Thursday, June 30, 2011

Blaming Autism Parents: The Self Described Science Bloggers

Harriet Hall, MD,  photo by Sgerbic 

There are a number of so called science bloggers on the internet that routinely attack any criticism of, or concerns about,  vaccine safety. Because of the belief by many parents of autistic children that their child's autism is in essence a form of vaccine injury, parents of autistic children are routinely attacked, ridiculed and mocked by self described science bloggers and authors on the internet.  Any scientific study is used as a pretext to attack the "anti-vaccine contingent" code for for autism parents (medical persons who ask questions about vaccines and autism such as Dr. Bernadine Healy are simply ignored) who feel their children's autism resulted from, or was triggered by, vaccine injections.  A blatant example of this type of "science" blogging can be found in the comment by Harriet Hall MD,  Autism and Prenatal Vitamins, on the blog titled Science-Based Medicine .

In Autism and Prenatal Vitamins Dr. Hall, also known as the "SkepDoc" embraces the recent study by Schmidt et al. published in Epidemiology on May 23, 2011, entitled “Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism.”  That study as summarized by Dr. Hall, "found that mothers who didn’t take prenatal vitamins were at greater risk of having an autistic child, and certain genetic markers markedly increased the risk. There was a dose/response relationship: the more prenatal vitamins a woman took, the less likely she would have an autistic child."

The good Doctor does report some weaknesses of the study: "A weakness of their study is that it depends on patient recall long after the fact. Also, it did not attempt to gather any diet information." I am just an ignorant parent of an 15 year old son with autism (and a neutral in the vaccine autism controversy) but it seems to me, as someone who is also a lawyer, that evidence based on memories long after the fact, with no record of other sources of vitamins ... diet ... are not just weaknesses. It seems to me they are serious weaknesses in the study.

It would also be interesting to see the actual questions asked about prenatal vitamin consumption long after the fact  to see if they were in any way "leading" questions.  As a humble, but active, litigation lawyer I have to be conscious of such questions in a courtroom or tribunal proceeding since leading questions contain the answers being sought by the person asking the question. They suggest the "correct" answer to the person being questioned. The risk of such questioning arising in a study based on memories of long ago events which do not account for possible competing factors .... diet ... seem to this humble small town lawyer to be quite substantial.

I describe myself as a neutral in the vaccine autism war. I do not know what caused my son's autistic disorder.  I do accept the prevailing view that autistic disorders likely result from the interaction of genetic and environmental factors. I believe that the well known fact that autism research funding has been overwhelming directed towards genetic research has limited our understanding of possible environmental triggers. I also believe that vaccine autism connections have not been thoroughly studied despite the Offit Offensive rhetoric to the contrary.  Specifically, Dr. Bernadine Healy pointed out that more study is needed on the possible impact of vaccines taken by pregnant women, particularly when they contain thimerosal.

I welcome research like the vitamin study commented on by Dr. Hall and hope that more studies are conducted on the possible role of prenatal vitamins in causing or triggering autism. Presumably such studies might confirm, refute, modify, or clarify the results reported in this initial study. What I do not welcome is the tendency of intense vaccine safety defenders like Dr. Harriet Hall to use any such study as a launching pad to attack autism parents and to deter any further examination or study of possible vaccine autism connections. Having provided a clear and comprehensible summary of the prenatal vitamin-autism study that even this  autism parent can understand Dr. Hall apparently felt the need to attack autism parents and defend vaccine safety even though the study had nothing to do with vaccines:

"How will the anti-vaccine contingent react to this new study? It was convenient and satisfying for parents to be able to blame vaccines and accuse the evil medical establishment of causing their children’s autism. Now will those parents accept that at least part of the responsibility lies with their own genetic contributions and the mother’s actions prior to pregnancy? That’s not as palatable a thought, but it’s more realistic."

Dr. Hall's comment amounts to a confession of some important points:

1) The "anti-vaccine" contingent is simply a code for autism parents. When she and other vaccine safety defenders talk about anti-vaccine persons, when they attack or criticize them, they are simply attacking parents of autistic children.

2) More than just attacking the views of autism parents Dr. Hall makes it clear that, in her mind at least, the causes of autism disorders rest with the parents ... their genetic contributions, their actions, even their actions prior to pregnancy.  

Autism can not, in Harriet Hall's opinion, result from the contributions of vaccines, the pharmaceutical companies that manufacture them, the doctors who inject them into patients, including pregnant women, the manufacturers of jewelry, children's toys and common household items containing mercury, lead, arsenic, or any other known environmental contaminants in our air or water supplies. 

No, what Dr. Harriet Hall has been quite honest about, to her credit,  is the need of many medical professionals to blame parents in the vaccine autism debates and deter any further investigation of possible vaccine autism connections. 


Shannon said...

I took my vitamins religiously through all three of my pregnancies and had two children on the spectrum. Granted, my recall is a little rusty, but it was something my husband and I considered important and he regularly asked me if I had remembered to take my vitamins so I made it a part of my daily routine.

Most women take prenatal vitamins (I've never known a single woman who didn't). Dr. Hall is going to have to look elsewhere for some way to make parents responsible for our childrens' autism.

M.J. said...

I love the phrasing that the good MD used - "Now will those parents accept that at least part of the responsibility lies with their own genetic contributions and the mother’s actions prior to pregnancy".

Because, you know, every autism parent out there is just shirking their responsibility when they try and blame some external factor for their child's autism when what they should really be doing is accepting that it is all their fault. Someone should tell Ms. Hall that the 1950s is calling and wants their theory of autism back.

I wonder how the evidence based crowd can reconcile the strict adherence to "show me the evidence" while at the same time saying that a parent is "responsible" for failing to take an action that isn't evidence-based. If there is no evidence that doing something (i.e. taking prenatal vitamins before pregnancy) will help prevent autism, how on earth can the same parents have blamed for not doing it? Are we supposed to follow the evidence or not?

Usethebrains Godgiveyou said...

We don't have a clue, so we make wild guesses, and try to prove them correct. That's not science. It is a nice way to get your name in the paper, though.

As long as parents are blamed, their lack of professionalism isn't noticed.They are looking for a scapegoat. Like schools that blame the children for not learning the way they teach.

I knew I would comment when I saw the title. I guess I really do have a vendetta against science in regards to autism. They have proven themselves dishonest time and time again, yet ask for my undying devotion to their brilliant minds.

It's hard, too, because I love science. I always scored at a very high percentile in testing when a child, and lived and breathed observation of nature.

Usethebrains Godgiveyou said...

Scapegoat. Did I say scapegoat? That's the point I wanted to make. Learning Disabled kids and parents of autistic children can be easy scapegoats for professionals.

Minority said...

I think the "attack parents" approach can backfire badly for the skeptics.

Claire said...

Wow. I know this is serious business but...20 years ago with my first, I took no prenatal vitamins and indulged, daily, my pregnancy induced craving for curried meals. My eldest ended up neither autistic, nor East Indian. Keep pounding away at it, Harold.

Anonymous said...

Took my vitamins during both pregnancies. Didn't get any vaccines- not even the flu shot!- during either pregnancy. Still ended up with a kid on the spectrum, and a kid who is absolutely fine. Correlation does not equal causation!

farmwifetwo said...

1. Like Shannon I took my vitamines.

2. Is she now blaming me for the high blood pressure. The kind of prenatal care I received when my bp went up with both boys. And some how it's my fault that when I told them - and I was in antenatal - on Sat morning my kid had stopped moving and that they waited until Sun morning to do the non-stress test. And then instead of a quicky "c" they induced and that "c" wasn't done until his heart rate dived near midnight - as it did 5 days before when we arrived at the hospital and were given a bed - that all this is somehow my fault???

Yep... all my fault...

AutisticAlms said...

I find it funny that they ridicule parents of vaccine-injured children, claiming that their claims of vaccine injury are subject to recall bias. However, when a study that comes out that supports their position that also is subject to recall bias, then it's a perfectly legitimate study.