Autism & Environment Study:Genetics Only Autism Gang Running Scared, Creates Faux Controversy

Scared by althetrainer

The "it's gotta be genetic" gang is running scared over the recent twins study which confirms the pardigm shift in autism causation from 100% genetic to a gene-environment interaction model and which places much greater emphasis on the role of environmental factors, particularly perinatal and prenatal factors in triggering autism disorders.   The ink is barely dry on the paper and already  an article has appeared online at "Science" News with the headline and sub headline:  Environment blamed for autism Controversial twin study challenges idea that genes determine autism risk.

Where is the controversy?  Under the guise of science ScienceNews is helping create controversy by describing the study as controversial.  Teresa Binstock was right many years ago when she described the thinking of the public health research establishment as fixated on the view that autism has to be genetic. That view has been eroded over the last half decade by an autism paradigm shift which views autism as resulting from gene environment interaction.  The failure of the overwhelmingly genetic oriented autism research of the past decade to provide a clear genetic basis for autism causation preceded the recent studies which assign more responsibility for autism causation to environmental factors.  The "it's gotta be genetic" autism crowd is running skeeeeered. 

Autism and Environment: Dr. Szatmari Gets It Backwards

The New York Times, to its credit, understands the implications of the recent twins study in terms of its potential to shake the old boys (and girls) network that has clung to the "it's gotta be genetic" paradigm in exploring and understanding autism.  It is also clear, as the following two quotes make clear, one a comment by the NYT journalist who wrote the article  and the second by respected Canadian autism expert Dr. Peter Szatmari.

NYT Reporter Laurie Tarkan:

New Study Implicates Environmental Factors in Autism

A new study of twins suggests that environmental factors, including conditions in the womb, may be at least as important as genes in causing autism.

Autism Expert Dr. Peter Szatmari

“This is a very significant study because it confirms that genetic factors are involved in the cause of the disorder but it shifts the focus to the possibility that environmental factors could also be really important."

With all due respect to the learned, and respected, autism expert Dr. Szatmari the significance of this study is that it tilts thinking, hopefully finally, away from the established expert obsession with the belief that genetics explains autism completely.  The study is not important because it confirms that genetic factors are involved in the cause of the disorder. Dr. Szatmari has it backwards. The study  is important for the exact opposite reason ... it demonstrates the very important role of environmental factors in causing autism as subsequent quotes and comments in the NYT article assert:

"“I think we now understand that both genetic and environmental factors have to be taken seriously,” said Dr. Joachim Hallmayer, an associate professor of psychiatry and behavioral sciences at Stanford and the lead author of the new study, which is to be published in the November issue of Archives of General Psychiatry. ....... surprisingly, mathematical modeling suggested that only 38 percent of the cases could be attributed to genetic factors, compared with the 90 percent suggested by previous studies .... And more surprising still, shared environmental factors appeared to be at work in 58 percent of the cases" 

The respected Dr. Szatmari got it backwards. The 100% genetic explanation for autism has dominated official thinking for over a decade.  In the last half decade a new paradigm has been emerging which views autism as resulting from the interaction of genetic and environmental factors.  That paradigm has now clearly arrived.  Those who cling to the it's gotta be genetic paradigm will now have to be viewed as the dinosaurs they are..... unless of course they evolve very quickly and adopt the environmental-genetic interaction paradigm of autism causation.

Firefighters Find and Rescue Man With Autism Lost in Sewer System

Firefighters in Downers Grove Illinois have found and rescued a 20 year old man with autism whose parents reported that he might be lost in the sewer system.  Apparently after being notified by the family that the man might be in the sewer system the firefighters lifted man hole covers looking for the man. The article on mysuburbanlife.com, Downer's Grove Reporter, does not specify how severe the man's autism was, stating only that he was deaf,  but given the facts it is a safe assumption that he is functionally impaired by his autism disorder.  This father of a severely autistic 15 year old son  is very happy to hear of the man's safe return to his family.

No word yet on whether the very high functioning members of the Board of Directors of the Autism Self Advocacy Network who campaign, in the harsh glare of major media attention and in high level political and government institutions,  against curing autism disorders  have complained about the firefighters interference with the man's right to roam as a free ranging "autie" or "aspie".

Glenn Thibeault's REAL National Autism Strategy

In the past 36 hours I have criticized CASDA's claims to be advocating for a National Autism Strategy and to be presenting a unified national autism voice.  Lawrie Mawlam of CASDA, a conscientious and courteous individual with whom I have had the privilege of talking in recent months,  has taken some objection to my criticism and I thank her for expressing her opinions so forthrightly.   I hope though that CASDA will consider the criticisms of their efforts before rejecting them defensively.  I also ask CASDA, and any one else purporting to advocate for a National Autism Strategy to consider and support the private members bills of Sudbury MP Glenn Thibeault. The two bills express a clear and coherent National Autism Strategy that would be great benefit to autistic Canadians and their families and that is consistent with the efforts by many Canadians seeking a REAL National Autism Strategy for many years before CASDA and its constituent elements began seeking a national approach to autism.

I recommend that CASDA, Conservative MP Mike Lake,  and all others seeking a real and meaningful national autism strategy support, and encourage their members of Parliament to support, Glenn Thibeault's private member autism bills as described on Mr. Thibeault's site:

"THIBEAULT RE-INTRODUCES AUTISM LEGISLATION


2011 06 15


OTTAWA – Today MP Glenn Thibeault (Sudbury) re-introduced two Private member`s Bills designed to assist individuals diagnosed with autism spectrum disorders.


The first Bill would amend the Canada Health Act to include Applied Behavioural Analysis (ABA) and Intensive Behavioural Intervention (IBI) as medically recognised treatments for individuals living with autism spectrum disorders.


The second would create a National Strategy for individuals living with autism spectrum disorders, therefore ensuring that these individuals would receive the highest level of care, regardless of which region of Canada they live in.


“Far too many Canadians and their families are coping with autism spectrum disorders without adequate support from any level of government” said Thibeault. “Together, these two Bills would ensure that all Canadians, irrespective of where they live, have access to the most appropriate forms of care and extended health services.”

“With negotiations between the provinces and federal governments on the Canada Health Accord starting in 2014, I am calling on the Government to implement the provisions of these bills to ensure that individuals suffering from autism spectrum disorders are properly covered by the Accord.”

Autism spectrum disorders are a spectrum of psychological conditions, including autism and Asperger’s syndrome, which are characterised by an impairment of social interaction, restrictive interests and repeated behaviours. Currently, around 1 in 200 Canadians – representing roughly 190,000 Canadians - are estimated to have autism spectrum disorders. Incidence rates have been on the rise over the past decade, with the prevalence rate in children estimated to be 1 in 165.

-30-

For further information, please contact:

Alex Bushell, Parliamentary Assistant (Glenn Thibeault): 613-996-8962 or glenn.thibeault.a2@parl.gc.ca"

Autism Research Awakening: Environment Plays A Role In Causing Autism

“We have to look also at environmental factors, and from my point of view, the interaction between the genetic factors and the environmental factors ... It looks like some shared environmental factors play a role in autism, and the study really points toward factors that are early in life that affect the development of the child"

Joachim Hallmayer, MD,  associate professor of psychiatry at Stanford University in California

WebMD reports on a new study published in the Archives of General Psychiatry which  found that autism was surprisingly common in fraternal twins, despite the fact that they don’t share as many of the same genes as identical twins, suggesting that some common environmental factors might be playing as big a role in causing their autism disorders as genetics.  Dr. Hallmayer was one of the study researchers who were surprised with the result.  Is this an awakening in the autism research professions?

For some it probably is.  For others not so much.  Even this humble autism father/blogger reported an autism paradigm shift 4 years ago and I have followed it since then blogging on developments in the area of environmental causes of autism. But there are die-hards who will not be convinced, who will not change their minds no matter what. Academic careers and reputations as expert witnesses have been built promoting the view that autism is 100% genetic and that accordingly autism disorders are not actually increasing.  Reported increases of autism diagnoses are routinely dismissed as due entirely to diagnostic definition change and increased awareness.  Of course manufacturers of products from vaccines to children's toys have a vested interest in encouraging the "it's gotta be genetic" autism causation paradigm described over a decade ago by Teresa Binstock.  Many will never admit that autism could ever be caused by the interaction of environmental and genetic factors.  

CASDA National Autism Strategy Is Not A REAL National Autism Strategy: It Does Not Help Canadian Autistic Children and Adults

In looking at the National Autism Strategy information from a CASDA (Canadian Autism Spectrum Disorders Alliance) conference held in Ottawa on June 8 2011, and which I have posted following this comment,  I see that there is the suggestion for expansion of tax relief for autism families. That is certainly a specific, concrete step that will help some families with autistic children. Beyond that though I don't, with all due respect, see anything being proposed to assist autistic children, regardless of where they live in Canada, to receive evidence based effective early intervention, yes that still means ABA, a real education and for the many who will require it, decent, autism specific residential care and treatment as adults.

Early autism intervention across Canada resulted from a wave of focused determined parents advocacy which began over a decade ago. It did not result from conferences of persons building careers in politics or charitable bureacracies or attending subsidized conferences in Banff or Ottawa. 

I recommend that this organization stop pretending and start getting serious about helping with early intervention, education, adult residential care and treatment for autistic Canadians. Sorry I if sound harsh but these types of conferences, with their timid agendas,  have accomplished nothing over the past 10 years. Pretending to help is worse than doing nothing at all. It creates the illusion that something is being done when that is not the case.

Conservative government MP Mike Lake, to his credit, did provide  links to parliamentary sites if you are interested in following autism bills introduced by Sudbury NDP MP Glenn Thibeault who has been a determined advocate for a real National Autism Strategy for several years.  My final comment is to recommend to Mr. Lake and other attendees at the CASDA conferences to fight for a real National Autism Stategy as Mr. Thibeault has done along with fellow NDP member Peter Stoffer and former Liberal MP Shawn Murphy.

"In 2007, Autism Canada spearheaded the Canadian Autism Spectrum Disorders Alliance (CASDA) and today sits on the Leadership Committee. On June 8, 2011, Laurie Mawlam, the Executive Director at Autism Canada, was in Ottawa with the others on the CASDA Leadership Committee advocating for a National Autism Strategy. Please find below the notes from that meeting, including the individuals the Leadership Committee met with and a synopsis of their conversations.

  

Connor Robinson, Canada Revenue Agency

• Broadening the interpretation of existing categories of eligible expenses under the Medical Expenses Tax Credit to include more expenses often faced by families with a child with an Autism Spectrum Disorder
• Adding Autism Spectrum Disorder-related expenses to the list if eligible expenses under the Medical Expenses Tax Credit
• Clarifying the rules and procedures of the audit process                    

Lisa Belzak, Epidemiologist, Public Health Agency of Canada 

• The development and design of a National Surveillance System for Developmental Disorders, including Autism Spectrum Disorders
• The creation of a nomination committee to create an advisory committee for the National Surveillance System
• The creation of an advisory committee for the National Surveillance System

Nathalie Gendron, Assistant Director, Institute of Neurosciences, Mental Health and Addiction, Canadian Institute of Health Research 

• The current levels of funding for research in Autism Spectrum Disorders
• New developments that are in the works that should be made public shortly

The Honourable Jim Munson, Senator, Ottawa-Rideau Canal 

• Raising awareness of Autism Spectrum Disorders among Senators and Members of Parliament
• The reintroduction of Senator Munson's bill honouring Autism Awareness Day 

The Honourable Mike Lake, Member of Parliament, Edmonton-Mill Woods-Beaumont 

• Reviewed outcome from meetings of the day
• Discussed Mike playing a role in reaching out to other MPs that have a family member with an ASD, to increase the base of support for a federal ASD agenda
• Reminder from Mike that the following website permits us to follow the progress of bills related to ASD -www.parl.gc.ca
• • There are presently two bills dealing with Autism Spectrum Disorder, which are being introduced by the Member of Parliament for Sudbury, Glenn Thibeault (NDP).
• • Bill C-218: http://www.parl.gc.ca/LegisInfo/BillDetails.aspx?Language=E&Mode=1&billId=5079448
•      Bill C-219: http://www.parl.gc.ca/LegisInfo/BillDetails.aspx?Language=E&Mode=1&billId=5080253
  
  
  These meetings were an opportunity for CASDA to reinforce the importance of action on the federal level in the area of Autism Spectrum Disorders and share our vision that all Canadians with an Autism Spectrum Disorder have full and equal access to the resources that they require to achieve their full potential.
  
  
  Thank-you for joining CASDA to ensure that our vision becomes a reality. Our strong, collective voice for the Autism Spectrum Disorder community at the federal level is making a difference!

TIME Promotes Myth That Many With Autism are Highly Intelligent

In Could Amanda Knox Have an Autism Spectrum Disorder? TIME adds its influential voice to those who propagate the  myth that "many with autism are highly intelligent".

Amanda Knox is the 23-year-old American college student who was convicted of sexually assaulting and killing her roommate, Meredith Kercher, in Italy in 2007.  The TIME article makes a plausible case for the proposition that some of the evidence used to convict Ms Knox, including a forced confession, and some seemingly callous behavior, may indicate an un-diagnosed Asperger's Disorder condition rather than evidence of guilt. That possibility has become particularly important in light of revelations that DNA trace evidence used to convict Ms Knox may, after review by independent experts, be considered unreliable.  

In elaborating on the Asperger's Disorder possibility,  and explaining some aspects of Ms Knox's behavior including the confession, the TIME article states:

"like many autistic people, Knox was highly intelligent but also extremely naïve and gullible:

"She's the smartest person you'd ever know" but "dumb as a rock" when it comes to "street sense," [her stepfather said]. In conversations with her friends and family, a portrait emerges of a person with a childlike innocence. She was, as her mother, Edda, puts it, "oblivious to the dark side of the world.""

If the above quote said like many people with Asperger's Disorder", Knox was highly intelligent it might be an accurate statement.  Under the DSM-IV an Asperger's Disorder is excluded where the person has no cognitive development issues:

"E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood."

The lack of clinically significant cognitive developmental delay does not necessarily mean that a person has high intelligence but it does leave that possibility open. The article provided no studies to indicate that many persons with Asperger's are highly intelligent.

Where the article is flat out wrong though is in stating that many persons with "autism" are highly intelligent.  That information is contradicted by the Canadian Psychological Association 2006 brief to a Canadian Senate Committee stated that:


• Cognitive impairment is present in about 80% of persons diagnosed with Autism and general intellectual functioning is most often below average.  Persons diagnosed with Asperger’s Disorder have average to above average intellectual functioning. [underlining added]


As noted above the CPA reference to autism is a reference to the autism spectrum disorders except Asperger's.

The United States Centers for Disease Control, the CDC,  has conducted two surveys which looked at the entire spectrum of autism disorders, including those with Aspergers and found that:

"Data show a similar proportion of children with an ASD also had signs of intellectual disability than in the past, averaging 44% in 2004 and 41% in 2006."

Contrary to the view, expressed by TIME,  that many persons with autism are highly intelligent, the US National Institute of Mental Health states with respect to Autism Spectrum Disorders in the section titled Problems That May Accompany ASD:

"Mental retardation. Many children with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a child with ASD may do well on the parts of the test that measure visual skills but earn low scores on the language subtests." [underlining added]

If Amanda Knox does in fact have an Asperger's Disorder, and if the Disorder casts doubt on the confession obtained from her and provides an alternative explanation for the behavior that was used to convict her then I certainly hope the issue is fully explored.  To that end TIME's powerful voice could be of substantial value in overturning a possible wrongful conviction for murder.  That would be a great accomplishment if all those developments play out as indicated.  In reaching such a conclusion though it is unnecessary for TIME to proceed by promoting the myth that many persons with autism are highly intelligent.  This myth, while pleasant for many to embrace, in fact obscures the very serious challenges faced by the vast majority of persons with Autistic Disorder who in fact are also cognitively impaired or intellectually disabled.

TIME with its great influence should be more careful in how it portrays autism, including Autistic Disorder, and the challenges, including intellectual disabilities,  faced by persons with Autistic Disorder, to the world.

Autism and Wandering: Fredericton in 2003 and Abbotsford in 2011

The story of the autistic child in Abbotsford, Brisith Columbia (1,2) removed from her home with her caring father by provincial government officials has hit a nerve with many parents of autistic children including me.  In Abbotsford the girl was removed after she wandered from her family home.  She was found, at a neighbor's safe and sound. Despite the efforts the father had taken to prevent such occurrences and despite his diligence in searching for her and contacting authorities when he realized she was missing, the child was taken from the family home and placed in government "care" by government officials.  

I agree with the teacher who commented on this case and emphasized that autistic children need stability.  Removing them from their home can be a harmful event in itself. Maybe there are other facts, not disclosed in the local news reports, that prompted the removal of this child.  In the absence of any further information though it seems clear that government officials did not act in the best interests of this autistic child in taking her from her home.

I have mentioned in commenting on the Abbotsford story that my son had also wandered from our home on a day when I was the sole adult in our house and while I was answering a business phone call.   I was thankful beyond belief that my son did not come to harm when he "got away" many years ago.   I am also thankful that authorities here in Fredericton, New Brunswick did not react in 2003 as the authorities have reacted  in Abbotsford, British Columbia  in 2011.   Following is the comment I first posted in September 2006 about the time, three years earlier, when my son left our home while I was distracted by a business phone call:

Saturday, September 09, 2006

Vigilance, Constant Vigilance

A recent tragedy in Toronto has revived some terrifying memories for me. A 12 year old autistic boy fell to his death from the 16th floor of a Toronto highrise in early May while under the supervision of a caregiver who resided at that location and who has now been charged with criminal negligence causing death. The case has prompted calls from the Autism Society Canada for national standards for caregivers working with autistic persons.

I know from personal experience the challenges of caring for autistic children and the need for constant vigilance. Three years ago I was home alone on a Saturday with my then seven year old profoundly autistic son when I took a business call on my phone. I had gotten into the habit of taking such calls while listening for my son's whereabouts. This time I got too involved in the call.


When I hung up I could not find my son. I ran frantically around the house and the yard before calling 911. I was informed that he was safe at the nearby Ultramar. He had attempted to cross a busy neighborhood street oblivious to the dangers posed by traffic. A good Samaritan had stopped and helped him into the Ultramar from where I picked him up. The man was still there, waiting to ensure my son was safe, when I arrived but at that point he turned and left without waiting for recognition, reward, or expressions of gratitude.

In my entire life I had never felt such fear, guilt, relief and gratitude. The impact of these intense feelings in one short span of time was difficult to absorb. I can literally still feel them now as I type, three years later. The lessons learned will never be forgotten.

As a lawyer I would not pre-judge the caregiver in the Toronto case - or the outcome of that case. As a parent who has "been there" I know that it is all too easy, unless we want our autistic children to live imprisoned in "safe" environments, for the unthinkable to occur. There is no training that can absolutely guarantee our childrens' safety. But, to improve the odds and reduce the incidents of tragedy, there should be minimum national training standards for those who provide care for autistic persons - parents included.

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. 

Blaming Parents: Autism Families Torn Apart by Ignorance

Families with autistic children, parents who love their autistic children dearly,  must endure much in order to live a normal life with their children, to be happy with their children to see them grow and develop to the best of their abilities notwithstanding their disabilities.  The concerns and challenges of parents of autistic children are often dismissed contemptuously by scientists, health care professionals, educators, social workers ... and some involved with the justice system. 

Last week the world learned that a caring British Columbia single father lost his autistic daughter to that province's children's authorities, at least temporarily, because she had left the home unattended and wandered to a nearby home where she stayed for a couple of hours. The father had taken precautions to prevent such incidents and had run to look for her when he realized she had left the home. He called police and she was found safe and sound but still the government took his child apparently because they doubted his ability to provide her with secure care.   

The Detroit Free Press has been reporting extensively (1, 2, 3, 4, 5, 6 ) on the havoc wreaked upon a Michigan family, the Wendrow family,  when the parents were charged with sexually abusing their severely autistic and mute daughter. The evidence was provided by a social worker who purportedly communicated with the daughter via facilitated communication a process which in this case involved the worker guiding the child's hand as part of the "communication" process. The case imploded when the child could not answer ANY questions, in any format, unassisted. It became obvious that the information purportedly communicated by the daughter was simply the beliefs of the social worker not the allegedly abused daughter. The parents did spend time in jail and the family, including the daughter, were separated. What I find most bizarre and disturbing  in this case though is how far the prosecution continued without any apparent legal foundation:

"Julian and Thal Wendrow were criminally charged in late 2007 after their 14-year-old autistic and mute daughter alleged, through facilitated communication, that her father had been sexually abusing her. They were separated from their children for 106 days, until prosecutors dropped the case because of lack of evidence.


...


The ordeal didn't end when it was clear that the girl wasn't communicating, after all. It didn't end when a sexual assault exam found no proof of abuse. And it didn't end when a prosecution witness insisted the abuse never happened."

TIME has reported on the six part investigative series by the Detroit Free Press and noted in its own commentary about facilitated communication generally, and the horrendous impact on a family of its use in this criminal prosecution of the father for allegedly raping his autistic daughter, that:

"the technique, in which the aide's hand is supposedly guided by the child to type what she wants to say, has been proved ineffective. It has been shown to rely on the aide's projections rather than to reflect the child's thoughts. Although some autistic children can learn to communicate genuinely via a keyboard with only initial guidance, facilitated communication, in which an aide always does the typing has repeatedly failed to demonstrate that the words are written or thought by the child. For example, when the facilitator is not allowed to hear the questions being asked of the child, the resulting answers are wrong or nonsensical.

When the Wendrow's daughter's aide typed allegations of sexual abuse against the girl's father and brother — and claimed that the child's mother had been ignoring her complaints — a prosecution of the family was set into motion that became nearly unstoppable. The aide refused to believe she was not typing her own ideas, even though the child was clearly not capable of the complex language being attributed to her. Once prosecutors and the aide became convinced of the truth of the allegations, even overwhelming evidence of their falsehood was ignored."

Parents of autistic children face many challenges trying to raise and care for their autistic children. Most of us  face some of those challenges .. the stares and looks from strangers who do not understand the screaming of the "obviously spoiled" child in the grocery store, the educators and doctors who ignore the input of parents.  Some face the grief a father is going through right now in British Columbia.  Few of us face the horror of a wrongful criminal prosecution as the Wendrow family has had to endure; or the after effects they will probably have to continue to face.  Behind it all though is a common thread, a thread that goes back to the "refrigerator mothers" theory of autism causation that was embraced so willingly by the psychology and psychiatry establishments, to that theory's politically correct replacement - the "it's gotta be genetic" theory of autism causation. It is easy to find fault, to blame parents, for the challenges faced by their autistic children who suffer from serious neurological disorders ... who suffer from autism spectrum disorders. 

As a father with a severely autistic son,  who happens to also be a lawyer,  I commend the defense team that represented the Wendrows throughout the criminal prosecution.  I commend the Detroit Free Press for bringing this story to the forefront when so many in the mainstream media refuse to comment on the harsher realities of autism disorders and their impacts on families.  Most of all I commend the Wendrow family for staying strong, for fighting the good fight.  I wish them well.

Kim Oakley: Medical mysteries, autism and chronic self-injurious behavior

One of the blogs I follow,  and list on the side bar of this blog, is Autism, Epilepsy and Self-Injurious Behavior by Kim Oakley. A couple of days ago Kim Oakley wrote on the subject of Medical mysteries, autism and chronic self-injurious behavior. As is always the case Ms Oakley writes with straight up honesty and with a view to understanding and helping her son, and others,  who engage in self-injurious behavior.  In this comment Oakley describes some of her son's self-injurious behavior, in what contexts it arises and how long the last episode lasted:  4 days.

Obviously 4 days is a long time.  My son's self-injurious behavior has never lasted more than half an hour to an hour to  my knowledge.  I can't imagine 4 days of self injury, the pain it must have inflicted on her son or the courage Oakley and her family needed over those 4 days. Oakley isn't sure what caused the 4 day self-injurious "bender" to suddenly stop but she offers some speculation about what brought it to an end.  

I recommend anyone struggling with self-injurious behavior in an autistic child to read  Medical mysteries, autism and chronic self-injurious behavior. Oakley does not pretend to have all the answers but she gives us plenty to think about.    Once again, I recommend anyone with a child with autism who engages in self-injurious behavior to visit and bookmark Autism, Epilepsy and Self-Injurious Behavior by Kim Oakley.  It might provide one more piece of information to help you understand the mystery of chronic self-injurious behavior of your autistic child.

TAKEN: BC Government Takes Autistic Girl From Caring Dad

 

Derek Hoare shows a picture of himself with his daughter Ayn in happier times

John Van Putten Photo

The British Columbia government,  Ministry of Children and Family Development, has taken an autistic girl from her father's care after she went missing, very briefly, and was found safe at the nearby home of a neighbor. The father is on social assistance and had care of two autistic children, with the agreement of his wife.  He is described in the Adrian MacNair - Abbotsford  News report on  bclocalnews.com  as a caring father.  

I felt a real chill reading this article and the father's description of his discovery that his daughter had gone missing. I felt that chill, in large part, because years ago my son Conor went missing on my watch and I reacted much as the father did in this case,  running around looking for him, then calling police. In my case my son was safe and sound in the neighborhood, at a local convenience store.  In Mr. Hoare's case his daughter was also safe and sound, at a neighbor's pool just two houses away.  In my case I recovered my son without further ado.  In Mr. Hoare's case the BC government took his daughter away from him as he describes:

 "More than three hours later, Ayn was found two houses over in a neighbour’s pool. She was safe and sound. It was a fairy tale ending, told by various media covering the story. And for a moment, it was.When the police brought Ayn back, she ran to her father and threw her arms around his shoulders as he breathed tearful relief. But four days later, representatives from the Ministry of Children and Family Development came to his house with orders to take Ayn away.

“Basically, what they’re saying is I’m a single dad and I have two autistic kids and my other son and it’s too much for me to handle. So, they’re going to take one of my kids away to lighten my load,” said Derek on Tuesday, after learning he wouldn’t even be able to see his daughter until a hearing determines access rights.

Because of her 24-hour care requirements, she won’t go into a foster home, but will be placed in a psychiatric facility for evaluation.Derek is concerned she will be sedated and drugged for her autism, which he has always opposed, despite doctor advice to the contrary.“They’re probably holding her down and sedating her,” he said, his voice choking. “This is a nightmare.”A single father on social assistance, Derek said he has custody of his three children with the approval of ex-wife Amie Van Dyk."

The BC Local News article goes on to describe the steps that the dad had taken to provide a safe environment for his autistic children.  When my son went missing we did call a behavior consultant who was already working with Conor and she designed some programs to encourage him to stay in our yard.  Even with that training though Conor, like Derek Hoare's daughter, requires 24-7 supervision. 

I hope that the BC Ministry of Children and Social Development does not keep this father and his daughter apart. I hope they work with him and provide help for his daughter.  Government's should not be punishing the father ... or his daughter ... because they face serious challenges arising from her autism disorder. They should work WITH the father ... not AGAINST him and not against his daughter's right to live with a caring parent.  A caring parent is an important asset for any child, including and perhaps especially, a child with a severe autism disorder.  It is an asset that should not be lightly squandered and taken away by government officials.

Autism Research: Which "Autism" Is Being Studied?

Neuron, Cover Page, 23 June, 2011 Volume 70, Issue 6

The abstract for the study Disrupted Neural Synchronization in Toddlers with Autism,  reported in the current issue of Neuron, indicates that autism is tied to disrupted cortical synchronization, weak "functional connectivity" across two hemispheres of the brain:

" we show that disrupted synchronization is evident in the spontaneous cortical activity of naturally sleeping toddlers with autism, but not in toddlers with language delay or typical development. Toddlers with autism exhibited significantly weaker interhemispheric synchronization (i.e., weak “functional connectivity” across the two hemispheres) in putative language areas. The strength of synchronization was positively correlated with verbal ability and negatively correlated with autism severity, and it enabled identification of the majority of autistic toddlers (72%) with high accuracy (84%). Disrupted cortical synchronization, therefore, appears to be a notable characteristic of autism neurophysiology that is evident at very early stages of autism development."

The abstract does not explain what is meant by "autism" for the purpose of the reported study. The DSM-IV does not list "autism" as a specific diagnostic label or category. It does list autistic disorder. Common usage refers to all of the Pervasive Developmental Disorders, including Asperger's Disorder as variations of "autism". It is very common for very high functioning persons with Asperger's Disorder to tell the world about their experiences as autistic persons. Some such as Ari Ne'eman, a very intelligent, articulate individual with the social skills to participate in IACC and government meetings, likes to declare to the world,  that "WE", referring to persons with "autism",  do not want to be cured of their autism.  The DSM-5 will expressly merge the various "autism" disorders into one Autism Spectrum Disorder. 

It is not clear to me what is meant by the term "autism" in this abstract study.  Is it Autistic Disorder in the DSM-IV? Is it the PDD's in the DSM-IV all of which are now referred to as autism in common usage? Is it the Autism Spectrum Disorder of the DSM-5? Does the term autism as used in this study exclude persons with autism who are also intellectually disabled as the DSM-5 definition appears to do?

If anyone has read the full study report could they indicate how autism is being used in this study? Do the subject toddlers have Autistic Disorder in the DSM-IV, all of the PDD's of the DSM-IV, or Autism Spectrum Disorder from the DSM-5? Were potential subjects with "autism" and intellectual disability excluded?

The media coverage (1, 2, 3, 4) of this study also refers generically to "autism" without indicating which autism is being studied, a piece of information that I would think is fundamentally important to understanding the study's conclusions.

CBC: New Brunswick Lacks Residential Care for Adults with Autism

Emma Smith and CBC did a feature (at minute 23:40)  on last evening's news on the lack of residential care available for New Brunswick adults with autism.  I was interviewed along with some other parents and staff from the Autism Connections Fredericton community autism centre.  Paul McDonnell, Ph. D., UNB Professor Emeritus (Psychology), clinical psychologist and mentor to many parents of autism children, was also interviewed.  

Paul McDonnell is the autism expert who helped educate many parents of newly diagnosed autistic children, including me, about the benefits of evidence based interventions for our children.  He really has been the intellectual force behind the progress that New Brunswick has made in early intervention and education of NB children and students with autism.  While the progress in early education in particular, and in our schools to a lesser extent, has been significant, no progress whatsoever has been made in developing an appropriate residential care system for New Brunswick adults with autism disorders.  Paul McDonnell talks about the need for a high end facility, one which would incorporate a variety of arrangements to accommodate adults from different points on the autism spectrum.  He also points out that as much as $500,000.00 a year is being spent to provide care for just 1 New Brunswick adult with autism ... at the Spurwink facility in Maine.  He points out it would make economic sense to design and construct a facility which could be designed to provide community integration here in New Brunswick. 

The struggle for improved autism services in NB has been taking place in a serious fashion over the last 12 years. During that time activist parents advocated, argued, struggled and fought for evidence based early intervention for autistic children.  We had some success, albeit not total success, in obtaining 20 hours of government funded intervention for autistic children aged 2-5.  Some gains have been made in our schools although much, much more effort is need there. No progress though has been made for adults with autism in New Brunswick. 

Government drags its feet on adult autistic care for a number of reasons.  In my experience as an autism advocate it is easier to get public attention for the need to help children then it is to attract their concern over autistic adults. It seems to be a natural inclination for people to be stirred more easily to help children than adults.  There is also the fact that once in the care of government autistic adults are out of the public eye. Out of sight, out of mind. The government can, and will, cite privacy reasons of the autistic adult as a reason for refusing to disclose information about them.  The most extreme examples of the privacy issue being used in this way is taking place right now in Ontario where that government has sent its lawyers in to action to prevent disclosure of information in the two inquests, including the Ashley Smith and G. A.  inquests.  In those cases the government is arguing against disclosure of information about what happened to these two youths, purportedly to protect their privacy,  even though they are now dead. 

In New Brunswick a huge obstacle to development of an autism specific residential care and treatment facility is the opposition of the very influential NB Association for Community Living.  Community living cliches are pulled out at every discussion of adult care issues. "No bricks and mortar" solutions is the cry of the community living advocates who believe that all problems are solved by dumping adults, including severely autistic adults, into privately owned group homes.  The powerful and influential people who subscribe to this ideology are well connected to cabinet ministers, the Human Rights Commission, the department of education, schools and school districts,  even the Ombudsman and Youth Advocates office. As long as we all go to bed at night repeating "community", "inclusion" and other cliches over and over again until we fall asleep all will be well.  But there will be no talk of "institutions' ... or any other facility that might be needed to help autistic adults.

No serious thought is given to providing the residential care and treatment that many with autism will require throughout their adult years. In fact active resistance emerges at events like the Ombudsman and Youth Advocate office's recent  Complex Needs consultations, in which I participated,  to any discussion of a facility that might provide the expertise, security and access to autism specific programs required by autistic adults.  

It is not cash that is preventing adequate residential care for autistic adults in New Brunswick. Huge sums are being sent to export our autistic adults to the United States. The "bricks and mortar" of buildings that might be necessary to provide residential care and treatment are not the problem either.  The real problem is the "bricks and mortar" that encases the thinking of the community living adherents who have subscribed to the same  ideology for decades and refused to consider the needs of severely autistic adults.  Their philosophy has ruled New Brunswick with an iron fist for decades even though the failure of that rigid philosophy is evidenced by the people with autism living on general hospital wards, in psychiatric institutions, in specialized facilities in Maine and other provinces, in hotel rooms and even on the grounds of youth correctional facilities. 

In truth we all want our children to remain as integrated as possible in our communities, as close as possible to our families.  As a parent though I know that talking about community and inclusion does not address the need of some autistic adults for expert care, for expert based continuing education and recreation opportunities and for security.  These requirements, for some, can not be provided in a small, privately owned group home. We need a facility close to autism expertise such as exists at UNB and at the Stan Cassidy Centre to provide appropriate life arrangements for our autistic loved ones as adults.   

The need is painfully obvious to parents who see their adult children sent to live in general hospital wards, psychiatric hospitals .... and facilities in another country.  New Brunswick needs to fill the gap between the inadequate group homes and hospital institutions and provide a modernized autism  facility to accommodate the needs of out adults with autism.  Here in Fredericton we have developed some behaviorally based autism expertise of note. It is time for the community living adherents who are so influential in our government institutions in New Brunswick to let go of their rigid and dated perspectives,  to loosen up and let the needs of autistic adults be addressed with modern evidence based solutions, with facilities that can provide security, expertise, education and recreation in as community integrated a manner as the circumstances served by those facilities  permit.  

Autism's Compelling Question: What is Causing Spontaneous Mutations Linked to Autism?

"One compelling question is what is causing the mutations ... The obvious conclusion one has to reach is that something environmental may well be the cause of these [spontaneous] changes in DNA"

Irva Hertz-Picciotto, autism researcher and professor of public health science at UC Davis, commenting on studies led by Matthew W. State and  Michael Wigler, showing hundreds of spontaneous mutations linked to autism, LA Times, June 9, 2011 

The gene environment interaction (GEI)  model of autism causation has been emerging over the past half dozen years. Even this humble layperson has noted the GEI model on several occasions on this blog. The "it's gotta be genetic" (IGBG) model was noted over a decade ago by Teresa Binstock. The GEI model has developed despite, or perhaps more accurately because of, the almost exclusive dedication of research dollars to  the  "it's gotta be genetic" (IGBG) model of autism causation. 

It is the failure of the pure genetic research to identify a specific genetic basis for  autism that only now is beginning to cause its adherents to doubt their faith.  It is the failure of the pure genetic model to explain autism causation beyond the existence of hundreds of spontaneous mutations that must finally make even the most determined of the IGBG school of autism causation ask ... could environmental factors be involved?  Spontaneous mutation is giving rise to spontaneous combustion as the purely genetic model of autism causation burns in the flames of failure.

Autism's most compelling question, as stated by Hertz-Picciotto: What is causing the spontaneous mutations?

Autism and Haircuts: Conor Has A Great Haircut Treat Adventure

Above: Conor after this morning's haircut.

Below: Conor before this morning's haircut.

Conor has full blown Autistic Disorder with profound developmental delays. Haircuts were a real challenge at one time.  But things have improved dramatically with time, effort, planning and education.Today was a great haircut day for Conor with very little difficulty and he is much more comfortable with much of his thick hair laying in piles around the barber chair.  

I thought I would share some of our approach for those who are looking for ideas; things that have helped us with Conor:

1. Pick a spot which has less traffic and noise for your child's haircut.
2. Pick a time when there will be less traffic. For us it is 9 am Saturday morning.
3. Find someone to cut your child's hair who has patience, understanding, empathy and willingness to take her/his time, using scissors as much as possible, and, as much as possible, without electric buzzing clippers.
4. Stick with the same person, place and time for the haircuts as much as possible.
5. Tell your child beforehand that they will be going for a haircut in a day or two, so that it is not a surprise for them.
6. Have mom  or dad close by ready to hold their hand and talk to them.
7. Distract them if necessary with verbal games eg having them count by 10's, 5's, 2's etc, or sing songs.
8. Bribe them. Tell them they are going on a haircut treat adventure with the treat following the haircut.
9. Tell them what a great job they are doing, what a great boy/girl they are as they are getting their hair cut.

These are some of the things that have worked for us.  Each time Conor gets a haircut with minimal fuss it is in itself a form of reward that should make it easier the next time.  Maybe some autistic children don't need special efforts by their parents and power to them and their families. If you do you may want to consider these suggestions ... if you haven't already.

(Yes, I bribed Conor today too, with a trip to McDonald's for some hash browns, which Dad also enjoys)

Edmonton Father Guilty of (Severely) Abusing Autistic Son

A 59 year old Edmonton father has been found guilty of abusing his autistic son. He was convicted of unlawful confinement, failing to provide the necessaries of life, assault with a weapon and assault. Alexandra Zabjek of the Edmonton Journal reports that the son's situation came to the attention of police when his two older sisters returned home to visit after having left the family home a few years earlier. They found him unresponsive, emaciated and chained in a room with a urine soaked mattress.

"Police officers, paramedics, and an emergency room doctor who treated the teenager told court during the trial that he looked "like a concentration camp victim."Court heard the teenager weighed 86 pounds when he arrived at the Glenrose Hospital for rehabilitation. He was five-feet, seven-inches tall. His muscles had atrophied, he suffered from bed sores, and his arms and legs were stuck in a curled-up position. He couldn't initially stand. The teenager gained 10 pounds in the five days immediately after he was taken into care, court heard."

The Edmonton Journal also reports that the man testified in his own defence and claimed that he locked his son in the room because of " episodes and reactions to his mother". The man also denied specific allegations brought by the sisters that he had hit his son with a coat hanger and a shoe. He testified the son received three meals a day. Obviously the son's condition was the most powerful evidence, evidence that spoke for itself, irrefutable evidence of abuse.

What the Edmonton Journal article does not mention is whether the man testified about why he and his wife  kept his autistic son in their home when they could not properly care for him.

Why keep their son in their home while he deteriorated in front of their eyes instead of asking the Province to take care of him or to provide help in taking care of him?

Autism Functioning Levels Are Important, Reality Based Distinctions, It Is Time To STOP Pretending They Do Not Exist

There are people whose opinions about autism are sought out by members of the media who promote the falsehood that there is no such thing as people who are low-functioning. Those who promote this falsehood should STOP doing so and they should stop right now. They are causing harm. 

We do not do any favors for persons who are severely affected by disorders like autistic disorder, those who have serious intellectual deficits and lack the ability to function independently, by making statements denying that some persons with autism are low functioning because of their autism.  We are hurting them by denying their reality and by assigning blame to them and family members because they do not meet  the high standards of those less severely affected, if at all, by autism. Under the DSM5's new Autism Spectrum Disorder persons who lacks functioning deficits in everyday life activities should not receive a diagnosis  and should not be described as autistic. The proposed wording of the New Autism Spectrum Disorder, despite some questionable components, does make the functioning issue clear in Criterion D of the 4 mandatory criteria to meet an ASD diagnosis:

"D.         Symptoms together limit and impair everyday functioning."

The three categories in the New ASD are distinguished based on functioning levels:

"Level 1 Requiring Support


Level 2 Requiring Substantial Support 


Level 3 Requiring Very Substantial Support "

Being positive about facing challenges should not be taken to the extreme of denying that many people have disorders that in fact render them low functioning even to the extent of being dependent on the care of others in order to live. J E Robison, Alex Plank, Ari Ne'eman, Michelle Dawson and most, if any,  of the members of the Board of Directors of ASAN Inc. do not share the deficits, the low functioning levels, of the 80% of persons with Autistic Disorder (DSM-IV) who have intellectual disabilities.  These successful business people, college graduates, researchers and political participants, some who have sufficient communication skills and social abilities to be able to play in rock bands, find marriage partners, raise families, and participate in high level political and corporate environments do not share the challenges faced by the low functioning persons with autistic disorder whose realities they downplay or deny entirely.  The great irony is that it is on THE Spectrum, Autism Spectrum Disorder, where you find persons with an incredibly wide and disparate range of abilities, deficits and challenges that we are most likely to find people denying that functioning levels matter or even exist.

The attempt to deny the importance of different functioning levels among persons with Autism Spectrum Disorders should STOP right now.  It hurts those most severely affected by autism.

Here We Go Again: Citizenship and Immigration Canada Divides Family, Rules Son with Asperger's and Tourette's Medically Inadmissible

Here we go again. 

Nicholas Keung, immigration reporter with the Toronto Star reports that a Toronto family will be ripped apart by a Citizenship and Immigration Canada  ruling that University of Toronto professor Thomas Reynolds son Chris is is medically inadmissible to Canada and therefore ineligible to stay with his father because of his Asperger's Disorder and Tourettes disorders. As reported by Nicholas Keung:

"Born in Nashville, Tenn., Chris, an American citizen, has lived in Toronto since 2007, with his expatriate father, a tenured theology professor at the University of Toronto’s Emmanuel College, and younger brother, Evan, 17, who is still in high school — both here on their father’s work permit. Shortly after arriving in Toronto, the family applied to immigrate from within Canada.

An early medical assessment by Citizenship and Immigration Canada concluded that Chris would place an “excessive demand” on health and social services, and hinder the family’s chances of being accepted.

Officials never met with Chris but deemed him “medically inadmissible” and estimated his care could cost Canadians $7,000 a year."

It remains to be seen whether people in Toronto and Ontario will exert the kind of pressure necessary to pressure politicians to take action to stop the division of this family.  New Brunswick is a small province where the Cheers refrain  "everybody knows your name" rings very true. Ontario, where I attended high school (Petawawa)  and Toronto, where I have previously worked and  lived are obviously much larger, urban and complex entities than New Brunswick.  Will the plight of one family facing division drive the good people of Ontario to take the intense, sustained action necessary to move politicians and bureaucrats to reverse this family dividing decision?  

Personally I hope so.  In the Reynolds case two sons have been living here for 4  years with their expatriate father who is a tenured professor of theology in Toronto.  I am very uncomfortable with Canada breaking up or exporting families solely because a family member has an autism spectrum diagnosis or any medical condition. There are differing opinions on these issues but I don't like it. To me it doesn't feel right. It doesn't feel Canadian. I am hoping for a Vancouver victory in the Stanley Cup Final tonight and I am hoping for a Reynolds family victory in their struggle to stay together. One family. In Canada.

Autism and Environmental Pollution: Review Shows Serious Study Needed

EPA, United States Environmental Protection Agency

Judith Pinborough-Zimmerman, research assistant professor in the University of Utah’s Department of Psychiatry,  has called for more serious study of links between toxic pollution and autism spectrum disorders after a  preliminary review showed that children with autism spectrum disorders and other intellectual disabilities are more likely to have been born near industries that emit toxic chemicals or heavy metals. As reported by Heather May of Utah News the researchers found that children of mothers living within a mile of "Toxic Release Inventory" sites were were more likely to have autism spectrum disorders and intellectual disabilities:

"They found that children born to mothers who lived within a mile of what are called Toxic Release Inventory sites that emit certain chemicals and heavy metals were more likely to have those problems. TRI facilities release or dispose toxic chemicals regulated by the Environmental Protection Agency. The EPA maintains a database of all such facilities and the type and amount of chemicals they release.

• The risk of having an autism spectrum disorder was 3.5 times greater for children born within a mile of a site releasing between 5,000 and 10,000 pounds of halogenated chemicals (dioxins, polychlorinated biphenyls and trichloroethylene). There were five such TRI sites emitting at those levels in the mid-1990s.

• The risk of having an autism spectrum disorder was twice as big when living within a mile of one of six TRI sites emitting up to 5,000 pounds of the heavy metals arsenic, cadmium, lead, nickel and mercury."

To this lay person a finding that risk of autism spectrum disorders arises by 2 to 3.5 times with children born of mothers living near one of these pollution sites seems to be a very strong indicator of the need for further "serious" study as indicated by Assistant Professor Pinborough-Zimmerman.   We can always cling to the unproven assumption that autism has a 100% genetic basis and keep finding excuses for why autism rates continue to climb for a purely genetic disorder.  Or we could actually try to find out what has been happening to our children.