Invitation to Upcoming Seminar on Autism Treatment April 21, 2011 – Open to the Public and Available by Webcast

19 Apr

Below is the announcement from the Office of Autism Research Coordination (OARC). This meeting will be in only a couple of days:

The Office of Autism Research Coordination (OARC), NIMH is pleased to be co-sponsoring the National Institute of Mental Health (NIMH) Autism Awareness Month Seminar: “Advances in Treatment Research.” This event is open to the public, both in-person and by webcast.

The seminar will feature presentations by Dr. Susan Swedo and Dr. Rebecca Landa about their research on innovative drug and behavioral treatments for autism spectrum disorder. For speaker biosketches, please see below.

EVENT DETAILS

Date: Thursday, April 21, 2011

Time: 10:30-11:30 am ET

Location: The Neuroscience Center
Conference Room C
6001 Executive Boulevard
Rockville, Maryland 20852

Webcast Live: http://videocast.nih.gov/summary.asp?live=10144

For in-person attendees, seating is on a first come, first served basis. The event will also be videocast live and archived through NIH Videocast: http://videocast.nih.gov/summary.asp?live=10144 for remote access.

Individuals with disabilities who need Sign Language Interpreters and/or reasonable accommodation to participate in this event should contact Christine Kaucher, Kaucherc@mail.nih.gov, 301-443-4058, and/or the Federal Relay (1-800-877-8339).

Please send questions about this event to nimhpress@mail.nih.gov. We look forward to your participation on April 21st!

SPEAKER BIOSKETCHES

Susan Swedo, M.D.

Dr. Susan Swedo is Chief of the Pediatrics & Developmental Neuropsychiatry Branch, NIMH. She is a board-certified pediatrician, who trained at Northwestern University’s Children’s Memorial Hospital in Chicago, Illinois. Dr. Swedo has authored/co-authored over 100 research publications since joining the NIMH in 1986. Her research has focused on diagnosis and treatment of childhood neuropsychiatric conditions, including Sydenham’s chorea, Tourette Syndrome, Obsessive-Compulsive Disorder (OCD), and autism spectrum disorders. Dr. Swedo and colleagues were the first to describe a post-infectious etiology for OCD and define criteria identifying the PANDAS subgroup (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). Current research efforts are directed at identifying biological causes for behavioral syndromes and developing new and more effective therapies. Dr. Swedo received her B.A. degree from Augustana College in 1977 and her M.D. from Southern Illinois University in 1980.

Rebecca Landa, Ph.D., CCC-SLP

Dr. Rebecca Landa is the founder and director of Kennedy Krieger’s Center for Autism and Related Disorders. She is an associate Professor of Psychiatry in the Johns Hopkins University School of Medicine. Dr. Landa obtained her master’s degree at the Pennsylvania State University and her doctorate at the University of Washington. She completed post-doctoral training in Psychiatric Genetics at Johns Hopkins. She is the recipient of the NIMH Shannon Award for excellent and innovative research, as well as the Rita Rudel Prize for Developmental Neuropsychology. Dr. Landa is the recipient of the 2009 Alumni Recognition Award from the College of Human Health and Development of the Pennsylvania State University.

Dr. Landa’s research has focused on neuropsychological, learning, and communication processes in autism across the lifespan. She was the principal investigator of an NIH STAART Center of Excellence, through which she developed and defined the evidence-base for the Early Achievements intervention for toddlers with autism spectrum disorders. She has pioneered research aimed at identifying the earliest signs of autism through the study of infant siblings of children with autism. Dr. Landa is the author of the Pragmatic Rating Scale, used internationally in autism-related research and clinical practice. Her current research focus is on learning processes in autism, as well as early detection of and intervention for autism spectrum disorders (ASD).

Save the Date: Joint Meeting of the IACC Subcommittee on Safety and Services Subcommittees – May 19, 2011

19 Apr

Next month the Interagency Autism Coordinating Committee will be hosting a joint meeting of the Safety and Services subcommittees. The subject will be seclusion and restraints. The announcement is below:

Save the Date: Joint Meeting of Interagency Autism Coordinating Committee (IACC) Subcommittee on Safety and IACC Services Subcommittee

Please join us for a in-person joint meeting of the IACC Subcommittee on Safety and the IACC Services Subcommittee to discuss issues related to seclusion and restraint and autism spectrum disorder (ASD). The meeting will take place on Thursday, May 19, 2011 from 10:00 a.m. to 4:00 p.m. ET. The meeting will also be available for public access by conference call and live webcast.

Meeting location:
Bethesda North Marriott Hotel and Conference Center
5701 Marinelli Road
Bethesda, MD 20852

The meeting will be open to the public and pre-registration is recommended. Seating will be limited to the room capacity and seats will be on a first come, first served basis, with expedited check-in for those who are pre-registered.

The meeting will also be accessible by conference call and live webcast. Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard.

Conference Call Access
USA/Canada Phone Number: 888-577-8995
Access code: 1991506

Webcast: http://videocast.nih.gov

If you experience any technical problems with the conference call or webcast, please e-mail IACCTechSupport@acclaroresearch.com or call the IACC Technical Support Help Line at 443-680-0098.

Please visit the IACC Events page for the latest information about the meeting, including registration, remote access information, the agenda and information about other upcoming IACC events.

Contact Person for this meeting is:

Ms. Lina Perez
Office of Autism Research Coordination
National Institute of Mental Health, NIH
6001 Executive Boulevard, NSC
Room 8185a
Rockville, MD 20852
Phone: 301-443-6040
IACCpublicinquiries@mail.nih.gov

93% of US parents trust vaccinations

19 Apr

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

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

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

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

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

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

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

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

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

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

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

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

Source.

Left Brain/Right Brain Performance Issues – need your input

19 Apr

Hi friends (as pD would say),

As a few of you have noticed, LBRB is getting a bit slow. I think there are some obvious reasons for that – the database is heavy with nearly 9 years worth of posts and comments, our hosts are not all they could be etc.

However, there are a few things I can and have tried. I’ve cut out a few of the site features and I’ve optimised scripts etc to within an inch of their life. What I need now is your input. Is the site faster? Is it performing better? What pages/sections are particulalry troublesome for you? etc etc.

Thanks for any input you can offer.

Indictment for Poul Thorsen

19 Apr

Poul Thorsen was a key person in setting up a CDC funded team to perform epidemiology in Denmark. He has recently been indicted for wire fraud. Below are some of the key parts of the indictment which I feel will be of interest to the discussion:

Count Paragraph 5 of the indictment reads:

Aarhus University and Odense University Hospital administered the CDC grant under the direction of a principal investigator, who was assigned scientific and administrative oversight.

Count Paragraph 6 starts with:

In 2002, after CDC awarded the grant, defendant THORSEN went to Denmark and became the principal investigator, responsible for administering the research money awarded by the CDC to Denmark.

So, at least according to the Grand Jury that indicted him, Poul Thorsen was the “principal investigator” and was assigned “scientific and administrative oversight”. I bring this up because the question posed by many is “how much was he able to influence the scientific results?”. I can’t find the comment right now, but I do recall one collaborator (I believe Madsen) stating that Mr. Thorsen did not have the ability to

From Count Paragraph 8 we get some details as to how the scheme was allegedly pulled off:

“The invoices falsely claimed that a CDC laboratory had performed work under the grant for which Aarhus University owed money.

I.e. he told his University in Denmark that the CDC was doing some of the work and that money had to be transferred back to pay for that. But, it appears that the money was transferred into personal accounts belonging to Mr. Thorsen.

Now, here’s the part that’s going to get a lot of speculation going.

On or about the dates set forth below in the Northern District of Georgia and elsewhere the defendant! POUL THORSEN aided and abetted by others known and unknown to the Grand Jury and for the purpose of executing the aforementioned scheme and artifice to defraud, transmitted and caused to be transmitted by means of wire communication in interstate and foreign commerce, writings, signs, signals, and sounds, that is, wire transfers ln the following amounts from accounts held by Aarhus University in Denmark to accounts held by defendant THORSEN at the CDC Federal Credit Union Atlanta, Georgia:

aided and abetted by others known and unknown to the Grand Jury

Many will ask “were members of his scientific team involved in the money transfers?” Some will just assert it as fact.

Note that the dates involved are from December 2006 to October 2008. This is long after the main autism/vaccine studies were performed. However, if true, these charges do show a man of low personal integrity. This will be used to question his work. However, the fact remains: his work has been replicated. Take the studies from his group out–discard them entirely–and the story remains the same: neither thimerosal nor the MMR vaccine caused an autism “epidemic”. The risk of autism is not higher for those who got vaccines with thimerosal or the MMR vaccine.

Mother who withheld cancer treatment from autistic son sentenced

16 Apr

Kristen LaBrie was sentenced today to 8 years in prison in the death of her son. Her son was autistic and developed cancer. Doctors thought the cancer (non-Hodgkins lymphoma) was treatable, and gave the child a 90% chance of surviving. His mother didn’t give him the chemotherapy and he developed leukaemia. In the end, the leukaemia killed him.

Courtroom video is here (I can’t figure out how to embed the video).

The announcer in that video states “her mental state was weakened after providing 99% of his care”

Her attorney is shown towards the end of the video stating: “She made a decision in her mind to stop the medication. But the decision was not made consciously. It was a result of her losing her ability to be objective”

From the Boston Herald:

LaBrie’s lawyer, Kevin James, told the jury LaBrie was depressed and overwhelmed by caring for her son. She made a “tragic mistake” in stopping her son’s at-home medication, James said, but her actions were not criminal.

From the Boston Globe:

LaBrie, 38, told the jury she stopped giving him the medications because she couldn’t bear to see how sick the side effects made him.

Prosecutors portrayed her as a single mother seething with resentment because she had to care for Jeremy alone.

TIME Magazine posed this question:

Was justice done? It’s hard to know. Certainly, disabled children have rights. But moms do too, and it appears that LaBrie did not have adequate support. Being a single mother of a healthy child is tough enough. Factor in autism and a kid who can’t communicate makes it that much harder. Add non-Hodgkin’s lymphoma, and the burden is fierce.

Do autistics get enough support? No.
Do parents get enough support? No.
Is this an excuse for withholding medication? No.

There are cases through the years of parents of disabled kids either actively or passively assisting in the deaths of those children. How can we as a people figure out ahead of time that these parents are making these tragic, and criminal, decisions?

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

15 Apr

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

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

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

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

Federal government denies Oregon waiver on special education cuts

15 Apr

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

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

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

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

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

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

Studies on the autism-vaccine hypothesis

15 Apr

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Studies looking at thimerosal:

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

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

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

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

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

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

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

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

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

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


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

Additional studies looking at vaccine safety:

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

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

A Systematic Review of Secretin for Children With Autism Spectrum Disorders

15 Apr

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

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

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

Here is the conclusion of the paper:

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

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

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