Respectful Insolence

And I thought, whatever his other faults and whatever my disagreements with his politics,, that Bill Clinton was incredibly smart. Apparently I was wrong:

“You do not want to bring your children into the world where we go on with the number of children who are born with autism tripling every 20 years, and nobody knows why,” he said.

Even if the true prevalence of autism is increasing (which is highly debatable), it is not tripling every 20 years–nowhere near it. Again, the apparent increase in prevalence observed over the last two decades can be explained largely by increased awareness and diagnostic substitution. There is no autism epidemic.

The stupid, it burns.

Comments

  1. #1 Ms. Clark
    May 12, 2008

    I wonder where he got that idea? Tripling every 20 years since when?

    I worry about children who are already here and being demonized as having a horrible effect on “the world” by their existence.

  2. #2 jennifer
    May 13, 2008

    I just tangled with anti-vaccine people in a comment thread for the vaccine trial new story. I would have spent my time better slamming my hand in a car door. At least then I could get drugs. For this, there is nothing.

  3. #3 Chemgeek
    May 13, 2008

    Wait just a minute. Don’t you see the hope in his comment?

    “…and nobody knows why.”

    He didn’t jump on the mercury/toxins/vaccines cause everything bandwagon.

    His exaggeration was for dramatic effect (this is Bill Clinton we are talking about). At least he didn’t spew the same anti-vaccination crap.

  4. #4 jypsy
    May 13, 2008

    Yesterday on “The View” they were talking autism & vaccines -
    Two of them argued over the “autism rate” was “1 in 150 boys” or “1 in 4 boys”
    Later they talked about how sugar cubes were given after the DPT shot to “make kids feel better”

  5. #5 PlanetaryGear
    May 13, 2008

    I think if you add in the clustering of mild autism spectrum people in the tech industry and their propensity for having children that share their genetic traits that you can explain 100% of the numbers on autism. So you dont actually need to be so wishy washy on the “explained largely” how about “explained completely”

  6. #6 DLC
    May 13, 2008

    Trust a politician to screw things up.
    I am reminded of Mark Twain, who said: “Show me member of congress, now show me an idiot — but I repeat myself. “

  7. #7 Abel Pharmboy
    May 13, 2008

    This is extremely disappointing – say what you will about Bill, especially these days, but he is a supremely intelligent guy and should have had the right data before spouting out, unless he’s pandering of course.

    Similar to what the Good Doctor O points out, increased awareness (but less sp diagnostic substitution) is mostly responsible for the apparent epidemic of prostate cancer. It’s really easy to fool oneself into false conclusions without considering non-conspiratory causes.

  8. #8 albatross
    May 13, 2008

    ISTM that not understanding the cause of an increase in the numbers of diagnosed autism cases is a pretty forgivable mistake for a smart person outside his field. Though I suspect he’s doing a dogwhistle for the mercury crowd, while not saying anything embarrassingly stupid right out loud where anyone can hear him.

  9. #9 abfh
    May 13, 2008

    Note that he said “born with autism.” Both Clintons understand quite well that autism is genetic. This is all about eugenics, not about pandering to the mercury crowd; the Clintons are strong supporters of Autism Speaks and its quest to develop a prenatal test to “eradicate” autistic people. Disgusting.

  10. #10 DrugMonkey
    May 13, 2008

    I’m with Chemgeek, BubbaC is all about exaggeration, he’s the smartest US politician in a generation. but notice that he doesn’t spew more vaccine crap and he says “born with”. i bet if you get him alone in a room he knows precisely what the evidence shows and is simply being slippery about increased diagnoses for political expediency. as autism crankery goes, this is pretty small potatoes.

  11. #11 wfjag
    May 13, 2008

    Let’s see if I get the facts straight: Bill is campaigning for Hill; Hill is behind BHO in most areas; However, Hill gets overwhelming support from voters who are not African-American making under $50K/year and/or whose education is H.S. grad or less; Jenny McCarthy appears on The View and Oprah to promote her book & those shows demographics looks a lot like the profiles of one of Hill’s key groups of support; Hill’s only hope is to convince the Dem. Superdelegates that BHO is unelectable since his appeal is to African-Americans and Egg-Heads and not “hard working Americans, white Americans” (as Hill recently said); Bill was speaking at a Middle School; Bill has a history of being Truth-Challenged.

    So, what’s unexpected about his statement?

  12. #12 josh
    May 13, 2008

    At least he said “born with”. That’s a huge difference from most of those with little/no knowledge on the subject.

  13. #13 dwight meredith
    May 13, 2008

    Dr Bernadine Healy, former director of NIH, head of Ohio State medical school, member of IOM must be “bringing the stupid” as well. See here

  14. #14 dwight meredith
    May 13, 2008

    Is Dr Bernadine Healy, former director of NIH, head of Ohio State medical school, member of IOM “bringing the stupid” too? See here

  15. #15 Kev
    May 13, 2008

    Yes, Dwight, yes she is.

  16. #16 David
    May 13, 2008

    Umm…isn’t this post really driven by quote cropping?

    Here is the excerpt in context:

    “But it was the promise of universal health care coverage and **medical research** that got the crowd going. (emphasis added)

    “You do not want to bring your children into the world where we go on with the number of children who are born with autism tripling every 20 years, and nobody knows why,” he said.”

    The point behind the comment is the need to allocate research dollars according to diagnosed prevalence of a disease state.

    Why EXACTLY is this stupid?

  17. #17 Orac
    May 13, 2008

    Because autism prevalence is not tripling every 20 years. Nowhere near it. This statement feeds into the myth of an “autism epidemic” and demonstrates extreme ignorance about the science.

    That’s why.

  18. #18 Lestat Rett
    May 13, 2008

    Do not want your children to be born in a world full of autistics?

    What an ignorant, obnoxious son of a whore, then again, anybody who supports autism squeaks after reading about them is in dire need of a slapping.

    *click-click…boomf x8*

    *Reloads spas-12*

    What, pray tell, is wrong with being autistic? last time I checked, some of us were responsible for many great scientific developments, for one, amongst other things, and for two, we should not be regarded as though we SHOULD justify the existence of our kind by such exceptional feats.

    We are people, and will tolerate being treated as no less.

    Lestat (very angry autie)

  19. #19 David
    May 13, 2008

    Orac:

    I’ve gone back and read some of your other posts to get a better idea of your perspective.

    I think that you may be applying a scientific standard inappropriately to a political speech.

    I believe that your primary concern about an “autism epidemic” is connected with the thimerisol hypothesis. Except for a few desperate parents (with whom I sympathize), this hypothesis is not currently scientifically credible. Note that Bill Clinton even implicitly agrees with you as a previous poster has suggested.

    I think that we also agree that apparently increasing rates in autism may be the result, to a greater or lesser extent, of shifting patterns in diagnosis.

    However, what your posts have not addressed is whether the shift in diagnosis leads to a better approach to treatment of ASD. For instance, diagnosing a child as mentally retarded rather than autistic tends to drive outcomes to institutionalization rather than treatment for the underlying pathology. If that child experiences a better outcome using the “autism” paradigm rather than the mental retardation paradigm, then ASD is a more helpful disagnosis.

    If the diagnosis shift leads to better treatment (and there is a reasonable research to suggest that it does in the case of MR vs. autism), then we’re back where I started: an apparent increase in prevalence, regardless of what drives it, is worthy of stimulating (re)allocation of research dollars.

    That’s what Bill Clinton is saying. Admittedly in a way that would not pass muster in a scientific publication, but then again the Oregon campaign trail is not the same thing as the floor of the American Association of Neurology annual meeting.

  20. #20 jre
    May 13, 2008

    Why, as I live and breathe, it’s none other than Dwight Meredith — autism advocate and moderator of the respected Koufax awards — showing up in comments!
    In response to Dwight’s question, I think it would be fair to say that Dr. Healy’s comments are better informed than Bill Clinton’s unfortunate off-the-cuff remarks, and worthy of consideration. I don’t agree with much of what the good doctor has to say, but that’s a different matter.
    Now, it it’s not too impertinent, I have a couple of questions for Dwight. A little over two years ago, you quoted a study by David and Mark Geier that purported to show a link between mercury in childhood vaccines and autism. The tone of your post was approving, though you did issue the disclaimer that “I still have not had time to look at the study. … I still plan to look at the study once other things settle down a bit.” Have you had a chance yet to look at the study? If so, do you think it’s a good one? And do you still consider the Journal of American Physicians and Surgeons to be a reliable source of medical information? Because if so, I can point you to some stuff in that journal that you have just got to read.

  21. #21 Woobegone
    May 13, 2008

    David, I don’t see anything in Bill Clinton’s speech (or any of his others) to suggest that he’s saying anything like that re: the usefulness of diagnoses. You make a good point. Clinton doesn’t, he’s alluding to the supposed increase in autism prevalence, for which there is no evidence. Simple as that. I’m not sure why we’re surprised at this – it would be political suicide to dissent from this view, after all.

  22. #22 Orac
    May 13, 2008

    In response to Dwight’s question, I think it would be fair to say that Dr.
    Healy’s comments are better informed than Bill Clinton’s unfortunate
    off-the-cuff remarks, and worthy of consideration.

    As you might imagine, I don’t. Healy’s remarks were teh stupid–big time. I’ve just been doing so much blogging about the whole “vaccines cause autism” nonsense lately that I couldn’t force myself to do another post to deconstruct her ill-informed remarks. A guy can only dive into so much of teh stupid before his brain starts to protest.

  23. #23 jre
    May 13, 2008

    Fair enough! But someone with even a superficial claim to credibility deserves a smackdown far more than a politician on the stump. You have spent a great deal of time on the Geiers, whose reputation as hacks-for-hire was already solidly established. And you have read entire articles by Vox Day and Dean Esmay’s pinhead-of-the-month without any apparent lasting neuronal damage. So a bit of the old RI directed to Bernadine Healy might not be entirely out of place.

  24. #24 Mariah
    May 13, 2008

    The Bernadine Healy interview (transcription mine):

    “I think people understand a polio epidemic. I think they understand a measles epidemic. I think they understand congenital rubella. I think they understand diphtheria. Nobody’s going to turn their back on vaccines.” (~1:06 in)

    Well, clearly she’s wrong here. Wrong 5 times, too.

  25. #25 wfjag
    May 13, 2008

    “As you might imagine, I don’t. Healy’s remarks were teh stupid–big time. ”

    As part of your deconstruction of Dr. Healy’s “remarks”, it might be interesting if you obtained a complete transcript of the interview — to compare what was said, and in context, against what was reported.

  26. #26 Orac
    May 13, 2008

    You do know, of course, that Bernadine Healy was on the the radio show of that enabler of antivaxers everywhere, Don Imus this morning, don’t you? I have a transcript of that show, as well as having seen video of her appearance on CBS News. Then there’s her article on the Huffington Post, which really was teh stupid. Taking in the totality of what I’ve seen of her comments thus far, I can’t help but conclude that Healy is pretty clueless about the issue.

  27. #27 Mariah
    May 13, 2008

    I noticed a couple of interesting things on the Healy interview. She was never asked by the sycophantic reporter anything like:

    *Do you advise people to avoid vaccinations?

    or

    *Do you think there are other causes, possibly genetic, for autism?

    Or maybe she was asked in the cut segments. But the hard-hitting reporter didn’t seem to go there.

  28. #28 Peter G
    May 13, 2008

    Apparently because you know a fact that Bill did not about the growth in the number of diagnosed cases of autism he is stupid. I wonder how many things he knows that you do not? It would be interesting to know who is more stupid. You or he? Since you appear to claim some expertise in this field perhaps you could answer the question about the causes of autism.

  29. #29 Dr. T
    May 13, 2008

    And I thought… that Bill Clinton was incredibly smart. Apparently I was wrong…

    Bill Clinton was incredibly sly, not incredibly smart. Nothing he ever did or said convinced me that his IQ was above 120. Of course, in Arkansas and in politics, an IQ of 120 might be considered genius-level.

  30. #30 Nat
    May 13, 2008

    Bill Clinton was a Rhodes scholar. He is clearly pretty smart Dr T

  31. #31 Orac
    May 13, 2008

    A good post on why Clinton’s bringing home teh stupid. He bought into the whole “autism epidemic” meme.

  32. #32 Joseph
    May 14, 2008

    taking in the totality of what I’ve seen of her comments thus far, I can’t help but conclude that Healy is pretty clueless about the issue.

    She’s naive about the science, probably, but more importantly, she doesn’t know who she’s getting in bed with. To suggest that people won’t turn their backs on vaccines means she’s completely unaware of who the anti-vaxers are, what they say among themselves vs. their public claims that they are not anti-vaccine. Kind of reminds me of Dr. Gupta’s naive take some time back.

  33. #33 Orac
    May 14, 2008

    No, she’s turning into a crank. For example, she has been quoted as calling evidence-based medicine “microfascism.” Yes, she was clearly referring to and at least partially agreeing with this outrageously idiotic article that I deconstructed a while ago, as the column in which she referred to EBM as “microfascism” was published in September 2006, a mere couple of months after the aforementioned outrageously idiotic article was published.

    I wonder if Dr. Healy has joined the AAPS. She’s sure sounding as though she would fit right in. Indeed, the AAPS very much approves of what she said about EBM.

  34. #34 Donna
    May 14, 2008

    People with autism are so often associated with medical problems – problems being born (breach birth, induced birth, etc.), needing antibiotics, having accidents. I know that it is more difficult to understand the direction of causation rather than just an association, but couldn’t there be some increase in the number of people with autism because of the great advancements in medicine and safety. I know it isn’t as exciting an idea as having a villain, but it makes as much sense.

  35. #35 the Integral
    May 14, 2008

    wow Orac….you’ve done a TON of blogging about antivax and other autism-inspired quackery.

    You should get a separate blog award just for that……

    I think there should be a “database of truth” somewhere…..created with all articles and blog posts written in response to the outrageous claims of the mercury militia, autism speaks, cure autism now, Jenny McCarthy…..etcetera.

    Boy that would take quite some time to put together. …

  36. #36 jre
    May 14, 2008

    Oh, all right. I was a sucker to think that Healy deserved even a moment’s thought. There — I feel better having admitted that I was gullible. Your turn, Dwight.

  37. #37 Prometheus
    May 19, 2008

    I think I’ve said this before on this ‘blog, but apparently it bears repeating:

    Politicians care about only two things:

    [1] Winning the next election.
    [2] Getting enough money to win the election after that.

    What Bill Clinton said was all about getting Hillary Clinton nominated – so that she can go on and potentially become the next president. If he thought (based on poll data and focus groups) that talking about alien abductions would help get her elected, he would have mentioned that.

    Bill Clinton may be smart – they don’t usually give Rhodes Scholarships to dummies – but he knows nothing about biology or medicine. In those categories, Orac beats Bill hands down.

    There seems to be a developing societal resistance to seeing science as a field requiring special competence. This is strange, since the same soceity seems to have no problem seeing carpentry, flying airliners, law, plumbing, eletrical work and car repair as needing special competence.

    I don’t see MBA’s, financial advisors, B-list actresses or even politicians claiming that they can fly a Boeing 747-400 or rebuild your fuel injector based on what they’ve read on the Internet, yet they feel they are equal to (or better than) scientific experts who have spent decades researching the field.

    Politicians seem to be willing to do or say almost anything in order to win an election. Why should we expect it to always make sense? Why should we expect it to ever make sense?

    Prometheus