic/physical make up of parents might have something to do with causes is pounced on and denounced in increasingly hysterical overtones.

Personally I don’t see the issue. Does it matter? No, not to me. But it seems to these parents that the idea that they might carry some responsibility for the fact their kids are autistic fills them with an utter horror. Even to the point that they have to delude themselves.

Take the cases of Erik Nanstiel’s daughter and John Best’s son. Here are two fathers who regularly sing the praises of their children’s doctors (the Geier’s and Andy Cutler respectively) and yet…

When we look back at everything we pay out of pocket… and for everything we pay as a co-pay… it’s several THOUSAND a year.

Why are we still doing biomed after six long years? Because we’ve seen our daughter go from failing-to-thrive to a pretty healthy kid. From a kid who couldn’t balance her copper and zinc… who had lead and mercury through the roof, with very little glutathione… who had constant diarrhea and wouldn’t sleep at night… and terrible eyesight…

to a kid with darn-near normal mineral levels, whose heavy metals have been more than half depleted, is thriving on a good nutritional program… and whose glutathione levels are now higher than daddy’s… is sleeping wonderfully through the night and has seen a 60% improvement in her eyeglass prescription.

She’s also nearly lost her tactile-defensiveness, loves attention (much more than before), stims a LOT less… is beginning to potty train and needs less “prompting” from us for life skills that she’s learning (like using silverware at meal time and dressing/undressing, etc.)

She is still considered low-functioning…

Like Brad and I, Erik and I have also had our fair share of verbal jousts but when I read this I want to weep. How can a man who so obviously adores his daughter fail to see that which is right in front of his face? They’ve been doing biomed for six years and his daughter is still low functioning (Erik’s words). The improvements he describes have little to no bearing on autism.

I waste no pity on John Best but once again, his denial is as plain as the autistic son in front of him:

I’ve done 55 rounds of chelation safely following the advice of Andy Cutler. My son keeps improving. I advise everyone that contacts me through GR to read what Cutler has to say and consider his protocol over what some DAN doc’s say. He has answered all of my questions at no cost and this chelation for a severely autistic child is working.

Whereas today, John made a post on EoH that stated:

In the time it took me to type my last reply, my son smeared feces all over himself and his room again. I’ve long since lost track of how many hundreds of times this has happened.

By the standards of Kim Stagliano – smearing (A Crappy Life remember) equals not cured. How exactly is the chelation working for John’s son? Or is it merely a panacea for the denial that ails his dad?

Attempts at intimidation

3 Aug

I was interviewed for and quoted in the latest edition of Nature Medicine (oops caught by Ms Clark). The piece in question was an uneasy look at the continuing and escalating violent overtones emanating from the mercury militia – parents who believe against all evidence that their kids autism was caused by vaccines.

The piece started with a look at the experiences Paul Offit faces now and then:

….as Paul Offit, a vaccine expert who served on the committee, tried to make his way through the crowd, one of the protestors screamed at him through a megaphone: “The devil–it’s the devil!” One protester held a sign that read “TERRORIST” with a photo of Offit’s face. Just before Offit reached the door, a man dressed in a prison uniform grabbed Offit’s jacket. “It was harrowing,” Offit recalls.

and….

He has since received hundreds of malicious and threatening emails, letters and phone calls accusing him of poisoning children and “selling out” to pharmaceutical companies. One phone caller listed the names of Offit’s two young children and the name of their school. One email contained a death threat–“I will hang you by your neck until you’re dead”–that Offit reported to federal investigators.

Offit’s crime? He’s performed science that doesn’t support the vaccine/autism hypothesis and spoke out about it.

His experiences mirror those of scientist Paul Shattuck who also published science that didn’t support the vaccine hypothesis. After a highly inaccurate smear campaign from the National Autism Association, Shattuck also received threats:

One person said, “Don’t be surprised if you get a knock on your door in the middle of the night and I’ll be there.” Another message said it was easy in the age of the Internet to find out where people live.

Arthur Allen and Professor Roy Grinker have also been on the receiving end of threats of violence:

these people need to be horse whipped…

I’ve also been on the receiving end of various nastiness. From the cowardly actions of John Best who once compared my autistic daughter to a monkey after I related how well she was doing and his follow ups:

….My wife bought too many bananas so I’ll send some for your daughter …..

…Perhaps you can teach your daughter to swing from tree to tree…

we can see how little the mercury militia actually value children. John followed this up by joining the AWARES conference under the username ‘megan leitch’ and posting more cowardly material. John’s regulars at his blog thought this hilarious. John’s blog regulars are anonymous members of the Evidence of Harm Yahoo Group. People who say they care about autistic kids and the discrimination they face.

Recently, this blog was blessed with a series of short lived visits from Ray Gallup, the co-founder of the Vaccine Autoimmune Project. He started off with a series of sneery comments – par for the course and easily deflected. However, he then decided to start posting under the names of others, including fellow antivaxxer Alan Rees and the afore mentioned Dr Paul Offit. It was easy to spot it was him because the IP address was exactly the same.

Shortly after this I was forwarded an email from someone who had followed the Gallup idiocy (he’s banned now by the way) and had mailed him to ask what he was up to – here is the first reply:

Dear ****:

I heard through the grapevine that the Kevin Leitch crowd and his fellow swine assholes where accusing me and Alan Rees of putting things on their website/blog. These people are a bunch of scumbags and I wouldn’t waste my time with dumb fucken people.

Thanks.

Ray Gallup

Except you _did_ Ray. So why lie about it?

Anyway, that was just the starter. The main course that followed showed yet again, the full extent of the bitter hate and violent tendencies of the mercury militia:

Dear ****:

Since you seem to follow what is going on with the Leitch list let me know if Leitch, Deer and the others get hit with a fast moving truck or bus that leaves their carcasses mangled and bloodly on the street.

I will be devotely praying night and day that something like this happens to them and their followers. Especially since these creeps say such hurtful things to parents. They deserve all the best in something terrible happening to every last one of them and I will pray daily.

I usually pray for good things for families that suffer but in their case I will make a big exception.

Ray Gallup

Jim Laidler was also interviewed for the Nature piece. His words are worrying but I cannot deny their veracity:

This stuff is frighteningly violent,” Laidler says. “With the Omnibus trial looking like [the Cedillos] are going to go down in flames, I would be appalled, but not surprised, to hear that some act of violence was carried out.

Its certainly gearing up for that. It was only recently that Brad Handley of Generation Rescue said to me:

If we were on a rugby pitch, Kev, I’d put my boot in your eye and twist…

These are a set of people winding themselves up like a bunch of toddlers ready to have a major tantrum. But they aren’t toddlers. These are, amazingly, adults. I challenge them to find a single incidence of any Autism Hub blogger threatening violence towards antivaccers/autism believers.

Elsewhere
Orac.
Kristina.

Safe Minds and David Kirby

5 Jul

Suspicions have been circling for a long time that there was more than just coincidence to the timing of writing and publication of Kirby’s Evidence of Harm. Those suspicions were enhanced for me when it became clear that a lot of Kirby’s associations with certain autism/anti-vaccine groups such as the National Autism Association were on a financial footing.

The ‘official’ story regarding the writing of Evidence of Harm, as reported by Kirby himself, was that Kirby was casting about for something to write about of book length and had been approached by several autism parents who wanted to share their beliefs that vaccines had made their kids autistic. According to Kirby, he was skeptical and unsure about whether to proceed with it or not. What made up his mind apparently was seeing a news report that a politician had managed to attach a no fault rider to a bill passing through Congress, absolving vaccine makers of any legal responsibility.

However, I don’t believe him. Up until recently, that belief was simply a belief. Rumours circulated that Sallie Bernard of Safe Minds was listed as the domain controller (i.e. she’d bought and paid for) the domain evidenceofharm.com. I emailed her to ask her one way or the other. She refused to answer that question. Kathleen Seidel has asked David Kirby that question. He refused to answer.

Why does it matter? Because Kirby claims to be impartial in this debate. His reviewers claim he ‘walks the middle line’ in his book. that his account is ‘even handed’. I would like to know how someone who has an established financial relationship to one major autism/anti-vax group can possibly be impartial. Would the NAA continue to fund Kirby’s website if he said he didn’t think thiomersal caused autism? I doubt it.

Turning our attention to Safe Minds, we can look at their records – records they must supply be law as they’re a non-profit organisation – and see exactly what they have financed. You can access these records via the orgs IRS Form 990:

Form 990 is an annual reporting return that certain federally tax-exempt organizations must file with the IRS. It provides information on the filing organization’s mission, programs, and finances.

Attached is Safe Minds 990 for 2005. It has some interesting details in it.

If we look at line 43, it has a listing amount of $99,196 for ‘Professional Fees’ expenses placed under the ‘Program Services’ Category.

This means that they paid people they considered professionals almost $100k to provide services to their programs. On page 15 of this same document they go into detail about what these services are.

…..THE BOOK “EVIDENCE OF HARM, MERCURY IN VACCINES AND THE AUSTISM EPIDEMIC: A MEDICAL CONTROVERSY” WAS RELEASED IN 2004 AND SAFEMINDS PRESIDENT, LYN REDWOOD, WAS FEATURED ON THE MONTEL WILLIAMS SHOW ALONG WITH AUTHOR, DAVID KIRBY. THIS IMPORTANT BOOK EXAMINES BOTH THE PERSONAL STORIES OF FAMILIES AND THE UNFOLDING DRAMA IN THE COURTS AND HALLS OF CONGRESS.

This is listed as a ‘Program Service Accomplishment’.

So what can we conclude? To me, this is pretty damning evidence that David Kirby was paid by Safe Minds to write Evidence of Harm. It certainly ties in with Kirby’s other financial benefits from the NAA. So much for impartiality.

I have some questions for Safe Minds and David Kirby.

1) Did David Kirby receive any kind of financial incentive from Safe Minds or NAA or any of their boards prior to writing Evidence of Harm?
2) If so, how much?
3) If not, please explain the 990 form from 2005 above and tell us exactly what the information in it means.

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