Trying Autism in the Vaccine Court

Todd Fletcher | June 12, 2007, 1:10pm | #

I'm not a scientist, but Autism just doesn't seem like it would be the result of brain damage, especially in it's milder forms like Asperger's, which my oldest boy has. Many with autism have higher functions in certain areas of cognition - how could brain damage cause that?

Mr. Obvious | June 12, 2007, 1:13pm | #

Perhaps the old saw about "spare the rod, diagnose the child with autism" has some relevance?

Neu Mejican | June 12, 2007, 1:21pm | #

Todd Fletcher,

The issue is very complicated, but the simple answer is that brain damage can be diffuse or site specific. Diffuse damage will impact certain cognitive process (and each case of diffuse damage will be somewhat unique) while site specific damage will impact different cognitive processes that will depend on the location of damage.

Austim seems (with current evidence) closer to the diffuse damage end of this spectrum than site specific. Possibly due to differences in linkage between sites and the dynamic developmental consequences that result from those differences (maybe better to think of as a diffuse pattern of site specific damage).

If, by "brain damage" you mean "resulting from measles," then you are talking about diffuse damage that might lead to symptoms that fit under the very broad category of Autism Spectrum Disorders.

Neu Mejican | June 12, 2007, 1:27pm | #

Full disclosure:

I have done a fair amount of study on this issue.

There is no reliable link between vaccinations and autism, despite a plausible link between mercury, genetic disposition, and the symptoms.

Proving the case for a specific child would be beyond our current scientific abilities. Convincing the jury that vaccines were "more likely than not" the cause for this class of children in general would require a misrepresentation of the facts. The epidemiology is pretty clear that the risk of autism from vaccination is nearly zero.

Phillip Conti | June 12, 2007, 1:38pm | #

Am I the only one to question the phenomenology of autism as it stands?

Cab | June 12, 2007, 1:39pm | #

I must admit, I had my first son around the time they pulled thimerosal, and I would not let him get vaccines that were “still on the shelf” that still contained it.

Kinda ironic that the pharmaceuticals pulling thimerosal was seen as an act of admission rather than an act of caution. It certainly was to me, and I consider myself fairly rational. Then again, my kids didn’t turn out autistic...I’m sure my rationality would be different had they.

ron | June 12, 2007, 1:43pm | #

WHY ARE YOU ALWAYS LINKING TO THE SECOND PAGE OF ARTICLES

R C Dean | June 12, 2007, 1:47pm | #

Convincing the jury that vaccines were "more likely than not" the cause for this class of children in general would require a misrepresentation of the facts.

Sounds like a job for - the plaintiff's bar!

Paging John Edwards . . .

Kinda ironic that the pharmaceuticals pulling thimerosal was seen as an act of admission rather than an act of caution.

No good deed, etc.

joe | June 12, 2007, 1:55pm | #

Oh, well, all good things...

Cab | June 12, 2007, 2:04pm | #

I think food allergies is the next big issue. There is a non-insignificant upward trend of children born with food allergies and these food allergies are testable with blood tests, so there is less chance of a diagnosis bias.

But I can’t say why I think there is the upward trend in allergies, for I would be wing-nutted out of here and be branded a tin-foil hat wearer forever.

Jennifer | June 12, 2007, 2:07pm | #

Those 4,800 kids: what percentage of vaccinated kids do they represent? If a huge majority of vaccinated kids wound up autistic, that would be worth looking into, but when you'r talking about what I suspect is less than one percent, I'm shocked this case is allowed in the courts at all.

Cab | June 12, 2007, 2:14pm | #

Well, thoreau...the way I see it, in order for the food allergies to increase so rapidly, either humans have changed relatively quicky, or the food has.....and there is only one of the two (that I know of) that has been altered with bioengineering recently.

This shiny hat looks kinda cool on me.

thoreau | June 12, 2007, 2:22pm | #

To be clear, I'm not saying that the existence of a third possibility means your hypothesis is guaranteed to be false. It just means that if your reasoning was based on a process of elimination, then the existence of another very plausible possibility means that we need more data.

I don't know what the state of knowledge is in this area of researcher, however.

Abdul | June 12, 2007, 2:29pm | #

If some children are impaired in different ways, with various degrees of severity, is lumping them all together under "Autism" appropriate?

Autism is a "spectrum disorder." The symptoms are really severe in some kids but less severe in others. However severe the symptoms, they all respond to certain treatments that are usually not available in a regular classroom.

I would like to see a study of how families, or even the children themselves respond to a more general diagnosis of cognitive impairment.
Unlike some other diagnoses (Attention Deficit Disorder, Oppositional Defiance Disorder) I never met a kid diagnosed with autism that didn't have a verifiable cognitive disorder which responded to treatment. I've seen some parents in denial demand mainstreaming for their autistic kids. After a month or two, it became clear to the most recalcitrant parent that their child just couldn't function in a mainstream classroom (or the kid would require treatment and support for a while before being able to do so).

I have read a number of anecdotal reports where parents said that the onset of symptoms correlated with the vaccinations, but may be due to the fact that overt evidence of cognitive impairment appears around the same age that the children are normally vaccinated, so its the old "after that therefore because of that" logic.
You guessed it with the last bit. Autism symptoms usualy present at exactly the same age that MMR vaccines are given. It's a coincidence, but to too many people coincidence = causation.

joe | June 12, 2007, 2:33pm | #

Cab,

Peanuts haven't really changed in the past century, but peanut allergies sure have.

I suspect some third factor that messes with people's immune system. And as a matter of fact, some people attribute asthma to an immune response as well.

The predominance of asthma among poor, urban kids would seem to undercut the "hygiene hypothesis," as old, poorly-maintained housing results in lots of exposures.

just sayin | June 12, 2007, 2:39pm | #

I'm the parent of a diagnosed Asperger's kid. Given the number of symptoms that were described to us that I reacted to with "Really? That's unusual?", I'd guess there's a good chance I could be diagnosed as ASD (autism spectrum disorder) too, if there was any point to it at 50.

Which leads me to a couple of theories about the increase in ASD diagnosis.

First is that the condition is more widely known and understood, which leads to some diagnosis substitution as well as diagnoses for kids who would have just beeen known as some combination of odd, disorganized, and physically and socially clumsy in the '60's.

Second is that the job market rewards different things today. People on the high functioning end of ASD are particularly well suited for the obsessive demands of the IT industry, so the guy who would have been a slightly odd lifelong bachelor living on the edge of town with his unbelievable stamp collection in generations past is now an ace software coder with stock options and a much better prospect for marriage and children, who will be disproportionately likely to be ASD themselves.

Third - yes, I'm sure some of the diagnoses are scams to get testing accomodations and other help.

Why does this make a difference? Because intervention, especially early intervention, changes outcomes. Higher functioning ASD kids can do better at organizational and social tasks when they are taught things neurotypical people find intuitive in an intentional way. For example, looking at people while you talk to them is as much of a learned skill for an ASD kid as riding a bicycle is for the other 99% of humanity. Getting them to look them in the eye is more like a unicycle.

Life as an ASD person is a little like the square peg in a round hole thing - sort of like being a libertarian in the US. I developed a set of coping mechanisms on my own over the years, but it was hit or miss and (as my wife would sometimes tell you) some of them may not be that effective. If earlier diagnosis and help can spare my kid that, I'm all for it.

thoreau | June 12, 2007, 2:42pm | #

BTW, if peanuts are indeed more common in our diets than we realize, and childhood exposure is indeed causing more allergies, then I blame Jimmy Carter.

Jimmy, repent or we'll send the rabbit after you again!

:)

Cab | June 12, 2007, 2:54pm | #

Have peanut allergies in fact changed in character, or just become more common?

Peanut allergies have doubled in industrialized countries in the past decade.


But the fact remains that reasoning based on a process of elimination needs to be done carefully, because you might not have a complete list of things to eliminate.

True dat.

Peanuts haven't really changed in the past century, but peanut allergies sure have.

I suspect some third factor that messes with people's immune system. And as a matter of fact, some people attribute asthma to an immune response as well.

Yeah, like I said, I assume there is some “Perfect Storm” of factors, I would just like to include the actual peanut itself as a possible factor. It seems all research I can find disregards this (although I have read studies on how the preparation of the peanut itself may be a problem, such as roasting versus boiling).

joe | June 12, 2007, 2:57pm | #

Jennifer,

Kids living in crummy apartment houses or crumbling "projects" in the city are exposed to plenty of dirt, as well as stuff like dust mites and insect droppings.

Dave W. | June 12, 2007, 3:08pm | #

Yeah, like I said, I assume there is some “Perfect Storm” of factors, I would just like to include the actual peanut itself as a possible factor.

or a change in milk, or a change in eggs, or a change in strained carrots or . . .

there is nothing to say that a peanut allergy needs be caused by only by the peanut itself -- it could be caused, at least in theory, by anything that a kid with the "wrong" genetic predispositions ingests at an early age.

I mean, look at the reason for the emergence of bad e coli:

- cows get fed corn instead of grass

- corn makes for different pH in cows' stomachs

- corn fed cows shit on everything because it wasn't realized that their shit was more toxic

- society has to pay the price by being more careful about cooking meat and washing raw veggies

I am not saying that the story of e coli is problemmatic to me because: (i) they figured out what the problem was (probably because people dropped dead so quick); and (ii) it can be solved by good hygeine (which we should be doing anyway). However, how many people would have guessed at this causation chain without being told? This kind of stuff is not commonsense. It demands scientific research even though most hypotheses will be proven wrong.

Or look at Mad Cow. be honest: had you ever heard of a "prion" before this disease started killing people.

As long as people die quickly, the market responds well and does the crazy research it needs to do to make the food (or drug) supply safe. The problem occurs when the health problems emerge only slowly over time and/or are non-lethal. Then the scientific community likes to make it has no burden to do any research until somebody can first prove exactly what the problem is. This is an impossibly circular standard of proof, and it is an example of modern science adopting lazy attitudes.

Cab | June 12, 2007, 3:14pm | #

thoreau,

http://news.ufl.edu/2006/12/04/peanuts/

Dave W. you stated, - it could be caused, at least in theory, by anything that a kid with the "wrong" genetic predispositions ingests at an early age.

We can eliminate that theory given that my kid has my genes, damn good ones too.

(jokes)

Jennifer | June 12, 2007, 3:26pm | #

Joe, I see what you're saying, but I don't think you and I are contradicting each other; I think we're discussing two completely different things. The hygiene theory basically boils down to this: we evolved in environments filled with dirt and pollen and animal dander and whatnot, our immune systems evolved to deal with these on a constant basis, and thus babies not exposed to such things are more likely to get allergies.

If this turns out to be 100 percent true, the statement "lack of early exposure to pollen, dirt and dander causes allergies" does not in any way negate "early exposure to chemical pollutants can also cause allergies."

R C Dean | June 12, 2007, 3:52pm | #

My French friends tell me this

Ouch. You were doing so well, t, and then you have to bring in your "French friends" . . .

T | June 12, 2007, 4:41pm | #

dhex,

Similarly, more boys are diagnosed ADHD/ADD than girls. Despite years of attempted brainwashing by some, the genders are different. Generally and broadly speaking, boys are little heathen monsters that will do appallingly stupid crap just because the idea occurred to them. Girls? Not so much. From my ignorant and unlearned perspective, this is part of what drives the diagnoses up for boys. Little Johnny is doing something, whereas little Janey may not be so obvious.

mediageek | June 12, 2007, 4:50pm | #

"Ouch. You were doing so well, t, and then you have to bring in your "French friends" . . ."

I prefer to think of them as "Freedom Friends."

Neu Mejican | June 12, 2007, 5:48pm | #

Eric.5B,

I didn't claim any particular expertise...but I have worked in the field of developmental disabilities since the 80's, and can put a Ph.C., CCC-SLP behind my name. I have been involved in the diagnosis/ruling out of diagnosis for Austism Spectrum disorders as part of a diagnostic team for over 100 children. I have provide direct intervention for a good dozen children on the Autism Spectrum.

I would not call Autism Spectrum Disorders my area of expertise, however. I do research on Fetal Alcohol Spectrum Disorders.

MattXIV | June 12, 2007, 7:00pm | #

joe,

Kids in shiny new apartment buildings might lack exposure to good old fashioned, immune-system-priming dirt, but not the poor kids in poor neighborhoods who are showing the spike in asthma.

The hygiene hypothesis is that the increases sensitivity is driven by the lack of exposure to pathogens, not allergens. For interpreting this spike, you need to look at relative exposure to pathogens the same demographic over time, so an increase in urban asthma would be consistent with an increase in sanitation over the same period, so you can't rule out the hygiene hypothesis.

Acute symptoms can also be triggered or exacerbated by respiratory irritants, so the dirt, mold, and air pollution of urban enviroments probably makes increased incidence look more dramatic.

Cab/Thoreau - They've done the same with cats. This is part of why I'm skeptical that GM products have much to do with allergy rates. The receptors which bind an antigen are very specific to the antigen they bind to, and only a small number of molecules are antigens. Transgenes aren't going to cause an allergy unless the specific gene in question codes for an antigen from the source organism, the probability of which is low, because most genes don't code for stuff that could be picked up as antigens and before picking a transgene you're going to have some idea what role it plays based on the reason you want to move it and the antigen itself is more complicated than just the raw proteins that are used in it, so a comparable antigen may not be produced when the protein is expressed in the target organism. Changing existing genes coding for potential antigens is unlikely to increase allegies either since the interaction with the antigen is likely to get weaker. The technique used to make hypoallergenic cats (and probably sooner or later peanuts) is to find variations of the gene that codes for the proteins in the antigen that are different enough that they don't bind well with the receptors. The critical change is probably within the eater of the peanuts, not the peanuts themselves.

Neu Mejican | June 12, 2007, 7:44pm | #

Audrey,

It is quite likely that your subjective sense is correct. Most of the best research supports the efficacy of integration into the regular classroom to the greatest extent possible. Accommodation in a regular education environment is the preferred mode of service delivery for most children with learning difficulties...

I can't speak to your particular case, of course. But it is the nature of the accommodations that makes the difference (if accommodations are needed and not provided, being in the regular room can be counter-productive for everyone).

Many school districts do not have the expertise to make the appropriate accommodations in the regular classroom, so they opt for creating a special classroom (easier to implement).

Not ideal, but that is the real world.

Karen | June 12, 2007, 11:29pm | #

This is worth the amount you all paid for it, but my singular-of-data story is this:

My older son got antibiotic resistant ear infections from daycare, where he was in the company of five other little vectors of infection known as "classmates." Six boughts in three months, between the ages of five and eight months. He got ear tubes at seven months, and since then has had one cold, one stomach virus, and many broken bones, which I can't quite prove are contagious. No allergies.

Second son had a urinary tract infection at six months, consequently spending half of his first year of life on prophylactic antibiotics. No ear infections at all. He has, however, developed moderate allergies to cedar pollen and mold. (Like every other resident of Austin, Texas but his own brother.)

My conclusion from this is that Andy, the older kid, had enough "insults" to his immune system to sort of calibrate it to recognize proper responses. Aaron, because of both the severity of the UTI, followed by the six months of Augmentin, never got the same settings and therefore his immune system overreacts to things like cedar pollen. Again, worth what you paid for it.

Dmitri | June 13, 2007, 3:23pm | #

So why aren't we talking about a question like:

Why does the government think they can vaccinate me, or my children?

Audrey B | June 13, 2007, 4:27pm | #

Neu Mejican, I didn’t go to special classes in regular school, I was shipped to a special (inferior) school.

Mom who care's about children | June 13, 2007, 4:48pm | #

The full transcript of this secret, closed-door meeting held by the
CDC at the United Methodist Retreat Center, Simpsonwood, can be read
at NoMercury.org or PutChildrenFirst. org.

The mercury-based preservative thimerosal has never been fully
removed from childhood vaccines.
A simple check on the FDA's website would have confirmed this:
http://www.fda. gov/cber/ vaccine/thimeros al.htm#t1.
Mercury is still
in most flu, tetanus, and diphtheria/tetanus vaccines--and an array
of vaccines still contain "trace" amounts. (The term "trace" must be
used loosely as this aspect of vaccine production is not being
regulated and there is some variation on what constitutes a trace
amount. As children often receive multiple "trace" amounts of
mercury in one sitting, cumulative amounts and potential adverse
effects are as yet unknown.)

While no reputable medical practitioner in this country would allow
even "trace" amounts of lead to be injected through vaccines given
its known neurotoxicity, physicians continue to allow mercury, which
exceeds the toxicity of lead by more than 100-fold, to be routinely
injected into humans.