One of the core beliefs of the antivaccine movement is that there is an “autism epidemic.” The observation that autism prevalence has been climbing for the last two to three decades led some parents with autistic children to look for a cause, specifically an environmental cause, for autism. Because several vaccines are given in the age range when children are typically diagnosed with autism, they fell victim to the all-too-human tendency to confuse correlation with causation and latch on to vaccines as the main cause of their child’s autism. Then, when these parents banded together, they naturally latched on to vaccines as The One True Cause of the Autism Epidemic because there was an expansion of the recommended vaccine schedule back in the 1990s that they viewed as coinciding with the increase in autism prevalence. Of course, it never occurred to them to blame other things that increased around the same time, such as Internet usage, cable TV viewing, and, my favorite, sales of organic food. That’s right, no one blames organic food for the “autism epidemic.”

Scientifically, the question has been whether this increase in autism prevalence is a true increase rooted in biology or whether it is an artifact of something else—or a little of both. For example, the way we diagnose diseases and conditions change with time. In the 1990s there was a broadening of the diagnostic criteria for autism spectrum disorders. That alone would be expected to increase apparent autism prevalence. Screening is another reason why the apparent prevalence of a condition or disease can increase. As I like to say, whenever you look harder for a medical condition, its incidence will increase. The example I like to use is ductal carcinoma in situ (DCIS), a premalignant condition in the breast whose incidence increased 16-fold since the 1970s. Now, there is no reason to think that this represents biology or that the incidence of DCIS has really increased that much in such a short period of time. We did, however, start to screen for breast cancer in the late 1970s and early 1980s, and a whole lot of preclinical DCIS.

Another example is hypertension. Before the 1920s doctors didn’t routinely measure systolic/diastolic blood pressure ratios; so there were few, if any, cases of hypertension because doctors weren’t looking for it and didn’t know how to easily measure it. Even over the last decade, prevalence of hypertension has increased (for instance, in Canada). Perhaps a better marker for hypertension diagnoses is the percentage of adults who have been prescribed antihypertensive medications, which has skyrocketed since 1950. Of course, over that time, the definition of what constituted “hypertension” has changed markedly, to lower and lower diastolic and systolic pressures, as evidence showed that treating lower blood pressures could prevent premature death, although that trend appears to have leveled off. Amusingly, various denialists lambaste such broadening of diagnostic criteria to claim that hypertension is an “engineered” epidemic.

Of course, there are other potential causes of the apparent increase in autism prevalence. One that I noted a long time ago is diagnostic substitution. In diagnostic substitution, children that would have received one diagnosis in the past now receive another. In the case of autism, diagnoses of mental retardation decreased at the same time diagnoses of autism spectrum disorders increased.

In other words, definitions of medical conditions matter. They can have a huge influence on prevalence rates observed. Moreover, if you don’t look for something, you won’t find it, and if you do look for something, you will find a lot more of it than you expected. It is quite possible that that is what’s happening with autism, but such a narrative doesn’t fit into the vaccine-autism idea. The antivaccine movement needs an increasing apparent autism prevalence. If there’s no “autism epidemic,” there’s no way that vaccines cause autism. Over the years, there has been quite a bit of evidence that the “true” prevalence of autism has been fairly stable for quite some time. For instance, one study examined autism prevalence using stable diagnostic criteria between 1990 and 2010 and found “no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs.” Steve Novella has summarized several of these studies.

Now there’s a new study out of Australia looking at the same criteria. It basically relies on one of my favorite sayings, namely that the harder you look for a medical condition the more of it you will find. Actually, it uses a corollary of that maxim, namely that, when you look for a condition and diagnose more of it (i.e., cause its apparent prevalence to increase), many of those cases will be milder cases. So, just as mammographic screening led to an increase in diagnosis of smaller tumors and premalignant DCIS, screening for prostate cancer led to milder cases of prostate cancer being diagnosed, and screening for hypertension led to milder cases of hypertension being diagnosed, if the increase in prevalence in autism is due to the broadening of the diagnostic criteria plus increased screening, we’d expect that the average severity of cases diagnosed would decline with time.

The authors had the advantage of a good tool to look at this question, a register of newly diagnosed cases of autism spectrum disorder (ASD) in Western Australia. Data are collected prospectively and include information on the “diagnostic criteria met by each new case, as well as the severity of behaviors relevant to each criterion.” They then examined all new cases that received the diagnosis of Autistic Disorder, diagnosed using DSM-IV-TR guidelines) from 2000 to 2006, a time period when the diagnostic criteria for Autistic Disorder was stable and selected for:

These years were selected for analysis because during this period: (1) diagnostic assessments were predominantly conducted through four Government centres, and there was a central administrative portal for archival reviews, which provided confidence in achieving near-complete ascertainment of new cases of Autistic Disorder; (2) diagnosticians were strongly encouraged to complete severity scores for each criterion, and a near complete data-set was available; and (3) numerous studies [Boyle et al., 2011; Maenner & Durkin, 2010], including those in Western Australia [Parner et al., 2011], have found that this period corresponded to a particular increase in the prevalence of Autistic Disorder.

The authors studied 1303 children who met the inclusion criteria for the study. 51 cases were excluded because complete data on the criteria met and/or severity ratings by the diagnosing clinician(s) were lacking, leaving 1252 cases which were analyzed thusly:

Analyses included investigations of: (a) the age and sex distribution of the sample across the study period; (b) change in percentage of cases deemed to meet diagnosis criteria (individually); (c) change in percentage of individuals deemed to be displaying extreme behaviors for diagnosis criteria (individually and aggregated), and (d) the number of criteria diagnosed as extreme (per case). Percentage change across calendar years within the study period was quantified using linear regression.

The answer was striking. There was a statistically significabnt reduction in the percentage of diagnoses meeting two of 12 criteria, as well as a reduction in the proportion of new cases having extreme severity in six criteria. Concurrently, the percentage of new cases with no “extreme” rating in any criteria increased from 58.5% to 86.6%.

Here’s a representative graph, this one showing the percentage (a) and count (b) of Autistic Disorder diagnoses in each calendar year who are rated as having “extreme” behavior on DSM-IV-TR criteria (click to embiggen):

Autism graph

This is pretty dramatic evidence. Basically, over a seven year period, among children diagnosed with autistic disorder, the severity of symptoms at diagnosis decreased considerably, and this happened during a period of time where there were no changes in diagnostic criteria to confound the analysis. The authors conclude:

The current findings may inform our understanding of why the prevalence of ASD diagnoses has increased markedly over the past 50 years from 0.05% in the 1960s [Lotter, 1966] to at least 1% in the 2010s [Elsabbagh et al., 2012]. In the current study, we found that the number of individuals with no diagnostic criteria rated as “extreme” in severity increased by an average of 21 cases per year from 2000 to 2006, whereas there was no statistically significant increase in the number of individuals with at least one diagnostic criterion rated as “extreme.” This observation indicates that the majority of the increase in Autistic Disorder diagnoses in Western Australia during this period [Parner et al., 2011] is likely due to an increase in the diagnoses of individuals with less severe behavioural phenotypes. A range of sociological factors may have contributed to changes over time in the behavioural profiles of individuals presenting for a diagnostic assessment, including greater awareness of ASD among clinicians and the community [Charman 2002; Leonard et al., 2010] and the introduction of Government funded services specific to individuals with a diagnosis of Autistic Disorder [Gurney et al., 2003; Leonard et al., 2010; Mandell & Palmer, 2005; Nassar et al., 2009].

One more time, if you look for something more intensely, you will find more of it, particularly if you broaden the criteria for what constitutes what you’re looking for. In the case of medical conditions, you will find a lot of more mild cases of what you are looking for.

Is this definitive evidence? On its own, of course it’s not. Taken in the context of existing evidence, however, it is yet another study that adds to the growing body of evidence that autism prevalence has been fairly stable for the last few decades. There is no “autism epidemic” (or, as antivaccinationists like to call it, “autism tsunami”), and vaccines still don’t cause autism.

Comments

  1. #1 brian
    January 25, 2017

    Harvard child psychiatrist Joseph Biederman, who helped popularize the previously-rare diagnosis of pediatric bipolar disorder some years ago, wrote that “bipolar disorder is a serious illness that is estimated to affect approximately 1 percent to 4 percent of children.” It’s hard to believe that the actual percentage of children affected by the disorder increased from essentially zero to up to 4 percent in just a few years; instead, it’s likely that the apparent increase in prevalence reflected changes in diagnosis and awareness–although it does correlate with the increasing sales figures for organic foods.

  2. #2 Christine Rose
    Ann Arbor
    January 25, 2017

    Do those charts show that the number of diagnosed cases of “extreme” autism is decreasing?

    • #3 Orac
      January 25, 2017

      As a proportion of total diagnoses, yes.

  3. #4 Lighthorse
    January 25, 2017

    I assume that by now you’ve seen the recent promotion of camel milk as an “alternative” treatment for autism, as well as allergies. Until the FDA requested that it be removed, an American supplier of the milk apparently had a section on their site titled “Science & Research”. To learn why it had to be removed, which I think we all know, visitors are invited to enter the search term “camel milk” at PubMed. The basis for the claims can be seen a recent review prompted by the widespread promotion of the milk for all sorts of maladies. Finding poorly conducted preliminary studies and case reports, the bottom line of the reviewers is: “Based on the evidence, camel milk should not replace standard therapies for any indication in humans.” But you would never know it from the proliferation of anecdotal accounts online.

  4. #5 Daniel Corcos
    January 25, 2017

    I am not an expert in ASD, but in the case where early treatment prevents the development of extreme behaviors, then the absence of decrease of the incidence of these cases would suggest an increase in ASD incidence.

  5. #6 Eric Lund
    January 25, 2017

    the harder you look for a medical condition the more of it you will find

    This phenomenon is not limited to medicine. I’ve seen at least a couple of instances within my own sub-subfield of physics. It’s a lot easier to find something when you know what you’re looking for.

  6. #7 Panacea
    January 25, 2017

    @Daniel Corcos: no, it wouldn’t suggest that at all. You’d have to identify the autism so early, and get treatment started so early, that the extreme behaviors would essentially be invisible.

    But resources are notoriously difficult to come by, and the more extreme the behaviors, the more difficult they are to treat.

    And that’s assuming your basic premise is correct in the first place. I doubt that’s true.

  7. #8 Dorit Reiss
    January 25, 2017

    Given the relatively high rate of comorbidities in children with autism, I hope this or another team follows up on the rates of comorbidities – it would be interesting to know if we are also catching, for example, more children without seizure disorders today, though that’s a separate question.

  8. #9 Daniel Corcos
    January 25, 2017

    @ Panacea
    “You’d have to identify the autism so early, and get treatment started so early, that the extreme behaviors would essentially be invisible.” That’s basically what I am saying: if you identify early forms of ASD and if treatment is efficient in preventing evolution to extreme forms, then extreme behaviors would decrease. The fact that they do not suggest that early detection occurs at the same time when occurs, for another unknown reason, an increase in ASD incidence. I may be wrong if treatments have no effect on ASD evolution.

  9. #10 Lowell Gilbert
    MA, United States
    January 25, 2017

    Of course you tend to find more of something when you look harder for it. In general, that was *why* you looked harder in the first place.

    • #11 Orac
      January 25, 2017

      Dammit. I should have added that to my saying. OTOH, often when you look harder for something you find too much of it.

  10. #12 Daniel Corcos
    January 25, 2017

    @ Lowell Gilbert
    Then the question would be “why do you need to find more ASD?”. If the answer is not “because early treatment means better prognosis”, then one should find another answer, like “the more we diagnose, the more we sell drugs”.

  11. #13 vinu arumugham
    United States
    January 25, 2017

    Orac,

    How do you explain 75% of ASD patients testing positive for folate receptor antibodies, that preferentially bind to bovine folate receptor proteins?
    Hint: You don’t have to look very hard.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578948/
    https://www.researchgate.net/publication/301602551_Pandemrix_induces_narcolepsy_and_cow%27s_milk_contaminated_vaccines_induce_Autism_Spectrum_Disorders

  12. #14 vinu arumugham
    January 25, 2017

    Orac wrote:
    “Moreover, if you don’t look for something, you won’t find it”
    Yep, you nailed it. That’s why vaccine safety trials don’t look for (solicit) severe adverse events.

    • #15 Orac
      January 25, 2017

      That is, of course, bullshit. You clearly do not know how clinical research works.

      • #16 vinu arumugham
        United States
        January 25, 2017

        “You clearly do not know how clinical research works.”
        One can only know how clinical research works, if it works. It does not work. It is completely broken.

        • #17 Orac
          January 26, 2017

          Thank you for demonstrating the correctness of my observation that you do not know how clinical research works.

  13. #20 MarkN
    January 25, 2017

    @ #2 & #3 (Christine & Orac, respectively) comment position at time of my comment — If I remember, the 2013 analysis I saw also show an apparent decrease in severe (I think was around 17% going to 6%) — However, there was a need to adjust for bias inherent in the analysis. I thought the agreed number was more like 14 to 15% approx. So, there was a conclusion that severe was holding steady, but mild case due to criteria expansion and increased diagnostic awareness was driving the overall, in any case, but for mild.

  14. #21 Eric Lund
    January 25, 2017

    So, there was a conclusion that severe was holding steady, but mild case due to criteria expansion and increased diagnostic awareness was driving the overall, in any case, but for mild.

    Indeed, many people on the autism spectrum can function reasonably close to normally, so they wouldn’t have been diagnosed back in the day. I have occasionally considered the possibility that I might be one of these people. For instance, my mother tells me that when I was a year old, my favorite song was Tchaikovsy’s 1812 Overture (because of the cannons, of course). Most children that age don’t have attention spans that long, but I apparently did: in the recording I have of that piece, the first cannon fire comes 12:55 into a track with a total length of 16:20.

    One of the significant characters in Michael Lewis’s The Big Short is a man who had the patience to read through all the minutiae of the prospectuses for mortgage-backed securities, realized they were all a bunch of junk, and went on to make a fortune betting against (i.e., “shorting”) these securities. He had no idea that he was on the autism spectrum until his son was diagnosed as autistic. Upon hearing the doctor’s description of his son’s symptoms, he realized that the doctor could just as easily have been describing him. It was precisely because he was autistic that he had the patience to read through all the details in the prospectuses.

  15. #22 MarkN
    January 25, 2017

    Eric, wasn’t there some further irony in that he was also an MD? If I’m thinking about the same guy.

  16. #23 shay simmons
    January 25, 2017

    So we have a study from Denmark saying that much of the increase in autism diagnosis is due to expansion of the criteria (http://jamanetwork.com/journals/jamapediatrics/fullarticle/1919642), a study from Utah saying the same thing (http://link.springer.com/article/10.1007%2Fs10803-012-1566-0) and now this.

    Unfortunately, there are those who will take this as proof of how Big Pharma can buy off researchers all over the world.

  17. #24 Daniel Corcos
    January 25, 2017

    @ shay simmons
    If you read the first paper carefully, the interesting part is that a large part of the increase remains unexplained.

  18. #25 Marry Me, Mindy
    United States
    January 25, 2017

    Is this definitive evidence? On its own, of course it’s not.

    It’s not definitive, certainly, but what it does show is that this needs to be taken into account when discussing the increase in the rate of autism. Makes that a lot harder.

    Do those charts show that the number of diagnosed cases of “extreme” autism is decreasing?

    As a proportion of total diagnoses, yes.

    This seems disingenuous to me. Of course *as a proportion* it is decreasing. That is because other versions are increasing.

    But I think Christine’s question is legitimate. On an absolute basis, are the number of extreme cases increasing? Decreasing? Holding steady?

  19. #26 jrkrideau
    At the bottom of the lake, (the bottom end that is)
    January 25, 2017

    2 Christine Rose

    Good point, those graphs (using the term loosely) are terrible.

  20. #27 jrkrideau
    At the bottom of the lake, (the bottom end that is)
    January 25, 2017

    # 6 Eric Lund

    the harder you look for a medical condition the more of it you will find

    I am reminded of a city police chief who wanted to hire more officers. He warned that the crime rate would increase since he had more officers.

  21. #28 Richard
    January 25, 2017

    @ Eric Lund, #6

    It’s a lot easier to find something when you know what you’re looking for.

    You obviously never mislaid your car keys 🙂

    But yes, this principle applies in a lot of fields — and perhaps most of all in quackery such as homeopathy: these people ‘find’ things all the time, not because they exist (they don’t), but for no other reason than that they very much want to find them.

  22. #29 Daniel Corcos
    January 25, 2017

    @ Marry Me, Mindy
    You can see it from the figure: they don’t vary. In other terms, although more mild cases are detected, this does not result in the decrease of severe cases, which would be expected if severe cases were evolved from mild cases and the total incidence constant. So, either mild cases are not related to severe cases or there is a concomitant increase in ASD incidence.

  23. #30 Michael J. Dochniak
    Minnesota
    January 25, 2017

    Orac writes,

    …it is yet another study that adds to the growing body of evidence that autism prevalence has been fairly stable for the last few decades.

    MJD writes,

    Over the last several decades, there has been an escalation of autism-related U.S. Patents.

    An analysis of such patents is often a reliable indicator of the prevalence and severity of this medical condition.

    Learn more about autism-related patents at:

    https://www.novapublishers.com/catalog/product_info.php?products_id=60248

    @ Orac’s minions,

    Question: At the Scienceblogs Respectful Insolence, why is it difficult to see the forest from the trees with respect to an autism epidemic.

    Answer: Orac bias

  24. #31 Michael J. Dochniak
    Minnesota
    January 25, 2017

    Eric Lund ( #6) writes,

    It’s a lot easier to find something when you know what you’re looking for.

    MJD says,

    When you find what your looking for it’s always in the last place that you looked for it.

    Alternatively, when you use pseudoscience to find what your looking for it’s always in the first place that you look for it.

  25. #32 sadmar
    January 25, 2017

    Regardless of the various fine points brought up here, the collected evidence even before the Australian study is enough to totally discredit the ‘vaccines caused an autism epidemic’ tsunami thesis, and that’s what matters. However, with any diagnosis as subjective and changing as ASD, I would urge caution in going as far as saying “autism prevalence has been fairly stable for the last few decades”. Even if that’s probably the case, the confidence level seems rather low, and given the politics it might be a claim too far. Among other things, it could be interpreted as ‘autism isn’t that big a deal’ and have negative consequences on the availability of services for ASD kids and parents on the state and local level – [Forget the Feds under Trump; the EPA has just been effectively shut down by executive order, and there’s no reason to expect things won’t be going down the tubes at HHS and Education as well.] I know that a ‘no big deal’ reading is dead wrong, but that’s how people are.

    I’ll ask Orac and other experts: Is is possible there has been some gradual, relatively small increase in ASD over a relatively long period of time? If so, that could be helpful in identifying real causes (genetic?) that could help undermine vaccine hysteria.

    On the comedy front, for an alternative cause of an early 90s spike, I wouldn’t go for TV, Internet or organic food. For the conspiracy theorists, I think the answer should be obvious: Bill and Hillary Clinton. Not that they did anything to cause the spike. The cosmos just went on the fritz in reaction to their general perfidy. Or G-d just visited vengeance on the human race for abiding these ‘criminals’. [And yes, I wouldn’t be surprised if this thesis soon appears in a story by Sorcha Faal…]

  26. #33 Lawrence
    January 25, 2017

    Suits you to a “T” MjD.

  27. #34 Eric Lund
    January 25, 2017

    Alternatively, when you use pseudoscience to find what your looking for it’s always in the first place that you look for it.

    Nice to see that MJD and Orac agree on this point.

  28. #35 Denice Walter
    January 25, 2017

    Although AoA mavens and the like at other sites, would pooh-pooh the idea that looking for something leads to finding more of it when applied to ASDs IN GENERAL but might themselves apply that in order to explain why the British study found adults with ASDs living in the UK at a rate similar to that found in younger people.

  29. #36 Denice Walter
    January 25, 2017

    @ sadmar:

    Heh. comedy gold, dude.

    I have seen a theory floated about that in the age of the internet, more nerds might be ‘getting together’ and reproducing
    .
    More feasible ideas-
    – people are delaying having children and this in either men or women has been associated with an increased risk of ASDs.
    – more people live near cities/ freeways which has been associated with an increased risk of ASDs
    – minorities are better screened than they were decades ago which adds more dxs.

    I could probably think of more if I had more time.

  30. #37 Denice Walter
    January 25, 2017

    re the 1990s ‘spike’ in ASD dx

    change in DSM dx
    grunge music/ fashion
    increased usage of the internet and cell phones
    organic foods increased availability
    increased sales of supplements
    increase in alt med bloggers and websites
    increase in political cable news

    I personally blame Nirvana and marc Jacobs but that’s just me.

  31. #38 MarkN
    January 25, 2017

    Sadmar, one of the questions I had over the past was the ‘steadiness’ of severe, what were other countries or continents experiencing in severe cases?

    The trouble I had was difference in comparison methods, so I think others had to go back and find a better picture of apparent vs actual. Since that time, I think we’ve seen studies from Europe/UK, Japan, Aussie (i.e. first world) that show no significant increase other than mild cases due to increased awareness and expanded diagnostic criteria. However, one thing we consider looking into further is paternal gene effect in spermatogenesis, and maternal stressors, due to parents having kids later in life. There could be some influence in autism genetic predisposition due to socioeconomic factors.

    Also to add, over the past few years multiple studies offered that measles was indeed more dangerous than perceived in unvaccinated. We knew measles was dangerous, but finding occurrences more common. Although, I’m skeptical that 1:1000 to 1500 is a true picture, because samples seem small to me in those studies. I’m more apt to believe 1:3500 to 5500 for measles severe morbidity/mortality rate for unvaccinated.

  32. #39 Eric Lund
    January 25, 2017

    I have no idea without Googling who Marc Jacobs is/was, but I’m with you on Nirvana. Have you ever listened to “Smells Like Teen Spirit”? (Here’s the parody by Weird Al Yankovic.) Maybe I’m unhip, and I never got into grunge, but how did anybody mistake that for a great song? The chorus is just the same two bars of music repeated ad nauseam, and the only intelligible lyrics are, “Here we are now/Entertain us”. (Yo, Kurt: You and your mates are the band. You’re supposed to be entertaining us.) I prefer Weird Al’s version: “And I don’t know/What I’m singing”.

  33. #40 Gilbert
    January 25, 2017

    “”would pooh-pooh the idea that looking for something leads to finding more of it

    The first part involved the use of healthy associates or “pseudopatients” (three women and five men, including Rosenhan himself) who briefly feigned auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals in five different states in various locations in the United States. All were admitted and diagnosed with psychiatric disorders. After admission, the pseudopatients acted normally and told staff that they felt fine and had no longer experienced any additional hallucinations. All were forced to admit to having a mental illness and agree to take antipsychotic drugs as a condition of their release…

    The second part of his study involved an offended hospital administration challenging Rosenhan to send pseudopatients to its facility, whom its staff would then detect. Rosenhan agreed and in the following weeks out of 193 new patients the staff identified 41 as potential pseudopatients, with 19 of these receiving suspicion from at least one psychiatrist and one other staff member. In fact, Rosenhan had sent no pseudopatients to the hospital.

    https://en.wikipedia.org/wiki/Rosenhan_experiment

  34. #41 Anonymous Pseudonym
    In Your Head
    January 25, 2017

    @26 MJD
    There has been a massive increase in all kinds of patents. Next you’ll show that the rise of computer patents is the cause of autism spectrum disorder. I think that there is a fallacy named after this kind of thinking. Something about corollations and causations and such.

    @27 MJD Very astute psuedoprofundity.

    @34 MarkN How much of the increase in severity is us just realizing the full impact of measles vice the original limits of our knowledge. I’m guessing that the same can be said for many child-hood illnesses. Chickenpox comes to mind. When I was young, the connection to shingles wasn’t something people mentioned (Don’t know if they didn’t know yet or just didn’t mention). Chickenpox was a mild irritant that children went through. Shingles was a debilitating curse that laid people up for days when it flared-up. How many other diseases fit that description? How long did it take before science identified that mumps caused sterility beyond the initial discomfort, etc.

  35. #42 herr doktor bimler
    January 25, 2017

    the British study found adults with ASDs living in the UK at a rate similar to that found in younger people.

    It even works retrospectively! Look at the lists of famous artists and scientists, previously regarded as eccentric but in retrospect diagnosed as autistic, put out by various autism-support groups.* The autism epidemic is so bad, it is PROPAGATING BACKWARDS IN TIME.
    Probably it’s because their descendents were vaccinated.

    * Most of the lists are pretty crap, and put together on the principle that “any form of eccentricity = autism”. I can see the Aspergers-ish traits in Wittgenstein, say, or Cavendish or Dirac. But Einstein and Bartok were weird in completely different, non-autistic ways. Autism is not the only way of being neuro-atypical.

  36. #43 LouV
    France
    January 25, 2017

    Daniel Corcos
    #12

    If the answer is not “because early treatment means better prognosis”, then one should find another answer, like “the more we diagnose, the more we sell drugs”.

    Unlikely given the fact that guidelines (including the HAS’) don’t recommend drugs in first intention, compared to educative therapies.
    ***
    MJD
    #27
    Patents, an indicator of prevalence ? Why not an indicator of better public and professional information ?
    In France, 10 years ago, we didn’t have a lot of books on autism, and even less written for parents or on Asperger syndrome. However, governmental plans (the “Plans Autisme”) pushed for better information, which made this subject attractive to editors ; and there are a few publishers created by parental associations (like “Autisme France Diffusion”). So there are far more books published in France on that subject.
    And God knows there was a need for it, because a good part of our psychiatrists, still following psychoanalysis, unfortunately refused to openly diagnose autism, and a lot of cases went undiagnosed. Hence a great effort to better inform so that less autistics go undiagnozed.
    With your logic, since you don’t account for societal changes like better patients information and advocacy, the greater number of books on autism would mean there is an epidemic…

  37. #44 Chris
    January 25, 2017

    Le sigh. There is a reason why I ask which version of the DSM was for the autism diagnosis. And now with the three levels in DSM V, I ask which level.

    The folks calling it an “epidemic” seemed confused by those details.

  38. #45 MichelleN
    January 25, 2017

    Apparently scientists and science lovers are planning to march in Washington and elsewhere. Here’s the link to the public facebook group:

    facebook.com/marchforscience

    If St. Louis ends up with a local march, I would love to meet up with other RI peeps there.

    • #46 vinu arumugham
      United States
      January 25, 2017

      Which science?

      Tobacco’s corrupted science?
      Pharma’s corrupted science?
      ADA’s flossing-is-good corrupted science?
      Monsanto’s Roundup-is-good-for-your-baby science?

  39. #47 herr doktor bimler
    January 25, 2017

    because a good part of our psychiatrists, still following psychoanalysis, unfortunately refused to openly diagnose autism, and a lot of cases went undiagnosed.

    Or misdiagnosed and subjected to officially-sanctioned quackery.

  40. #48 sadmar
    January 25, 2017

    Maybe you had to be there, but Nevermind breathed life back into rock at very dead time, ans is a concensus classic, #17 on Rolling Stones list of the 500 greatest albums of all time.

    ‘Teen Spirit’ became an anthemic huge hit, bringing Cobain a fame and adulation he didn’t want. He might have agreed it wasn’t a great song, but rock is about great records, not great songs, and that’s what ‘Teen Spirit’ is. Great singles aren’t measured by musical complexity or lyrics. One of the greatest of all-time is The Kingsmen’s version of ‘Louie Louie’, one riff repeated over and over, clumsily and with an outright mistake left in, and adenoidal vocalizing that was legendarily declared “unintelligible at any speed”.

    ‘Teen Spirit’ is one of Cobains more artful lyrics, and only a few lines in the verses (italicized below) are actually hard to make out unintelligible:

    Load up on guns / Bring your friends / It’s fun to lose and to pretend She’s overboard, self assured / Oh no I know, a dirty word

    Hello, hello, hello, how low [x3] / Hello, hello, hello

    With the lights out, it’s less dangerous / Here we are now, entertain us / I feel stupid and contagious / Here we are now, entertain us / A mulatto, an Albino / A mosquito, my libido / yeah

    I’m worse at what I do best / And for this gift, I feel blessed / Our little group has always been / And always will until the end

    And I forget just why I taste / Oh yeah, I guess it makes me smile / I found it hard, it was hard to find / Oh well, whatever, nevermind

    With the lights out, it’s less dangerous / Here we are now, entertain us / I feel stupid and contagious / Here we are now, entertain us / A mulatto, an Albino / A mosquito, my libido
    A denial, A denial, A denial, A denial, A denial, A denial, A denial, A denial, A denial

    Any typical gen-x-er will immediately recognize any line from the chorus.

    You can still blame ‘grunge’ for the spike 🙂 since the commercial success of Nevermind opened the door for a few more excellent albums (/i>Ten by Pearl Jam, Superunknown by Soundgarden, Siamese Dream by Smashing Pumpkins) but also garbage like Nickalback and Bush. Grunge style quickly became commodified as mere fashion (that would be represented by Mr. Jacobs), as taken down by the The Baffler‘s classic Alternative To What?t issue (#5).

    Actually, we may indeed be able to blame everything bad in the world since 1995 on Nickelback…

  41. #49 JustaTech
    January 25, 2017

    sadmar @42: Is that what the lyrics are? All I knew when I first heard it was that it spoke to the lonely looser in me (though I didn’t speak back, since I was at preppy girl’s camp in Texas as a damn Yankee).

    I don’t know Siamese Dream by the Smashing Pumpkins, but I darn near memorized Mellon Collie and the Infinite Sadness one summer in the lab. That’s a pretty brilliant album. (Having recently seen the Smashing Pumpkin and support crew in concert, don’t bother. The new stuff is meh and for the most part the support folks detract from the old stuff.)

  42. #50 brian
    January 25, 2017

    On an absolute basis, are the number of extreme cases increasing? Decreasing? Holding steady?

    The right-hand figure that Orac included (figure 3b in the paper) showed that extreme cases are bouncing around but may be slightly decreasing (perhaps due to early diagnosis and treatment) but cases that are not extreme increased faster than extreme cases decreased: it wasn’t just a swap, but an actual increase in the diagnosed prevalence of less severe cases, almost as if mild cases that earlier would not have been diagnosed with ASD under stable diagnostic standards are now given that label, and almost as if increased awareness of ASD among parents and healthcare providers has some effect:

    http://onlinelibrary.wiley.com/doi/10.1002/aur.1740/epdf

  43. #51 JP
    January 25, 2017

    I don’t know Siamese Dream by the Smashing Pumpkins, but I darn near memorized Mellon Collie and the Infinite Sadness one summer in the lab.

    That’s my favorite, too. As far as Nirvana goes, I’m a bigger fan of In Utero than Nevermind, but I like their whole discography. Bleach is the “grungiest,” as far as I’m concerned.

  44. #52 JustaTech
    January 25, 2017

    Hey JP, if you ever want to see the house where Cobain died, it’s on my running route. (I have been known to snark at lookie-loos who get in my way.)
    Oh, and the actual SoundGarden is up the street from my office, but you have to show ID to get in because it’s in a NOAA facility. But the Black Hole Sun is in a park up the hill that’s open to all.

  45. #53 Bob G
    Los Angeles
    January 25, 2017

    For those who want to postulate some sort of environmental cause or aggravation of an underlying disorder, the curves suggest that there is no actual increase at all. If there were an environmental precipitating effect then you would expect that it would be generating severe cases at increasing numbers, just as it is precipitating less severe cases. Even if the postulated cause doesn’t work quite as strongly on the severe cases as on the mild cases, you would still expect something to show up in the numbers of severe cases. There doesn’t seem to be any variation other than modest statistical variation in the severe case numbers, so whatever it is that brings on severe autism, it doesn’t seem to be anything that has changed since the year 2000.

    Also, something that has been mentioned here numerous times — parents of autistic children are learning how to get governmentally sponsored aid, and this drives up the number of official diagnoses. That’s a lot different from the previous style of keeping the eccentric relatives inside or up in the attic.

    I also wonder whether part of this trend is that parents used to just beat their difficult children but now it’s against the law, so they have to find some other way of dealing with problem children.

    One question for the behavioral science experts: Has anybody done a study which looked at autistic children vs. controls and compared the fractions of parents with some sort of paranoid personality disorder? The working hypothesis would be that the same genetic differences that can lead to severe autism may also express themselves with paranoia or frank schizophrenia.

  46. #54 JP
    January 25, 2017

    Hey JP, if you ever want to see the house where Cobain died, it’s on my running route.

    I actually lived in the same apartment building that Kurt Cobain lived in in Olympia when I was in college. I was sceptical when the manager told me, but then I saw a picture of Kurt Oin an apartment with the same wallpaper and cabinets. It wasn’t exactly renovated often. (The cheapest building in town, it used to be famous as something of a heroin den.)

  47. #55 JP
    January 25, 2017

    ^Kurt COBAIN.

  48. #56 Robert L Bell
    I swear that this is not spam
    January 25, 2017

    @JP #46 Quite sound reasons why Bleach is the grungiest while Nevermind was the breakout album. As a general statement, Smells Like Teen Spirit is a parody of a pop hit.

    Switching gears, back when the dinosaurs roamed the Earth and I was taking my first stab at epistemology, we had a case study in psychosis rates of America v Great Britain after WWII.

    Somebody had noticed that Schizophrenia was more common in the states while Manic-Depressive was more common the the UK. Much bloviating followed, about scientific Americans and the legendary tolerance of eccentrics by the Brits.

    So money was found for an exploratory committee, to examine this nut, and they did the right thing: trans-Atlantic conferences to develop a uniform set of diagnostic criteria and to train a cadre of practitioners on both sides of the pond.

    The study found what you might expect: same rates of incidence in both populations, when judged by a consistent set of criteria.

    Which, leaping forward sixty years, is important when considering the superficial explosion of Bipolar diagnoses in the last fifteen years. Setting aside DMS V and the billing controversies, Bipolar Affective Disorder has become something of a wastebasket category.

  49. #57 titmouse
    January 25, 2017

    Off topic but this seems like a cool idea:
    http://www.scientistsmarchonwashington.com

    I don’t know who is behind this plan. Hopefully some good people. Maybe somebody can find out?

  50. #58 Daniel Corcos
    January 25, 2017

    @ Bob G
    What I understand is that the figures represent new diagnoses. If you make the diagnosis when patients have mild symptoms, you will be less likely to make the diagnosis when they have severe ones, and the number of these new severe cases should fall. Only in the case you count the prevalent cases of ASD you should not observe this decrease (or you should observe an increase in the case of an epidemic).

  51. #59 Julian Frost
    Gauteng North
    January 26, 2017

    @ Daniel Corcos #56:

    If you make the diagnosis when patients have mild symptoms, you will be less likely to make the diagnosis when they have severe ones, and the number of these new severe cases should fall.

    Um, what?
    Autism is not progressive. A patient who is on the less severe end of the spectrum is unlikely to move to the more severe end. Your argument is illogical.

    • #60 vinu arumugham
      United States
      January 26, 2017

      Not necessarily. In 75% of the ASD cases that are caused by folate receptor antibodies, a milk-free diet reduces symptoms. So conversely, increased milk intake can cause increased severity of symptoms.

  52. #61 Daniel Corcos
    January 26, 2017
  53. #62 herr doktor bimler
    January 26, 2017

    Somebody had noticed that Schizophrenia was more common in the states while Manic-Depressive was more common the the UK.

    And then there was the time in the Soviet Union, when diagnoses of Anti-state Oppositional Disorder skyrocketed. I am given to believe that a similar syndrome has been rediscovered in Putinist Russia, again requiring compulsory institutional care. I don’t recall if they ever tracked down the environmental toxin responsible for the epidemic.

  54. #63 Murmur
    UK-ia
    January 26, 2017

    #12 “Then the question would be “why do you need to find more ASD?”. If the answer is not “because early treatment means better prognosis”, then one should find another answer, like “the more we diagnose, the more we sell drugs”.”

    What drugs would those be then? We used sod all drugs with autistic bairns, other than melatonin with a few for sleep difficulties, mebbe methylphenidate if there was co-morbid ADHD and an occasional AD if there was some co-morbid depression which did not respond to non-pharmacological approaches.

    There are no “anti-autism” drugs…

  55. #65 Murmur
    UK-ia
    January 26, 2017

    Oh, and what Julian said @ 57.

  56. #66 LouV
    France
    January 26, 2017

    There are no “anti-autism” drugs…

    ^^^ This.
    There are genuine concerns on other changes in the DSM, who might broaden criteria a bit too much for pathologies like depression. But if I had to link criteria broadening for autism to an outside group, it would be primarily advocacy groups, not drug manufacturers.

  57. #67 Daniel Corcos
    January 26, 2017

    @ LouV
    I agree with you, selling drugs cannot be a factor, but advocacy groups and therapists may be involved. Since you seem to be an expert, what is the percentage of cases evolving from mild to severe?

  58. #68 Julian Frost
    Gauteng North
    January 26, 2017

    @vinu #60:
    citation needed.

    • #69 vinu arumugham
      United States
      January 26, 2017

      Thanks to Roger Kulp for taking care of that.

  59. #70 Eric Lund
    January 26, 2017

    HDB@62: Quiet now, we don’t want to give Tom Price any ideas.

  60. #71 Politicalguineapig
    January 26, 2017

    hdb: I don’t recall if they ever tracked down the environmental toxin responsible for the epidemic.

    Stalin isn’t an environmental toxin? Or maybe it’s Lenin; didn’t they bury him in a lead coffin.

  61. #72 Roger Kulp
    January 26, 2017

    Murmur @ 63
    As far as identifying problems for treatment,you could start here.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073259/
    http://questioning-answers.blogspot.co.uk/2016/10/autism-inborn-errors-metabolism.html

    There’s lots more options,including treatment for autism caused by Pediatric Acute-onset Neuropsychiatric Syndrome or PANS,but I can only post two links,before I get put in mod queque

  62. #73 Roger Kulp
    January 26, 2017

    Julian Frost @59
    For citation of FRAAs that vinu arumugham mentioned @ 60 see the PubMed link l just posted or maybe these

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783401/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715943/

    I am sure you have heard of regressive autism,which I had for decades,before underlying (genetic) metabolic and immune causes were found.Including the folate receptor autoantibodies vinu arumugham mentions.When most people talk about autism,the autism they talk about is not regressive.With regressive autism,with underlying metabolic,or immune disorders,which most doctors do not test for,any illness,or severe stress to the body,like a seizure,can lead to regression at any age.Regressive autism is a lifelong cycle,of regression,some improvement,followed by another illness andregression.Depending on the severity of the illness,the regression can cuse you to be in a worse place intellectually and neurodevelopmentally than you were before.It isn’t just vaccines.

    trust me.I lived it for over 40 years before underlying causes were found.Causes doctors did not know existed when I was a child.

    It’s true,nonregressive autism does improve over time,though

  63. #74 Roger Kulp
    January 26, 2017
  64. #75 MrrKAT
    Finland, EU
    January 26, 2017

    Frequency of rare athmospheric halo phenomena have increased a lot. You’d think due to climate change but main reason is increased knowledge and many more amateurs staring to the sky looking for them.

    Once here one engineer claimed in his dissertatis (scandalous ->cancelled) that leukemia didn’t exist until radio masts were build around at the end of 19th century.

  65. #76 Old Rockin' Dave
    January 26, 2017

    One reason for diagnostic expansion from the ’90s on up is the first awareness of Hans Asperger’s research and increasing awareness of the eponymous syndrome.
    Before that, many Aspies, me included, either were just thought of as oddballs and eccentrics, or were tagged with a variety of other terms: learning disabled, behavioral problems, monomania (Now there’s a nice obsolete term for you.), obsessive, antisocial, and various Freudian, I.e. useless, mythos.
    It amuses me to think that I was a small part of the apparent “epidemic”, having been diagnosed at the age of 50

  66. #77 Old Rockin' Dave
    January 27, 2017

    Mein Herr Doktor, Another Soviet diagnosis was “sluggish schizophrenia”, applied often to people whom the state found disagreeable. It could only be diagnosed by specially certified psychiatrists. People of the “reformist” kind seem to have been particularly predisposed. Institutionalization could be indefinite. It was such a dangerous and insidious disease that these special psychiatrists could diagnose it people who displayed no symptoms or signs of it.
    Incidence began to decrease about the time that Boris Yeltsin became president, and there appears to be epidemic coincident with the rise of Vladimir Putin (Remember! Correlation is not causation.).
    If memory serves, one of the “treatments” was the painful injection of a drug that left characteristic blue spots on the skin. The name escapes me, but I believe that the spots appeared on the face.

  67. #78 Old Rockin' Dave
    January 27, 2017

    Addendum to my #75: Other things we were tagged with were queer, homo, fag, similar unlovely things.
    Generally not athletic, seeming unaware of our surroundings, pedantic, made us easy targets.

  68. #79 LouV
    France
    January 27, 2017

    Since you seem to be an expert, what is the percentage of cases evolving from mild to severe?

    Haha, I’m not a researcher, I only work as a specialized librarian on the subject. And unfortunately, I know just enough to say that it’s pretty complicated to answer and/or would require a search that I have neither the time nor the motivation to do. Sorry !

  69. #80 Murmur
    UK-ia
    January 27, 2017

    #64

    Except that paper doesn’t say what you say it does…

    And it is a very limited paper, as the authors themselves point out: “This study was not a clinical trial and neither the physicians nor the parents were blinded to treatment. In additional, our controls were not given a placebo; hence, the magnitude of the placebo effect was not taken into account, and we used a subjective parental report rather than objective assessment measures.”

    Really I am fed up of reading “papers” to do with autism which do not include any halfway objective measures or lack confirmed diagnoses (at least this one passes that test) or willfully use inadequate assessment tools (yes, Geiers, that’s you, that is).

    At least Roger’s references (thank you: some interesting reading for later!) are rather better.

  70. #82 dz
    United States
    January 27, 2017

    #64. This paper states “This study was not a clinical trial and neither the physicians nor the parents were blinded to treatment. In additional, our controls were not given a placebo; hence, the magnitude of the placebo effect was not taken into account, and we used a subjective parental report rather than objective assessment measures. Double-blind, placebo-controlled studies are required to confirm and expand upon the findings of this case series.”
    Did you read your citation? It does not provide any credible evidence of your claim.

  71. #84 Andy Jones
    January 27, 2017

    This has simply become to political to have accurate data anymore. There may be a concerted effort, even if subconscious, to give other names to developmental disorders previously known as autism.

    A game of semantics similar to renaming paralytic polio acute flaccid paralysis.

    If the CDC and AMA want to hide the thimerosal/autism link through a misdiagnosis campaign, there will be nobody to stop them.

    • #85 vinu arumugham
      United States
      January 28, 2017

      And the media has no problem going along with such alternative facts.

  72. #86 Julian Frost
    Gauteng East Rand
    January 28, 2017

    There may be a concerted effort, even if subconscious, to give other names to developmental disorders previously known as autism.

    The opposite is true and has been shown to be true. Many conditions now fall under the autism label.

    If the CDC and AMA want to hide the thimerosal/autism link through a misdiagnosis campaign, there will be nobody to stop them.

    Except researchers have looked at whether thimerosal causes autism and it doesn’t. In fact, this was one of the hypotheses settled as disproven in front of Vaccine Court.

    • #87 vinu arumugham
      United States
      January 28, 2017

      Here’s the joke called vaccine safety science.
      In ANY well engineered product, safety problems are supposed to be analyzed and ELIMINATED by DESIGN. Not in vaccines.
      Here the victims have to provide the hypotheses! And the “experts” will test SOME of them while complaining loudly about “shifting hypotheses”. Corrupt science makes vaccine safety an oxymoron. Why would thimerosal safety have to be tested AFTER autism complaints? Why was it NOT proven safe BEFORE vaccine approval?

      Vaccines and Autism: A Tale of Shifting Hypotheses
      https://academic.oup.com/cid/article/48/4/456/284219/Vaccines-and-Autism-A-Tale-of-Shifting-Hypotheses

  73. #88 Chris
    January 28, 2017

    Andy Jones: “A game of semantics similar to renaming paralytic polio acute flaccid paralysis.”

    A really stupid argument when they actually check which of the three serotypes causes an infection:
    https://microbewiki.kenyon.edu/index.php/Poliovirus_and_its_three_serotypes

    I knew this even though I am not a biologist. What is your excuse?

  74. #89 Chris
    January 28, 2017
  75. #90 herr doktor bimler
    January 28, 2017

    There may be a concerted effort, even if subconscious, to give other names to developmental disorders previously known as autism.

    I would welcome the names and prevalences of the developmental disorders that were previously known as autism.

    This has simply become to political to have accurate data anymore… renaming paralytic polio acute flaccid paralysis… hide the thimerosal/autism link through a misdiagnosis campaign

    I wonder if there is an accepted name or abbreviation for this particular approach to rejecting reality and substituting one’s own, where the reality-rejecter decides that the repeated refutation of his bullsh1t is “making the issue political”, therefore no evidence is reliable so he can invent his own.

  76. #91 Hugh Robertson
    January 28, 2017

    The changes in the polio nomenclature have been well documented and proven.

    It’s a fact asshole.

  77. #92 doug
    January 28, 2017

    fendle’s turd?

  78. #93 Hugh Robertson
    January 28, 2017

    What did you say?

    And “Dangerous Bacon” is complaining about 7th grade insults on the other thread.

    LOL.

    It is this website that is full with some of the most egregious playground humor.

    “Woo”

    Looks like Dougie Wougie needs a lolly. Whaaa!

    And when someone else does it, you people just bitch like hypocrites.

    The only two with any class besides the guests are Herr Doktor and Squirrel Elite. The rest of you are shit-flinging apes.

  79. #94 Hugh Robertson
    January 28, 2017

    Moderation is for teetotalers.

  80. #95 doug
    January 28, 2017

    Q.E.D.

  81. #96 Narad
    January 29, 2017

    There may be a concerted effort, even if subconscious

    There’s nothing so sad as failed Bad Fazzm.

  82. #97 herr doktor bimler
    January 29, 2017

    Went to a concert last night with a couple of Klezmer bands. Now I am wondering what a Fazzmer band would sound like.

  83. #98 Narad
    January 29, 2017

    Now I am wondering what a Fazzmer band would sound like.

    One of the God and Hair CDs, as I recall, came off as though The New Seekers had gotten the Patty Hearst treatment, but I’m losing patience trying to sift through them.

  84. #99 Julian Frost
    Gauteng East Rand
    January 29, 2017

    Here the victims have to provide the hypotheses!

    False. In Vaccine Court, it is on balance of probabilities, aka 50% plus a feather. The fact that you don’t know this speaks volumes.

    And the [experts] will test SOME of them while complaining loudly about “shifting hypotheses”

    Large studies have settled the question. Vaccines do not cause autism. And the experts have every right to complain about shifting hypotheses. Repeatedly, a hypothesis was raised about how vaccines caused autism. Each time, research disproved it, and each time the antivaxxers came back with a new one.

    Why would thimerosal safety have to be tested AFTER autism complaints?

    Because there wasn’t (and still isn’t) any plausible mechanism of action by which thimerosal can cause autism. And because antivaxxers are a bunch of whiny, goalpost shifting loudmouths, for whom vaccines are the problem.

    • #100 vinu arumugham
      United States
      January 29, 2017

      “In Vaccine Court,”
      I am not talking about the court, I am talking about vaccine designers like Plotkin and Offit. Why did they not hypothesize all possible vaccine safety problem during design and fix them?
      For example, they knew that DTAP vaccine is contaminated with milk proteins. Where are the safety studies demonstrating the safety of the milk contamination w.r.t allergies and bovine folate receptor antibodies leading to autism?

    • #101 vinu arumugham
      United States
      January 29, 2017

      “Large studies have settled the question. Vaccines do not cause autism. ”
      Nope. Cite them please. Maglione et al., Taylor et al. and the IOM 2012 report do not cover milk contaminated vaccines causing folate receptor antibody induced ASD.

  85. #102 Michael Pyshnov
    Toronto
    January 29, 2017

    I don’t believe in snake oils. Even less – in statistics. I believe in studying phenomena and finding cause and effect thing.
    If it’s true that at least in small number of cases there was this vaccine-high fever-autism sequence taking just a few days to display a drastic effect, I believe the statistics becomes irrelevant.
    The simplest explanation, of course, would be that vaccine causes sometime high fever, and then high fever sometimes causes autism, i.e. not the vaccine itself. I remember that doctors warned that high fever in children can cause brain damage..

  86. #104 Julian Frost
    Gauteng East Rand
    January 29, 2017

    The changes in the polio nomenclature have been well documented and proven.

    False. And you really should learn to use proper sources, not lying antivaccine websites.

  87. #105 herr doktor bimler
    January 29, 2017

    high fever sometimes causes autism,.

    I take pleasure in awarding this comment the coveted order of the Face and Palm, for stupidity above and beyond the call of duty.

  88. #106 gaist
    January 29, 2017

    The simplest explanation, of course, would be that vaccine causes sometime high fever, and then high fever sometimes causes autism

    Sure, if you discount lack of supporting evidence (and all the evidence to the contrary), non-existence of any plausible (or even wildly fantastical) mechanism of causation, dismiss how autism actually manifests itself and ignore all the simpler explanations.

  89. #107 Old Rockin' Dave
    January 29, 2017

    “The changes in the polio nomenclature have been well documented and proven.”
    Citations, please.

  90. #108 Old Rockin' Dave
    January 29, 2017

    “A game of semantics similar to renaming paralytic polio acute flaccid paralysis.”
    Acute flaccid paralysis. is a finding not a disease in itself. It’s like renaming influenza to fever.
    If you are going to make assertions as fact, it helps to know the facts.

  91. #109 Michael Dochniak
    Minnesota
    January 29, 2017

    @ Michael Pyshnov (#100),

    Surprisingly, some studies indicate that fever may reduce autism-like symptoms. A few examples are described below:

    1) Treatment of autism spectrum disorders with agents that activate the Locus coeruleus-noradrenergic system (Purpura, et al. Patent number 8,470,546 – June 25, 2013)

    In inventors explained that the association of febrile episodes and improvement in autistic behaviors provides a basis for the use of α-adrenergic agonists and α-adrenergic re-uptake inhibitors for the treatment of autism.

    2) In a research paper on febrile episodes from Medical Hypotheses (April, 2013) titled, is fever a predictive factor in the autism spectrum disorders? author Megremi AS writes, “Literature data indicate that probably there are differences in susceptibility to various infections between normal and autistic children. In addition, some autistic children show improvement in the characteristics of their autistic behavior during febrile incident and repression of fever (through antipyretics) might be associated with the onset of autistic disorder. Since fever has been associated with mental illness since the time of Hippocrates already and the presence of fever is associated with a favorable outcome in various pathologic conditions, it is assumed that there are probably two subgroups of autistic children: those who have the possibility to develop acute febrile incidents and those who develop acute incidents without fever. If this is the case, it is important to know whether there are differences between the two subgroups in various biological markers (cytokines/chemokines, autoantibodies), neuroimaging findings, personal and family history of these children (use of drugs, vaccinations, history of autoimmunity, etc.) and, if the first subgroup consists of autistic people of higher functionality and better outcome, or not. If such a classification is real, is there a possibility for the fever to be used as a predictor of the autistic disorder outcome and of whether that person will achieve an acceptable level of functionality in the future? If there are positive answers to these questions, are autistic children, who develop fever, at a very critical stage in evolutionary terms, where it is very important not to lose the defense mechanism of fever development and thus mast use the fever repression methods (antipyretic drugs for example) with caution and chariness? If it is confirmed that autistic children with high fevers are of higher functionality, it is possible for preventive intervention programs to be developed where children are exposed to the least possible chemical drugs intervention (antipyretics, antibiotics, etc.) or even selective vaccination. Further experimental, epidemiological and clinical studies are necessary to investigate the above.”

    Learm more about Autism-related Patents at —>

    https://www.novapublishers.com/catalog/product_info.php?products_id=60248 🙂

  92. #110 Chris
    January 29, 2017

    “The changes in the polio nomenclature have been well documented and proven.”

    Sorry, Hughie, John Scudamore’s lunatic writings on whale.to is not actual factual documentation. Only an idiot would use that stupid article, and then double down after a link was used as evidence your claim was, well… again, very stupid.

    There are actually lots of people who have been researching polio for decades. They did not change the “nomenclature”:
    http://www.virology.ws/2015/08/12/a-collection-of-polioviruses/

    Also, silly boy, “acute flaccid paralysis” is a symptom of many diseases. Not just the three serotypes of poliovirus.

  93. #111 Chris
    January 29, 2017

    Michael Pyshnov: “The simplest explanation, of course, would be that vaccine causes sometime high fever, and then high fever sometimes causes autism, i.e. not the vaccine itself. I remember that doctors warned that high fever in children can cause brain damage..”

    You know what else causes high fevers? Try influenza, measles, Hib, mumps, and a bunch of other vaccine preventable diseases. If you are going to clam that the fevers caused by vaccines are more dangerous than the diseases: then provide the PubMed indexed studies by reputable qualified researchers to support that assertion.

  94. #112 herr doktor bimler
    January 29, 2017

    Only an idiot would use that stupid article, and then double down

    Or a troll in the lordosis posture for attention.

  95. #113 Alain
    January 29, 2017

    Dear Mr Pyshnov,

    How do you prove that autism equal brain damage?

    Alain

  96. #114 brian
    January 29, 2017

    The simplest explanation, of course, would be that vaccine causes sometime high fever, and then high fever sometimes causes autism, i.e. not the vaccine itself. I remember that doctors warned that high fever in children can cause brain damage.

    Well, no.

    “There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications.” [Fever and antipyretic use in children. Pediatrics. 2011;127(3):580.]

    http://pediatrics.aappublications.org/content/127/3/580.long

    Although the evidence doesn’t support their position, many healthcare providers mistakenly believe that fever can cause brain damage. That’s too bad, as their confusion causes confusion and worry for parents. [Fever phobia: the pediatrician’s contribution. Pediatrics. 1992;90(6):851.]

    http://pediatrics.aappublications.org/content/90/6/851

    Here’s a good overview:

    https://sciencebasedmedicine.org/fever-phobia/

    • #115 vinu arumugham
      United States
      January 29, 2017

      Most occurrences of fever are of course normal body response to infection and are part of the healing process.
      It may even be part of nature’s cancer control system.

      Vaccines induce febrile seizures.
      https://www.nap.edu/catalog/13164/adverse-effects-of-vaccines-evidence-and-causality
      “Conclusion 4.4: The evidence convincingly supports a causal relationship between MMR vaccine and febrile seizures.”
      These can easily be dangerous because of route of exposure.
      For example, measles, mumps, rubella virus exposure in nature, occur through nose, eyes or mouth.
      With an MMR vaccine, the exposure occurs through damaged skin and nerves. So encephalitis (and related febrile seizure) is a known injury following MMR and is listed on the vaccine injury table.

  97. #116 Michael Pyshnov
    Toronto
    January 29, 2017

    1) I believe that molecular biological “studies” are irrelevant. In nature, almost any A is
    influencing almost any B. Surprising is finding no correlation. First mol.bio. works were
    revealing mechanical, structural interactions between molecules and the systems with small
    number of components in vitro were working. Now you find “statistically blah blah” correlation
    of names and terms and publish it. They call it “evidence based medicine”.
    2) That vaccine-fever-autism sequence is unique. So, first, it should be decided if this is two independent processes or one.
    3) I doubt that Hg alone does it. It binds to proteins, “denaturates” them, forms very high
    concentration of this complex, which was not present in the 19th century Hg cures. It’s strange how these drastically changed vaccine proteins create immunity.
    4) It all went too far.
    5) I had no intention to prove anything except the urgent need to think again.

  98. #117 gaist
    January 29, 2017

    I had no intention to prove anything except the urgent need to think again.

    Great. Reading Respectful Insolence is a solid first step. I wish you luck on your journey.

  99. #118 Chris
    January 29, 2017

    Mr. Pyshnov: “2) That vaccine-fever-autism sequence is unique. So, first, it should be decided if this is two independent processes or one.”

    Why and how?

    “5) I had no intention to prove anything except the urgent need to think again.”

    Have you thought of the genetics? Lots other people have done that, and if you want to participate go to https://sparkforautism.org/ , and sign up.

    I recently went to a presentation titled “State of Autism in 2017.” It included discussion of legal, political, social and science pertaining to autism.

    The science part included some recent research matching some genetic sequences to behaviors that are associated with autism. It is very complicated, since if you meet one person with autism you have met exactly one person. The others are often very different. But the point is that they are finding patterns.

    It does not seem to be published yet (the presenter works with the principle investigator), but here is a preliminary paper: A Genotype-First Approach to Defining the Subtypes of a Complex Disease.

  100. #120 Dangerous Bacon
    January 29, 2017

    “Dangerous Bacon” is complaining about 7th grade insults on the other thread.”

    Actually Hugh, I was referring to the irony of a certain antivax opthalmologist bitching and moaning about people from RI being rude, while himself using a bunch of grade school insults on his Facebook page.

    Antivaxers can engage in whatever feces-flinging they choose; they just look silly when they turn around and complain that their targets are being mean to them.

    Not as foolish as their tired, logic-free antivaccine arguments, but pretty darn silly nonetheless. 🙂

  101. #121 herr doktor bimler
    January 29, 2017

    I doubt that Hg alone does it. It binds to proteins, “denaturates” them, forms very high
    concentration of this complex, which was not present in the 19th century Hg cures.

    Yeah Nope. The bond between EtHg and cysteine thiols in proteins is reversible, so you must mean “denatures” in the special sense of “not denatured”.

    How low concentrations of EtHg can form “very high
    concentration of this [hypothetical] complex” is anyone’s guess. Perhaps homeopathy is involved.

    It’s strange how these drastically changed vaccine proteins create immunity.
    Strange indeed! It’s almost as if the vaccine proteins are not in fact drastically changed!

  102. #122 Julian Frost
    Gauteng North
    January 30, 2017

    @vinu #100 and #101:

    I am talking about vaccine designers like Plotkin and Offit. Why did they not hypothesize all possible vaccine safety problem during design and fix them?

    Because it’s literally impossible to hypothesise all possible problems.

    [T]hey knew that DTAP vaccine is contaminated with milk proteins

    This has been covered before. You are talking out of your backside.

    “Large studies have settled the question. Vaccines do not cause autism. ”
    Nope. Cite them please.

    Yes.
    https://www.ncbi.nlm.nih.gov/pubmed/24814559

    Maglione et al., Taylor et al. and the IOM 2012 report do not cover milk contaminated vaccines causing folate receptor antibody induced ASD.

    Maybe because you just made that syndrome up.

    • #123 vinu arumugham
      January 30, 2017

      “Because it’s literally impossible to hypothesise all possible problems.”

      These top vaccines experts work their entire life injecting viral/bacterial proteins into people and watching them develop IgG antibodies that protect against disease.
      It never occurs to them that if they inject milk protein contaminated vaccines, that the patient may develop IgG to milk proteins as well? A completely alien, earth shattering concept is it? Were they expecting your immune system to read their mind and ONLY develop antibodies to the viral/bacterial proteins?

      Vaccine safety is “settled science”, remember? They absolutely have understood every possible problem hypothesis. How else can it be called “settled science”?

      If it is “literally impossible to hypothesise all possible problems.”, then accept that there can be “shifting hypotheses” as we try to find the real culprit in an unsettled science environment.

    • #124 vinu arumugham
      January 30, 2017

      “https://www.ncbi.nlm.nih.gov/pubmed/24814559”

      Already told you, Taylor et al. does not cover the mechanism I describe.

  103. #125 Chris Preston
    Australia
    January 30, 2017

    Folate receptor antibody associated ASD is a real proposal. It seems to come from a single laboratory though and is based on relatively small studies of children.

    There is absolutely no evidence that vaccines have anything to do with this proposed syndrome.

    • #126 vinu arumugham
      January 30, 2017

      Chris Preston,
      “There is absolutely no evidence that vaccines have anything to do with this proposed syndrome.”

      Viral/bacterial proteins in vaccines, cause the development of IgG antibodies that help protect against disease.
      When other proteins contaminate vaccines, IgG antibodies are produced against those proteins as well.
      Numerous vaccines are contaminated with cow’s milk proteins that are used as growth media for the bacteria.
      So it is not rocket science that folate receptor proteins in the cow’s milk contaminated vaccines will cause the induction of IgG antibodies against folate receptor proteins. That is exactly what Frye et al. found. IgG antibodies against folate receptor proteins.
      As I pointed out before, we have seen this occur in the case of Pandemrix. Instead of milk proteins, it was the influenza nucleoprotein IgG that bound to hypocretin receptors and resulted in narcolepsy.

    • #127 vinu arumugham
      January 30, 2017

      ” relatively small studies of children”

      There are two things that make it powerful.
      1. Reduction in milk intake, reduces folate receptor antibody production which improves symptoms.
      2. Folinic acid therapy, which uses an alternate pathway to supply folate to the brain (bypassing the one blocked by the folate receptor antibodies) also improves symptoms.

      These clearly demonstrate that the mechanism being described is correct.

  104. #128 Chris
    January 30, 2017

    Vinu, the Pandemrix influenza vaccine was never used in the USA. Just that alone shows you have no idea what you are blathering about.

    So, silly man, why does my household WIFI crap out so often? Fix that, you fool… and then you might have some credibility.

    • #129 vinu arumugham
      United States
      January 30, 2017

      “Pandemrix influenza vaccine was never used in the USA.”

      How does that make any difference? I never claimed it was used in the US.

    • #130 vinu arumugham
      United States
      January 30, 2017

      “why does my household WIFI crap out so often”

      My apologies, although I don’t design WIFI products. Unlike vaccines, there are vendor reviews and many competitors supplying WIFI equipment. My personal view is you should avoid WIFI equipment to reduce exposure to radiation. A wired connection when possible is more reliable and radiates less.

  105. #131 Niels
    January 30, 2017

    Yeah Nope. The bond between EtHg and cysteine thiols in proteins is reversible, so you must mean “denatures” in the special sense of “not denatured”.

    It is in a sense reversible, but it is thermodynamically very improbable. Here is a quote from an article:

    The stability constant of the CH₃Hg(cysteinate) complex is 3.98 × 10¹⁶ M⁻¹, which is largely contributed by favorable enthalpy and entropy terms.

    Now, with a bigger protein you would have an even higher stability constant because the difference in entropy would be smaller. That is to say the gain of entropy on disassociation would be less since the larger protein is barely effected. The stability constant above with bare cysteine above represents the minimum value.

    The enthalpy is more or less the same of course with larger proteins. The enthalpy does change greatly however.

    So when you say “reversible” you are using this term in the loosest possible sense. You will not find in the literature anything that binds ionically to sulfhydryl groups stronger than mercury. Nothing. Mercury and sulfur are exemplary soft acid and soft bases of each other and their pi-electrons overlap perfectly, or about as perfect as any two atoms can.

    And on the topic of denaturing. This has nothing to do with how reversible the denaturing ions are. You can denature a protein, change the pH, and remove the denaturing ions. In most cases, the protein remains denatured although it can be reversed in certain cases.

    So your comment is essentially silly, because you say that only non-reversible bonds are capable of denaturing a protein. This is incorrect, and moreover, the sulfur-mercury bond is probably the strongest ionic bond in biology.

    Evaluation of the association of mercury(II) with some dicysteinyl tripeptides
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448868/

  106. #132 Niels
    January 30, 2017

    Mercury is certainly capable of disrupting disulfide bridges. If you doubt that, then I have a disulfide bridge over the Mersey to sell you.

  107. #133 Niels
    January 30, 2017

    Typo above. Meant entropy where I said enthalpy for the second time.

  108. #134 Poincaré
    January 30, 2017

    How can a vaccine be contaminated with milk proteins?

    Why would this be a problem? Wouldn’t the body’s protease enzymes eventually just degrade the nanomole amounts of casein anyway?

    I mean, even if it were true: is this something even worth considering?

    Maybe someone here can give us the plasma filtering rate and we can estimate the half-life of trace endogenous proteins and their effect on health. This seem inconsequential to me honestly.

    Is the the new anti-vaxx talking point? Milk proteins???

    This is bottom-of-the-barrel stuff here. Come on.

  109. #136 Julian Frost
    Gauteng North
    January 30, 2017

    Numerous vaccines are contaminated with cow’s milk proteins that are used as growth media for the bacteria.

    False. We had this discussion on a previous thread. You are going beyond the facts and drawing unwarranted and unlikely conclusions.

    • #137 vinu arumugham
      United States
      January 30, 2017

      I wrote:
      ” Numerous vaccines are contaminated with cow’s milk proteins that are used as growth media for the bacteria.”

      Julian Frost wrote:
      “False. ”

      http://www.jacionline.org/article/S0091-6749(11)00747-0/fulltext
      “We noted that these vaccines are labeled as being processed in medium containing casamino acids (derived from cow’s milk), raising the concern that residual casein in the vaccines might have triggered these reactions. “

  110. #138 Iggy McQuiggles
    January 30, 2017

    I can see egg protein, but milk?

    Where does milk enter the vaccine production process?

  111. #139 Poincaré
    January 30, 2017

    Chris said:

    Also, silly boy, “acute flaccid paralysis” is a symptom of many diseases. Not just the three serotypes of poliovirus.

    True. Acute flaccid paralysis is what happened to your husbands penis after you turned 37.

  112. #140 Orac
    January 30, 2017

    Looks like we had a dual Fendelsworth incursion. Sorry about that. It’s been handled for now. There might be one or two more. I’m keeping my eyes out.

  113. #141 Niels
    January 30, 2017

    I saw ORAC at the county fair. He was eating one of these: http://images.says.com/uploads/story_source/source_image/440954/a95f.jpg

  114. #142 Niels
    January 30, 2017

    I never saw him so happy.

  115. #143 Old Rockin' Dave
    January 30, 2017

    “My personal view is you should avoid WIFI equipment to reduce exposure to radiation.”
    You can reduce your exposure even more by wearing a hat made out of aluminum foil.

  116. #144 Michael Pyshnov
    Toronto
    January 30, 2017

    One thing I should comment on – genes. In the 80’s, as a PhD student (never got it; my research was stolen), I attended lectures of Prof. Siminovich on molecular mechanisms of diseases. Another student asked him: “What should I study to go to the cancer genetics?” Siminovich answered: “I already told you that we discovered cancer genes. Don’t bother to go to this area. By the time you finish your PhD, cancer will be beaten.”
    For some reasons known to me, mol. biol. miserably failed. They morphed into “omics” and then into fraud.

  117. #145 Chris
    January 30, 2017

    A true scientist would never say something so absolute. Especially since modern genetic sequencing has advanced so much further since the 1990s.

  118. #146 Julian Frost
    Gauteng North
    January 31, 2017

    raising the concern that residual casein in the vaccines might have triggered these reactions.

    1) “Raising the Concern” and “might have”. That’s conjecture, not hard evidence.
    2) That’s not “numerous”.
    Once again, you got a whole load of nothing.

  119. #147 ChrisBP
    January 31, 2017

    @vinu arumugham
    I have looked at the studies you used in previous comments. The one you “cite” the most (the one about the folate receptor antibody, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578948/) has this as an interesting little fact deep down in its discussion:

    Study limitations
    “This case series had several notable limitations, including a high male-to-female ratio (9:1), as compared with the more typical ratio for children with ASD of 4.5:167 or CFD of 2.5–3:1.2, 4, 5 In addition, both clinics included in this report primarily serve children with ASD who have persistent cognitive-behavioral deficits. This suggests that the samples may be subject to referral bias. Future studies are required to address whether a general ASD population also has an elevated FRA prevalence. Even if the presence of FRA is limited to a smaller subset of the ASD population than reported here, the significant response to leucovorin calcium in some children suggests that this in an important abnormality found in the ASD population that requires further study.

    This study was not a clinical trial and neither the physicians nor the parents were blinded to treatment. In additional, our controls were not given a placebo; hence, the magnitude of the placebo effect was not taken into account, and we used a subjective parental report rather than objective assessment measures. Double-blind, placebo-controlled studies are required to confirm and expand upon the findings of this case series.”

    So no, it’s not conclusive evidence for anything, in fact it states directly that biases might be affecting the study. It is also not a clinical study (although apparently in your mind they don’t work anyway). Other publications you cited have been critizised for not being thorough enough and being biased themselves. I don’t see “overwhelming evidence” from your side. On the other hand:
    http://www.sciencedirect.com/science/article/pii/S0264410X14006367?np=y&npKey=a18ae675c68358fe36e20f051512d6ff45760da76b5bf5ab27d47fd7898f1f09
    Multiple metastudies like this one have shown that there isn’t a connection between vaccines and autism. You are simply cherrypicking, something antivaxxers are very good at.

  120. #149 vinu arumugham
    United States
    February 3, 2017