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 seriously. From 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 Disabilities, an editorial in a recent issue of Environmental Health Perspectives, authors 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.