Autism Reality Check: Where Are The IACC Results?

I have previously written about the importance of the IACC and in a 2009 blog comment expressly thanked the IACC for its role in advancing autism research.  With the passage of 3 years though I have  become a less enthusiastic IACC booster.  Both the Canary Party and the Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) have called for an accounting from the IACC and its leadership. I support their calls for accountability.  

Autism advocate representatives on the committee have been anti-cure ideologues while autistic persons seeking cure like Jonathan Mitchell are ignored in every sense of the word.  The IACC, despite paying lip service to gene environment interaction has for the most part continued to subscribe to the "it's gotta be genetic" belief system for explaining what causes autism. 

During the IACC existence, and during the 14 years since my son's autistic disorder diagnosis,  autism diagnosis rates have literally exploded. Yet the IACC makes no serious effort to address this burgeoning rate and allows the public to believe the tired, repetitive, and unsubstantiated excuses that every single reported increase in autism is due entirely to mid 90's diagnostic definition changes, enhanced awareness and diagnostic substitution motivated by parental desire to obtain all those wonderful autism services that apparently exist in every school district in the US.

I am not anti-IACC but I do believe there should be some accounting provided.  As the Autism Gadfly Jonathan Mitchell has said non-Americans, including Canadians like me, have no right to DEMAND anything from an American taxpayer funded institution but the IACC has an important role to play in autism research and, like many US institutions, has a world wide impact.  As a Canadian autism dad I ask the IACC to provide a real world accounting of its efforts.  Are we any closer to understanding autism causes? Will the IACC continue to politely ignore the environment side of the gene environment base of autism disorders?  Will we actively direct our research towards cures and treatments?

If I have been too one sided I invite anyone reading this blog, including the academics and researchers who occasionally humor this autism dad with a visit to my blog, to please provide examples of real world results achieved by the IACC or indicate where the IACC is going and whether it still hopes to find causes, cures and treatments for the increasingly diagnosed autism disorders.

Autism Rising: LA Times Gets It Wrong

The LA Times has written an  ill informed, one sided, article on autism increases which misleads the public into believing that the evidence has clearly established that the entire increase in autism diagnoses over the past two decades is attributable to the 1994 DSM diagnostic manual changes, diagnostic substitution, and the hunt for government funded autism services. The article, Discovering Autism Unraveling an epidemic, can be summarized in the following paragraph from the article:


"Two decades into the boom, however, the balance of evidence suggests that it is more a surge in diagnosis than in disease."

The truth is the LA Times article publishes no reference to studies that confirm that conclusion about the alleged balance of evidence.  The LAT does refer dismissively to Dr. Irva Hertz-Piccioto who has conducted research on possible environmental causes of autism disorders.  It also offers selective quotes from a variety of other autism sources, in addition to Roy Richard Grinker, the anthropologist and father of a high functioning child with Aspergers, who has sought out all the allegedly autistic Korean children who function very well in Korean society.

What the article does not mention is the emerging consensus that autism arises not just from genetic factors, which would support the biased perspective the LAT offers, but from the interaction of genetic and environmental factors.  Nor, in dismissing Dr. Hertz-Picciotto's work, does it mention that genetic autism research has been overwhelmingly funded at the expense of environmental autism research.  Better to present positively the opinions of a biased anthropologist with an agenda then an actual autism researcher.

Dr. Bearman, a sociologist, is also quoted but not in any meaningful way. He was interviewed more fully, or quoted more fully, in an article on the National Institute of Mental Health website reporting a discussion Dr. Bearman had with Dr. Tom Insel of the IACC:

Dr. Insel: From what you know now when you add all of those together how much of the increase can you explain?


Dr. Bearman: Well that’s a complicated question, but I think we can pretty uniquely associate about a quarter of the increase from the birth cohorts from 1992 to 2001 which is a lot, to diagnostic change on the border between diagnosis and mental retardation in autism. I think we can associate about 16 percent of the increase on the other border between autism and other neurodevelopmental disorders on the spectrum: Asperger’s, PPDNOS etc. And those are largely non over-lapping components of increase, so that’s about 40 percent. I think the spacial clustering itself adds another few percent. I would say I am confident that 40 percent of the increase I think I know what caused that. That leaves a lot of increase left, 50 percent is a lot to look for still.


Dr. Insel: Any ideas about what’s driving that other 50 percent?


Dr. Bearman: Well, some is genetic. I think that the increased parental age accounts were 11 percent of the increase over this period and that’s a lot and the mechanism by which increased parental ages expressing itself I think likely largely genetic. I think the tricky part is going to recognize that it would be harder now to find that 50 percent. It would look like it should be some toxicological environment that’s shared because of the spacial clustering. Because there’s a very strong process of amplification of the understanding of autism that leads to increased diagnosis as parents learn how to recognize symptoms a very, very, small event that would transform the environment five years ago, ten years ago, even you could imagine, 40 years or 50 years ago, when the moms of children with autism now were in utero as eggs- a very small event could cascade into a larger epidemic now."

The LA Times could have checked out the web site of the IACC, the Interagency Autism Coordinating Committee which states:

"As with many complex disorders, [autism] causation is generally thought to involve some forms of genetic risk interacting with some forms of non-genetic environmental exposure. ... In addition, a number of other environmental factors are being explored through research because they are known or suspected to influence early development of the brain and nervous system. Recent studies suggest factors such as parental age, exposure to infections, toxins, and other biological agents may confer environmental risk. ... Progress in identifying environmental factors which increase autism risk has been made recently (Eskenazi et al., 2007; Palmer et al., 2006; Palmer, Blanchard,; Wood, 2009; Rauh et al., 2006; Roberts et al., 2007; Windham et al., 2006), although this area of research has received less scientific attention and far fewer research dollars than genetic risk factors" [Underlining added - HLD]


- United States IACC (Interagency Autism Coordinating Committee)

No one disputes the obvious fact that the 1994 DSM changes increased the number of autism diagnoses.  The LAT implies though that the "science" indicates that the increase in autism diagnoses is simply a matter of diagnostic change and substitution and that environment plays no significant role in causing autism disorders. That position amounts to a confession of ignorance and/or bias by the LAT ... and a lack of concern over whether the number of autism diagnoses could be decreased if the research dollars were distributed more evenly towards research of environmental causes and triggers of autism disorders. 

Should Grinker and Co's Flawed South Korean Autism Study be Taken Seriously?

The newly reported autism study from South Korea with its "shocking" 1 in 38 autism rates figure doesn't make much sense. As reported in the Boston Globe:

"Roy Richard Grinker, a cultural anthropologist at George Washington University who worked on the study, said his own child with autism would probably function very well in such a system.

"Many kids with autism who are doing well can adapt to that highly structured situation," he said.

So, what does this finding mean for the United States?

Not necessarily much, according to several researchers who were not involved in the study. They praised the study generally, but pointed out flaws and assumptions that raise questions about whether there really are so many kids with autism in South Korea -- and by extension, in the United States.

Dr. Isaac S. Kohane, a professor of pediatrics at Children’s Hospital Boston and Harvard Medical School, said he thinks the researchers may have taken their estimations too far by assuming that the rate of autism was the same among the nearly 700 families who declined followup assessments for their children, as among the ones who agreed. Wouldn’t a parent worried about a child be more likely to participate than one with no concerns? Without this assumption, Kohane says the researchers would have found roughly the same 1 in 100 prevalence we see in the United States.

Also, the definition of "autism" is so squishy today that it’s very hard to draw the line between autistic and non-autistic, he and other researchers said."

I am the father of a low functioning son with Autistic Disorder and I am not a fan of Roy Richard Grinker's involvement in defining autism and autism prevalence estimates. Grinker is the father of a high functioning child with Asperger's who favors the New Autism Spectrum Disorder definitions of the DSM-5.

I don't know why an anthropologist with strong biases was involved in an autism prevalence study in South Korea. I am not surprised though if a Grinker involved study found higher rates of autism ... particularly if the autistic persons found to have been missed were very high functioning.

Regardless, Dr. Kohane a professor of pediatrics at Children’s Hospital Boston and Harvard Medical School has pointed out some serious flaws and assumptions involved in the study. Hopefully other serious professionals will examine the study and consider Dr. Kohane's comments before promoting the 1 in 38 study from Grinker and Co.

Autism Research After the DSM5? At Least Grinker Will Be Happy

Will the DSM5 render meaningless all autism research to date? Will the DSM5 make it impossible to determine whether autism disorders are increasing or whether they are triggered or caused by environmental factors? The odds are good, given the difficulties in answering these questions resulting from the expansion of "autism" disorders in the DSM-IV and DSM-IV-TR to include Asperger's, that our understanding of autism prevalence and causation will be hampered substantially, and perhaps totally undermined, by yet another revision of the autism diagnostic categories in the DSM-5.  Even our understanding of what autism is will likely change, again, as a result of the DSM-5 revisions.  The intellectual disabilities that characterized the vast majority (Yeargin-Allsopp) of persons with classic autism will now be totally  replaced by the "socially quirky" model of autism.

Autism is now recognized globally with a World Autism Awareness Day each April 2.  While the day is used for autism fund raising, and celebrating the color blue,  it does little to actually raise awareness about the nature of autism, the numbers of persons with autism disorders, or the causes or treatment of autism.  Amongst the leading factors that contribute to our inability to qualitatively improve our understanding of autism disorders is the changing diagnostic definition of autism, increased social awareness and according to some at least, the widescale availability of autism treatments and education accommodations prompting diagnostic substitution by professionals, often prompted by parents.

Roy Richard Grinker is one of the best known advocates of the "don't worry, be happy" autism is not really increasing school of thought.  A 2007 copyright summary of Grinker's  book Unstrange Minds tells us all what was really happening with autism increases ...  in Grinker's opinion:

"Unstrange Minds shows how the shift in how we view and count autism is part of a set of broader shifts taking place in societies throughout the world. The growth of child psychiatry, the decline of psychoanalysis, the internet, the rise of international advocacy organizations, greater public sensitivity to children's educational problems, and changes in public policies have together changed the way autism is diagnosed and defined.


Societies are becoming more aware of children's behavioral and learning differences at earlier and earlier ages and more comfortable with diagnosis, medication, and psychiatric labels. Under the rubric of autism we now find a multitude of emotional and cognitive problems, problems that used to be given other diagnostic labels or that were even considered within the range of the normal. Doctors now have a more heightened awareness of autism and are diagnosing it with more frequency, and public schools in the United States, which first started using the category of autism during the 1991-1992 school year, are reporting it more often, developing ways to help children with autism, and directing parents to appropriate resources. Epidemiologists are also counting it better.


As a result, the statistics on autism that we have today - 1 in 166 -- are the most accurate we've ever had."

 The 2007 summary was written more than a dozen years after the last diagnostic definition change for autism disorders in the DSM manuals.  Yet the CDC recognized rates have moved upward twice since then to 1 in 150 and most recently to 1 in 110.  I am no cultural anthropologist but with a change from 1 in 166 to 1 in 110 it seems fool hardy to simply assume that the increased rates of approximately another 50% in 4 years are accounted for solely on the basis of diagnostic and social ascertainment factors. 

It is worthy to note that the IACC has acknowledged that the almost 100% dedication of autism funding toward genetic focused research has come at the cost of needed environmentally focused research, that the current thinking is that autism arises from the interaction of genetic and environmental factors (hardly a radical concept) and that the IACC view is that the social and diagnostic changes account for only approximately 50% of the dramatic increases in reported cases of autism disorders.

It seems that, finally the feel good, autism is 100% genetic and is not really increasing view of the Grinker (and Neurodiversity) model of autism is about to be seriously challenged and hopefully researched.  But wait a minute ... along comes another autism diagnostic revision in the DSM-5. 

PREDICTION: The DSM-5 autism diagnostic revisions will once again be used to cloud and confuse our understanding of autism rates and causation.  Many concerned parents and concerned professionals will be  Out of Luck in hoping for more understanding of autism.  Roy Richard Grinker, however, and those for whom exploration of potential environmental causes of autism are a nuisance, should be happy that Grinker's 100% genetic, stable model of autism will be protected from serious research challenges for decades to come.

An Open Letter to Dr. Steven Novella Concerning His Positions on Vaccines and Autism and Dr. Novella's Reply

UPDATE: See end of this comment for Dr. Novella's reply

Dear Dr. Novella

I am a parent of a 13 year old boy with Autistic Disorder. I also have a blog site on which I commented unfavorably on your response to the possibility that the IACC might recommend some vaccine autism research. I ask your response to a few questions if you have the time and are inclined to respond.

One is your apparent opposition to any further research exploring possible vaccine autism connections. I am not an "anti-vaxxer". I have never attributed my son's autism to vaccines. Until recently I accepted the official view that vaccines play no role in causing autism. More recently my views have moved toward an undecided position. This change began when reading Dr. Bernadine Healy's observations about the limitations of the epidemiological studies which are usually used to allegedly "debunk" any vaccine autism connection. In her comments she indicated that such studies are not specific enough to address the possible impact of vaccines or their ingredients on potentially vulnerable population subsets.To this layperson Dr. Healy's criticism seems reasonable as does her call, a call also made by Dr. Julie Gerberding, that an observational study comparing autism rates in existing vaccinated and non vaccinated populations could and should be done. Your opposition to further vaccine autism study does not, with respect, seem either reasonable OR science based. I ask if you could provide a clear rationale for opposing a study which has been called for by two prominent health authorities and which might provide useful information to what is a heated debate on all sides.

The second question I have for you concerns the increase in autism diagnoses which has really been quite startling by any measure. In my son's lifetime the figure has changed from 1 in 500 to 1 in 150 with the two recent studies indicating it might now be 1 in 91. Many authorities dispute though that the increases are real pointing to the autism definition changes in the DSM and ICD diagnostic manuals in the 1993-4 period and increased social awareness as the reasons for the increases in diagnoses. Is it your view that the increase in autism diagnoses does not reflect a real increase in autism disorders? If so what are the implications of that position for the argument that epidemiological studies have disproved any thimerosal vaccine link because autism rates increased after removal of thimerosal from MOST vaccines?

Also if you have the time and inclination do you think Dr. Healy's observations that thimerosal which continued to be found in flu vaccines, some of which historically were administered to pregnant mothers, was a matter worthy of investigation given that the thimerosal crosses the placenta is a legitimate concern worthy of further investigation? This is an important matter here in Canada where the squalene adjuvant was removed from the vaccines given to pregnant women but there has been no indication that thimerosal has been removed.

I would genuinely appreciate your responses to these questions which I am posting on my blog site. If you do me the courtesy of an informed reply I would be happy to post that reply as well.

Respectfully,


Harold L Doherty

cc. Facing Autism In New Brunswick

UPDATE:

Dr. Novella's Reply:

Harold,

Thanks for your thoughtful e-mail. I would be happy to address your questions.

Regarding further research - it is always possible, in the face of negative results, to call for still more research. And it is easy to make this seem like the default scientific position. ESP proponents, after a century of failed research, call for still more research, and accuses anyone who says further research is not worthwhile of being unscientific.

Also, to clarify my position, I am not categorically against further research into vaccines and autism. I think any such research is most likely to confirm the lack of a correlation. And if there is a susceptible sub-population, of course it would be good to know about it to make the vaccine program even safer. (But keep in mind - it is a common form of special pleading to argue that, when the effect you are looking for is absent, that is only exists is a subpopulation that existing data was not powerful enough to detect. This may be true, but it is just post-hoc speculation, and doesn't change the fact that the data is negative.)

My position is that ideological groups should not be dictating how scarce research funds are allocated. When we put money, people, and resources into chasing down an unlikely hypothesis those resources are not available for what might be more promising research. My position is that objective scientists, justifying their position with a careful analysis of the research, should decide how best to allocate scarce research funds. The anti-vax movement, however, is trying desperately to put their thumb on the scale - and that is what I oppose. They are trying to subvert autism activism to serve an anti-vaccine agenda - and they are hurting the autism community as a result, in my opinion.

I respect Healy and Gerberding, but I disagree with their approach in that they think more research will satisfy vaccine critics, but this is a naive position. The anti-vaccine movement has already demonstrated that they are impervious to facts and evidence, and spending time and money trying to placate them is a fool's errand. The CDC even went as far as to include them in designing a trial looking at vaccines and neurological disorders, and then only after the results came back negative, did they criticize the study.

You specifically mention an observational study comparing vaccinated and unvaccinated children - I do not oppose this. If it can be done with reasonable resources, there are scientists willing to carry out such a study and think it is worthwhile, and the results will be useful, then I fully support it and await the results. (And in fact I have never opposed such studies.) What I and others have written is that an experimental (not observation) comparison of vaccinated vs unvaccinated children is unethical, because it would randomize children to no get standard preventive care, and that directly violates human research ethical guidelines. Observational studies are fine, but they are never definitive, and they will not, in my opinion, change or end the debate. They will not move the anti-vaccinationists one bit

The increase in autism diagnoses has been studied from multiple angles - not just the expansion of the diagnosis.

You will find a summary of relevant research here: http://sciencebasedmedicine.org/reference/vaccines-and-autism/

So far, every way it has been looked at the hypothesis that the increase in diagnosis of ASD is due to increased surveillance and expanded diagnosis has been confirmed. There is evidence of diagnostic substitution (as ASD numbers increase, the numbers of other similar diagnoses decrease). There is evidence that different age groups have the same prevalence of ASD (rather than increasing with younger age, as would result from a true increase in ASD). And if you apply the same diagnostic and surveillance methods to a cohort over time, you get the same ASD prevalence. The data is actually quite convincing that true autism rates are not significantly increasing (you cannot rule out a small real increase, or decrease for that matter, that the data is not powerful enough to detect) but that there has been expanded diagnosis with diagnostic substitution and increased surveillance.

I discuss this further here ( http://www.sciencebasedmedicine.org/?p=95) and here ( http://www.sciencebasedmedicine.org/?p=340)

The implications of this position to the alleged thimerosal link is complex, but supports a lack of correlation. What the data shows is that in various countries ASD diagnoses began to rise around the same time (as diagnostic patterns changed), in the early 1990s, and have continued to rise through today. Meanwhile, vaccine policies have varied considerably with regard to total thimerosal dose, with several countries, at different times, removing most thimerosal from vaccines. Every study looking at the data shows no correlation between the steadily increasing ASD diagnostic rates with the rising and falling thimerosal doses at different times in different countries. This is powerful evidence for a lack of correlation. As you likely know, toxicity is always about dose, and seeing a proper dose-response is essential to proving toxicity causation. What we have with thimerosal is an absolute lack of any dose-response, in many studies and sets of data.

Also, please keep in mind that the anti-vaccine movement used the increase in ASD in the 1990s as their original justification for the claim that thimerosal causes autism. They predicted that autism rates would decline after thimerosal was removed from the childhood vaccine schedule, and we agreed that if that happened we would need to rethink the possibility of a connection. Well, rates continued to rise without a blip, effectively putting the final nail in the coffin of the thimerosal hypothesis.

Regarding thimerosal and pregnancy, to the extent that this has already been studied (again, you can find references in the vaccine-and-autism link above) there has been no correlation. I do not oppose further research, however, if the CDC or others think it is warranted and feasible.

Thanks again for the interesting questions, and I hope this adequately clarifies my position.

Regards,

Steve Novella

PS - You can publish my response on your blog, and I will do likewise.

autism

Double Standards Applied to Autism Prevalence Data

With the recent dramatic change in estimated autism rates from 1 in 150 to 1 in 91 over just a two year period public health authorities, and Neurodiversity ideologues and pseudo skeptics have pulled out a number of arguments to deny, once again, that autism is rising, that there is a real increase in autism. The arguments used in denying any real increase in autism disorders over the past 2 years, are reruns of arguments used to deny increases in autism for the past 15 years. Very, very curiously, however, the same authorities, the same allegedly skeptical, scientific voices, denying autism increases also point to studies, particularly the Danish studies, using prevalence data reflecting decades of diagnoses from the early 1970's to 2000, a period encompassing drastic changes in diagnostic definition of autism disorders, heightened autism awareness, growth in autism services and increasing ability to diagnose autism.

The change in autism diagnostic definitions in the DSM III-R and DSM IV are trotted out once again 15 years later to deny the reality of autism rising. Increased social awareness is a favorite. And of course there has to be a blame the parents excuse: the alleged availability of autism services has resulted in parents seeking autism diagnoses for their children. Dr. Thomas Insel urged the world to be cautious because, after all, authorities are now better at diagnosing autism. It is not clear how the ability to diagnose autism increased by more than 50% over a two year period or what studies the good Doctor Insel relied on but after all he is the Chair of the IACC ... isn't he? But what are the implications of the unreliability of autism rate information for the vaccine autism studies which relied on such data over a longer period of time?

If all these factors diminish the reliability of a reported increase in autism disorders over a two year period, so long after the DSM III-R and DSM IV revisions of the diagnostic definitions of autism disorders, what are the implications for the vaccine autism studies that relied on increases in autism diagnoses after the removal, or the alleged removal, of thimerosal from vaccines? These studies were conducted using data that actually spanned the period prior to and after the period for which data was obtained. Can the prominent Danish studies still be used to assert that there is no correlation between thimerosal and autism?

The Madsen study (Pediatrics, September 2003) found that there was an increase in reported autism diagnoses after the removal of thimerosal from vaccines in Denmark in 1992. The authors also noted though that:

The increase in the incidence of autism from 1990 on may be attributable to more attention being drawn to the syndrome of autism and to a change in the diagnostic criteria from the ICD-8 tothe ICD-10 in 1994. Also, outpatient activities were included in the Danish Psychiatric Central Research Register in 1995 and because many patients with autism in former years have been treated as outpatients this may exaggerate the incidence rates, simply because a number of patients attending the child psychiatric treatment system before 1995 were recorded for the first time, and thereby counted as new cases in the incidence rates.

The above caution is not mentioned by those who claim that this study disproves a thimerosal autism correlation. Dr. Insel for example did not mention this caution when he appeared before Senator Harkin's subcommittee although he now frequently mentions such factors to downplay the recent reports of a more than 50% increase over a period of just 2 years. Dr. Offit speaks so often in support of vaccine safety that it is difficult to say that he NEVER mentions the caution expressed by the authors of the Madsen Danish study but I have never encountered it in his many high profile media appearances on the subject.

There are many other critical flaws in the studies cited by Insel, Offit and others as proving that there is no autism thimerosal connection, no autism vaccine, connection. They have been addressed at length elsewhere by Generation Rescue and other true skeptics. At this time what is terribly striking to me is the ease with which Insel and Offit and their follower's embrace wholeheartedly the studies which they claim support their no vaccine autism connection even though they suffer from the same factors they cite in denying a real autism increase, perhaps even more so. Conspiracy perhaps but the evidence is not sufficient in my humble opinion. Conflict of interest? Probably. Bad faith? Definitely.

Double standards and hypocrisy take on a serious twist in this story. The failure by Insel and Offit to properly inform parents of the risks associated with injection of potentially damaging substances into their children is justified by reliance on studies flawed by the same factors they point to in denying the existence of real increases in autism disorders.

Autism IS rising OR many of the vaccine autism studies of are of no value whatsoever. Those whose careers and livelihoods depend on denying environmental, including possible vaccine, contributors to autism are growing increasingly desperate but even they can not have it both ways when it comes to assessing autism prevalence.

autism

Should Dr. Thomas Insel be Replaced as Chair of the IACC, Interagency Autism Coordinating Committee?

It is clear that Dr. Thomas Insel will not permit the IACC to recommend funding of an observational study comparing autism rates of existing vaccinated and unvaccinated populations as called for by many parents and credible health care professionals. He claimed before Senator Harkin's committee that such a study could not be done, contrary to the opinion of many health care researchers including Dr. Alexander on the IACC.

Such a study could actually provide reliable information about the possible role played by vaccines in triggering autism. Dr. Insel has also downplayed the recent studies recently reporting a 50% increase in autism diagnoses over a two year period. This latest information brings the reported rates from 1 in 500 to 1 in 91 over a 10 to 15 year period. Despite this alarming trend Dr. Insel responds with speculation, unsupported by any studies, that the increase could be due to better ability to detect autism disorders.

Should Dr. Insel be replaced as Chair of the IACC, the Interagency Autism Coordinating Committee by someone who would take autism disorders seriously?

Offer your opinion here and vote in the poll on the sidebar of this site.

autism

List of Excuses for Recent Autism Rate Increase - Add Your Own

The incidence of autism spectrum disorder in eight-year-olds in the U.S. has risen by 50% since 2007, from one in 150 to one in 100, according to a CDC report that will be released later this year. However, the higher rate might not mean that more U.S. children have autism spectrum disorder, but instead that physicians' ability to detect the disorder is improving, according to Tom Insel, director of the National Institute of Mental Health.

California Healthline, October 5, 2009

It was completely predictable.

As soon as word began to circulate that studies announcing an increase in autism diagnoses from 1 in 150 to 1 in 100 or is it 1 in 91 you had to know that the usual excuses would be trotted out so that health authorities could continue to deny that there actually is an autism epidemic.

1. The 1994 DSM definition changes are STILL being used to explain a 50% increase in autism rates between 2007 and 2009.

2. Increased social awareness.

3. Alleged availability of autism services. Autism diagnoses provided so that patient can obtain autism services.

4. Greater ability to detect autism. Thank you Dr. Tom Insel.

If anyone has any other excuses being used to deny that autism is really increasing despite a 50% increase in two years feel free to offer them for this list. Maybe it is time to stop conducting such surveys if the people who actually provide the surveys and studies do not take them seriously.

autism

Autism Rate Now 1 in 100: Here Comes the Diagnostic Change Excuse Yet Again

The CDC is now revising its autism rate figure from 1 in 150 to 1 in 100. Watch for the usual bright lights to trot out the 1994 DSM definition change to rationalize this very dramatic increase in autism rate estimates. From 1 in 500 to 1 in 250 to 1 in 166 to 1 in 150 to 1 in 100.

Amazingly the same factors - diagnostic definition change, increased social awareness etc are trotted out each time to deny that autism is really increasing. This happens almost as soon as the estimate is changed and without any science to back up the claim. Anything as long as we can deny that autism rates are really increasing.

Amazingly, US Secretary of HHS Kathleen Sebelius has, according to the Age of Autism, called for more genetic as opposed to environmental autism research to explain the increase.

Incredible. Someone should change her talking points.

autism

With Autism Rising in Indiana, 1 in 113, it is Time to Study Environmental Toxins and Autism

The United Kingdom is not the only jurisdiction in the world with a higher rate of autism diagnosis than the 1 in 150 estimated by the CDC or the 1 in 166 to which the Canadian Neuroscience & Neurodiversity establishments cling.

In a series the likes of which is unlikely to surface at the New York Times, the Globe & Mail or the CBC, 'On the Trail: Autism and the Environment', the Bloomington Alternative examines autism in relation to environmental toxins. In Indiana: High rates of autism, toxic pollution, the Stephen Higgs, continues his autism and environmental toxins series at BA with a report on Indiana's high rates of autism and toxic pollution noting that Indiana's identified autism diagnoses rate changed from 1 in 128 to 1 in 113 in one year.

The Denialists will point, yet again, to the change of diagnostic criteria back in 1993-4 as an explanation for this latest increase in diagnoses in Indiana. They will offer no actual study to back up the claim, a claim that grows weaker each time it is trotted out to explain a new increase in autism rates, and as we move further away in time from 1994. Seriously, 15 years after the change in DSM autism definitions it is no longer credible to point to the 1994 DSM change as a full explanation for the startling increases in diagnoses.

It is time to look at ALL possible environmental causes of autism from vaccines to industrial plants and toxic toys and jewelry. It is not enough to scoff and pretend to be "scientific" while denying, refusing to look at possible causes of autism as suggested by facts and evidence.

autism

1 in 94 Autism Rate In New Jersey AND The USA?

One of the interesting discrepancies, amongst many, in the autism world is the difference between the 1 in 150 rate cited by the CDC in the US and the 1 in 100 rate cited by Simon Baron-Cohen and other experts as the autism rate in the UK. What is also interesting is the 1 in 94 rate cited by the CDC for New Jersey which is obviously much closer to the UK figure. Is the 1 in 94 NJ rate more representative of actual rates across the US ?

If the rates of autism are affected, in whole or in part, by environmental considerations then it would be difficult, if not impossible, to reach any conclusions about USA rates based on the NJ figures. But if there are no environmental factors influencing the development of autism, if autism is, as some argue, simply a naturally occurring genetic variation, then it may well be that the NJ rate is representative of the USA as a whole with the higher NJ rate, which brings it much closer to the UK, being attributable to better awareness, diagnosis and other services compared to other parts of the US.

Kristina Chew is the host and author of Autism Vox, a very well written "autism" blog which presents a neurodiversity ideological perspective on autism, a perspective which does not embrace environmental considerations as possible causes of autism or rising autism rates. She is also a New Jersey resident and has commented on New Jersey's 1 in 94 rate suggesting some factors which, if true, would seem to suggest that the NJ autism rate of 1 in 94 might be a more accurate number for the US as a whole then the 1 in 150 cited by the CDC. As she comments in A Whole Lot of Autism To Account For in New Jersey:

Rather than trying to get to some “bottom,” some specific thing that we can point to and say “this is the cause of autism,” I would suggest that numerous other force are working in concert. These forces range from “better understanding of autism and diagnosis” to the expanded definition of autism to embrace the notion of an autism spectrum.

Ms Chew's list of "numerous other forces" working in concert does not include possible environmental causes. The autism spectrum factor is a constant in the US. That leaves better understanding of autism and diagnosis as explaining New Jersey's higher rate. Presumably, if Ms Chew's list is a good explanation for NJ's higher rate, than rates in other regions would climb if those regions also benefited from better understanding and diagnosis. In that case their autism rates should resemble New Jersey's 1 in 94 rate ... or perhaps at least the UK's 1 in 100.

Of course that assessment could change considerably if environmental factors are shown to play a causal role, to one extent or another, in some cases of autism.

Autism Surging - Some Plain Truth From Dr. McCarton

With news of autism surge in the UK the response was swift. Vaccine causes autism believers claimed vindication. Simon Baron-Cohen, for reasons that aren't clear, went 180 degrees in the opposite direction. Not content to point out the current scientific consensus negating the existence of a causal relationship between vaccines and autism the Baron-Cohen went on to say that we should assume that the surge is simply a result of changing diagnostic criteria and increased awareness. On that assumption there is no scientific consensus.

From Cecelia McCarton, M.D. comes some common sense and some truth speaking: we simply don't know what is behind the staggering increases in reported cases of autism. The implication of that factual statement is that we should not as Baron-Cohen advocates assume that environmental factors play no role in the autism surge that the world is witnessing.

Dr. Cecelia McCarton is a Professor of Clinical Pediatrics at the Albert Einstein College of Medicine. She is the founder and director of the McCarton Center for Developmental Pediatrics and the Executive Director of the McCarton School for children with autism spectrum disorders.

Surge in Autism Cases Confounds Researchers, Expert Says

By Victor M. Inzunza

The nation is in the midst of an “explosion” in the number of children with autism and researchers are at a loss to explain the surge in cases, said an expert in the treatment of childhood developmental disorders at a conference at Fordham University.

Speaking at the Fordham Graduate School of Education’s fifth annual Early Childhood Conference on April 27, Cecelia McCarton, M.D., said that the Centers for Disease Control and Prevention now estimate the prevalence of autism among American children at 1 in 150.

“These children are coming at us day after day after day,” said McCarton, a professor of clinical pediatrics at the Albert Einstein School of Medicine and founder of the McCarton School, which treats children with autism. “The numbers are staggering. I would say that 15 years ago, if I saw two children a month who … were classified as being autistic, that was a lot ... . Now, I probably see four or five cases a week that come to my office.

“We don’t know the reason for this. We simply don’t know the reason this is occurring.”

Autism is a spectrum of developmental disabilities that strike early in childhood that can interfere with the ability to communicate, learn and form relationships, locking some young people in a kind of mental prison.

The conference, which was co-sponsored by Los Niños Services, Autism Speaks and Riverside Publishing, drew more than a dozen scholars and healthcare professionals from throughout the country to discuss the latest research on and treatment of autism and developmental disabilities.

Autism is a particularly difficult disorder to treat, McCarton said, because of its pervasive nature. Unlike disorders that affect only motor skills or speech and language, she said, autism “cuts across every single developmental area.”

For McCarton, a key is to first get a comprehensive evaluation of the child that includes such things as a neurological exam, cognitive testing, speech and language assessments, and physical and occupational therapy evaluations.

This comprehensive exam should form the basis of a tailored and multidisciplinary plan to help the child overcome some of autism’s most ravaging effects.

“If you give a diagnosis [of autism], it is not a death sentence,” she said. “There is hope. What we are able to do now with children who are on the [autism] spectrum would have been inconceivable 50 years ago. So there is tremendous hope. Of course, it’s sad. Nobody wants that for their child…, but we can really do something about this.”

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Autism, Vaccines & the Spread of Mumps - Eastern Canada

The belief that some vaccines, or mercury based vaccine preservatives, cause or contribute to today's increasing autism rates, now estimated at 1 in 150, persists despite an almost total lack of support in the scientific community for any causal connection. The fear generated by that belief is itself believed to have contributed to higher rates of vaccine refusals with resulting increases in diseases such as measles and mumps. In Atlantic Canada we are currently suffering an outbreak of mumps, with the particular strain of mumps having orginated in the UK where immunization rates dropped from fear that the measles-mumps-rubella vaccine caused autism.

Health: ALERT: INFECTIONS

Mumps outbreak spreads

CAROLINE ALPHONSO

May 11, 2007

Nova Scotia's mumps outbreak has spread to Ontario, infecting five people so far and putting public-health officials in the province on alert for even more cases in the weeks to come.

The latest outbreak indicates that many who were vaccinated years ago are now susceptible to catching the disease. Public-health officials are now debating whether they need to administer a booster shot.

Ontario's Ministry of Health and Long-Term Care confirmed yesterday that the cases, two of which are in Toronto, are linked to the outbreak in Nova Scotia, where more than 200 people have been infected by the disease. The outbreak, which began in late February, has also infected 34 people in New Brunswick and one in Prince Edward Island.

...

Neil Rau, an infectious disease specialist at Halton Healthcare Services in Ontario, said the current strain of mumps originated in Britain, where there was a large outbreak in 2004. Immunization rates had drop significantly in Britain because many people believed the measles-mumps-rubella vaccine caused autism. The vaccine-autism link has since been disproved, he noted.

The disease reached Iowa last year, and Dr. Rau said it has now found its way into Canada.

"It's global travel compounded with vaccine refusal," he said.

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