Saturday, July 14, 2012

The Burden of Proof: IACC Director Insel's 2009 Statement On Autism Increases

"Based on the above mentioned research, approximately 53% percent of the increase in autism prevalence over time may be explained by changes in diagnosis (26%), greater awareness (16%), and an increase in parental age (11%). While this research is beginning to help us understand the increase in autism prevalence, half of the increase is still unexplained and not due to better diagnosis, greater awareness, and social factors alone. Environmental factors, and their interactions with genetic susceptibilities, are likely contributors to increase in prevalence and are the subject of numerous research projects currently supported by Autism Speaks.

The increase in autism prevalence is real and the public health crisis is growing. More families are affected by autism today then ever before."

Autism Speaks Official Blog, October 22, 2010, 
Before the Recent CDC estimate that autism now affects 1 in 88 children.

The Neurodiversity ideologues are doing it again.  

Each announcement of increased  rates of autism diagnoses (the past year saw the CDC revise its estimate from 1 in 110 to 1 in 88) brings the same, tired refrain about increases in autism: it ain't real babe.  The Neurodiversity ideologues recycle the explanations trotted out for each announced increased in autism rates: 1994 DSM diagnostic definition changes and increased awareness being the two most prominent. 

They have done so again in an article in Discovers "big idea" blog "The Crux" by Emily Willingham. Discover is the home of Neurodiversity writer Steve Silberman and the Willingham article was immediately embraced in an article by another Neurodiversity "science" journal: Boing Boing.  Boing Boing quickly  applied its scientific expertise and  reported, based on Willingham's opinions, that " It looks like the majority of the "increase" in diagnoses can really be attributed to the process of diagnosis itself"

No one denies that the two decade old diagnostic definition change and increased awareness factors, explain part of these increases, the issue is whether they explain them entirely or to what extent and whether the increased rates also reflect real increases, increases arising from environmental factors. 

Dr. Tom Insel is known to everyone involved in autism issues as the head of the IACC, the Interagency Autism Coordinating Committee.  He can not be attacked as being an "anti-vaxxer" or as an emotional, hysterical parent of an autistic child.  Dr. Insel had this to say in a December 18, 2009 interview by David Kirby:

"It looks like about 24 percent of the California increase can be attributed to something like a change in diagnosis criteria. They are beginning to use multiple diagnoses. So that children before, who were listed simply as mentally retarded rather than autism - but they had both - are now logged in with both. But that really caps out at around 24 percent. There’s probably another piece of this, which globally could be attributed to ascertainment. But that caps out at around 16 percent, or something like that. And when you put all of that together, you are still well below explaining 50 percent of the increase.

So what does that mean? It means that, as far as I can tell, the burden of proof is upon anybody who feels that there is NOT a real increase here in the number of kids affected. Because all of the evidence we have up until now says that, well there are what we could call – I wouldn’t call them ‘trivial’ factors – but they are factors that are not related to incidence, but would be simply related to prevalence, like ascertainment. But they don’t really explain away this huge increase. "

This tells you that, you really have to take this very seriouslyFrom everything they are looking at, this is not something that can be explained away by methodology, by diagnosis. Some piece of it can, but the whole thing can’t."" 

It fits Emily Willingham's Neurodiversity ideology to recycle the diagnostic change/substitution and increased awareness factors.  What we don't need is yet another recycling of these long understood factors which undoubtedly explain part of the increases in autism rates.  What we do need is a focused environmental research strategy as advocated for In A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilitiesan editorial in a recent issue of Environmental Health Perspectivesauthors Philip J. Landrigan, Luca Lambertini and Linda S. Birnbaum.

Landrigan, Labertini and Birnbaum summarized the evidence for the "proof of principle" that early exposures during “windows of vulnerability” that open only in embryonic and fetal life and have no later counterpart can cause autism.  They review the large numbers of synthetic chemicals, many of them untested, some of which are known to have toxic properties. The authors proposed a strategic approach to researching possible environmental causes of autism by focusing:

"research in environmental causation of NDDs on a short list of chemicals where concentrated study has high potential to generate actionable findings in the near future. Its ultimate purpose is to catalyze new evidence-based programs for prevention of disease in America’s children."

We don't need more recycling of the known diagnostic change and ascertainment factors that undoubtedly explain part of the incredible increases in autism diagnoses. What we need is leadership by the IACC and other major autism focused health agencies to encourage a stragic approach to determine  possible environmental factors involved in causing the various autism disorders. 

What we need is to find out what has been, and still is, happening to our children.  Until we do the burden of proof is on those who push the non-environmental factors which explain only part of the incredible increases in autism diagnostic rates.


Katie Wright said...

What Dr. Insel says and what Dr. Insel does are often 2 different things. Insel has talked about about he gets it- parents want more environmental research. However in the past 5 yrs only 5 % of ALL autism research $ has been spent on environmental research. Over and over again the research highlights Insel chooses to share w committee are the same old gene/ brain/ early intervention studies. Insel has been ignoring the explosion of research connecting environmental toxins, and yes vaccines, to autism.

Listen, no one expects Insel to appoint (and let's be real- Insel makes the appts, Sebelius has never even sat through 1 mtg and know so little about autism)all ASD parents but 4 HF Aspergers people and only 1 parent involved in a environmental research? Only 1 parent w regressive child? Only 1 parent who works with sick and medically affected ASD kids? 1 out of 20+ is not fair representation. Insel is responsible for this.

Unknown said...

I don't disagree with you Katie. I agree that environment has been largely ignored for autism research funding purposes. I applauded the job you and other Canary Party activists did in standing up for our children, for the environment, for common sense and reality at the IACC meeting.

My point in this comment is that even IACC director Insel has acknowledged straight up that environment plays a substantial role, that a substantial part of the increases are real and that anyone who denies those points has the burden of proving otherwise.

I am glad you commented on this topic on this blog. I do want you to know that I was very impressed with what you and the other "Canaries" did in speaking the truth to power at the IACC.

Harold Doherty

Dolly said...

Is the chart here Canadian? Im doing Autism for a mental health fair in school, and wanted to get Canadian stats.. I know this is based off NB just wanted to make sure. Thanks :)

Unknown said...

Dolly the information published here is American from the US Center for Disease Control. Canada does not have up to date information to my knowledge.