Autism causes

[RisingSun]

I just finished listening to a talk radio show that covered the recent disgusting remarks by Savage on how autism is "99 percent" the result of poor parenting and out of control "brats." A number of people called in to give their opinion and there was like a stretch of almost one hour were every single caller stressed the relationship between autism and vaccines, particularly the MMR vaccine. One even went so far as to say that the government has been sitting on this news for years and kept it from the American people so that the drug companies could profit by giving our children vaccines. It was really disturbing, actually, to listen to these people. Finally, a professor of microbiology and immunology called in and started off by saying that she is now going to talk about this from the standpoint of science, and debunked all of the claims that had been made over the previous hour. The radio show host was very unconvinced, and mentioned that he had no intention of having someone from the medical community with knowledge in these matters on his show, and after the professor was off, he basically said that the scientific community could not be trusted and that we need to follow our common sense.

What do you tell people like those who insist that MMR vaccine, in particular, is the root of autism? I seems like everything they say flies in the face of science, and that nothing that the scientific community can come up with will convince them otherwise.

Thoughts?

---

Members don't see this ad.

 

[ForbiddenComma]

The radio show host was very unconvinced, and mentioned that he had no intention of having someone from the medical community with knowledge in these matters on his show, and after the professor was off, he basically said that the scientific community could not be trusted and that we need to follow our common sense.

There is no reasoning with barbarians.

 

[cpants]

It reminds me of the 9/11 conspiracy nuts. No amount of scientific evidence will convince these people that there is no conspiracy.

 

[RisingSun]

It reminds me of the 9/11 conspiracy nuts. No amount of scientific evidence will convince these people that there is no conspiracy.

I foresee many more combined deaths due to preventable illness among those not vaccinated than the number of unfortunate victims of the 9/11 attacks. The fact is that these people have a very loud and, unfortunately, convincing voice that speaks to many mothers' concerns. There are innumerable websites that make this assertion and I don't see it going away, no matter how much scientific evidence we produce to the contrary. For me, parents like these would be the worst part of being a pediatrician, and although of course it is not ethical of us as physicians to force anyone to do something that they do not agree to, it would be frustrating knowing that I could not help keep the kid safe from preventable, and possibly fatal, diseases.

 

[ForbiddenComma]

On my pedes rotation, we had one family where the mother had planned in the past to vaccinate her kids. But then the stepfather intervened with all his bull**** conspiracy theories. He seemed eager to take on the pediatrician, since she was a member of the Evil Medical Conspiracy, even though it was obvious that he had zero grasp of even basic science. It was also obvious that the mother didn't really buy into this, but she had submitted herself to this ***** and bade his every order, so in a way she was just as culpable.


Incidentally, I have a relative who has Asperger's Syndrome. He ran into minor trouble while applying for college. It seems that his school wanted vaccination records... and for some reason he hadn't gotten all his childhood vaccinations. He had never gotten his MMR.

 

[Tired]

What do you tell people like those who insist that MMR vaccine, in particular, is the root of autism? I seems like everything they say flies in the face of science, and that nothing that the scientific community can come up with will convince them otherwise.

You tell them the truth: There was one study 20 years ago that suggested there may be a link, but multiple studies investigating 2 generations of children has shown that the initial study was wrong. All of the authors (save one) of the initial study have formally and publicly admitted they were wrong. Every major organization of health professionals and the Centers for Disease Control say that there is zero link between vaccines and autism.

After that, recite the worst symptoms of measles, mumps, whooping cough, etc. Make sure you mention orchitis to the fathers.

Then tell them that it is ultimately their choice, but that they may be unable to enroll their child in school if they choose not vaccinate. End with a dead-pan comment like, "So I assume you're looking into home schooling?"

 

[All4MyDaughter]

My daughter is "working" this week at a day camp for autistic children. She's serving as a "typical peer" - a model playmate for the kids who are on the spectrum.

It's interesting. I was waiting with the parents of the other "typical peers," none of whom have a child with autism. Several of them could be characterized as buying into the conspiracy theory. These are highly educated individuals who homeschool their kids and don't vaccinate. They also had some weird ideas about dietary stuff. I mostly just listened to them b/c I didn't feel like getting into an argument...

 

[Dirt]

Eh it seems to me that the whole no-vaccine thing is just a fad, like Kabbalah. The American public is fickle, give it a few years to die out.

 

[dienekes88]

I think the American public in general has a complete and utter lack of understanding for science. Furthermore, there's an obsession with "bad/stupid government."

Side note: It's funny that these same people expect the "bad/stupid government" to cook up a complicated and devious plan that only a few select people can unravel. They also expect the "bad/stupid government" to successfully fund a universal healthcare system. BRILLIANT!

My tactic: quote the NEJM and the BMJ. Studies have shown that the link is not there.

At the end of the day, people are allowed to make their own medical decisions...

 

[Tchaikovsky]

I think that mandatory education of germ theory in elementary through high school will help Americans overcome this grave ignorance in the future.

 

[edmadison]

I think that mandatory education of germ theory in elementary through high school will help Americans overcome this grave ignorance in the future.

Funny, there is a similar thread on sermo that I just posted on. Check out Parikh's essays in PEDS: PEDIATRICS Vol. 121 No. 3 March 2008, pp. 621-622

Our problem is that we are scientists. We think like scientists and argue like scientists. We need to get nasty about this. We need to stop hedging our bets and parsing our language. They think measles and mumps are like bad colds, they have no idea what the diseases can do. We need to show pictures of kids s/p HiB meningitis. Have you ever tried to argue with a creationist? It's the same thing. These people are fanatics. I took care of a kid in the PICU who was just short of death from pertussis. The family still refused to vaccinate their other children.

Ed

 

[Josh L.Ac.]

My wife and I decided to stager / delay our son's vaccinations more on the basis of medical need [HBV...really?] rather than autism worries.


Turns out he is autistic anyway.



Granted, this is an n of 1, but since the general populations seems more interested in personal anecdote than scientific research, when we tell this story to members of the anti-vaccination movement, it makes them go "hmmm..."

 

[dienekes88]

Funny, there is a similar thread on sermo that I just posted on. Check out Parikh's essays in PEDS: PEDIATRICS Vol. 121 No. 3 March 2008, pp. 621-622

Our problem is that we are scientists. We think like scientists and argue like scientists. We need to get nasty about this. We need to stop hedging our bets and parsing our language. They think measles and mumps are like bad colds, they have no idea what the diseases can do. We need to show pictures of kids s/p HiB meningitis. Have you ever tried to argue with a creationist? It's the same thing. These people are fanatics. I took care of a kid in the PICU who was just short of death from pertussis. The family still refused to vaccinate their other children.

Ed

Shocking.

 

[NonTradMed]

This is the result of the success of the vaccination program. Too many parents has never seen the results of the diseases that vaccinations prevents. Talk to anyone over 75 and they will probably the polio scare, or the results of measles, pertussis etc. It's quite sad that Americans have such a short attention span and forget the anguish that their grandparents undergone at a time when these diseases were so prevelent.

I think the autism-vaccination link is just a facade (albeit a dangerous one). When no more data is forth-coming, when every study disputes it, when new studies come out with a better understanding of the cause of autism, then parents will stop blaming vaccinations. Right now, given no idea of what causes autims, some parents are willing to grab at straws to explain their child's problems.

 

[montessori2md]

I recommend having an alternative vaccination schedule already written and in hand, which isolates the "problem" vaccines (many peds practices already do this for MMR -that is, you only give MMR at that visit, not MMR, Hib, and dpat together). And then say, from your perspective, that you would feel terrible if you were to choose not to immunize your child and then have them actually get, say, tetanus, and then have to explain to his grandparents that he was dying because he wasn't vaccinated.

Alternately, get an older MD or nurse to describe pediatric wards back in the day (I had a nurse describe the meningitis wards to me, and all the LPs they used to do, wow), and then tell that story.

Offer to give the parents the lot number and manufacturer of the immunizations to them to take it home and research. Ask them if they prefer a specific vaccine manufacturer, or if they would be willing to do the MMR if you offered them individually (just the R).

Honestly, if you're talking to someone whose kid is "odd" or allergic to everything in the known universe, or someone who has experienced a medical error, you might try and empathize with their being overprotective. It seems a bit nuts, but parents do a LOT of things that strike me as nuts supposedly to protect their children. And the absurdity of it is magnified in clinic because you are seeing 1000s of totally healthy kids getting shots, and 100s of kids whose parents don't seem to be protecting them enough.

 

[Sunfire]

You tell them the truth: There was one study 20 years ago that suggested there may be a link, but multiple studies investigating 2 generations of children has shown that the initial study was wrong. All of the authors (save one) of the initial study have formally and publicly admitted they were wrong. Every major organization of health professionals and the Centers for Disease Control say that there is zero link between vaccines and autism.

After that, recite the worst symptoms of measles, mumps, whooping cough, etc. Make sure you mention orchitis to the fathers.

Then tell them that it is ultimately their choice, but that they may be unable to enroll their child in school if they choose not vaccinate. End with a dead-pan comment like, "So I assume you're looking into home schooling?"

Excellent, thanks. I just emailed it to myself for reference.

 

[facetguy]

My daughter is "working" this week at a day camp for autistic children. She's serving as a "typical peer" - a model playmate for the kids who are on the spectrum.

It's interesting. I was waiting with the parents of the other "typical peers," none of whom have a child with autism. Several of them could be characterized as buying into the conspiracy theory. These are highly educated individuals who homeschool their kids and don't vaccinate. They also had some weird ideas about dietary stuff. I mostly just listened to them b/c I didn't feel like getting into an argument...

I'm not sure it's fair to condemn the families of autistic kids for trying some outside-the-box thinking for the benefit of their kids, especially something as benign and health-promoting as cleaning up their diets.

(8/1/08: Bad timing on my part...I was unaware of All4MyDaughter's loss until just now. My prayers go out to her. What a tragedy. I have a son of similar age and can't even imagine the depth of her grief.)

 

[McDoctor]

Some parents, mothers in particular, take it very hard when they see their infant get numerous shots. It sticks in their mind. Then in those instances when a developmental problem occurs, their mind goes back to the shots. It's very easy to see why this occurs to the non-scientific parent.

I try to gain some credibility by acknowledging that some things we do are possibly unnecessary. I don't believe every single 9 month old needs a CBC and lead screen...there is reason to think selective screening would be more rational...and though I recommend it as part of my job, I haven't taken my own daughter for a lead test. Vaccines don't fall into this category, and my daughter received 6 different vaccines at her 6 month visit. This is what I try to tell patients, and I've had some success with this approach.

 

[Pharmavixen]

I'm not sure it's fair to condemn the families of autistic kids for trying some outside-the-box thinking for the benefit of their kids, especially something as benign and health-promoting as cleaning up their diets.

She was talking about the parents of other non-autistic children.

BTW, All4MyDaughter just put up a lovely post.

 

[ForbiddenComma]

That is horrible.

Peace be with you, A4MD.



I'm glad they caught the monster...

 

[shmrshines]

I just finished listening to a talk radio show that covered the recent disgusting remarks by Savage on how autism is "99 percent" the result of poor parenting and out of control "brats." A number of people called in to give their opinion and there was like a stretch of almost one hour were every single caller stressed the relationship between autism and vaccines, particularly the MMR vaccine. One even went so far as to say that the government has been sitting on this news for years and kept it from the American people so that the drug companies could profit by giving our children vaccines. It was really disturbing, actually, to listen to these people. Finally, a professor of microbiology and immunology called in and started off by saying that she is now going to talk about this from the standpoint of science, and debunked all of the claims that had been made over the previous hour. The radio show host was very unconvinced, and mentioned that he had no intention of having someone from the medical community with knowledge in these matters on his show, and after the professor was off, he basically said that the scientific community could not be trusted and that we need to follow our common sense.

What do you tell people like those who insist that MMR vaccine, in particular, is the root of autism? I seems like everything they say flies in the face of science, and that nothing that the scientific community can come up with will convince them otherwise.

Thoughts?

My oldest sister has a daughter who is said to be autistic, and my sister didn't get her children vaccinated until it was mandatory for entrance into k-garten, and the child clearly showed signs of being a special needs child before the vaccinations, soo...

 

[PeepshowJohnny]

Honestly, I'd love to get in a time machine (or failing that, find home video) of these kids that parents swear were "Completely normal before getting their vaccinations", especially those in the classic "1 year old got my MMR" range.

I GUARANTEE you that these kids are already showing the signs. The problem is, they're subtle and most pediatricians might not even notice them (Lack of mimicking behavior and lack of ability to maintain focus are big ones that are missed according to a developmental pediatrician who gave us a lecture).

But of course, you still see the kids who come into pediatric clinic and they're parents say "Yep! Everything's great!" and it's a one year old who can't even support their head or a two year old who hasn't even said his first word, so excuse me for taking parents accounts with skepticism.

But really, it is the exact same reasoning as the 9/11 conspiracy. It's much more comforting to think "There's a vast conspiracy out there and I'm fighting to expose them!" and not "The world is full of randomness and things we don't understand" because randomness is scary, and admitting there are things we don't understand or anticipate is even scarier. So parents convince themselves "Yep, Billy was completely absolutely one hundred percent normal. Yep, yep yep. It's those vaccinations!"

Really, it's stuff like this that keeps me from going into peds. I can deal with the ignorant parents and the bad parents, I can't handle the pseudointellectual B.S. parents who are sure they know better than me about science. I can throw the studies in their face about how the rate of autism went UP in California after thimerosal was removed from vaccines, or the studies in Europe where the autism rate between vaccinated and unvaccinated children was EQUAL, but they just brush it off and go on in their blissful ignorance and tell me to read Jenny McCarthy's book.

 

[Tired]

But of course, you still see the kids who come into pediatric clinic and they're parents say "Yep! Everything's great!" and it's a one year old who can't even support their head or a two year old who hasn't even said his first word, so excuse me for taking parents accounts with skepticism.

Or worse yet, the ones who rave about how "advanced" their infants are because they're head control is excellent, not realizing it's actually increased tone from their CP . . .

But really, it is the exact same reasoning as the 9/11 conspiracy. It's much more comforting to think "There's a vast conspiracy out there and I'm fighting to expose them!" and not "The world is full of randomness and things we don't understand" because randomness is scary, and admitting there are things we don't understand or anticipate is even scarier. So parents convince themselves "Yep, Billy was completely absolutely one hundred percent normal. Yep, yep yep. It's those vaccinations!"

It is sad, because you totally get what's going on, you feel very bad for them, and you really understand why they unconciously choose to believe the conspiracy instead of the randomness of the universe.

But it's painful when a defence mechanism becomes a basis for public policy. And it's frustrating for physicians to be told on one hand, that the science is a big lie, but on the other hand we need more science because they just don't like the conclusions.

 

[facetguy]

For what it's worth, David Kirby's book Evidence of Harm does a pretty good job of reviewing the history of autism. I think at least some of the conspiracy and skepticism stuff present today comes from the way the various governmental health agencies did a poor job at transparency in the earlier years. Instead of saying, "OK, perhaps there is an issue with this autism thing, so we will fully investigate...", they made access to relevent data all but impossible to outside scientists/investigators, held what some consider shady closed-door meetings, and the like. The end result was that concerned/frustrated/heartbroken parents of autistic kids became resentful and conspiratorial, and I'm not sure I can blame them to a certain extent.

Regardless of the history of autism, something continues to drive this disorder, thimerasol or not. Perhaps in the future, susceptibilities can be tested for and a different track can be taken with these kids.

 

[ManualEvac]

For what it's worth, David Kirby's book Evidence of Harm does a pretty good job of reviewing the history of autism. I think at least some of the conspiracy and skepticism stuff present today comes from the way the various governmental health agencies did a poor job at transparency in the earlier years. Instead of saying, "OK, perhaps there is an issue with this autism thing, so we will fully investigate...", they made access to relevent data all but impossible to outside scientists/investigators, held what some consider shady closed-door meetings, and the like. The end result was that concerned/frustrated/heartbroken parents of autistic kids became resentful and conspiratorial, and I'm not sure I can blame them to a certain extent.

Regardless of the history of autism, something continues to drive this disorder, thimerasol or not. Perhaps in the future, susceptibilities can be tested for and a different track can be taken with these kids.

I agree. The FDA's refusal to open the book on this has only fanned the flames. I work with about 25 autistic kids in my therapy practice, and the families are split about 50/50 on vaccines, but most everyone agrees that there is some sort of very real environmental contaminant activating an already present genetic predisposition (most of the kids have at least one anti-social, not quite autistic engineer for a parent), and this is driving the high incidence, esp. in boys (1 in 75ish). Thimerasol is not a likely cause with younger kids since it has been diluted out of most current strains of vaccine, although the significant presence of aluminum and formaldehyde may have some role, as well as many other toxins in water supplies, fish, paints, pesticides, and so on. Evidence of Harm is a good read, as long as you compliment it with something more even-handed like Dr. Sears' "The Vaccine Book," which also has a website to make up-to-date studies and recommendations available to the general public.

 

[facetguy]

I agree. The FDA's refusal to open the book on this has only fanned the flames. I work with about 25 autistic kids in my therapy practice, and the families are split about 50/50 on vaccines, but most everyone agrees that there is some sort of very real environmental contaminant activating an already present genetic predisposition (most of the kids have at least one anti-social, not quite autistic engineer for a parent), and this is driving the high incidence, esp. in boys (1 in 75ish). Thimerasol is not a likely cause with younger kids since it has been diluted out of most current strains of vaccine, although the significant presence of aluminum and formaldehyde may have some role, as well as many other toxins in water supplies, fish, paints, pesticides, and so on. Evidence of Harm is a good read, as long as you compliment it with something more even-handed like Dr. Sears' "The Vaccine Book," which also has a website to make up-to-date studies and recommendations available to the general public.

Dr. Sears' book is a very good recommendation for those new parents who want to be informed and involved. It is levelheaded and largely science based. He even includes 2 alternate vaccine schedules, which seem to be getting more and more popular these days. My wife and I did something similar with our child when he was younger. I just had reservations about him receiving numerous shots (and all the accompanying preservatives, additives, etc.) all at once. Why not spread them out over a few weeks/months?

 

[ManualEvac]

Dr. Sears' book is a very good recommendation for those new parents who want to be informed and involved. It is levelheaded and largely science based. He even includes 2 alternate vaccine schedules, which seem to be getting more and more popular these days. My wife and I did something similar with our child when he was younger. I just had reservations about him receiving numerous shots (and all the accompanying preservatives, additives, etc.) all at once. Why not spread them out over a few weeks/months?

We are doing the same with our son. After reading how it's made, I've also decided to NEVER get the vaccination for Japanese encephalitis

 

[Tired]

Dr. Sears' book is a very good recommendation for those new parents who want to be informed and involved. It is levelheaded and largely science based. He even includes 2 alternate vaccine schedules, which seem to be getting more and more popular these days.

I'll make sure I look for a decreased autism incidence in the coming years.

 

[oohchki]

Search for David Kirby's name on google and scienceblogs to see him demolished. As for Sears, as long as it gets parents who otherwise would not vaccinate at all to vaccinate...

 

[facetguy]

I'll make sure I look for a decreased autism incidence in the coming years.

It sure would be nice. Although cynical (and sarcastic in a humorous way...I get and appreciate that), you must admit that the current approach to autism is lacking, to say the least.

 

[facetguy]

Search for David Kirby's name on google and scienceblogs to see him demolished. As for Sears, as long as it gets parents who otherwise would not vaccinate at all to vaccinate...

Kirby took a hard look at a highly charged and hotly debated topic. Would you not expect some to disagree with him and try to 'demolish' him? Nobody is saying that Kirby is the end-all authority on autism...he's a journalist, not a scientist. He simply exposed issues that have led to some of the conspiracy notions noted earlier.

 

[ForbiddenComma]

The conspiracy theories make for comical reading. Is there really a lot of money to be made on vaccines? We keep running out of flu vaccines because they are so low-margin! The only vaccine that makes any significant money for the parent company is Gardasil, and that only because it still has its patent.

It makes me sad that so many people want to roll back one of the two most significant medical advances of the 20th century. Combine the ignorance-based war on vaccines with emerging antibiotic resistance, and we can find ourselves back in the year 1900 when it comes to infectious disease.

 

[oohchki]

Kirby took a hard look at a highly charged and hotly debated topic. Would you not expect some to disagree with him and try to 'demolish' him? Nobody is saying that Kirby is the end-all authority on autism...he's a journalist, not a scientist. He simply exposed issues that have led to some of the conspiracy notions noted earlier.

Kirby is not objective in the least. I don't want to look for them now Okay, I dug up some links.

http://www.sciencebasedmedicine.org/?s=kirby
http://www.google.com/cse?cx=017254414699180528062:uyrcvn__yd0&q=david+kirby&sa.x=0&sa.y=0&sa=search

When I said demolish, I did not mean destroy his character; I meant refute his pseudoscientific claims with science.

 

[facetguy]

Kirby is not objective in the least. I don't want to look for them now Okay, I dug up some links.

http://www.sciencebasedmedicine.org/?s=kirby
http://www.google.com/cse?cx=017254414699180528062:uyrcvn__yd0&q=david+kirby&sa.x=0&sa.y=0&sa=search

When I said demolish, I did not mean destroy his character; I meant refute his pseudoscientific claims with science.

Kirby aside, even the CDC says that 1 in 150 kids have autism. You speak as though autism is a non-issue and we know all there is to know about it. Something is driving the prevalence of autism (or maybe it's just those crazy parents making things up again). And until we have this thing solved, all plausible theories should be explored or at least considered. Demolish Kirby all you want, the facts remain.

 

[oohchki]

Kirby aside, even the CDC says that 1 in 150 kids have autism. You speak as though autism is a non-issue and we know all there is to know about it. Something is driving the prevalence of autism (or maybe it's just those crazy parents making things up again). And until we have this thing solved, all plausible theories should be explored or at least considered. Demolish Kirby all you want, the facts remain.

Isn't it generally accepted that 95% or so of autism cases are caused by genetics, and that there is no sudden epidemic, but rather a broadening of diagnostic criteria and greater awareness? Autism certainly is an issue, but to use it to discourage vaccination when there is no good science to support a link? That gets to me.

 

[facetguy]

Isn't it generally accepted that 95% or so of autism cases are caused by genetics, and that there is no sudden epidemic, but rather a broadening of diagnostic criteria and greater awareness? Autism certainly is an issue, but to use it to discourage vaccination when there is no good science to support a link? That gets to me.

I'm certainly no epidemiology expert, so I can't say with any authority that 95% of cases are or are not genetic. I tend to doubt that they are purely just genetic though. There is likely an environmental trigger of some sort, or perhaps even multiple triggers, that cause problems in those that have a genetic predisposition. That trigger doesn't have to be vaccine-related! I think what has happened is an oversimplification of the issue in the eyes of some. It became that you either believe vaccines cause autism and therefore vaccination is bad, or you believe that vaccines are safe and so these autism people are crazy. Such polarization is not helpful to getting to the root(s) of this problem.

Perhaps in the future, we will be able to determine early on which kids have predispositions and thus treat them accordingly. In other words, take into account each of our biochemical individualities instead of a one-size-fits-all approach.

As for the broadening of the diagnostic criteria idea, there seems to be plenty of ammo on both sides, so it's not that simple.

 

[ManualEvac]

Isn't it generally accepted that 95% or so of autism cases are caused by genetics, and that there is no sudden epidemic, but rather a broadening of diagnostic criteria and greater awareness? Autism certainly is an issue, but to use it to discourage vaccination when there is no good science to support a link? That gets to me.

No it's not generally accepted, at least not among the 50 or so families with autistic children that I work with. Although it's a compelling claim, I would like to see where you got this striking statistic.

 

[oohchki]

No it's not generally accepted, at least not among the 50 or so families with autistic children that I work with. Although it's a compelling claim, I would like to see where you got this striking statistic.

Yeah, I know, wikipedia, but for starters on the genetic claim (it's 90% rather the the 95% I remembered):
http://en.wikipedia.org/wiki/Autism#Causes
http://en.wikipedia.org/wiki/Causes_of_autism
http://en.wikipedia.org/wiki/Heritability_of_autism

As for the general acceptance: in a recent trial where a couple attempted to sue Wyeth because they believed that Wyeth's vaccines caused their child's autism, the Judge found that "it is generally accepted in the relevant scientific community that thimerosal in vaccines does not cause or contribute to neurodevelopmental disorders such as autism," and that "it is generally accepted in the relevant scientific community that autism is genetic in origin except in rare instances of prenatal exposures to certain substances at defined periods during pregnancy."

When I say generally accepted I'm talking about scientific consensus, not about the parents who need someone besides themselves to blame for their children's disorders. Something may be accepted among the general people (flat earth, dozens of gods), but that doesn't mean it's an scientifically based position.

 

[facetguy]

Yeah, I know, wikipedia, but for starters on the genetic claim (it's 90% rather the the 95% I remembered):
http://en.wikipedia.org/wiki/Autism#Causes
http://en.wikipedia.org/wiki/Causes_of_autism
http://en.wikipedia.org/wiki/Heritability_of_autism

As for the general acceptance: in a recent trial where a couple attempted to sue Wyeth because they believed that Wyeth's vaccines caused their child's autism, the Judge found that "it is generally accepted in the relevant scientific community that thimerosal in vaccines does not cause or contribute to neurodevelopmental disorders such as autism," and that "it is generally accepted in the relevant scientific community that autism is genetic in origin except in rare instances of prenatal exposures to certain substances at defined periods during pregnancy."

When I say generally accepted I'm talking about scientific consensus, not about the parents who need someone besides themselves to blame for their children's disorders. Something may be accepted among the general people (flat earth, dozens of gods), but that doesn't mean it's an scientifically based position.

Would you at least agree that it is plausible that those affected by autism may have a genetic predisposition that is then manifested by some environmental trigger? Such a trigger would be important to identify, and it is likely that there are multiple triggers (which explains why different kids have different histories). No conspiracies, no wacky paranoia. Just a search for answers beyond "it's genetic and that's that".

 

[oohchki]

Would you at least agree that it is plausible that those affected by autism may have a genetic predisposition that is then manifested by some environmental trigger? Such a trigger would be important to identify, and it is likely that there are multiple triggers (which explains why different kids have different histories). No conspiracies, no wacky paranoia. Just a search for answers beyond "it's genetic and that's that".

That might be possible, but if it's an immune system reaction to a vaccine, I'd think a similar if not worse reaction would occur if the child actually contracted what was being vaccinated against, and the probability of that goes up due to the anti-vax campaigns.

Whether or not it's worth putting more funding into that kind of thing I'm not so sure, having not heard of any leads in that direction.

 

[ManualEvac]

That might be possible, but if it's an immune system reaction to a vaccine, I'd think a similar if not worse reaction would occur if the child actually contracted what was being vaccinated against, and the probability of that goes up due to the anti-vax campaigns.

Whether or not it's worth putting more funding into that kind of thing I'm not so sure, having not heard of any leads in that direction.

The exponential increase in cases of any disorder in such a short time, even correcting for misdiagnosis, merits funding and serious investigation of all possible causes. Genetics couldn't possibly account for these kinds of numbers alone unless someone discovered the secret of the ooze and we're all experiencing some serious ninja turtles grade mutation.

I'm not sure that you realize the personal, economic, and medical implications of autism. These kids are seriously messed up, not just whimsical and inclined to count toothpicks. We're talking serious GI issues, muteness, illiteracy, violence, self-abuse (not the funny kind), obliviousness to lifesaving cultural mores (wandering into freeway traffic, etc.), and the list goes on. I'm not saying stop vaccinations or take any rash measures, but simply be willing to investigate possible etiologies without tiptoeing around big businesses like the pharms and kowtowing to the medical ivory tower which has not done the best job of investigating exogenic health hazards in the past.

 

[oohchki]

The exponential increase in cases of any disorder in such a short time, even correcting for misdiagnosis, merits funding and serious investigation of all possible causes. Genetics couldn't possibly account for these kinds of numbers alone unless someone discovered the secret of the ooze and we're all experiencing some serious ninja turtles grade mutation.

I'm not sure that you realize the personal, economic, and medical implications of autism. These kids are seriously messed up, not just whimsical and inclined to count toothpicks. We're talking serious GI issues, muteness, illiteracy, violence, self-abuse (not the funny kind), obliviousness to lifesaving cultural mores (wandering into freeway traffic, etc.), and the list goes on. I'm not saying stop vaccinations or take any rash measures, but simply be willing to investigate possible etiologies without tiptoeing around big businesses like the pharms and kowtowing to the medical ivory tower which has not done the best job of investigating exogenic health hazards in the past.

Do you think any study could possibly convert the anti-vax people? They've already made up their minds, and if they can't pin the blame to thimerosal (thimerosal all but eliminated in routine vaccines, autism rates continue to rise. oops!), they'll just move on and try to demonize another component of the vaccine with their brain dead scare tactics (oh noes! sodium chloride!). They can hook concerned new parents easily.

Sure, autism sucks, and I wish more of the people against vaccines would be as level headed as you, but I'm pretty sure that the fact is that most are not. It's impossible to disprove something, and the attempts I have seen trying to link vaccines to autism are weak at best and abysmal at worst.

 

[ManualEvac]

Do you think any study could possibly convert the anti-vax people? They've already made up their minds, and if they can't pin the blame to thimerosal (thimerosal all but eliminated in routine vaccines, autism rates continue to rise. oops!), they'll just move on and try to demonize another component of the vaccine with their brain dead scare tactics (oh noes! sodium chloride!). They can hook concerned new parents easily.

Sure, autism sucks, and I wish more of the people against vaccines would be as level headed as you, but I'm pretty sure that the fact is that most are not. It's impossible to disprove something, and the attempts I have seen trying to link vaccines to autism are weak at best and abysmal at worst.

Thimerasol is just one example of the many possible environmental triggers in the highly toxic society we live in. For example, in vaccines there is still a lot of aluminum, especially when multiple vaccines are administered in a short time. Anecdotally, I would say about 50% of the families I work with think they have pinpointed a 24-48 hour period where some event triggered a rapid change in functioning (vaccine, serious physical illness, food allergy etc.). 45% have no idea why it happened (probably the most rational bunch), and another 5% are diametrically opposed to any theories not endorsed by the FDA.

This fictional brain dead anti-thimerasol fanatic you portray is a rare find, even among the most guilt-ridden, CAM-using families I work with. If you talk to people struggling with autism, you find that most are pretty level-headed until someone attacks them for being leery of our national apathy toward toxic exposure. Granted, the human body can generally process and even thrive in the midst of the heavy metals, excess hormones, and pesticides all around us, but if any link in the immune system is vulnerable there is plenty of nasty stuff out there that will get you. Many of the things we expose ourselves to are not natural, and the determination of "SAFE" levels of toxins in our food, water, insulation, etc. is spurious and based on normal human functioning. Many people are compromised and so (IMO) we have increased autism, Alzheimer's, ADHD, food allergies, and so on. This is all in the context of genetics, of course, but to ignore the net chemical change to our environment due to human activity is silly.

 

[McDoctor]

The most simple and most plausible explanation for the increasing incidence and prevalence of autism is increased awareness, and above all, a broadening of the diagnostic classification of the disease. What would have previously been dubbed "developmental disorders" or "mental ******ation" is now classified "autism spectrum disorder".

A recent study looked at patients with a developmental language disorder diagnosed in 1980, and the authors found that if these same patients were examined using today's criteria, a significant number (about 1/4) would now have been classified as Autism Spectrum Disorder.

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

here's a few other studies which support the same conclusion, with much larger numbers of subjects.

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA

http://www.ncbi.nlm.nih.gov/pubmed/16585296?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/14695031

It's not sexy, it won't sell many books, it won't get much play on talk radio, but this is the cold, hard truth. When you broaden the diagnostic criteria of Autism, you will see an increase in the incidence and prevalence of Autism, and a corresponding decline in other developmental disorders which are now being reclassified.

Nobody is throwing around the theory, for instance, that vaccines or thimerosol are protecting children from other forms of mental ******ation or learning disabilities, which have declined over the past 2 decades, coinciding with the increased number of vaccines. That would be ridiculous.

 

[ManualEvac]

The most simple and most plausible explanation for the increasing incidence and prevalence of autism is increased awareness, and above all, a broadening of the diagnostic classification of the disease. What would have previously been dubbed "developmental disorders" or "mental ******ation" is now classified "autism spectrum disorder".

A recent study looked at patients with a developmental language disorder diagnosed in 1980, and the authors found that if these same patients were examined using today's criteria, a significant number (about 1/4) would now have been classified as Autism Spectrum Disorder.

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

here's a few other studies which support the same conclusion, with much larger numbers of subjects.

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA

http://www.ncbi.nlm.nih.gov/pubmed/16585296?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/14695031

It's not sexy, it won't sell many books, it won't get much play on talk radio, but this is the cold, hard truth. When you broaden the diagnostic criteria of Autism, you will see an increase in the incidence and prevalence of Autism, and a corresponding decline in other developmental disorders which are now being reclassified.

Nobody is throwing around the theory, for instance, that vaccines or thimerosol are protecting children from other forms of mental ******ation or learning disabilities, which have declined over the past 2 decades, coinciding with the increased number of vaccines. That would be ridiculous.

I think this is as clear-headed an argument as one can make given the paucity of hard data in autism, but it is by no means conclusive. For example, in the Pediatrics article you linked to the main variable appears to be special ed. classifications (very different from DSM diagnostic criteria), but according to the article only primary classifications are considered in the tabulation which disregards previous secondary diagnoses of ASD (autism spectrum disorder) as well as current secondary diagnoses of MR/LD. I know for a a fact that the latter is common practice, sometimes simply in order to secure more funding for special ed programs for these students. Ugly and unscientific, but it is the reality on the ground and skews data from these sources.

Money talks, and medical research is far from independent of powerful corporations and bureaucracies. I have tremendous regard for peer-reviewed research, but it is well-known that much of medical research is funded by drug manufacturers that are not pleased when their pharmaceutical product is implicated as a catalyst or cause of any disease, much less a detrimental childhood disorder, so good research with high n-values doesn't typically happen once a drug makes it through the pipeline. This is especially true of broad, poorly defined syndromes like ASD and other complex childhood disorders. That said, I personally do not think MMR vaccines "cause" autism, nor does any single trigger "cause"autism in all or even most cases. I think these kids are genetically predisposed and subsequently exposed to some environmental toxin or toxins that activates the disorder. The rate has increased significantly in my subjective experience, and this is corroborated by my colleagues who have been in the field of pediatric therapy for much longer than I have (PT, OT, SLP, MD, Dev. PhD., etc.). The feeling among those of us in the trenches of autism is that the incidence is increasing due at least in part to improved pre-natal and neonate care that has allowed critically ill babies to survive where they would not have 10-20 years ago. About 75% of my clientele were premature and/or critically ill as newborns. This can cause severe. sensory, immune, GI, and neurological issues that may (IMO) contribute to the development of autism.