Regular readers know that I have a tendency every so often to whine about when writing about the antics of the anti-vaccine movement seems to engulf this blog. Yes, it’s true. Every so often I get really, really tired of the bad science, pseudoscience, magical thinking, misinformation, and even outright lies that emanate from various anti-vaccine websites and blogs. This week, I promised myself I would try not to do it. There are times when duty calls, and this is one of those times. For better or for worse, as hard as I still find it to believe, somehow I’ve become one of the top bloggers defending vaccines, and there are times when I have to stop whining and just embrace this role. Given the one-two-three triple whammy of the start of the anti-vaccine autism quackfest Autism One, Andrew Wakefield having had his license to practice medicine in the U.K. yanked, and the hilariously insane anti-vaccine rally to take place in Grant Park in Chicago tomorrow, it’s time just to go with the flow and do what needs to be done.
Today this is something I’m more than happy to do, at least today.
If there’s one thing about the anti-vaccine movement that I’ve learned over the last several years, it’s that it’s nothing if not, for lack of a better word, nearly infinitely pliable. To put it more simply, anti-vaccine activists are experts at throwing out as much stuff as they can and seeing if anything sticks, adjusting their stories, and moving the goalposts every time each of their successive demands for more evidence are met by scientists. Although there has always been an anti-vaccine movement, its most recent incarnation is built primarily around the idea that vaccines cause autism somehow. First it was Andrew Wakefield presenting dubious, trial lawyer-funded “research” purporting to show that the MMR vaccine causes “autistic enterocolitis” and even autism itself. Then, not long after that, the U.S. version of this manufactrovery showed up in the form of the concept that mercury in the thimerosal preservative that used to be in vaccines cause autism, promoted initially by David Kirby and Robert F. Kennedy, Jr. Fortunately, more than a decade’s worth of research consisting of large epidemiological studies has utterly failed to find even a whiff of a hint of a link between either the MMR vaccine or thimerosal-containing vaccines and autism. Unfortunately, the anti-vaccine movement simply moved the goalposts to the “toxins” gambit, in which it is claimed that vaccines are laced with “toxins” such as formaldehyde, antifreeze, and tissue from aborted fetuses. Never mind that there are no parts from aborted fetuses or antifreeze in vaccines, and scary-sounding chemicals like formaldehyde are present in concentrations far too low to be a problem. Even so, “Green our Vaccines” sure sounds like a slogan that means something, even though it doesn’t.
The latest gambit, and arguably one of the most successful because it’s the most vague and difficult to falsify, is the “Too Many Too Soon” slogan. Under this idea, anti-vaccine propagandists claim that infants are getting too many vaccines too soon (hence the slogan) and that all those nasty vaccines being given to such young infants is somehow messing up their immune system, attacking their brains, and giving them autism. This is a tough one to combat because the only definitive way to refute it would involve studying unvaccinated versus vaccinated children (which, not surprisingly, is the latest demand of the anti-vaccine movement). Doing such a study in a rigorous prospective randomized fashion would be completely unethical because it would leave the control group unprotected, while retrospective studies would be prone to a lot of confounders, given that there are likely to be other factors besides vaccination status that make populations who aren’t vaccinated different from those who are.
That’s why a study hot off the presses yesterday (well, hot off the web, as it were, given that it’s an E-pub ahead of print) is so well timed. Released right as Autism One starts and Andrew Wakefield tanks, what better time for a study to look right at the very question that anti-vaccinationists seem to want answered? The title of the article is even an arrow aimed right at the heart of the “too many too soon” mantra, namely On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes.
This study, which comes from investigators at the University of Louisville, couldn’t compare unvaccinated children with vaccinated children. What it could do, however, was to provide about as good evidence shy of a prospective study to put the lie to Dr. Sears “alternative” vaccine schedule and the claims that, if parents just “spaced out” vaccines and “vaccinated more slowly,” it would be safer and wouldn’t cause autism. In this study, the investigators in essence compared children who had received all their vaccines on time with children who did not, looking for differences in neurodevelopmental outcomes.
Before I describe the study a bit more and, more importantly, its results, strengths and weaknesses, let me just predict what one of the criticisms of the anti-vaccine movement will be. Here is the paper’s disclosures:
Drs Smith and Woods are or have been unfunded subinvestigators for cross-coverage purposes on vaccine clinical trials for which their colleagues receive funding from Wyeth, Sanofi Pasteur, GSK, MedImmune, and Novartis; and Dr Woods has received honoraria for speaking engagements from Merck, Sanofi Pasteur, Pfizer, and MedImmune and has received research funding from Wyeth and Sanofi Pasteur.
Yes, anti-vaccinationists will be screaming “big pharma bought this study.” Of course, big pharma didn’t actually pay for this study, and Dr. Smith hasn’t even received any pharmaceutical funding. All an “unfunded unfunded subinvestigator for cross-coverage purposes on vaccine clinical trials” is is a physician whose partner is a funded investigator for a vaccine trial and who thus might have to cover for his from time to time for purposes of taking care of patients who are on the trial when his partner is out of town. As for the rest, I can only point out one huge difference: This potential conflict of interest (COI) is listed right up front. Andrew Wakefield did not disclose his COI of being funded by trial lawyers for his 1998 Lancet paper, nor did Laura Hewitson initially reveal that she is the mother of an autistic child who was a complainant in the Autism Omnibus trial the first time she tried to report her results.
Smith and Woods then did something ingeniously simple in concept but devilishly difficult in execution. Basically, they took publicly available data from the VaccineSafety DataLink Study of thimerosal exposure and 42 neuropsychological outcomes. This is the same dataset that I wrote about when its results were published in the New England Journal of Medicine nearly three years ago. Basically, the study looked at a whole bunch of neurodevelopmental outcomes other than autism and tried to correlate them with thimerosal-containing vaccines. There were no associations other than those likely to be due to random chance alone. More interestingly, Sallie Bernard of SAFEMINDS participated in the design of the study and then turned on it when it didn’t show what she expected that it would show, thus providing more evidence of the futility of trying to include anti-vaccine zealots in such activities is pointless and only leads to trouble.
This time around, Smith and Woods decided to look at the same dataset, which includes 1,047 children, and try to correlate on-time vaccination status versus delayed vaccines with neurodevelopmental outcomes. These are the same neurodevelopmental outcomes that Thomson et al reported on in the NEJM in 2007; so what this study does not provide us with is an answer to the question of whether “too many too soon” affects autism incidence. However it can answer a lot about the 42 neurodevelopmental measures studied in the original paper in 2007. The methods were as follows:
Publicly available data, including age at vaccination, from a previous VaccineSafety Datalink study of thimerosal exposure and 42 neuropsychological outcomes were analyzed. Vaccine receipt was defined as timely when each vaccine was received within 30 days of the recommended age. Associations between timeliness and each outcome were tested in univariate analyses. Multivariable regression models were constructed for further assessment of the impact of timeliness on neuropsychological outcomes after adjustment for potential confounders. Secondary analyses were performed on a subset of children with the highest and lowest vaccine exposures during the first 7 months of life.
These analyses were controlled for potential confounders, including age, gender, birth weight, poverty status, maternal IQ, maternal education, study site, cumulative ethyl mercury exposure during the first 7 months of life, and Home Observation for Measurement of the Environment score (an objective assessment of stimulation and emotional support in the home environment, which has been associated with developmental outcomes). Additional confounders examined included day care versus home care, language (English only versus multiple languages), duration fo breast feeding, Apgar scores, maternal age, and others. Both univariate (one variable at a time) and multivariate (correcting for multiple comparisons) were performed.
Now here’s where it gets interesting (and sometimes difficult to explain):
In the primary analyses, timely receipt was significantly associated with better performance on 12 of 42 outcomes in univariate analyses (Table 2). Specifically, children with timely receipt scored statistically better on the Boston Naming Test, grooved pegboard, metacognition, and teacher Connor’s ratings for hyperactivity and inattentiveness. They also had higher verbal, performance, and full-scale IQs and were reported by parents to stutter less than children with untimely receipt. Children with untimely receipt did not perform better (no clinically or statistically significant differences) on any of the outcomes.
So in this analysis, vaccines actually appear protective. But is this real, or is this just a bunch of spurious results from multiple comparisons? To test this, Smith and Woods subjected the data to multivariate analysis. When they did, what they found is that two of the 42 measures actually remained significantly different and continued to favor the group who received vaccinations on time according to schedule. Specifically, children who received vaccines on time scored 1 point higher on the Developmental Neuropsychological Assessment (NEPSY) speeded naming test. They also scored 2.7 points higher on the Wechsler Abbreviated Scale of Intelligence performance IQ, a standard test used by school psychologists and child psychologists.
Of course, the apparent better results noted in the group vaccinated on time could well be due to confounders not yet identified, but one thing’s for sure. Not a single statistically significant negative neurodevelopmental outcome was found in the group vaccinated on time compared to the group that received some or all of its vaccines late. Moreover, the investigators identified two subsets, a group who had the maximal exposure to vaccines during their first seven months of life, and compared them to a matched “least timely” group, who had, true to their name, the least timely exposure to vaccines and recieved almost half fewer than the most vaccinated group. Comparison of these groups showed that the more vaccinated group did better on 15/42 of the neurodevelopmental outcome measurements on univariate analysis, but these differences didn’t persist in multivariate analysis. In other words, there was no statistically significant difference in any of the measured outcomes between the two groups.
Overall, this study was fairly cleverly done, and quite timely. It has the strength of using a dataset that has a lot of socioeconomic indicators that might be confounders, allowing the investigators to correct for them. It is also a rigorous dataset that doesn’t rely on parental reporting but rather actual measures by health care professionals. I can, however, see one criticism that anti-vaccine zealots will level at it. Specifically, the children in this study were born between 1993 and 1997. The results reported in Thompson et al in 2007 examined neurodevelopmental outcomes between 2003 and 2004. Thus, the vaccine schedule was different. The authors answer this criticism quite convincingly:
Because the children in this study were born between 1993 and 1997, these results may not be generalizable to the current infant immunization schedule, which now includes 3 doses of heptavalent pneumococcal conjugate vaccine, 3 doses of oral rotavirus vaccine, and 1 or 2 doses of influenza vaccine in the first year of life (earliest eligibility at 6 months of age). This limitation is presently unavoidable in any vaccine safety study with long-term follow-up. However, most of the children in this study received DTP rather than DTaP, so the total antigenic burden to which children in this study cohort were exposed was actually higher than that encountered by children today.
It’s good to see a study like this begin to address the latest, most pernicious of antivaccine myths. Even though it doesn’t look at quite the same vaccine schedule as what we have today, the schedule that it did study was comparable. Moreover, if, as anti-vaccinationists say, “too many too soon” is bad and “spreading out” vaccines is safer, then one would expect to see differences between the most vaccinated and least vaccinated groups in a study like this. No such differences were observed that held up to multivariate analysis, and all the differences observed in univariate analyses favored the more highly vaccinated group. Finally, even though this dataset is from the “thimerosal era” of vaccination, when several childhood vaccines contained thimerosal and thus appears to be yet another weakness that anti-vaccinationists can point to. However, it’s fairly easy to answer that criticism by simply pointing out Thompson et al, which looked specifically at thimerosal exposure during that time period using exactly the same dataset. No differences due to thimerosal exposure was found in these neurodevelopmental outcome measures other than what could easily be ascribed to random chance. Taken together, these two studies provide a great deal of reassurance that vaccine exposure does not correlate with long-term developmental outcomes or that, if it does, less vaccinated or unvaccinated children actually do worse. Truly, maybe when anti-vaccine activists shout “too many too soon” at us we should should back “too few too late” is dangerous.
Actually, though, as much as I like seeing a study like Smith and Woods’, seeing such a well-designed study see print profoundly depresses me in a way. Even though Smith and Woods have provided a very strong bit of reassuring evidence that vaccines do not cause neurodevelopmental harm in a large number of outcomes, it’s depressing that such a study is even still considered necessary in 2010 and even more depressing that a lot more money and a lot more effort will be poured into similar studies. That’s money that gets diverted from much more fruitful potentially fruitful research into the causes and potential treatments for autism.
REFERENCE:
Michael J. Smith, MD, MSCE, Charles R. Woods, MD, MS (2010). On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes Pediatrics
149 replies on “No difference between “too many too soon” and “too few too late” when it comes to vaccines”
How about a study comparing autism disorder rates of existing unvaccinated and vaccinated groups?
Both Dr. Julie Gerberding, now a pharmaceutical company officer, and Dr. Bernadine Healy have said such a study COULD and SHOULD be done.
Credible autism researchers like Dr. Irva Hertz-Picciotto has also said that the thimerosal autism studies are flawed and stronger science is needed on this area.
Do you with your considerable autism expertise think that such research should be done?
Harold L Doherty,
I would expect that Orac’s position today would be along the lines of what it was a year ago when he wrote this post:
https://www.respectfulinsolence.com/2009/04/generation_rescue_and_fourteen_studies.php
In that post he referenced and enthusiastically endorsed this post by Prometheus:
http://photoninthedarkness.com/?p=154
That is, “No.”
“How about a study comparing autism disorder rates of existing unvaccinated and vaccinated groups?”
too many confounders mate, like Orac said. A better reason is that there’s no credible scientific theory that begs such a study to be done (if there is one please present in your next post).
c
Harold: at the risk of repeating myself for the nth time (but mothers are good at repeating information to their children who aren’t listening)…Such a study is unethical. You have been told that a million times. STOP. That is ENOUGH.
Cherry picking what Drs Gerberding and Healy said is rude. Please either put their comments in context or link to the statements. Or go away. Personally, I’d prefer the third option when it comes to your drivel.
Well how about that? So I guess the next study will be examining two groups, one group eats a dozen donuts a day for a month, the next eats 6 donuts everyday for two months and then look at which group gains the most weight. Brilliant!
Children that have already had vaccines refused are not having “life saving” medicine withheld and an observational study of that group versus the many contained in the “publicly available” VSD should be easy to do. This is the study that many are wanting to see (and rightly). Besides… to measure the benefit of any treatment or drug we always look at outcomes.
Except where vaccines are concerned.
In the first month, that would quite obviously be the first group.
@bensmyson
I don’t know which of you is responsible for that gem, but whoever it was isn’t very bright. The whole point of the study is that some of your fellow anti-vaccine cranks repeat the dumbass mantra of “too many too soon”. This study was done to demonstrate the incorrectness of that position.
@bensmyson
Good morning. How’s Ben? Have you even checked in on him before you came out to comment on this blog. Surely, parents as loving and caring as you would not troll for attention before at least giving breakfast to the kiddos, would you? Let me go check AoA and see if you’ve been over there yet… Yes, you have.
Then again, the only autism experts are parents, right? So you feel it is your professional duty to educate us. God knows Mom is an expert in infectious disease given how many times I caught a cold, strep throat, or the flu as I grew up. I think she got a doctorate-level education in virology from when I got chickenpox.
(Does Andy Wakefield have autistic children, because that seems to be the only people allowed to be experts on the matter, according to Ben’s parents and Kim-Kim.)
DISCLAIMER: Mom is not an expert in infectious disease. She opted for law school instead, for some strange reason. Oh, and the comments I make in this or any other media do not represent, in any way, the opinion of people I don’t even know.
Of course for someone like you, the conclusions are pre-determined. Also, for someone as scientifically-illiterate as you and didn’t even read the study, your observations account for exactly squat. I’m sure AoA will have their very creative interpretation of this study (once they find someone who can kind of read it to them); that will be more your speed to comment on.
False. As stated previously, too many confounders. And you obviously didn’t even LOOK at the links Allison posted. If you had, you’d also know that even using every single unvaccinated child in the US wouldn’t provide sufficient power to be meaningful.
The ONLY way to get meaningful numbers for such a study would be the grossly unethical large-scale prospective randomized trial.
Well, THAT was really impressively irrelevant, meaningless, and unrelated to anything at all.
@benismymom
seems about right: Decry current evidence as incomplete, whine about studies that haven’t been done, scoff at results when the study (or a preliminary version) is done (make sure to only make a feeble attempt at feigned amusement, do not, I repeat DO NOT provide a factual rebuttal), loudly question why someone would study this and not ‘x’ (where ‘x’ is the new supposed trigger for autism) despite the fact that it’s what you were asking for mere weeks before, decry the current evidence as incomplete, etc.
@cynic:
Guess what? You can do a study like that…but how are you going to control for all the cofounders? You won’t have comparable groups for the vax/non-vax so you can’t compare the results. So how will you control for parental education, diet, lifestyle, family history of autism, etc?
Basically the study will be no better than the infamous phone study done by Gen Rescue that you all ignore because the results show that unvax/partially vax children have a higher incidence of autism.
Try again.
That’s a ridiculous assumption. Especially considering we’ve accepted longitudinal studies for other outcomes. It is the ONLY way, you will silence vaccine critics.
It’s not unethical to use animals… we should probably do that before practicing on humans. Doh.
It is neither ridiculous nor an assumption. Read Prometheus’s analysis before you embarrass yourself further.
There’s no good animal model of autism, so this can’t even be done at all.
@bensmyson:
Your proposed “study” would likely result in more serious adverse results for the former (dozen-a-day) group. That is the opposite of the result described above.
Please read again, this time for comprehension.
This is a very loose position. Confounders are an obstacle in ANY study, even those that purport to disprove an association between thimerosal and austim.
The phone survey? Are we really calling that a study?
I have. Thanks for your borrowed insight.
Who said anything about autism? Yes. It can be done.
@Cynic
“It’s not unethical to use animals”
Actually, it is unethical, unless you can prove you have good reasons. That’s why we have ethical boards to approve animal studies.
One question of such a board will be: is the animal you propose to use a good model for the illness you want to study?
@cynic
Well, the AoA folks did. And it is a study. A bad one, but a study nonetheless.
Well, there are mouse models for autism, as was pointed out to me before. The problem is that it is a genetic model. So, it wouldn’t work for a vax-unvax study. Other than the genetic models, though, we don’t have any good animal models.
Cynic, what is your proposed study design for a) a retrospective comparison, making sure to explain your controls for confounders as well as how you would ensure sufficient power, given the limited number of subjects and b) a prospective, double-blind, placebo controlled study, explaining how you would overcome the ethical problems involved.
Fair question.
@cynic:
If you’re not talking about autism, then you’re grossly and ludicrously off-topic. And when you decide to start talking about something entirely unrelated to what everyone else is talking about, you really ought to say so!
So, WTF do you think you actually ARE talking about?
Harold Doherty wrote the above text. Check this out.
Harold seems to think arguments from authority are convincing. And maybe they are. However, he’s obviously not swayed by authority himself. He cherry-picks authority that already agree with his views.
Harold is a lawyer, BTW.
@Cynic
What do you mean, who said anything about autism? Isn’t that the whole point? Are you proposing a study in which we just inject animals with human vaccines and see what happens, even though it wouldn’t in any way be applicable back to humans? Yeah, there’s a fantastic idea.
Let’s go through the history. Harold said:
MI Dawn responded:
And cynic said to that:
So yeah, he’s very clearly and explicitly talking about autism and I can’t see a reason he’s backtracking now except trying to dodge being grossly wrong…
Hi Toddy W.,
Great questions. given the limited number of subjects… Do we really know that to be the case? I’m not convinced, though I hear it regularly.
a prospective, double-blind, placebo controlled study, explaining how you would overcome the ethical problems involved.
Since it wasn’t until the 80s that we began to vaccinate neonates within hours of birth, can someone tell me what safety data was used for the ACIP to make this recommendation? What animal model did we use to determine that this was “safe”, or that the benefit outweighed the risk?
Nothing will silence vaccine “critics.” They are, after all, still denying that vaccines do anything to prevent disease. Quite a few deny the germ theory of disease altogether. A remarkable number also insist that the Great Vaccine Conspiracy is covering up the “fact” that smallpox is still with us.
Good grief. Let’s just vaccinate the shit out neonates then and presume safety. Great idea.
Scott:
Except that YOU were the one that said “autism” – minor detail. Your claim buddy, not mine.
We are vaccinating a neonate on: birth day, 2 months, 4 months, 6 months… Since we are already doing this, surely data must exist on the safety outcomes (neuro, immune dysfunction, etc…) Right? Telling me we can’t do it, when we already are is just stupid.
Or, are we inaccurately assessing the risk of these interventions, since it is impossible to perform such science (according to you)?
@cynic
Thank you for not answering my questions.
Todd W.,
The answers should already exist.
@cynic
Perhaps you can point me to where your answers to my questions are located, then?
Never mind. I’m sufficiently reminded of why it’s useless to post here.
Shut up and take your vaccine people. It’s safe, the science sez so.
Have a great week folks, since it’s such a triumph to bring down the wakers, perhaps you should all just continue gloating and high-fiving each other. That’s what matters right?
I think it was completely reasonable to presume that someone responding with quote to a comment specifically about autism, without stating otherwise, was likewise talking about autism.
But if you want to talk vaccine safety in general, fine, we can do that.
You mean, like the pre-approval safety trials? Or the 8346 hits on PubMed for “vaccine safety”?
Why is it useless to post here? Todd asked you very good, relevant questions and you couldn’t or wouldn’t answer them. It’s hard when you have to actually think about what is entailed to validating the empty hand-waving assertions isn’t it?
You then move on to strawmen. Wakers brought himself down, no one else. If you wish to remain intellectually unchallenged, then yes, it is useless to post here.
@cynic
Because you are generally required to back up your claims with evidence, reason and logic and you don’t have any?
Just to recap:
Me: Cynic, what is your proposed study design for a) a retrospective comparison, making sure to explain your controls for confounders as well as how you would ensure sufficient power, given the limited number of subjects and b) a prospective, double-blind, placebo controlled study, explaining how you would overcome the ethical problems involved.
Cynic: Ummm, I don’t have any proposed design, but here are some questions that, even if by some contortions of logic implicate vaccines, still don’t support my position.
Me: Thank you for not answering my questions.
Cynic: The answers should already exist.
Me: Perhaps you can point me to where your answers to my questions are located, then?
Cynic: Crap, now I have to put up or shut up. I’ll just whine and disappear.
Hello friends –
Does anyone know how many children were in the low exposure group? How many were in the no exposure group? I think this would be useful information to have if we can use this information to come to conclusions.
It is nice to see the ‘antigenic load’ data get more press. It is a gross oversimplification, of course, but sounds real sciency.
– pD
@cynic
Don’t pretend that your leaving is anything but the result of the following trajectory: attempting to feign real concern over autism/vaccines, pretending to have a clue about scientific study design, getting frustrated when people who DO have a clue point out the glaring flaws in your ideas, pretending you weren’t really talking about autism, flaming out into “THERE’S SO MANY VACCINES AND THEY’RE TINY BABIES CAN YOU BELIEVE IT” scare tactics, getting in a huff because none of it took and you look silly, all of course capped off with the traditional anti-vax goodbye: a sarcastic, rebutal free insult or two and an instruction to take our vaccines. At least there was one good bit of advice in there.
Orac provided a cite and link to the paper, and the link leads to a free full-text PDF, so this is quite readily available to you. See in particular page 1136 and Table 1, but the headline numbers:
Timely=491 (11.80 +/- 0.6 vaccines in the first year)
Untimely=556 (10.10 +/- 2.34)
Least timely=112 (7.40 +/- 3.49)
Most timely=310 (11.80 +/- 0.64)
There was no “no exposure” group discussed.
so isn’t that like comparing kids who get a little poison to kids who get more poison? It really doesn’t say much.
Actually it does, since (a) if it’s *actually* poison there will be a dose-response curve and (b) the study was designed explicitly to compare the delayed schedules some people advocate without evidence to the recommended schedule.
It also doesn’t compare groups where the vaccine was administered by a doctor vs. a nurse; this is no more a flaw than not looking at a no-exposure group.
Off topic, but I saw Kirby’s new book in Border’s yesterday, on factory farming. I agree that we need to look at how our meat is raised and processed, but why do I doubt I will get a fair and scientific evaluation of the issues? Maybe he can team up with Rifkin.
@jen
Ummm, no. It’s like comparing the “too many, too soon” spaced-out schedule against the recommended schedule.
@cynic
Take your pick of studies linked here on Hep B alone:
http://www.nfid.org/library/hepb_safety.shtml
but I’m sure you will discount/ignore it all and just keep SCREAMING- WHERE IS THE SAFETY DATA!
@Jen:
Actually, as you would know if you’d read Orac’s post, let alone the article he discussed, the point of that study was to address the “too many, too soon” gambit. Hell, it’s right in the bleeding title of the post, for the love of all that is good and holy. So yes, it does say much: exactly what it needed to say to address the question of interest. Your side lost, again.
jen
“All things are poison and nothing is without poison, only the dose permits something not to be poisonous.” Paracelsus
Now go drink 3 gallons of water real fast-water is harmless, right?
With all of this information easily available, it boggles the mind that people are still so angry about vaccines. Just pick up a history book and learn about the lovely childhood diseases that used to plague us. Shouldn’t the parents of autistic children instead be angry that these anti-vaccine loons are taking away valuable time, money, and energy from research that might actually benefit their children?
Since it looks vanishingly unlikely that vaccines have anything whatsoever to do with autism, I have been wondering what else might have caused the increase in diagnoses of autism spectrum disorders in the past 20 years or so. That’s assuming there is a real increase in incidence, and not just increased awareness and widened diagnostic criteria. What has changed in developed countries across the world during this time?
The answer is, of course, “a lot of things,” but I wonder if early exposure to television might be one cause of autistic disorders. With the introduction of video, DVD and specialised children’s TV channels, young children are often left in front of a TV to keep them occupied, while parents get on with their busy lives. This rarely happened before the early 80s, and the increase in autism spectrum disorder diagnoses has happened since then. At least one study has found a correlation between access to cable TV and autism diagnosis.
http://www.johnson.cornell.edu/faculty/profiles/Waldman/AUTISM-WALDMAN-NICHOLSON-ADILOV.pdf
Is this worth some more research? If not, why not? There seems to be a much greater correlation between TV exposure and autism than between vaccinations and autism. It might even explain the alleged low prevalence of autism among the Amish. Whether it has anything to do with TV or not, I find the increased rates of autism in states where there is a lot of rainfall intriguing.
Looking at Jen’s comment, it now appears that the anti-vax ideologies have now endorsed homeopathic principles to dose response. After all, the Autism One event in Chicago now has homeopathic practitioners in speaking positions/guest panels.
I guess that means we have found the reason the autism rates continue to rise despite the removal of thimerosal. Clearly the vaccines’ substance has the “memory” of thimerosal despite being no longer present within the dose itself.
I suppose this study probably will not say a lot if you do not even understand the issues the study is addressing. Reading for comprehension is important.
Hmm, if good scientific and clinical studies and evidence say that vaccines are safe, why shouldn’t people take them? There is also evidence they’re extremely effective preventative treatment against disease, as well as being cost-effective. A cheap, effective treatment that only needs a little prick in the arm, essentially. Why exactly is this a bad idea?
bensmyson, I have a simple question for you.
What threshold of evidence would convince you that vaccines are not a plausible cause of autism?
In a sense, it is. With a real poison, you will find that the severity and frequency of toxic effects will be less in those who receive a little poison than those who get more poison, unless the “low” dose of poison is so high that 100% are killed by that dose. This has been shown over and over, and is one of the key criteria for distinguishing between a real toxic adverse effect and one that is imaginary or actually due to chance or coincidence.
If the immune system is “immature” in such a way that receiving vaccines early is more dangerous than receiving them later, then a study of this sort should be able to detect it. The absence of any such result is a strong argument that very few–quite likely zero–children exhibit enhanced susceptibility to adverse neuropsychological effects when they receive their vaccines on schedule rather than late.
Nick @ 48:
No, in that case vaccines should start to *cure* autism, since remember that in homeopathy, diluting something to absurdity will reverse its effect.
OMG! Vaccines cure autism! That explains the GR phone survey! (Oh wait, that survey was just a demonstration of the problem of confounding variables, since there is really no plausible reason yet proposed why vaccines should have a protective effect against autism. Never mind.)
@Calli Arcale
Except for rubella vaccine, that is, since rubella during pregnancy is a risk factor for autism.
Ruth quoted…
Ah, the famous Paracelsus. The guy who coined this very useful comment, and then went on to demonstrate it’s veracity by drinking himself to death.
That crazy Bombastus! Like the other alchemists at the time, he had concluded that alcohol was the true elixir of life. Dead by the age of 45.
Todd — I know, but person A not getting a vaccine for rubella can’t cause person A to get autism. It might cause person B to get autism, but that’s a horse of a different color.
@derelicthat
Many of the parents of autistic children here (and elsewhere) are very angry that the funds are being diverted to proving what we already know. I know I am insanely furious, but I guess we are just not as vocal (or nobody listens to us).
@Nescio
I remember hearing about this right about the time my son was born. I was extremely careful not to let him watch television for the first year or so of his life. My sister let my parents watch her son for the first few years of his life and they had the t.v. on constantly. Yet both of them are autistic. What they do have in common is genetics. This is anecdotal, of course, so I sure wouldn’t mind the television ‘connection’ being looked into further (far better to spend money looking there then vaccines).
Regarding the states with large amounts of rainfall, that intrigues me too. Most of all, though, I am curious about the genetic research going on.
There are _lots_ of _potential_ sources for the increase in autism rates. Remember the poster who came around not long ago postulating it was fluorescent lights? There have been worse suggestions.
I am still thinking it is the “Creamy” Desitin. Desitin itself has been around since the 1930s or before, but I have not been able to track down when the “Creamy” Desitin hit the market. Johnson and Johnson gave me the complete runaround when I asked them about it (My question, “When did “Creamy Desitin” come on the market?” Their answer, “Here’s our website. You can find it there.” I responded, “I have looked all over the website. I found a statement that said that Original Desitin has been around for more than 70 years, but it does not say when the Creamy version of Desitin was made available.” Their response, “You can call our Consumer Relations department.” Was it really that hard of a question?)
What about car seat laws? When did they become popular?
(ok, I’m not really serious in my suggestions, but am serious in the point – there are countless possibilities)
My husband just sent me this article from Ars Technica. Good to see the word getting around (at least in geek circles :)).
My favorite quote:
Well said.
@Kristen
How true. Why, even Jake’s most recent article at AoA says as much, before going into a rehashing of the Simpsonwood stuff.
@Nescio
You will also find a correlation between increased rates of autism and school spending on special education training/staff.
cynic:
As noted before, there are too many confounders involved with that subset of children. One of is that life saving medicine is withheld from them!
That was the case of the children who died of measles in Pennsylvania when measles came back about twenty years ago. The only way many children belonging to a particular church got care was by court order:
Also, during that same time, many of those who had measles in California had these demographis:
Pablo,
While I do agree with you, there has to be research into what factors may contribute to autism. As long as such factors are not scientifically implausible. I am not a neurologist, so I don’t know what is and isn’t plausible (all I know is what sounds right to me; not very scientific), but people who are smarter than me know. Whatever (real) scientists want to look at, if they think it might help I say go for it.
To me, the money needs to go first into finding how to help the persons who are already affected. Help me teach my son to be self-sufficient when he is grown, that is my ideal.
I am disappointed in the derail that the trolls have created. Can we get to what we SHOULD be doing with this post: trashing Bob Sears?
I mean, Bob Sears is the one who literally “wrote the book” on spacing out vaccines. One would think that given all the popularity he got from his book that there might actually be some basis for it. Alas, Bob knew, before this, as much as we all did that there is no basis to think that his alternate vaccination schedule is safer. Now we can say there is actually evidence that it is NOT safer, which is a bigger step altogether.
Unfortunately, I’m sure Uncle Bob will, with the help Cousin Jay, continue to feed on the fears and insecurities of parents, instead of allaying them, to collect that payment for the extra office visits.
“Not scientifically implausible” is too low a bar in the real world of limited funding. Every dollar spent on looking for a correlation with TV is a dollar that’s not spent looking at the genetics, or on research into interventions, or what have you.
It *might* be worthwhile to look for a correlation if there were an existing dataset where that might be done easily, quickly, and above all cheaply. Low-hanging fruit, as it were. But even that is a bit iffy.
Or put another way, there’s already a lot of research happening on contributing factors. It’s focused (as it has to be) on the most promising avenues.
@cynic: How is this qualitatively different from the study described in the post? You’re not going to find very many completely unvaccinated children in VSD either. It has to be a dose-response study.
an admittedly ANECDOTAL story, but the anti-Vax crowd loves this sort of thing, so thought I would share it.
I was listening to a podcast the other day of verbal histories of a WWII Medal of Honor winner (one of my little Memorial Day observances)…and he was talking about growing up in a poor farming family in the midwest US. He was the youngest of 11 children born in his family. When the interviewer asked if other siblings had also gone into the military, his answer was:
” I was the youngest of 11 children, but only 5 of us reached adulthood. THE REST OF MY BROTHERS AND SISTERS DIED OF THE USUAL CHILDHOOD DISEASES, THE FLU, or PNEUMONIA that were so common back then”
but hey, immunization programs, are all evil plots by the government and bigPharma, and ‘never have helped anyone,’ right?
Got my HepB this morning. So far my arm has not fallen off (in fact, it hurts far less than the seasonal flu shot did).
BlueMaxx, it’s a shame that the anti-vaxx mob won’t listen to the voice of experience. All they have to do is talk to those of us born before vaccinations against childhood diseases became available.
@Scott
This is exactly why the parents should not dictate the research. I am easily distracted by the new shiny ideas I hear from the media, no matter how much I learn about the issue. Like I said above, those smarter then me know where they aught to look. I can be curious about anything I want, but when all is said and done, science will find the answers, not me. I am okay with that.
Thank you for the reality check, Scott. The anti-science cult of parents scares me. I know I could easily become ‘one of them’ if I fall into the trap of trusting blindly in my own judgment.
Sorry, second paragraph should be in the blockquotes.
well Shay, they do sometimes seem to use what I call Homeopathic reasoning.
take a small kernel of truth, fact, or evidence. Dilute it to the Nth degree with parental anecdotes, web rumor, celebrity statements, new age natural magic nonsense, and then mix with the KoolAid powder. Drink liberally at a Green Vaccine/Autism Now meeting or while surfing to HuffPoof. All becomes clear and vivid, reality and fact not withstanding.
@ Pablo, Re: Dr. Sears
It’s weird, because the studies that are done on efficacy and safety of vaccines are often done using the current schedule. It’s like a self-fulfilling prophecy: you don’t want to use a schedule that hasn’t been tested so you… make up a schedule that hasn’t been tested? And then there’s the part where you don’t trust the authorities to create a safe schedule so you… trust some guy who pulled one out of thin air? But it’s OK to trust him, because he’s a doctor. But not other doctors, because… *headdesk.*
@ 40 Scott
I’m not sure, but I don’t think that accurately describes what the study was designed to do. I may not have understood it correctly, but when I read the study I thought it was about comparing kids who got their first 10 vaccines on time compared to kids who got at least one of those first 10 vaccines late. These 10 vaccines were the ones they were supposed to have by the time they were 6 months old according to the schedule at that time (for births in 1993-1997).
I’m not sure but I think it was 2 Hep Bs by 4 months, 2 polio by 4 months and 3 DTP and 3 Hib by 6 months. If they missed by less than 30 days they were counted in the timely group so they could have the 2 HepBs and 2 Polio vaccs by 5 months and the 3 DTP and Hib shots by 7 months and still be counted in the timely/”too many too soon” group. Anything other than that where one or more of the vaccinations was later and they were counted in the untimely/delayed group.
The timely group received a mean of 11 out of the 10 vaccines and the untimely group received a mean of 8 out of the 10 vaccines in the first 7 months.
I guess I was surprised when I read the study that the two groups were so similar. They both got almost all of their first 10 vaccines in a timely way. I suppose that’s why the researchers did the secondary analysis where they had a least timely group compared to a most timely group. There was a bigger difference in these groups. At one year, the least timely had a mean 7.4 of the 10 vaccines and the most timely had 11.8 of the 10 recommended vaccines. At 7 months it was 4.2 of the 10 for the least timely and 11.2 for the most timely.
The authors seem to believe that the least timely and untimely groups were because of unintentional delay. I wonder if there were some intentional delays related to kids with health problems like immunodeficiency disorders, prematurity, allergic or other adverse reactions to prior vaccines in a series, too. This came to mind for me because if it was live polio being given at the time, my daughter’s condition would have meant that she would have fallen into the untimely group and kids with her condition commonly have adverse neuropsychological outcomes. I know they did correct for a lot of confounders and they can’t control for everything but I just wondered about this.
Also, I’m not great at keeping track of the shifting goalposts, but I don’t think this study addresses the “spaced out” thing as much as it does the delay thing. I think when the anti-vaxxers talk about “spaced out” they mean kids getting fewer vaccines at a time. I think the majority of the kids in this study were getting up to 4 vaccines at a time at their doctor visits, it was just that the untimely kids were getting in to see the doctor at a later time than the timely kids.
“Spaced out” and “delayed” are the same thing when you’re not moving them earlier…
@Unconvinced, awesome points re: “spaced out VS “delayed” differences,your questioning of the whys of delaying the shots in that group (intentional delays related to immune problems, prematurity, previous probs with vaccines??) and last but not least the whole issue of the small differences in the mean number of vaccine doses received in the first 7 months of life between the timely and untimely groups (11 vs 8). Looks like more pharma slight of hand/spin to me.
I don’t think it affects my understanding of the science in this post, but there are bits where I can’t make out what’s being said. I can’t even parse the first sentence, or the sentence that mentions Dr. Sears.
While this study is not explicitly looking at the recommended schedule vs. Dr. Sears’ schedule, it does cast doubt on his (and Dr. Jay’s) assertion that a delayed or spaced-out schedule is safer than the recommended schedule.
Scott, I think unconvinced means the multiple shots (like lets expose the kids to measles, mumps, rubella and chicken pox all in one syringe).
@61 LovleAnjel
Increased rates of autism could easily cause increased spending on special education – indeed it would be surprising if it did not. Increased spending on special education could also lead to increased diagnosis.
The study I linked to used average rainfall as a surrogate for time spent watching TV (having successfully tested the hypothesis of a correlation between rainfall and time spent watching TV), as increased rates of autism could not possibly cause increased rainfall. They also looked at exposure to TV before age 3 and autism (not ASD) diagnosis at age 8 to test the hypothesis that the former caused the latter.
I find it hard to fault the design of the study, and the results are correlations with a confidence limit of better than 1%.
That said, I tend to think that it is better to spend money on looking more directly at autism than throwing money at chasing correlations, whether real or anomalous.
I don’t believe Sears recommends splitting that up. But on review, you and he do have a point and I was incorrect. The study is suggestive WRT that schedule but not precisely on-point.
Scott, when the monovalents were available, Sears did recommend splitting them up, for in his words, “just in case”. His current recommendation is even worse because he backed himself into a corner trying to be avant garde. He is now telling parents to wait until 4 years old so you only have to do one dose. I’m just the messenger, he’s the originator.
@Nescio
I was trying to point out that correlation is not causation. Autism rates also increase with increasing gasoline prices, starling population growth rate and the proportion of reality TV programming. What takes a correlation beyond mere coincidence is an explanatory framework for a direct cause-and-effect relationship. The authors actually specifically state that “by using an instrumental variables(sic)or natural experimental methodology we avoid the problem of cause and effect” (p. 37). Cause-and-effect is not a problem! It’s what you need to demonstrate to support your hypothesis!
They also mention that maybe autistic kids are more drawn to TV – not that TV is in any way to related to the condition (p. 37). This paper in NO WAY elucidates if TV triggers autism, or if autistic kids just like watching TV. This is the problem with correlation– it can go either way.
This does not appear to be a peer-reviewed scientific publication. The research seems pretty poor to me too, since they measure TV watching by rate of cable subscription and rainfall. That’s a little like monitoring people’s exercise & eating habits by rate of gym membership and weighing grocery bags as people exit Walmart.
@pD
Nine (0.86%) children received no vaccines at all during the
study period.
—————
@Chris
Measles is fatal in only about one in 300 cases,
You meant 1 in 8,000
——————————
Hello friends –
The TV stuff is an interesting discussion point. When I first read the news articles about it I was incensed. Further reflection and accidentally running into some abstracts has blunted my rage somewhat.
There is actually a substantial amount of animal research on the effects of environmental enrichment and some rather amazing impacts on brain functions of interest to autism and other neurological disorders.
By way of example, “Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice” used a knockout model of Alzheimers and found striking differences in amyloid beta deposits between groups. Similar findings have been found in terms of dendritic spine shape and neuronal plasticity. There is a surpising amount of information on this subject. [well, I was surprised anyways]
Unfortunately, this discussion can get touchy quickly as it can be tied to the refrigerator mother theory.
Note that I’m not advocating that TV might cause autism, but it does mean, maybe we should turn off the goddamned tv.
– pD
@ScienceMom:
Apparently I’m wrong again. Mea culpa.
@pD
That was one of the first things that occurred to me when Nescio first posted the study, that it sounded like a variation of the “refrigerator mother” nonsense.
No Sid, U.S. measles case deaths have been ~1:1000 since antibiotic usage and the last largest outbreak (1989-1991) had a measles case fatality ratio of 3:1000. The UK is ~1:5000 and Switzerland has been ~1:500.
Sid Troll, bring up that number with the person who wrote that quote (which is why it is indented with a little dotty line on the left side, though I can see why you missed that distinction on this blog, just like the folks you do not understand the words with blue type of URL hyperlinks — which means if you click on them you will go to another web page).
By the way, why do you think even a one in eight thousand rated of death for measles acceptable? For that matter, why is even a one in a thousand rate for encephalitis okay dokay with you?
What level of disability and death do you think is enough to protect a child from a disease? Is the one in five to ten rate of death of diphtheria high enough?
@Chris
Sorry that I failed to recognize those dotty lines. Anyway
It’s not about what’s acceptable. Its about parents having real data, not propaganda, with which to measure the risks and rewards of vaccination.
@Sid
Well, there you go. You were shown real data, not propaganda like AoA and their ilk put out.
The tv/autism study originated with a behavioral economist. As a social scienctist, I had trouble with lots of the behavioral economics in the popular press. There isn’t usually a discussion of correlation vs causation. It’s not impossible to take two very large data sets and find some correlation somewhere even if just by randomness. Or small data sets.
For instance how the Redskins are doing can in theory predict which party will win the White House with a reasonable amount of certainity. I’ve seen the math. Do I believe that how well the Washington Redskins play is actually in any way shape for form related to which party wins the White House? No. I can’t even imagine a bad causal link, let alone a plausible one.
I read an interesting paper about the numbers of autism and mental retardation diagnoses over the last few decades. The increase of autism cases tracks nearly one for one with the decrease in mental retardation cases. Curious.
If I can track down the paper again, I’ll post the link.
Harold L. Doherty asks:
As I’ve said before, I would be willing to do such a study – or find a team to do it – if one of the groups who want this sort of study will come up with the funding.
It is possible to do a study of currently existing vaccinated, partially vaccinated and unvaccinated individuals, although – as has been pointed out ad infinitum – doing a prospective study would be unethical.
The reason I emphasize “individuals” is that the popular (within the vaccines-cause-autism community) idea of studying groups with low (or zero) vaccination rates is flawed. Such groups (e.g. the Amish, home-birth groups, Christian Scientists, etc.) are rarely a good match to the general population and may – as I’ve mentioned before – give a false association between autism and not vaccinating.
Studying a group like the Amish or Mennonites (who do vaccinate their children but at a lower rate than the general population) could also – because they are a genetically isolated inbreeding population – show false associations between not vaccinating and a host of genetic disorders.
The best way to do a study like this would be a case-control method, with each autistic subject matched with one (or, even better, two) control subject of the same age, race, sex, socioeconomic group, geographic location and parental education level. As much as possible/practical, the cases (autistic subjects) should vary from their matched control only in the presence of autism. Then we could look at the vaccination records and see if there is a statistically significant difference in the number of vaccines or their timing or whatever.
However, I’d be willing to bet a month’s salary that nobody in the vaccines-cause-autism community is willing to fund a study like that. It is much better for their cause to cry “Why won’t they do a study?!?” because the most probably outcome of such a study is that no association will be found.
Here’s the realpolitik answer for Harold and others of his ilk:
[1] The legitimate scientific/medical community doesn’t see a need for a “vaccinated vs unvaccinated” study because there is no indication that the hypothesis (“vaccines cause autism”) is plausible. To them, there is no reason to do a study that will tell them what other studies have already suggested.
[2] The vaccines-cause-autism movement won’t do a “vaccinated vs unvaccinated” study because they don’t need to; they’ve already convinced their people that vaccines do cause autism. At best, a study would only confirm what they already “know” – at worst (and the most likely outcome), a study would contradict their received wisdom that vaccines cause autism.
[3] IF a legitimate “vaccinated vs unvaccinated” study were done and it showed no association between vaccines and autism (as several other studies already have), the vaccines-cause-autism movement wouldn’t “believe” the results. This gives legitimate scientists very little motivation to do such a study, as the only people asking for it have already said they will only believe the results if they show a connection between vaccines and autism.
[4] If anyone out there truly wants to see a “vaccinated vs unvaccinated” study done, they had better find a way to fund it themselves. I’ve repeatedly offered my assistance in getting such a study done, but I won’t be writing any grants.
The ball is in the court of the vaccines-cause-autism groups. If they want a study done, they’d best stop whining and start writing grant proposals.
Prometheus
Hello? Anybody interested in doing a study?
[crickets chirping, wind blowing, the sound of a lone tumbleweed rolling by]
Prometheus
@LovleAnjel
I take your point about correlation not equating to causation, but I still find this study interesting. I have read it carefully several times, and I think there is something interesting going on here that warrants further study.
The authors do propose a possible explanatory framework – that watching TV may be an early environmental trigger in genetically or otherwise susceptible children. This is the hypothesis their study was designed to investigate; they did not come across these correlations accidentally. Early exposure to TV has been proposed as a possible trigger for autism by others referred to in the study. I have no desire at all to cause any offence to parents of autistic children, but the fact that it is a “touchy” subject has no bearing on the possible truth of the hypothesis. I would suggest that the only parent of a young child in the past 20 years who has never put their child in front of a TV to distract them for a while either does not possess a TV or is a saint.
You wrote:
I think you misunderstand what they mean. The problem of cause-and-effect they refer to is being unable to tell which is cause and which is effect. Their study eliminates the possibility that the cause-effect can go the other way to that proposed by their hypothesis. This is why they used an instrumental variables methodology (I don’t know why you felt the need to write ‘sic’ when their spelling was perfectly correct). Instrumental variables methodology is a way of eliminating the possibility you suggest, that children who will later be diagnosed as autistic like to watch more TV than neurotypical children. Wikipedia has a good explanation of the use of instrumental variables.
http://en.wikipedia.org/wiki/Instrumental_variable
As the authors of the study state, “Basically, if early childhood television watching is a trigger for autism, then our finding that young children watch more television when it rains or snows means that autism rates should be higher in communities that receive a lot of precipitation, and especially among age cohorts within those communities that were exposed to a relatively large amount of precipitation.” Clearly, an increased incidence of autism diagnoses in a community cannot possibly cause an increase in rainfall in that community. They established that increase in rainfall does lead to an increase in TV viewing, so rainfall in different counties can be used as an instrumental variable to eliminate the possibility you suggest. There are other logical possibilities – one that occurs to me is that increased rainfall might lead to an increase in indoor molds and exposure to mycotoxins, which might in turn act as a trigger for autism, but that is another controversial area.
The study also found a positive correlation between household cable TV percentages and autism rates, even after taking great care to eliminate possible confounding variables. This time they used the percentage of households with cable TV as an instrumental variable.
I agree the study doesn’t seem to be peer-reviewed, and it is written by economists, not by epidemiologists, and they can’t spell ‘thimerosal’. However, I’m impressed with the statistical strength of the study, and the magnitude of the correlations they found. Food for thought at the very least.
Yeah. The problem is, as we know, that the anti-vax ignoromases (who are, curiously, also the anti-vax experts) do not understand scientific studies or evidence. Nothing we can discover, test, or evaluate – using the scientific method – will ever impinge on their opinions or prejudices.
Orac, and all scientists, will change their mind and more significantly their mindset on any intervetion if the evidence shows a better way, even if only mildly indicated.
Not so the nutters.
Wakefield is still a hero.
Sigh.
Lysenko, anyone?
Prometheus, for what it’s worth,I think your idea sounds appealing. I also think that primates wouldn’t be a bad comparison to study in terms of vaccine effects. Maybe an extended phase 3 clinical trials where the animals (vaccinated and unvaccinated)are not just killed immediately after for toxicology reports but studied for longer developmental outcomes.
Sorry, ignorance speaking here, but why should “watching TV” or indeed breast-feeding, or sucking on a pacifier, or…whatever, be a trigger to autism?
I thought it was a genetically-caused condition. Where is there any evidence of “triggers”?
Are there any triggers? Are there children who would have been autistic except for the fact that their parents did or didn’t do X,Y or Z? Or is the whole idea of a stimulus to an already vulnerable genome simply bullshit?
@97
Wakefield already did such a study. Unfortunately, as it completely typical for him, he did it so poorly that it is a worthless study:
https://www.respectfulinsolence.com/2009/10/some_monkey_business_in_autism_research_1.php
Oh, please…no more research on primates. Aside from us, they’re dying out. For fuck’s sake, don’t use them for experiments!
Caught Andrew Wakefield being interviewed by Matt Lower yesterday. Lower really tried to put him on the spot by presenting the fact that all of the evidence disconfirmed Wakefield’s point of view.
Wakefield quickly pulled out the government conspiracy card, then made up a claim that 12 studies confirmed his results. Of course, there were no references given. After all, there is a global conspiracy to cover this all up.
Cognitive dissonance is fascinating. This interview should be used in psychology classes.
So Dr. Bob Sears has weighed in on the validity of this study:
http://www.askdrsears.com/forum/message.asp?id=111153
Major flaws by Dr. Bob Sears – posted on 5/25/2010
Let me first say I haven’t read it yet. Too busy in office last few days. But here are three observations: 1 – they excluded kids with autism from the study (DUH! – that’s the type of kids you’d want to include in this!)
2. Hugely funded by pharmaceutical companies – the list of conflict of interest is quite long. Publishing a study like this with pharma funding is 100% worthless – the only people who will believe it are those who don’t mind conflicts of interest.
3. Here’s a comment from one of a doctor in the AAP who heads up one of the AAP divisions: this is the letter he wrote the journal:
“Dear Sirs,
I read with great interest Smith and Woods article, “On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes.” This issue is of paramount importance in clinical primary care practice today. However, I was dismayed by two factors within minutes of reading the piece. One, of perhaps lesser importance, in the Results Section, the numbers, simply put, do not add up. If all of the subjects are added as listed, a total of 1037 (not 1047) is obtained. Furthermore, the percentages are incorrect as listed. The final group (311) is in fact 30% of the incorrect total, not 20% as listed. It always concerns me and forces me to question the validity of the other findings when a mistake like this is notable. In any case, the finding that approximately 50% (depending on the true numbers) received an alternative vaccine schedule, even as long ago as 1993-1997 is of interest.
Of greater concern to me, personally, is the Financial Disclosure listings. It is very difficult in this day and age to review the authors’ conclusions without considering their considerable potential biases given where their funding comes from. I believe every known vaccine manufacturer is listed on the payroll. Until we have well-done, conflict- free published research on this topic, both the public and skeptical physicians must continue to look for honest answers.”
and my response:
This study reflected the same neurophysiological outcomes examined by Thompson et al. (2007). A study using the Vaccine Safety Datalink examining the effect of thimerosal exposure and autism spectrum disorders is in the data collection phase. Thus, it is not only appropriate to separate autism spectrum disorders from the rest of the neurophysiological outcome measurements, it is a preferred method since cohort selection is different and this study examined 42 neurophysiological outcomes as it is.
I’m sorry but where is there any statement of a pharmaceutical company funding source for this study? Also, here is the Conflict of Interest Statement from the authors:
So Dr Smith has never received any funding, honoraria or payout from any pharmaceutical company, his colleagues, who he has apparently helped out, have. Dr. Woods has openly declared his conflicts of interest as well to allow us the opportunity to decide if they pose any potential biases.
So Dr. Bob, considering that both your Autism and Vaccine Books are rife with dubious studies funded by agendised organisations and authors who have considerable conflicts of interest, both declared and undeclared, I find it most hypocritical, although humorous that you would have the audacity to deem this study worthless, when you have a considerable financial and personal stake in the outcomes of such studies.
As to the AAP division physician’s statement (you don’t disclose who this is), s/he is correct that the study groups don’t add up and that is problematic. I look forward to an author response on this, as should you before rendering any decision as to the accuracy of the work. As for someone who didn’t even read the study before rendering his decision of ‘worthless’, isn’t that the very definition of close-minded? I, for one, think you owe it to your readers and people who buy your books, products and services, to at least, attempt to cultivate a more objective disposition, even when you are faced with studies that contradict your beliefs.
@Pablo-58,
The Highway Safety Institute made installation of car seats mandatory in 1968, but their use was optional until 1984 when state laws start to mandate it. They were starting to become more popular before then but were still optional. The 1962 Chevy Bel Air I drove in high school had seat belts.
http://www.enotes.com/science-fact-finder/cars-boats-planes-trains/when-did-seat-belts-become-mandatory-equipment
The real problem with the tv “hypothesis” is the timing delay. TV became common but still iffy in the 50’s and nearly ubiquitous in the 60’s, but autism diagnoses didn’t take off till the 80’s.
http://www.ncbi.nlm.nih.gov/pubmed/18384386?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Maybe it was MTV! Watching music videos on TV was very big in the 80’s with the advent of cable tv (and video recorders). MTV causes autism !!!
@Nescio–47 & 79,
I took a look at the study you linked to. The TV trigger hypothesis at least sounds plausible enough to merit digging up available numbers to see if anything shows up. The problem is, as you can see from other possibilities suggested here, that you’re basically looking at a forest of rising numbers and trying to figure out which two trees are correlated as a possible cause.
It is also based on two pretty fuzzy correlations.
Is autism correlated with early TV watching?
Is early TV watching correlated with precipitation?
If so, then autism should correlate with precipitation, which is what they looked at.
However, recent state by state numbers show how iffy that is.
I pulled out 5 states, 2 low precipitation and 3 high precipitation, from the states that are being tracked locally. (California wasn’t included.)
State Autism Precipitation (71-2000)
Arizona 0.48% 13.61
Pennsylvania 0.84% 43.02
Missouri 0.82% 42.23
South Carolina 0.53% 49.84
Utah 0.75% 12.26
First, the connection between TV watching and precipitation is almost certainly less than 1:1. Just guessing, but I doubt that kids in Pennsylvania, Missouri and South Carolina watch 3-4 times as much TV as kids in Arizona or Utah.
Second, the autism numbers don’t really correlate. South Carolina has the highest precipitation but the second lowest autism. Utah has the lowest precipitation but their autism rate was almost as high as Pennsylvania and Missouri.
Also, precipitation varies up and down from year to year staying roughly close to the average. However, autism rates have rising almost monotonically for about the last 20 years.
There may very well be some unknown environmental trigger, but since practically all of the increase in ASD diagnoses can be accounted for by the combination of expanding criteria, diagnostic substitution and increasing awareness, people looking for this trigger are left trying to filter out a signal from the data without even knowing which frequency to tune to. And a lot of the money that could be spent looking for this possible connection has been spent responding to the noise from the AoA/GR crowd.
http://www.fightingautism.org/index.php
Yes, that’s Thoughtful House. Click on Disability Prevalence Trends and compare Autism, Mental Retardation, and Autism + Mental Retardation. Data is from the CDC.
The trend is still upward, but not nearly so dramatic as the Autism curve. Clearly a great deal of diagnostic substitution is occurring. I’d like to see more data on the broadening of the diagnostic criteria.
@Gregarious Misanthrope,
Dr Novella has written a few posts on this in SBM.
Here is an article from two years ago.
http://www.sciencebasedmedicine.org/?p=95
More recently, he discussed a study looking at awareness as a factor.
http://www.sciencebasedmedicine.org/?p=4726
Major revisions to the DSM were published in 1980, 1987, 1994, and 2000 and another is being worked on now.
Anecedotally, my father spent well over a decade teaching what used to be called “special ed” students in the 1980s/1990s. He can remember teaching 1 child who was diagnosed as ‘autistic.’
Meanwhile, just last year, a friend was told his 6 year old son – who is fluent in 3 languages and quite popular with his peers – might be autistic because his reading skills were in the bottom quartile of the class.
Talk about broadening the diagnostic standards.
Generation Rescue clearly has the resources to fund such a study, but considering how badly they got burned by their phone survey, I’m not surprised that they haven’t. Their phone survey not only failed to substantiate the claim that autism rates are much lower in unvaccinated children, but actually found a lower autism rate in vaccinated girls. They pretty much swept it under the carpet. While underpowered and subject to numerous potential biases, their survey still rather clearly exploded the claim that autism rates are much higher in vaccinated kids (although there are still plenty of people who hold this as an article of faith). Organizations tend not to take actions that undermine their own reason for existence, so I expect Generation Rescue to continue to spend its money on advertising and public relations rather than research.
Of course, there’s no point for NIH to fund such a study. Legitimate scientists are pretty sure there would be no difference, and considering the difficulty in finding enough unvaccinated kids, the power would be low, and the antivax cranks would just come back saying “Your study wasn’t sensitive enough.”
What happened to H1N1?
In a typical flu season we are media blitzed beyond belief to actually believe that 36,000 Americans alone die from influenza but according to the CDC …between April 2009 and April 2010 there were only 2,125 flu deaths??? How can that be? We were in the midst of a pandemic.
…And now in the state of Illinois, The Dept of Public Health had to put out a bulletin about how to dispose of the the large amount of unused H1N1 vaccine and most of it is considered hazardous waste.
Hazardous waste
Unused or expired H1N1 vaccines are considered hazardous if they contain mercury (such as thimerosal) or cresol-based preservatives. These are most commonly found in multi-dose vials and some pre-filled syringes. If you already work with a hazardous waste disposal company, you might want to use them to dispose of unused or expired H1N1 vaccine.
A vial is considered empty when there is 3% or less of the original vaccine remaining and all vaccine that can be removed by normal means (syringe) has been removed. Single- or multi-dose vials that have been fully administered may still contain extra vaccine. If there is enough leftover vaccine in a vial that more liquid can be removed with a syringe, it must be managed as hazardous waste.
So just a few liquid droplets leftover are considered hazardous waste but the whole vaccine itself isn’t hazardous to the children that recieved it?
Ha!
Blood is a hazardous waste. Guess we shouldn’t give that people either.
Pretty much all bodily fluids are considered hazardous waste – just check out the trash recepticles at every doctor’s office or hospital – they don’t throw out the medical waste in the regular garbage now, do they?
At the end of the day, no amount of evidence is going to change the minds of the die-hard AoA’ers (and others on that side of things). They’ve already moved the goalposts from Mercury / Thimersol to timing & quantity of shots, and “green the vaccines.”
Even if a study came out tomorrow that definitely discovered the cause for autism (perhaps a genetic link), the anti-vaxxers would still find a reason to blame the vaccines. Imagine the amount of money that has been wasted (since medical study grants are finite) that could have been used to develop better treatments & find the real cause of autism.
That’s why I’ve located a safe disposal bin and am currently disposing of all the blood and vaccines I’m carrying. Including all of that dangerous blood in my veins.
Wonder if they’ve considered doing something as low-tech and non-trendy as an eye exam?
@AnthonyK
If autism was a purely genetic disorder, if one monozygotic (identical) twin was autistic, both twins would be autistic i.e. concordant. This is not the case. One study found that 60% of monozygotic twins were concordant for autism, and 92% for ASDs.
http://www.medscape.com/medline/abstract/7792363
This evidence suggests that some environmental influence is required to produce autism, as well as a genetic susceptibility. “Trigger” has been used as a perhaps unfortunate term for that theoretical environmental influence. It might not be an environmental influence at all, it might be some complex epigenetic phenomenon we simply don’t understand yet, as suggested by Dr. Art Beaudet.
http://www3.interscience.wiley.com/journal/109607286/abstract
@PhEd Up: as has been pointed out to you, many things are considered hazardous waste. That bandaid you pulled out your cut finger and tossed into the garbage that had 3 drops of blood on it? Naughty, naughty, that is hazardous waste and should be disposed of in a red bag and handled properly. Those tissues you blew your nose into? Hazardous waste. Guess you’ve been breaking the law for years, haven’t you?
Most MD offices consider ALL vials, even those that contained nothing more than saline, to be hazardous waste items and will throw them into the red Haz bags.
And, just to point out the obvious to you: only multi-dose vials will contain thimerosol. Any single dose vial or ampule will not, but will still probably be treated as haz waste because of the glass/metal.
And, other obvious thing: it was recommended that children receive the single dose vials, even though it is more expensive because of nuts like you who freak about thimerosol but probably feed your kids tuna sandwiches on a regular basis.
@GregariousMisanthrope #92.
I think this might be the blog you thought of – Pyjamas in Bananas, where autism rates go up in close correlation with a drop in mental retardation rates.
http://pyjamasinbananas.blogspot.com/2007/07/changing-diagnosis-of-autism.html
That is not an explanatory framework in any way. It’s nothing more than begging the question – how does TV trigger autism? By being a trigger of autism.
The paper you linked to really doesn’t make any meaningful attempt to justify why this is at all of interest. Their “four reasons” may be appropriately summarized as:
1. Autism diagnoses and TV watching have both increased. With no meaningful acknowledgement that the increase in diagnoses may not reflect a real increase in the condition. Sure, they SAY it, but then blithely proceed to (as best I can tell) assume that since California passed a law in 1969 the data from California necessarily reflect a real increase.
2. There’s a correlation between ADHD and TV watching. Going from that correlation to causation of ADHD, and then to autism, is a GARGANTUAN leap which was entirely unsupported.
3. Behaviors seen in high risk children may lead to more TV watching. This is actually an argument AGAINST the relationship being causal.
4. Olmsted says the Amish don’t have autism, and the Amish don’t watch TV. Yes, that’s right, Olmsted.
To make a long story short, what section 3 of the paper ACTUALLY demonstrates is (a) any association is unlikely to be causal, (b) the authors are utterly clueless about autism.
It occurs to me that one potential problem with the dataset is that parents who vaccinated late may have done so on purpose, because of pre-existing conditions in the child or genetic factors. Can anybody confirm whether or not the families in the dataset were selected so as to avoid this confounder, or otherwise address whether or not this matters?
I don’t know whether television watching is a trigger for autism. But it’s not impossible: there can be a genetic predisposition to something, with environmental triggers.
I read ages ago [citation to what my friend Lesley calls The Esteemed Journal of I Read It Somewhere] that if someone with an identical twin has MS, there’s about a 50% chance that their twin will also have it. So, clearly not entirely genetic, but either genes are a strong influence or pre-natal environment means an awful lot.
So Dr. Bob Sears has weighed in on the validity of this study:
http://www.askdrsears.com/forum/message.asp?id=111153
Major flaws by Dr. Bob Sears – posted on 5/25/2010
Let me first say I haven’t read it yet. Too busy in office last few days. But here are three observations: 1 – they excluded kids with autism from the study (DUH! – that’s the type of kids you’d want to include in this!)
2. Hugely funded by pharmaceutical companies – the list of conflict of interest is quite long. Publishing a study like this with pharma funding is 100% worthless – the only people who will believe it are those who don’t mind conflicts of interest.
3. Here’s a comment from one of a doctor in the AAP who heads up one of the AAP divisions: this is the letter he wrote the journal:
“Dear Sirs,
I read with great interest Smith and Woods article, “On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes.” This issue is of paramount importance in clinical primary care practice today. However, I was dismayed by two factors within minutes of reading the piece. One, of perhaps lesser importance, in the Results Section, the numbers, simply put, do not add up. If all of the subjects are added as listed, a total of 1037 (not 1047) is obtained. Furthermore, the percentages are incorrect as listed. The final group (311) is in fact 30% of the incorrect total, not 20% as listed. It always concerns me and forces me to question the validity of the other findings when a mistake like this is notable. In any case, the finding that approximately 50% (depending on the true numbers) received an alternative vaccine schedule, even as long ago as 1993-1997 is of interest.
Of greater concern to me, personally, is the Financial Disclosure listings. It is very difficult in this day and age to review the authors’ conclusions without considering their considerable potential biases given where their funding comes from. I believe every known vaccine manufacturer is listed on the payroll. Until we have well-done, conflict- free published research on this topic, both the public and skeptical physicians must continue to look for honest answers.”
and my response:
This study reflected the same neurophysiological outcomes examined by Thompson et al. (2007). A study using the Vaccine Safety Datalink examining the effect of thimerosal exposure and autism spectrum disorders is in the data collection phase. Thus, it is not only appropriate to separate autism spectrum disorders from the rest of the neurophysiological outcome measurements, it is a preferred method since cohort selection is different and this study examined 42 neurophysiological outcomes as it is.
I’m sorry but where is there any statement of a pharmaceutical company funding source for this study? Also, here is the Conflict of Interest Statement from the authors:
So Dr Smith has never received any funding, honoraria or payout from any pharmaceutical company, his colleagues, who he has apparently helped out, have. Dr. Woods has openly declared his conflicts of interest as well to allow us the opportunity to decide if they pose any potential biases.
So Dr. Bob, considering that both your Autism and Vaccine Books are rife with dubious studies funded by agendised organisations and authors who have considerable conflicts of interest, both declared and undeclared, I find it most hypocritical, although humorous that you would have the audacity to deem this study worthless, when you have a considerable financial and personal stake in the outcomes of such studies.
As to the AAP division physician’s statement (you don’t disclose who this is), s/he is correct that the study groups don’t add up and that is problematic. I look forward to an author response on this, as should you before rendering any decision as to the accuracy of the work. As for someone who didn’t even read the study before rendering his decision of ‘worthless’, isn’t that the very definition of close-minded? I, for one, think you owe it to your readers and people who buy your books, products and services, to at least, attempt to cultivate a more objective disposition, even when you are faced with studies that contradict your beliefs.
Jen (#97) comments:
Three problems, Jen:
[1] We don’t have a valid test for autism in primates. Heck, for that matter, the tests we have for autism in humans are questionable. Looking for language delay in primates might be problematic, as well.
[2] As expensive and difficult as a case-control study in humans would be, it would be positively cheap compared to a primate study of adequate size.
[3] Human and primate (even chimpanzee) development are not equivalent – not even close, in terms of rate or sequence.
Prometheus
Deareat Orac:
Please stop lying that Thimerisol USED to be in vaccines. It is actually, demonstrably STILL THERE!!! It may have been reduced in the initial Pediatric shot series, but it is very much still in the (annual) flu shots. These were given this year to pregnant women, resulting in fetal exposure, possibly greater than ever before (3 thimerisol containing shots in one pregnancy). They were also given to children. The primary Thimerisol free injectable H1N1 (SPasteur) was hard to find and then recalled. Children who opted out of the mist still got Thimerisol unless their parents were especially diligent.
If Thimerisol is so undangerous, then it should be no problem for you to speak honestly and accurately about it’s wherabouts. This is public information.
speaking for the learning disbale and TV. people with learning disblites watch TV beacause reading hurts and is really diffcult. also by not doing the work neccessary to improve the sitution and watching TV instead well not make the condition better. and yes this sorry state of writing is an imporvment and required alot of hard work that i have to maintain or it gets worse again 🙂 so i don’t for a secound that TV causes learning disblity but it can hamper ones ablity to progress in reading and writing. this could be happening in autism as well. where TV is the easier alterntive but not the cause.
speaking for the learning disbale and TV. people with learning disblites watch TV beacause reading hurts and is really diffcult. also by not doing the work neccessary to improve the sitution and watching TV instead well not make the condition better. and yes this sorry state of writing is an imporvment and required alot of hard work that i have to maintain or it gets worse again 🙂 so i don’t for a secound that TV causes learning disblity but it can hamper ones ablity to progress in reading and writing. this could be happening in autism as well. where TV is the easier alterntive but not the cause.
speaking for the learning disbale and TV. people with learning disblites watch TV beacause reading hurts and is really diffcult. also by not doing the work neccessary to improve the sitution and watching TV instead well not make the condition better. and yes this sorry state of writing is an imporvment and required alot of hard work that i have to maintain or it gets worse again 🙂 so i don’t for a secound that TV causes learning disblity but it can hamper ones ablity to progress in reading and writing. this could be happening in autism as well. where TV is the easier alterntive but not the cause.
@Science Mom: re: “As to the AAP division physician’s statement (you don’t disclose who this is), s/he is correct that the study groups don’t add up and that is problematic. ”
Dr Novella addresses this in his post about the article: http://www.theness.com/neurologicablog/?p=1976#more-1976
He found the numbers DO add up, however there are apparently copy editor errors.
Thanks triskelethecat, I did see Dr. Novella’s blogpost. The numbers add up in the table but they don’t in the results section. This should be addressed and is probably something innocuous like that and hence my advice to Dr. Bob to perhaps, wait for an explanation/correction prior to making such an issue of that, or rather, channelling someone else making an issue of that since he didn’t bother to read the study himself.
PhEd Up @ 109:
I think the idea behind the rules is that while one half-empty vial of vaccine chucked into the landfill isn’t going to hurt anything, a million of them in one place might start to present a problem.
I don’t think that PhEd Up understands the distinction between quantity and quality.
————————————————————————————————————————————–
@ Quit Hatin!:
Despite your choice of handle you sure seem to be rather full of hate. First of all Orac never said that Thiomersal was removed from all vaccines, you’re deliberately lying there, but from the childhood series. In fact Orac has been very clear about it in numerous posts, your own ignorance or dishonesty on that point isn’t Orac’s fault.
You know, like you just stated yourself. So why are you trying to lie about what Orac said? That sounds like you’re the one who’s “Hatin”….
But it does bring up an interesting question….Since by your own admission the amount of Thiomersal has been greatly reduced, why hasn’t it reduced the rates of autism?
Why all the hate for something that ultimately saves lives “Quit Hatin”?
The hazardous waste regulations do not take quantity into consideration. It is in the nature of regulations that they do not normally relay on the judgement of the regulated–that’s why you don’t see speed limit signs that just read, “Drive at a safe speed.”
In my own home, I can pour a bottle of vodka down the drain with impunity. But in my lab, I will get in trouble if I’m caught pouring a bottle of 50% ethanol down the drain, because 50% ethanol is a hazardous waste–it’s flammable–which means that I have to put it in my Hazardous Waste Accumulation Area, label it accurately, and then call Health & Safety for pickup by personnel trained and authorized to dispose of hazardous waste.
For clarification, if something doesn’t have fluid, blood, pus, etc actively dripping from it or squeezeable from it or otherwise obtainable from it or if it is not sharp, it is not considered hazardous waste and can be put in the regular garbage. If you can get something fluid from whatever “it” is, then into the biohazard garbage. A lot of this is driven by cost. Getting rid of biohazardous waste is expensive. There are maybe two companies that do it in the US and there are stupendous amounts of regulation around it.
trrll… heh… and yes, so very true.
@Scott 117
I don’t think you need a detailed explanation to have an explanatory framework. The word “framework” implies a broad and perhaps vague idea of how something might work.
How might any of the other possible environmental triggers for autism work? Mercury? Antigens in vaccines? Pesticides? Vitamin D deficiency? All of these have been suggested as possible triggers for autism, some have been researched very thoroughly, but I don’t know of any detailed explanatory mechanism that has been suggested for any of them.
TV is part of our environment, and a part that has only appeared relatively recently in human history. TV is, obviously, passive; a series of images and sounds that in part resemble human beings, but do not respond at all to the viewer. I don’t think it is unthinkable that a lack of feedback from the environment in a susceptible child could have some effect on social or neural development.
Maybe I should quote from the paper itself, page 4:
“As a final introductory point, although our perspective that early childhood television viewing may be an important trigger for autism diverges from current thinking in the autism medical research community, the idea is not inconsistent with current thought in the medical community more generally concerning early childhood development. As discussed in Shonkoff and Phillips (2000) (see also Knudsden et al., 2006), recent scientific findings show “…the importance of early life experiences, as well as the inseparable and highly interactive influences of genetics and environment, on the development of the brain and unfolding of human behavior…” (Shonkoff and Phillips (2000), p.1). Our hypothesis is that it is exactly the interaction between genetics and a particular type of life experience, i.e. early childhood television watching, that can result in the profound impact on the development of the brain referred to as autism.”
And on page 10:
“…our hypothesis is that a small segment of the population is vulnerable to developing autism because of their underlying biology and that either too much or certain types of early childhood television watching serves as a trigger for the condition. In other words, we are also focused on an environmental trigger but one associated with the family environment rather than a pollutant of the natural environment.”
If that is not a possible explanatory framework, I don’t know what is. It might be wrong (I personally think it very probably is), but it is a moderately plausible hypothesis that can be tested.
I’m not sure what other “meaningful acknowledgement” you expect apart from them stating it clearly in black and white. The authors discuss this at some length, on pages 7 and 8. I don’t think it has been definitively settled one way or another if true autism incidence continues to increase in California or anywhere else.
If there is definitely no real increase in autism, why are so many people doing research to find out why there has been an increase? One possible explanation for the increase in autism diagnoses is that it is an artifact due to widened diagnostic categories. Are you suggesting that research into other possible causes of the apparent increase should cease?
They do not make any such leap, they are simply formulating a hypothesis that they can then test. They state that the data from Christakis et al are suggestive of a possible causal link, and that autism may also be an attention disorder. They observe that in Christakis et al the problem of cause-effect arises i.e. that children prone to ADHD may like to watch more TV. This is one reason they designed their study to eliminate that possibility by using an instrumental variables method of analysis.
I disagree, I don’t think that is necessarily true, children susceptible to neurodevelopmental damage by TV may also like to watch it more than neurotypical children, which would increase the damage. In any case, this is not what they observed on this study. They used rainfall in each state as an instrumental variable to eliminate that kind of cause-effect error.
To be fair, this paper was written in 2005, the same year that Olmsted’s article on autism and the Amish was published, and revised in 2006. The authors did not have access to most of the critical reviews of Olmsted’s article that have appeared since. As a matter of fact the authors do not say anywhere that “the Amish don’t have autism”. What they actually say is:
“According to Olmsted, based on autism rates for the general population, there should be several hundred autistic individuals among the Amish. After extensive investigation, however, Olmsted was able to identify fewer than ten. Also, his interviews with individuals who should be in positions to know the general prevalence rate, such as doctors, health care workers, and an Amish mother of an adopted autistic child, indicate that the prevalence of autism among the Amish is indeed very low. Of course, this is far from definitive evidence for our hypothesis. Olmstedâs investigation was informal and possibly a more thorough investigation would turn up the expected hundreds of autistic Amish. Or possibly, since the Amish lifestyle is quite different in many ways â think about what your life would be like if you could not use electricity â there is some other trigger for autism and the Amish lifestyle results in less exposure to this trigger than the typical lifestyle … Or, since the Amish represent a relatively isolated gene pool, it is possible that the Amish have less autism because the genes that cause the condition exist at a much lower frequency in that population. Nevertheless, even given all these caveats, Olmstedâs findings do represent intriguing evidence consistent with our hypothesis.” My emphasis.
I think that was a very sensible way to view Olmsted’s article back then.
You only seem to refer to section 3 of the paper, entitled ‘Four Reasons to Suspect Television’, which is where they are formulating their hypothesis. I don’t see how we can eliminate the possibility that early TV viewing might have some effect on children susceptible to autism a priori. What evidence do you have that makes you so sure that anyone even suggesting a causal relationship between early TV viewing and autism must be “utterly clueless”?
These authors have suggested a plausible hypothesis, and constructed a sensibly designed (if retrospective) study to look for evidence to support that hypothesis. They found that the results of their study do support their hypothesis, and are statistically significant (a 1 standard deviation increase in rainfall in counties in Oregon and California corresponded to a 12% and 28% increase in autism at a confidence level of 99% and 95% respectively). These results remain unexplained, and I think further research in this area is warranted.
It has occurred to me that before the internet became ubiquitous, TV played a much greater role in providing information than it does now. It may be that the more that parents were exposed to TV, the more likely it was that they would be exposed to information about autism, and would subsequently be more likely to recognise autistic behavior in their child. Perhaps this might be an explanation of the correlations found by these authors. Other possible explanations include indoor toxins and vitamin D deficiency.
Maybe I’m a bit late to the party, but I’d like to point out that under Ontario’s environmental safety laws, crushed limestone, which is harmless, must be treated as an environmentally hazardous spill if it falls out of a truck onto a highway and must be cleaned up following the rules for hazardous materials. Some things just get lumped together by regulations. It doesn’t necessarily say anything about their intrinsic properties.
HIV denialists love to display lab hazard warnings about chemicals like AZT, indicating how “toxic” they are because they come with warnings about disposal and exposure.
I usually respond by digging out the data on some pretty harmless substance like sodium chloride, citric acid or salicylic acid, and show how these display even more frightening “toxic”-looking hazard warnings than do the “toxic” antiretroviral drugs.
http://www.sigmaaldrich.com/safety-center/understanding-the-label.html
Basic science always states that for an any experiment you should have a control group. That control group should receive a placebo. To say that it would be awful not to vaccinate a group of children because they would be harmed and would be more likely to contract the disease, is is simply awful science. As a child, I had the measles even though I was vaccinated. The interesting part is that I didn’t die. At least when I worked in the immunology field, they were willing to have a control that did not receive the vaccine. Pick chicken pox or influenza virus and do the study and have it done by the a third party who has no vested interest in the outcome.
Source: Houston Chiropractor
Ok, I personally am someone who didnt get my son vaccinated, and my next son my wife is having, isnt getting vaccinated either. I am leaving it up to my kids, as they get older, and are able to think clearly on there own, if they want to get the vaccines or not. I personally think, that with so much PRESSURE, to get vaccines done, that obviously something has to be wrong with it. Thats just my intuition. Im no scientist, but, in cases where the U.S Govt. and a giant majority of money hungry doctors and pharmacuetical companys are trying to FORCE people into getting these shots, then i get a little cautious. Anytime the govt. gets involved in acting like they “care” about you, then there is usually an alternative motive. I dont know about everyone else, but, has anyone studied the effect of vaccines long term? What vaccines are doing, are weakening the human gene pool. Humans are getting weaker and weaker, we are not allowing our bodys to build immunitys on its own, we are pumping vaccines into ourselves, thus, after years and years of doing this, eventually we are going to create a super bug, which will wipe out the population. Anyways, sounds crazy, i dont care what it sounds like, vaccines being such a big issue, and people trying to pump it down our throats, then obviously there is something wrong. There is proof that unvaccinated kids are healthier than vaccinated kids. My son who isnt vaccinated, is a genius!! He is only 3, he speaks fluently, he speaks spanish,he knows how to count up to 50 (on his own, no joke), He knows all his basic colors,numbers,letters etc. He is highly intelligent, his memory is superb. I just dont feel right pumping him full of WHO KNOWS WHAT. and just because a doctor, or a nurse tell me that its “safe”, ill ask you the same thing i ask EVERY doctor and nurse. “were you there when they made this vaccine?” “can you tell me exactly what they put in here?” no. they cant. same reason why im not pumping it inot my child. His immune system is top notch, and its time for us to strengthen the Human Race again against bacteria,viral,etc. I just believe, ovreall, vaccinations are bad for the overall picture, and they dont allow our bodys to grow,
Matthew: Thank you for preserving your son’s body as a breeding location for me and my fellow diseases. Make sure he visits children too young for vaccines as often as possible so he can share the risk of retardation, blindness and death with his little friends too. Thanks again.
Measles
Matthew,
What would it take to convince you that not vaccinating your children is a terrible mistake that puts them and others at risk of permanent disability and death?
And let’s hope their schools are better prepared than their parents to help them learn to think clearly on their own. Â I have hopes; my school taught classes in the critical thinking skills this gentleman clearly lacks.
Ah yes, the crystal ball called Cynicism! Â “There’s a warning on this packet of silica gel telling me not to eat it! Â It must be extra-delicious, or else they wouldn’t tell me not to eat it!” Â “Hey, there’s a guy over there motioning for me to come out of the middle of the street. Â He must be up to no good; I’d better stay standing in the path of traffic to be safe!” Â “The medical authorities say that vaccinations are important for protecting me and the people I love from disease! Â Obviously it must be much safer to go without!”
Â
No kidding you’re not. Â Scientists actually have to check their facts.
Â
See above about scientists checking their facts and you not. Â Where, exactly, is the government trying to force people to get vaccinations? Â ‘Cause last time I checked, there hasn’t been compulsory vaccination for a long time.
Oh, you mean that your precious little sprout isn’t allowed to go to public school without getting vaccinated? Â Well, isn’t that shocking! Â The government trying to insist on everyone taking advantage of a public school, doing their part for public health?? Â How absolutely outrageous! Â The next thing you know, the government will oppress your God-given right to bear arms by not letting you carry them into Town Hall!
Â
You misspelled “paranoid.”
Yeah! Â Cause you know that there couldn’t be any direct benefit to the government to have fewer of its people sick, dying and maimed by preventable diseases! Â That’s just crazy talk!
Like eliminating smallpox from the wild, you mean? Â Like making it so that kids don’t get stricken with polio every summer? Â Like massively reducing the numbers of people who become blind or deaf or mentally retarded from measles and mumps?
Oh, wait, no, you’re not talking about those long-term effects. Â You’re just attempting an argument from ignorance.
So is not allowing wild animals to roam the streets, you moron. Â If you think we should subject the population to a lot of unnecessary dangers so that the “unfit” will be killed off and the remaining population will be genetically better, I volunteer you to practice what you preach by outrunning a pack of wolves for your life every morning.
And where did you get the idea that the immunity that comes from actually getting the disease (which is the only way the body builds immunities “on its own”) is any better than the one that comes from priming the immne system through vaccination?
Ah, you mean the way that the global effort to eliminate smallpox only succeeded in creating a tougher, stronger variant? Â Oh, wait, that didn’t happen. Â Hmmm, super-polio? Â Never came about. Â Super-measles? Â Nope. Â Super-mumps? Â No, that never happened either.
The evolution of “super-bugs” is not a consequence of trying to do something about an infectious agent; it’s a consequence of doing some but not enough. Â That’s why when the doctor puts you on a course of antibiotics, he tells you to keep taking it every eight hours as long as the prescription lasts – because if you do it that way, you wipe out the bacterial infection. Â If you do the stupid thing – take the antibiotic until your symptoms improve then throw the prescription away (because God knows what fiendish plot that GP might have in mind that hinges on you taking your medication as directed, amirite?) then you wipe out only the weakest part of the infection and let the rest get a break, give it a margin of safety that lets it survive and grow and keep going.
You know what that means? Â It means that if an infectious disease is to become a “super-bug” it’s not those who are vaccinating but those who are refusing to vaccinate that are causing it. Â They’re the ones giving the disease safe harbor.
Â
Good for him; too bad his dad is a moron who thinks that a sample size of 1 constitutes “proof” and that the way to stay safe is to do the opposite of what anyone in authority says is safe.
@ Matthew: I think perhaps you are wrapped up in conspiracy theories, generated by certain sites you visit on the internet.
Why do you believe celebrity mommies, alternative practitioners who have no education in the science of immunology and diseases, anti-vax websites such as Age of Autism which only permit comments from posters in “lockstep” with their junk theories, authors without any credentials and education in medicine and NOT believe the American Academy of Pediatrics, trained physicians and nurses at your local health department, the CDC and researchers with impeccable credentials in medicine and epidemiology?
You don’t have to be a “scientist”…but you need an open mind and you need to stop relying on anecdotal information and your uninformed “intuition” and biases against modern modern medicine and public health. I also pose the question what would it take to convince you that immunizing your children is the best way to protect them against some deadly childhood diseases. If your unimmunized child inadvertently infects a very young infant too young to be immunized against pertussis and the infant dies…would that convince you?
Matthew–
There is a lot of pressure to wash your hands after using the bathroom, and even laws requiring some people to do so; does that mean there is something wrong with handwashing?
Were you there when they mined the salt that goes into your food? Would you eat a loaf of bread if you hadn’t been in the room where the dough was mixed and kneaded, and watched the bread put into the oven? Were you there when they manufactured the dyes that are used in your children’s clothing?
The problem with letting your children decide when they are old enough is that you’re betting that they will still be alive and healthy enough to make that decision. Some of the vaccines that you are denying your children are to prevent diseases that can cause brain damage or other incurable problems, and take away your bright, curious child. Part of parenting is making decisions that kids aren’t capable of at the time and that can’t wait. Mumps can cause sterility: not vaccinating a boy against could be taking away his eventual choice to be a father.
That your child is intelligent and unvaccinated proves nothing about any connection: I was given every available vaccine, and I was reading when I was your son’s age.
Matthew, did it take you a full year to type up your fact free rant?
Yeah, the human race is not so weakened we are now on average living twice as long and are taller than we were a century ago.
Vicki:
Or the child may have hyperlexia, a form of early reading that occurs in some autistic children.
@Matthew:
“Ok, I personally am someone who didnt get my son vaccinated, and my next son my wife is having, isnt getting vaccinated either. I am leaving it up to my kids, as they get older, and are able to think clearly on there own, if they want to get the vaccines or not.”
Well, Matthew, you’ve just won the prize for fuckwit of the century. Your kids rely on you by default to think clearly on their behalf whilst they are kids. So, huge fuckwit-size fail straight way there.
“I personally think, that with so much PRESSURE, to get vaccines done, that obviously something has to be wrong with it.”
OMFG! That’s your fucking reasoning, is it? Because there’s pressure, there has to be something wrong with it? If that is so, then you are probably a danger to your kids… because you’re definitely not thinking clearly yourself. And that is a thinking style you will model to your kids, who will basically grow up to be as stupid are their father. Who is – I can assure you – fucking thick!
“Thats just my intuition.”
As if ‘intuition’ is the best guide there is on anything. At all.
“Im no scientist,”
No, you’re not. You’re a stupid twat. Get used to hearing that, because many will be calling you it.
“but, in cases where the U.S Govt. and a giant majority of money hungry doctors and pharmacuetical companys are trying to FORCE people into getting these shots, then i get a little cautious.”
You mean paranoid, don’t you?
“Anytime the govt. gets involved in acting like they ‘care’ about you, then there is usually an alternative motive.”
You mean an ulterior motive and – in this case – the motive is the prevention of the spread of communicable diseases throughout the community. I’m not a fan of governments but I’d say that this desire to prevent such diseases is one of the few things on which a government should make this sort of ruling.
“I dont know about everyone else, but, has anyone studied the effect of vaccines long term?”
People have. I personally have not: I’m not an immunologist and nor am I a medical practitioner. I’m a psychologist, who has studied psychological development and psychoneuroimmunology amongst the many thing he had to study in order to qualify. Means I most likely know a shitload more than you do, even if I’m not up to the same level on these thigns are our illustrious lilady here (whose knowledge and understanding of these things already makes you look like a petty piece of shit who cannot act in his children’s best interests).
“What vaccines are doing, are weakening the human gene pool.”
First: incorrect. Since vaccines have been introduced we now live a lot longer, since the communicable diseases they were introduced to combat have been – if not eradicated – then certainly kept sufficiently at bay and/or resisted well enough (because of immunisation) by those who have been immunised to the point that this herd immunity protects those who cannot (for medical or developmental reasons) be vaccinated.
Second: they don’t effect the fucking gene pool, dipshit. At least, not directly. Sure, more people staying healthy enough to live longer means that more people are able to have an increased chance of passing on their genes to a next generation. But that is an effect of living longer, not of vaccines. It would also happen if those illnesses that are likely to kill kids didn’t exist.
“Humans are getting weaker and weaker, we are not allowing our bodys to build immunitys on its own, we are pumping vaccines into ourselves, thus, after years and years of doing this, eventually we are going to create a super bug, which will wipe out the population.”
Now you’re talking out of your stupid arse. You obviously have fuck all clue about how organisms evolve. You also have fuck all clue about some spelling rules, and have not been intelligent enough to check them. I’m surprised you knew what to do in order to bloody have kids whose lives you could so wilfully endanger.
“Anyways, sounds crazy, i dont care what it sounds like, vaccines being such a big issue, and people trying to pump it down our throats, then obviously there is something wrong.”
Yes, sounds crazy. Batshit crazy. For the reasons given before. And the fact that you don’t care that it sounds crazy suggests that your ignorance is wilful, which makes you a complete and utter pillock.
“There is proof that unvaccinated kids are healthier than vaccinated kids.”
No there isn’t. And you can’t adduce it from this n=1 ‘case’ ‘study’
“My son who isnt vaccinated, is a genius!!”
You have had him tested? Because now you’re talking to someone who knows what genius is. And – if your kid is learning how to think from you – then forget this idea that he’s a genius: you’ll kill off any thinking ability that would allow him to test at genius level in the very near future. Moronic bastard.
“He is only 3, he speaks fluently, he speaks spanish,he knows how to count up to 50 (on his own, no joke), He knows all his basic colors,numbers,letters etc. He is highly intelligent, his memory is superb.”
You give no test results (proper tests, administered by a psychologist, I mean); you give nothing in quantitative terms that would allow a proper comparison between your son and anyone else (which means that your anecdote is basically worthless); your only ‘evidence’ has been in the linguistic developmental domain (which says nothing about anything else he can or cannot do); you give no objective measures at all.
However… here goes.
At three to four years, this is what you can expect:
(linguistic domain)
Language milestones
A- Understands the concepts of âsameâ and âdifferentâ
B- Has mastered some basic rules of grammar
C- Speaks in sentences of five to six words
D- Speaks clearly enough for strangers to understand
E- Tells stories
(cognitive domain)
Cognitive milestones
A- Correctly names some colors
B- Understands the concept of counting and may know a few numbers
C- Approaches problems from a single point of view
D- Begins to have a clearer sense of time
E- Follows three-part commands
F- Recalls parts of a story
G- Understands the concept of same/different
H- Engages in fantasy play
In other words, what you tell is not so out of the ordinary for three to four years. Without some proper numbers and test names, your ‘data’ are not data. Just anecdotes.
For a three year old to be working at genius level, you’d need this lot along with a load of other skills found usually in the 4 to 5 age range:
Language milestones
A- Recalls part of a story
B- Speaks sentences of more than five words
C- Uses future tense
D- Tells longer stories
E- Says name and address
Cognitive milestones
A- Can count ten or more objects
B- Correctly names at least four colors
C- Better understands the concept of time
D- Knows about things used every day in the home (money, food, appliances)
The above milestones were taken from this website, which is maintained by the medical school at the University of Michigan.
Thing is this: you don’t mention any of the other milestones that you son has gone past yet, so without that information, the presumption is that he hasn’t. Here’s a clue, too: my daughter tested – twice – on two different block design tests (known to be a very good indicator of general intellectual ability – in particular, in visuo-spectial organisation; Lezak, M. D., 1983, Neuropsychological Assessment, Oxford University Press; p. 227). At 4y9m, she sat the tests under test conditions (for Wechsler Intelligence Scale for Children – Revised and Wechlser Abbreviated Scale of Intelligence) and her raw scores were the maximum available. No scaled score conversions were available (and one cannot just make these things up) so test age equivalences were used. She was performing at the level of a 12 yrs old child.
But does that mean she’s a genius? Fuck, no! It means that – in one domain tested in WISC-R and in WASI – she was performing way above her age level. But – as further testing demonstrated – she was not performing up to age level in some other domains (as tested by WISC-R). So, no… outstanding performance in one or two domains does not a genius make. Deal with it. What this testing with my daughter did do was to alert me to the possibility that she would encounter problems in school. Which she most certainly did.
As one person has already pointed out, given that you only mention linguistic achievements (and that you cannot expect us to infer possible achievement in other domains from that), it may be that you are looking at a hyperlexic child. This is a child whose linguistic achievements far outstrip his/her achievements in other developmental domains.
“I just dont feel right pumping him full of WHO KNOWS WHAT. and just because a doctor, or a nurse tell me that its ‘safe’, ill ask you the same thing i ask EVERY doctor and nurse. ‘were you there when they made this vaccine?’ ‘can you tell me exactly what they put in here?’ no. they cant.”
Can you tell me what gets put in every morsel of food you eat? I doubt it. And for that reason, your ‘reasoning’ about vaccines is rendered moot. Fucking idiot.
“same reason why im not pumping it inot my child. His immune system is top notch, and its time for us to strengthen the Human Race again against bacteria,viral,etc.”
Have you had his immune system assessed my an immunologist? If not, that is pure speculation. Dipshit.
“I just believe, ovreall, vaccinations are bad for the overall picture, and they dont allow our bodys to grow,”
Immunology fail.
Go home. Don’t talk again until you’ve at least learned to understand science, how it works, how it is applied in child development, and how to know when you’re talking bollocks sufficiently well enough to catch yourself on and stay quiet!
@everyone: Shitting Jesus… some people. Dunnng-Kruger reigns supreme in that fucking idiot’s house, no?
@ David N. Andrews: I love your cogent postings and your passion on behalf of kids on the Spectrum. We have had discussions before about our joint passions regarding science and you chided me for calling out someone as a POS troll…you seem to think that I shouldn’t use initials, but I find that I’m more comfortable not typing the words. I think I would be a wee bit more comfortable if you might substitute some other words and of course, keep in the meat of your postings and your brilliance in dissecting the b.s.
I often laugh about the time years ago, when my three year old daughter (the echo chamber)..repeated some of my more “colorful phrases”…hey it was my “therapy” to let off steam. They were words and phrases that you would usually hear spoken by a drunken sailor on shore leave. And, of course you never lose that talent…I’m still very proficient and now if I slip in front of my daughter…well, she’s 41 years old, now.
Keep up those great postings…we so enjoy them.
@lilady: you’re a darling! Thank you for your comment. I’m Scottish, so brutal language is a religious necessity 😉 But I hope to make it funny if I can, because I think it’s important that we vociferous defenders of the wee’ns and bigyins get to laugh at fools.
As you may gather, I do not suffer fools gladly. I was surrounded by them growing up as an autistic kid in the UK. Sadly, these fools were the professionals who had been involved in my case whilst I was growing up. My parents – who were not exactly advised the best way by these people – did their best for my sisters and me, and so the likes of Matthew (failing his kids hugely by refusing to take the initiative to get his kids vaccinated) piss me off hugely. He has access to better resources than ever my parents had at their disposal, and to see someone in that position failing so much as a parent… he definitely deserves whatever contempt I choose to pour out on him.
Also, I have worked in special education with students/clients of all ages and with all manner of special education needs. Some of these students/clients had very little chance of learning much because of some very serious infections laying waste to brain tissue. Some had been injured badly in road traffic accidents and some were abused as children (such as the lad in one class who had been thrown into a wall as a baby by his dad – the person whose job was to protect him from harm – and who was left blind and severely intellectually disabled from this injury). Then I see someone whose brain works as well as it needs to work for someone to operate a computer and to know how to become a parent and to decide to endanger his children’s lives every bit as much as this young boy’s life was endangered … I don’t really feel like holding back any longer. By not being exact in my language towards that sort of failure-parents, I’m basically reinforcing their behaviour.
Currently, I’m fighting with the Finnish state and a Finnish town to get adequate services so that I can be part of society and contribute to the general well-being of that society. And I’m being met with gross incompetence at all levels. And my patience with the grossly incompetent and unwilling has run out: twelve years of institutionalised abuse in any country will do that to a person. Add to that another 36 years in another country, and there’s plenty reason for a person to be ‘florid’ in his/her use of language.
I prefer to leave a person like Matthew in no doubt as to the contempt he is held in. There’s a great way for people like him to avoid getting that language from me: stop being fuckwits, and start being properly protective of their kids… protect them from diseases like measles, whooping cough, diphtheria and so on. Instead of selfishly leaching from the already reduced herd immunity provided by others. Gordon Ramsay uses this ‘approach-avoid’ method in his restaurants and for very good reason. It works. The cooks improve in order to avoid the nasty stuff, and this is removed and replaced by an equally positive response from GR upon engaging in appropriate behaviour. Standard operant conditioning.
Have a nice one. And I look forward to discussing more of the relevant stuff with you. Naturally, I would defer to you in matters of public health… you know that area far more than I do. I’d have to think back many years to the last time I talked with a PHN/HV about these things!
lilady: “I often laugh about the time years ago, when my three year old daughter (the echo chamber)..repeated some of my more ‘colorful phrases’…hey it was my ‘therapy’ to let off steam. They were words and phrases that you would usually hear spoken by a drunken sailor on shore leave.”
You have no idea how much I know what you mean. And think about trying to not inadvertantly teach one’s child English language ‘words of character’ (shall we say?) and trying to swear in one’s second language… when that second language is said kid’s first! Hearing her self-perpetuated successive approximations was like slow torture!
We have much in common, you and I, I suspect.
“assessed my an immunologist?” -> “assessed by an immunologist?”
@ David N. Andrews: Yes indeed, we have a lot in common. you know my background with my disabled son and you should know the “war stories” that I share with my good buddy who also has a very profoundly, multiply-handicapped, wheelchair-bound and medically labile son. He is “my other son”…I visit him weekly on Sundays and I am his alternative legal guardian.
We were certainly two crazy broads who fought the system for our kids and for all the developmentally disabled in our state. We changed State laws and testified at hearings and had “friends” in local and state media who were simpatico with our causes. They were frustrating times not totally devoid of some satisfaction when we went toe-to-toe with the bureaucracy.
Just one of the war stories… about 25 years ago friend and I met outside of a federal court to attend a very contentious trial. Friend was told by her husband “Make certain I don’t see you two babes on tonight’s evening newscast”. My (attorney) husband cautioned me, “Don’t call me from jail if you and the other ‘crazy’ get arrested”.
So, it’s agreed that:
a) Neither of us “suffer fools gladly”
b) I will remind you about using initials in lieu of colorful language.
c) You may feel free to be my grammar nazi…for my run-on sentences. (Plenty of people have tried…unsuccessfully I’m afraid…Orac only occasionally “runs on”…I am the undisputed Queen of The Run-On Sentence.).