Revisiting the Autism “Epidemic”

Anyone who cares about autism, and particularly the supposed spike in autism in recent years, would do well to read this very informative, cogent, and non-hysterical OpEd by Paul T. Shattuck and Maureen Durkin. It is written on the occasion of a case before the U.S. Court of Federal Claims that’s investigating whether autism is linked to childhood vaccinations, as many parents of autistic children believe.

Shattuck and Durkin’s argument, in a nutshell, is that:

1. Vaccines do not cause autism, according to the scientific consensus;

2. There surely has been an eruption of documented cases of “autism spectrum disorder,” but this does not mean that autism itself is actually on the rise, as many people believe.

3. There are a variety of reasons for the increase in documented cases of autism and related disorders, including:

a. better reporting/diagnosing;

b. more funds available for treatment, which incentivizes parents to have their children diagnosed;

c. a much broader definition in recent years of what constitutes “autism,” including the reclassification of other disorders into the autism umbrella label.

If you have an autistic child or know someone who does, you may not be satisfied with Shattuck and Durkin’s article, for it may be more comforting to have a tangible villain, like vaccines, to blame for this disorder. And a tangible villain would certainly make it easier to prevent autism in the future. But you should still read the article with an open mind.

There is one point that Shattuck and Durkin didn’t raise, which I sometimes wonder about when people discuss a link between childhood vaccines and autism. Autism usually begins to present itself at about three years of age, by which time kids have started to get a lot of vaccines. This proximity may naturally cause many parents to link the two events in their mind. But just because one event happens shortly before another does not mean that the first even caused the second — as comforting, in a warped way, as that may seem.

Here’s what we’ve written in the past about the subject.


minnie_matta

browndog, you are so wrong. Thimerosal was not removed from vaccines in the early 90's - that's when it was at its hight.
Thimerosal content was added up in 1999, realized to be way over EPA limits, and instead of doing a recall, the manufacturers were recommended to phase it out. It's still in flu shots, which are recommended annually, and trace amounts are in other childhood vaccines.

maatathena

Talk of the Nation on NPR did a whole segment today and one interesting point that came out was that its possible that autistic children have some kind of immune abnormality that causes them to be highly susceptible to environmental toxins. In other words, while in some cases a vaccination may be a direct trigger for autistic behavior to start occurring, its not exactly because of the vaccine. Its because the genetic problems of the child were activated by that particular stimulant. Perhaps in the future we will be able to have our cake and eat it too, as children who test with this genetic problem can avoid vaccines and other possible toxins, and children who don't will be vaccinated and still ensure a critical mass of non-infectable kids.

Jon Best

As a person with Autism I deem that any news on this is better than what the doctors told my parents in 1986. I am 25 years old and still living with the consequences of there discision to put me under their rulling of Autism. I do want to say that I am at least not Autistic as some other children because I have a high learning and greatly, miraclous, normal life. While the doctors told my parents that I will never read, write, do math, function in a socitiy as a normal person and which also means not able to drive, walk, talk, and communicate as a person to another person. Yes I do have some symptoms of it but bless God that he gave me a way out of it through video games, is this a shock? I have heard that a year ago on a tv program that made a reliasm of having about a room full of autistic children and put half of them with video games and half of them not and half of the children who did had better hand and eye reflexas than the ones that did not, reading, and God (which is my explanation of everything).

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anne borden

Some pregnant women are refusing the H1N1 vaccine, thus risking their unborn children's lives -- and their own.

We KNOW that swine flu can kill a pregnant woman and her unborn child. The autism link, by contrast, is disproven or unsubstantiated.

What does it say about our culture that parents are taking significant known risks (H1N1, pneumonia) out of fear based on a dubious claim (autism link)?

Gary Pears

As a parent of a 19 year old with what we think of as Autism, I would like this topic to be processed by the Freakonomic engine. What can we deduce by looking at the drugs that have been accepted as being harmful and their related spikes, such as thalidomide and then looking at MMR in the same way. I think that MMR 1 may spike differently to MMR2.

egretman

It can be statistically proven that medical researchers are statistically inept at the use of statistics. Often coming up with vague correlations and then leaping to wild causes such as "pesticides in the environment" or "mercury in the vaccines".

And unfortunately, Dr. Levitt has given up on doing his peer review in order to take up the subject of just how stupid do you have to be to play poker for a living.

shanek

As a parent of an autistic child, I think this article is wonderful. We need to face this issue with the courage to find the truth, instead of finding some convenient bogeyman.

The experience of raising an autistic child is so frustrating--for the child as well as the parents--that we can be more easily misled by anti-vaccine people, or those hawking false hope techniques like Facilitated Communication.

On top of the stamina we need to raise our children, we also need the courage not to be taken in by easy answers and peddlers of false promises.

schadenfreude

Shattuck and Durkin never make the argument that vaccines do not cause autism. Their analyses deal with years from 1991 thru 2003. During this entire time, thermisol was present in childhood vaccines, so they can draw no conclusions regarding the alleged vaccine-autism link.

one_comment

Something should also be said about the increasing numbers of adults realizing that they've known people with autism all along, or coming in to get themselves diagnosed, as autism, especially the milder variety, gets more and more widely written about.

bertrecords

My brother is autistic. So, I have listened as my mother told me about one study after another which linked heavy metals or whatever to autism. If you are a doctor and want to get your name in the public eye, I suggest correlating something to autism like everyone else.

Simon Fodden

"incentivizes"? Aii-yi-yi! Horrible coinage. How about "encourages" or simply "gives... an incentive to" -- one more syllable, granted, but what's your hurry?

jeffstier

And along those lines, a consumer friendly review of the issues, "The Promise of Vaccines: The Science and the Controversy."
is online at http://www.acsh.org/publications/pubID.423/pub_detail.asp

frankenduf

maybe so, but would you choose a vaccine sans heavy metals for your child?

bdh

As the father of a five-year-old with autism, I may be biased, or at least overly sensitive. But I don't believe that you can accurately summarize the article as stating that the scientific consensus disputes an autism-vaccine link. The article says:

"The claims for or against an autism epidemic simply cannot be proved given the evidence available."

Note the "against." They're merely saying that there's no proof either way. It seems like you're leaping to your own conclusion to claim that the article rejects the link.

I tend to believe there is no link, but I admit to being offended by suggestions that any parent who suggests there's a link is deluded by their desire for a "villain." There's a lot of serious research, done by serious people, suggesting a link, just as there's a lot (more, to be sure) research rejecting the link. This isn't just made up by trial lawyers looking to cash in or loony parents looking for a target.

I have also seen the argument made that there are "incentives" for parents to get an autism diagnosis because of the funding available for treatment. This is absurd. My son has been in a special school getting one-on-one therapy for two years at a cost of more than $50,000 a year, all of which comes out of my pocket. We've sold our house, moved to a cheaper area, and cashed out an IRA to pay for this. Excuse me for getting a bit testy about these suggestions that autistic parents are somehow chasing all of this free funding for treatment. It's inaccurate, and offensive to those of us whose lives have been turned upside down as we do what we can to try to help our kids have normal lives.

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schadenfreude

The heavy metals are added as a preservative, so the question is would you choose more expensive or expired vaccine for your child in return for sans heavy metal?

SAMIam

> that's investigating whether autism is linked to childhood vaccinations, as many parents of autistic children believe.

Is this really true? Or is it a vocal minority? (refernces?)

kaywil

Some of the successful treatments for autism deal with these types of environmental factors; vaccines, antibiotics, GI track infections, early allergens, etc. I would rather factor in all of the possibilities than wait for industry scientists to say 10-20 years from now "oops! like with cigarettes, we were wrong!"

I do not have a child with autism. I can only try to understand. But I am very concerned about my children's health, and when I look at all the things that scientists have said were safe that turned out not to be (household cleaners, Bisphenol A in baby bottles, bottle feeding better than breast...etc.), I wouldn't take everything they say as "the truth". Science is a work in progress, even though they'd like us to believe it's 'exact'.

palmd

You mention the "proximity association" or "misattribution argument...that vaccines and autism co-incidently happen at the same time in a child's life. This is a well-known logic error in medicine, and I suppose in other fields. It is an argument that can be made for any co-incident phenomena. For instance, vaccines can be said to cause growth retardation, or perhaps to cause increases in college admissions 16 yrs later...

egretman

We don't know what causes autism. Why can't people just accept that?

This is the reason that human beings invent gods. To give credit and blame to things and events that we have no control over.

We say it's god's blessing that my child has 10 toes and 10 fingers. And we say that Thor was mad if our child had 8 fingers.

It's really not this hard. And then we learn the real reason. Stay tuned for the real reason, folks.

palmd

It IS distracting to come up with misleading hypotheses...real work has to be delayed while they are investigated. However, if we really want people to get vaccines, it is up to us as a society to prove their safety. It is unfortunate that most parents don't remember the summers in the mid 20th century when parents would keep their children inside for fear of paralytic polio.