More than a week has passed, and I thought that this cup had passed from me, and I was glad. After all, if I analyzed every crap study done by anti-vaccine zealots to try to demonstrate that vaccines cause autism, I would have time for little else in terms of other kinds of that Insolence you all know and love. This particular study was released in late May and, at the time, I wasn't really in the mood to take it on; so I ignored it. But then wouldn't you know that the Autism Action Network would have to go and send out a press release yesterday entitled New Study Links Vaccines and Autism: Let your Representatives know about this study:
We frequently hear in the corporate media about studies that claim to show no association between autism and vaccines. But when do you ever hear about the studies that do show an association? Well, here's one that was just published.
A study in the Journal of Toxicology and Environmental Health finds a relationship between the proportion of children who received the recommended vaccines by age 2 years and the prevalence of autism or speech or language impairment. The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of AUT or SLI. The results suggest that although mercury has been removed from many vaccines, the remaining mercury as well as other culprits such as aluminum and live viruses may link vaccines to autism. Further study into the relationship between vaccines and autism is warranted.
Damn. Just when I thought I was out (at least for a while, on vacation, so to speak), they pull me back in. After all, this study, not surprisingly, is showing up in all the usual anti-vaccine locations, including the home of Olmsted's band of merry antivaxers known as Age of Autism, where the study author herself, Gayle DeLong, actually promotes her own study. Not a good sign. Not a good sign at all about the scientific credibility of the author. Word to Gayle: If you want to keep even a semblance of scientific credibility, showing up on AoA to pimp your latest study is not a particularly good way to go about it. From one academic to another. Of course, not surprisingly also, DeLong is not a scientist; she is, rather, a faculty member in the Department of Economics and Finance in the Zicklin School of Business, Baruch College/City University of New York. As always, the fact that DeLong is clearly not a scientist doesn't necessarily mean that she is wrong (although it does increase the probability). Rather, her poor study design and biased presentation are far more likely to show that she is wrong. That's something this study has in spades, and somehow she managed to get her paper accepted to the Journal of Toxicology and Environmental Health, a journal I only vaguely remember having heard of:
A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population
Journal of Toxicology and Environmental Health, Part A: Current Issues
Volume 74, Issue 14, 2011, Pages 903 - 916
Author: Gayle DeLong
DOI: 10.1080/15287394.2011.573736
Abstract
The reason for the rapid rise of autism in the United States that began in the 1990s is a mystery. Although individuals probably have a genetic predisposition to develop autism, researchers suspect that one or more environmental triggers are also needed. One of those triggers might be the battery of vaccinations that young children receive. Using regression analysis and controlling for family income and ethnicity, the relationship between the proportion of children who received the recommended vaccines by age 2 years and the prevalence of autism (AUT) or speech or language impairment (SLI) in each U.S. state from 2001 and 2007 was determined. A positive and statistically significant relationship was found: The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of AUT or SLI. A 1% increase in vaccination was associated with an additional 680 children having AUT or SLI. Neither parental behavior nor access to care affected the results, since vaccination proportions were not significantly related (statistically) to any other disability or to the number of pediatricians in a U.S. state. The results suggest that although mercury has been removed from many vaccines, other culprits may link vaccines to autism. Further study into the relationship between vaccines and autism is warranted.
When the fallacy count in just the abstract alone is so high, this is another very bad sign. In fact, I could probably dismiss this paper as an utter waste of time just by deconstructing the abstract alone. Of course, as I almost always do I'll go farther than that, but I can't resist pointing out a bit of misinformation right in the abstract. For example, the reason for the rapid rise of autism in the U.S. is not really much of a "mystery." It's very likely the result of diagnostic substitution in the wake of the broadening of the diagnostic criteria for autism and autism spectrum disorders that occurred in the early to mid-1990s, as Paul Shattuck has shown. Oh, there may be a genuine increase in autism prevalence over the last 20 years (although even that is debatable), but, if it exists, it's so small that it's not even clear that there is one.
DeLong carries on this sort of misinformation right in the text of her paper, which an anti-vaccine commenter on AoA has kindly provided a link to, at least until the publisher finds out that she's flouting copyright laws. Here's one thing you should know about reading scientific papers. The introduction is where the authors try to "frame" the issue that led them to do the research and the hypothesis that derives from that issue in the most favorable way possible. To the knowledgeable reader or reviewer, a botched up introduction section that misrepresents the scientific consensus and the issues is almost always a sure sign that the science that follows will either (1) not support the authors' hypothesis or (2) be of such poor quality that it doesn't really support any hypothesis or even (3) cast doubt upon the authors' hypothesis, even though the authors spin it otherwise. In this paper, for instance, DeLong argues that there "are several reasons why vaccines may trigger autism," after which she lists a veritable laundry list of long-discredited anti-vaccine notions as to how vaccines can trigger autism, bringing up (naturally!) old anti-vaccine bogeymen like mercury and aluminum. Nowhere is it mentioned that this is not the scientific consensus; only one side is presented, the anti-vaccine side.
One way you can recognize a truly bad introduction to a research paper is by the quality of the research that is cited in it. In DeLong's case, the research cited is awful indeed, with citations to papers by the incredibly logorrheic (even more so than Orac) Mark "Not A Doctor, Not A Scientist" Blaxill, Mark and David Geier (otherwise known as the doctor with a suspended license and his son busted for practicing medicine without a license), all purpose crank Russell Blaylock (who counts HIV/AIDS denialism, antivax, and many other forms of quackery are all part of his repertoire), and Laura Hewitson's execrable "monkey business" research, which, I note, was also published in the very same journal that DeLong's study appears in. There's more, but these are just some of the examples, perhaps the most egregious of which is a reference by the anti-vaccine homeopath James Compton Burnett writing in 1884.
Then there's the design of the study itself. Jumpin' Jesus on a pogo stick, there's the design of the study itself! If this is the sort of research design that is considered acceptable and routine in economics and business, no wonder our economy's in such a mess. First (and most egregious), there's the issue of why DeLong combined SLIs (see abstract above) with autism diagnoses to do her analysis. DeLong appears to have used statistics that states are required to maintain under federal legislation, the Individuals with Disabilities Education Act (IDEA). Under IDEA, every school is required to provide data on children who have an Individual Education Plan (IEP), including the students' primary classification. As Liz Ditz pointed out, IDEA classifications are not medical diagnoses. A child with a diagnosis of autism under IDEA may or may not really have autism. Also, children with an IDEA classification of SLI are most commonly children with problems in fluency, articulation, or voice, not autism. Examples include apraxia and aphasias, voice disorders, stuttering, and language-based learning disabilities. It's not for nothing that James Laidler characterized IDEA data as not being a reliable measure that can be used to track autism prevalence accurately.
Naturally, DeLong cites papers to justify lumping together SLIs and autism for purposes of her analysis. Also, naturally, they do not support her hypothesis. These are the three papers cited:
- Conti-Ramsden et al. (2006). The prevalence of autistic spectrum disorders in adolescents with a history of specific language impairment (SLI). J Child Psychol Psychiatry. Jun;47(6):621-8.. This paper concluded that "the prevalence of autism spectrum disorders in young people with SLI was found to be 3.9%, about 10 times what would be expected from the general population. In addition, a much larger number of young people with a history of SLI showed only some autism spectrum symptoms or showed them in a mild form." Let's put it this way. This paper still does not justify lumping SLIs in with autism because the vast majority of children with SLIs do not have autism. At most, the authors found that a quarter of children with SLI demonstrate behaviors that might indicate an ASD.
- De Fosse et al (2004). Language-association cortex asymmetry in autism and specific language impairment. Ann. Neurol. 56 , pp. 757-766. This paper deals with specific language impairment. This is not the same thing as the broad IDEA category of speech/language impairment. Admittedly, they do have the same abbreviation, though; so maybe DeLong thought they were the same thing. It's obvious that none of the reviewers noticed this, or, if they did bother to look at the references, were as clueless as DeLong was. You would think that reviewers would look at the abstracts of key references used to justify lumping together data from different conditions the way that DeLong did, particularly when the conditions are not obviously related. Apparently, you would be wrong.
- Herbert et al (2007). Altered brain wave activity in persons with chronic spinal cord injury. Int J Neurosci. 2007 Dec;117(12):1731-46. This paper has nothing to do with autism or even much to do with SLI. Did DeLong even read her own references? Or even read the abstracts from her own references?
I'm left with the not-so-sneaking suspicion that the only reason that SLIs were lumped together with autism and ASDs for purposes of correlation with the percentage of children in each state receiving their full vaccine schedule is because the numbers somehow worked out. Otherwise, DeLong's looking at mostly unrelated phenomena that have some degree of overlap. Certainly there appears to be no valid scientific or medical justification for combining the data from the IDEA classifications of SLI and autism.
Then there's the methodology chosen for trying to find correlations, described here:
Children who are vaccinated at age 2 years may not develop autism until they are older. To determine the prevalence of autism for a specific cohort of children, the vaccination data from when the children were 2 years old is compared with autism prevalence when they are 8 years old. The relevant vaccination data for children who were 8 years old in 2001 are those from 1995, when the children were 2 years old. For children who turned 8 years old in 2002, the relevant vaccination data are from 1996, and so on. The earliest available data--vaccination data from 1995--were matched with autism prevalence up to 2007.
Besides DeLong's having fallen for the ecological fallacy (group level comparisons rather than individual-level comparisons), she doesn't provide much in the way of a good justification for why she chose ages 2 and 8 as their vaccine time point and prevalence time point. Then there's the issue of confounders. DeLong tried to control for ethnicity, but in explicably she used the CDC's National Immunization Survey rather than, say, U.S. Census data to derive ethnicity figures. Other potential confounders examined included family income, other disabilities, and the number of pediatricians in each state. Of course, states range in size from small to very large, and it can easily be argued that state level data are not "fine" enough to be used for this purpose. After all, many states are quite large, with huge differences in urbanicity. Think, for instance, California, with several large cities separated by huge swaths of rural and mountainous land. Or think Pennsylvania, which is in essence a 360 mile wide state with two very large cities, one east and one west, and several medium-sized cities clustered mostly in the east, all separated by miles upon miles of farm land or mountains. Urbanicity, as you might recall, can have a huge effect on the number of autism diagnoses, as I discussed three years ago. Naturally, DeLong made no attempt to control for urbanicity.
In other words, there's no reason to put any real credence in this study, especially given how small the observed effect appears to be.
After reading this study, I'm left wondering why on earth DeLong did it. After all, most of her papers appear to have to do with banking, the FDIC, and financial risk taking. Why did she embarrass herself so by moving out of her specialty and producing such a craptacular study? (This leaves aside why the Journal of Toxicology and Environmental Health journal has such craptacular peer review that it actually accepted this study for publication.) After all, I would never think of trying to do a paper on economics or business and expect it to be accepted to a journal in the relevant academic discipline. (As Dirty Harry Callahan once said, "A man's got to know his limitations," and I do, for the most part, know my limitations.) One clue comes from the fact that it is DeLong herself who signed her name to the AoA post pimping her study. The second clue comes from her saying about Jake Crosby in a comment at AoA:
Jake,
You are indeed an inspiration. We're delighted you are putting your many talents to very good use.
OK, so DeLong's not a very good judge of character or talent.
The third and final clue comes from the observation that DeLong is on the Executive Board of the anti-vaccine group SafeMinds and is described there thusly:
Dr. Gayle DeLong is a parent of two girls with autism. Starting in May 2005, her family began biomedical interventions to treat the girls' illness. Both girls have benefited greatly from supplements, diet, chelation, and hyperbaric oxygen therapy. Gayle holds a Ph.D. in international business and finance from New York University as well as an International Master's in Business Administration from the University of South Carolina. She teaches international finance at Baruch College, City University of New York. She serves on SafeMind's research committee. She has attended rallies in Washington, DC to promote safer vaccines and spoken against adding vaccines to New Jersey's mandated schedule at a public hearing in Trenton, NJ. She lives with her husband and two daughters in Morristown, NJ.
And there you go. Like Laura Hewitson, an academic with an autistic child whose belief in biomedical woo led her to destroy her scientific career, DeLong has tarnished her own reputation and publication record by letting her belief in the scientifically discredited idea that vaccines cause autism lead her "down the rabbit hole" of pseudoscience. All she's managed to do for all her effort is to produce another poor quality paper to which anti-vaccine zealots will point as "evidence" that vaccines cause autism. While she is lauded by pseudoscience supporters, DeLong's article will, in the scientific community, fade into the oblivion it so richly deserves.
REFERENCE:
Delong G (2011). A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population. Journal of toxicology and environmental health. Part A, 74 (14), 903-16 PMID: 21623535
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OT blogwhoring and all that - but if there is anything you can add to this:
http://blogs.timeslive.co.za/expensive/2011/06/08/the-castro-hlongwane-…
I'd be incredibly happy - I am a journalist, not a scientist, so I hope I am making decent arguments against the Hlogwane document.
The effect size is what really shoots the paper in the foot, a 2% effect size is useless for propaganda purposes.
The effect size doesn't matter, 0.000001% would do to say that vaccinated children are diagnosed with autism more often than non-vaccinated. If the effect appears large they quote the figures, if not they just say it's a link.
Hmmm, my three year old gets speech therapy, does that mean I'm now a qualified "on the spectrum (Delong 2011)" parent for the purpose of internet forum arguments?
researchers suspect that one or more environmental triggers are also needed
[citation required].
Just from the information in the abstract, I did this same analysis a while back. It's a simple ecological association. It's true that if you try to naively associate proportion of children vaccinated in a state vs. administrative prevalence of autism, then you'll see a trend (even a statistically significant one.) Rural states tend to have lower vaccination rates, and they also have a lower administrative prevalence of autism. But once you control for some real confounding variables (e.g. # of doctors per surface area) the association goes away, as I recall.
The effect size is what really shoots the paper in the foot
The foot-bullet issue for me is that the paper is studying the prevalence of speech / language impairment -- of which the vast majority are not autistic -- while the title claims to be about autism.
herr doktor,
While it may be true that the vast majority of speech/language impaired kids studied are not autistic today, we've seen that the autism label can be expanded to include all manner of previously differentiated conditions. I suspect this researcher could further widen the ASD umbrella if it helped her further her cause. Science does not enter into that decision or any other in this paper seemingly.
Both of my daughters had IEPs briefly because of stuttering and lisping (the school demanded they have speech therapy; neither my pediatrician nor my husband and I felt it was necessary). But we were not allowed to refuse the services, at least for the first year, until our pediatrician got more involved. So I guess vaccines DO cause SLIs.
No, actually, I believe the school's desire for additional funding caused IEP need. Autism was not a common diagnosis then, but there were a lot of kids in speech therapy!
"A 1% increase in vaccination was associated with an additional 680 children having AUT or SLI."
680 out of how many? Out of a million? Out of a billion? I hate numbers that just appear with no connection to anything. I couldn't find any justification for that number in the (copyright-violating) copy of the paper.
Ugh, I think I am going to have to start trying to maintain a list of poor quality papers annotated with the paper's flaws and problems. I know this stuff will show up time and time again on various people's lists of papers that prove a link and my brain is too cluttered to remember them all.
@Travis
A list like that would be useful for people to reference, especially if it also included links to other people's critiques of the studies, as well.
There are many things I would ask. After all, people at good 'ol A of A like to pretend those with Aspergers don't exist, lest of course, you happen to be Jake Crosby. Through out what you quoted, not once did I see in this study the term "autism spectrum disorder" only autism. Alright, maybe I misread. She included those with speech/language impairments.
Still, since the mid-ninties, since Aspergers Syndrome and PDD-NOS have entered under the autism umbrella (forgive horrible spelling) there has been an increase in those recieving a autism spectrum disorder diagnoses. Since the awareness campaigns also seemed to have kicked into gear around the same time, I would say that also has played a vital role in increased diagnoses. Not to mention the fact that Aspergers seems to have taken the over the role of ADD/ADHD for being a trend diagnoses. There may be many who are getting misdiagnosed, just as many were misdiagnosed (I being one of them) with ADD in the early ninties.
I do tire of bogus studies being used to freak people out about autism, and also of autism being treated like the new Black Death! It is in most cases not a death sentence, not even for those who are on the other side of the spectrum from where I am. Who are we to determine whether or not they are happy? One of the most happiest people I happen to know has classic Kanner's. She was one of those who as the A of A ers would put it, smeared feces on the walls when younger.
That young woman, after much work and sacrifice lives on her own. She cleans her own house, cooks her own food, pays her own bills with an efficency that many should envy. Ok, that bit of the rant is over. Just nothing quite sets back people with autism getting treating like human beings more than the anti-vax movement and their absolute insistence that we are incapeable of ever doing anything, and if we are capeable, we are not autistic.
Todd W.
I was looking for a little something to do over the summer. I mean, finishing my masters might be a good idea as well, but I guess I can try to start putting together such a reference.
Orac,
I'm glad you had a chance to look at this study; not many besides the "vaccine-injury" groups had besides Neurocritic; I looked at it briefly in the post linked to in my name; in addition to her role on SafeMind's board is the fact that she's a petitioner in the NVIC.
The anti-vaccine movement (oops, pro-safe vaccines movement) continually complains about conflicts of interest in studies showing no link. The fact that she's on SafeMinds board and filing a lawsuit claiming vaccine injury is highly relevant. The fact that she ends the paper trying to implicate aluminum for autism is just another indicator.
It is interesting that DeLong had to lump SLI with autism to even come up with an anemic association with vaccination. This strongly suggests that when autism (already an over-broad category in IDEA) is examined in isolation, no such association is found (as has been shown by numerous other studies).
What is it with the business people (and economists) who think that they understand science better than people who have done it all their adult lives? I certainly wouldn't assume that my extensive science background would make me an "instant expert" in economics or business, yet they seem undaunted by the vast gulf between their education (and experience) and the task to which they have set themselves. Dunning and Kruger are proved right again and again.
Also, is it just me or has the Journal of Toxicology and Environmental Health become a safe haven for all sorts of autism crankery?
Prometheus
Pity you guys dont critique the Danish study sponsored by the vaccine manufacturer SSI and in part run by Poul Thorsen in the same way . That study of course , flawed as it was , says vaccines are 100% safe and not related to autism .
That study is cited by the Bad Science guru himself , Ben Goldigger , and Poul Thorsen is now wanted by interpol for theft of $2M .SSI are still beavering away making vaccine poisons and destroying kids .
@Simpson Wood - if you used the search function here, you would see that particular study was discussed in detail.
ahaha a Thorsen reference by an uneducated crank. These people keep flaring up like herpes. Not that I would know. Added bonus that Simpson Wood doesn't know how to use punctuation properly.
Anyhow, Mr. Wood, perhaps you can try and focus on the topic at hand, which is this train wreck. You can use the search bar (up and to the left) to look up Thorsen. In particular I suggest you read comments by people such as myself explaining why it is idiotic to refer to it as the Thorsen study.
@Simpson Wood
Couple questions for you:
1) Exactly which part(s) of the Danish study were "run" by Poul Thorsen?
2) What were the specific flaws of the study?
3) What does Thorsen's alleged embezzlement have to do with a study that occurred before the money was even granted for Thorsen's later project?
A few phrases set off bells and whistles: "corporate media", "further study", "environmental triggers", Blaylock, Jake as "inspiration", "rallies in Washington and Trenton", business/ finance major, kids benefit from " supplements, diet, chelation, HBOT"...
( takes off reading glasses) You know, when you've been in this business as long as I have, things people do or say can make you *very* suspicious:
Much here appears as though lifted from Mssrs ( and I use the term loosely) Adams and Null: web woo-meisters are intently creating an alternate universe of "research", "studies", and "data" to suit their own particularly bizarre understanding of the life sciences ( and social sciences are next! Woo hoo!), via an alternate media.
This is presented to the audience as "science" which is "independent" ( Hah!) of "corporatist" interests . Any linkage to pharma, the AMA and similar, the government, universities ( except when they can be used for advantageous bragging) renders research invalid: thus, a researcher who belongs to the AMA/ similar, teaches in a university, and has worked on a governmental project would be triply accursed and cast out from consideration by the blessed ( guess who that includes?).
How do we combat misinformation of this scope? Remember this stuff "gets around" ( as we have witnessed recently @ RI with the infamously transforming "iatrogenic death" figures). Because our woo-meisters are primarily salemen, they are masterful at delivering sound-bites, testimonials, ads, and expert slogan-eering. Most of their audience is not proficient at differentiating decent vs indecent research. (They think that Andy is OK.) These groups are inter-related and cross-reference each other incestuously. The science we would all hope to achieve can not be explained in a few sentences or an essay by Jake: it takes time and years.
My own method involves inviting the public to peer into the motivational mechanisms of activists: what makes people believe in and preach unrealistic notions like A-V? Personal monetary gain ( something to sell), grasping at fame, or avoiding stigma/ shifting blame to external causes are all possiblities. I would like to provoke the same suspicions in others that I experience all the time. It isn't comforting but it eventually seems to pan out as a first step.
I just love the way the anti-vax crowd preface everything with "tell your representative!" to circumvent science through courts and congress and cherry pick the odd study out that supports their claims. Which it does because it's rubbish made to reach those conclusions. Reminds me of kids fighting in the back of a car. If you don't like what the science says, throw a fit and run to your government to pass your beliefs into law.
Looking at the AoA linked article, I don't see references. Did the submitter reproduce the paper by copy + paste and omit the references? I guess the target audience wouldn't be interested in something like that.
A few phrases set off bells and whistles: "corporate media", "further study", "environmental triggers", Blaylock, Jake as "inspiration", "rallies in Washington and Trenton", business/ finance major, kids benefit from " supplements, diet, chelation, HBOT"...
( takes off reading glasses) You know, when you've been in this business as long as I have, things people do or say can make you *very* suspicious:
Much here appears as though lifted from Mssrs ( and I use the term loosely) Adams and Null: web woo-meisters are intently creating an alternate universe of "research", "studies", and "data" to suit their own particularly bizarre understanding of the life sciences ( and social sciences are next! Woo hoo!), via an alternate media.
This is presented to the audience as "science" which is "independent" ( Hah!) of "corporatist" interests . Any linkage to pharma, the AMA and similar, the government, universities ( except when they can be used for advantageous bragging) renders research invalid: thus, a researcher who belongs to the AMA/ similar, teaches in a university, and has worked on a governmental project would be triply accursed and cast out from consideration by the blessed ( guess who that includes?).
How do we combat misinformation of this scope? Remember this stuff "gets around" ( as we have witnessed recently @ RI with the infamously transforming "iatrogenic death" figures). Because our woo-meisters are primarily salemen, they are masterful at delivering sound-bites, testimonials, ads, and expert slogan-eering. Most of their audience is not proficient at differentiating decent vs indecent research. (They think that Andy is OK.) These groups are inter-related and cross-reference each other incestuously. The science we would all hope to achieve can not be explained in a few sentences or an essay by Jake: it takes time and years.
My own method involves inviting the public to peer into the motivational mechanisms of activists: what makes people believe in and preach unrealistic notions like A-V? Personal monetary gain ( something to sell), grasping at fame, or avoiding stigma/ shifting blame to external causes are all possiblities. I would like to provoke the same suspicions in others that I experience all the time. It isn't comforting but it eventually seems to pan out as a first step.
Sorry about that double: one was supposed to be "error"!
Cranks attract cranks. Seth Mnoonkin reports Wakefield is speaking at a conference of 9/11 Truthers. Just how low can he go?
Of note, Neuroskeptic has done a very nice takedown of this study's design:
http://neuroskeptic.blogspot.com/2011/05/vaccines-cause-autism-until-yo…
@ Simpson Wood:
I'll add a #4 to Todd's list:
4) Please provide the appropriate citation and quotation indicating that the study to which Thorsen was a minor contributor "says vaccines are 100% safe".
That's always a lie, since nobody actually does say that.
Ridiculous. If a study came out showing kids who are "gifted" or high scoring were correlated with being vaccinated would they line up to get vaccinated? of course not, so why are they always pushing correlations when they wouldn't accept it at the other end of the spectrum?
"Summon your representative". Do they mean Rep. Weiner? Congress is, as PJ O'Rourke so aptly put it, a parliament of whores. Funny, it was the U.S. Congress which created the vaccine court. They want to have it both ways based on pseudoscience, hoping that emotions overrule facts. But, autistic children, I guess, are more important in their eyes than dead ones.Also, who cares how the autistic are treated and integrated- it's all about their vendetta. Sheesh..
"The author is grateful to ... seminar participants at Baruch College and two anonymous reviewers for thoughtful comments."
The hell? Good thing the journal isn't a signatory to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.
@simpson wood
Citation please for your accusations?
(Not that I am expecting any, you seem to be a hit and run troll)
About the paper, I had the chance to scan through it a bit.
I had to stop halfway, it was just too painful and headache-inducing for me to read.
Allow me to provide some citations on behalf of poster Simpson Wood, viewable on the internet by keying in:
Simpsonwood Meeting on Mercury and Puerto Rico Meeting on Aluminum
After you read this drivel, go to the "home" page for more drivel on Alzheimer Disease, Big Pharma, Government Conspiracies......
One thing to notice (amongst many): vaccination rates are defined as those who get the full 1995 schedule vs. those who miss one or more of the vaccines.
They first study year is 1995, the year the new schedule came out. Not surprisingly, the "vaccination rate" climbs the first two years, as states and pediatricians adopt the new schedule.
What is surprising to me is that if you look at just the first two years of their data (table 1), you will see that there is no corresponding increase in autism/SLI rate. It's a simple consistency check--surely the biggest increases in vaccine rates would result in a noticeable increase in the autism/SLI rate.
My favorite part is the data itself. If you look at each state individually, it is obvious that there is no correlation. Vaccination rates go up and down, presumably reflecting political pushes, and autism rates either stay stable or occasionally trend upward. Here are just the first two:
U.S. state 1995 2001 1996 2002 1997 2003 1998 2004 1999 2005 2000 2006 2001 2007
Alabama 45.8 4.6 65.2 4.4 76.5 4.4 74.2 4.5 74.1 4.7 76.1 4.6 79.1 4.5
Alaska 54.3 5.8 67.2 5.1 68.8 5.5 74.1 6.0 74.5 4.8 70.6 5.0 71.2 4.8
The first number is vax rate, the second autism/SLI prevalence six years later.
Many of the Big Pharma-sponsored studies I've read have incredible logical fallacies, usually dancing skillfully around the fact that they really didn't study the question at issue at all ("We studied dolphins for five years, and we found NO EVIDENCE that lions eat people" - technically true but logically absurd.) If there are errors in her methodology, by all means point those out, but to bash DeLong purely because she raises the issue is exactly what gives her argument credence.
Dad:
Oh, please do share which "Big Pharma" sponsored studies on vaccines are so terrible, be sure to link to a critique by someone who is qualified. And really be sure that "Big Pharma" actually funded the studies, and not the American National Institute of Health or the UK National Health Service.
I suggest you read what Orac more carefully. He did go deeply in the methodological flaws, the biggest being calling all those kids with Specific Language Impairments, SLI, autistic. Trust me they are not all autistic. My younger son did receive language therapy for a language delay (a form of dysphasia, which is a very very mild form of developmental aphasia), but he graduated from that therapy and was a regular ed. student, and did graduate from high school as an honor student. He has never been autistic.
Gotta love the Autism Action Network's contemptuous reference to the "corporate media".
The news media were terrific when many of its members were happily regurgitating antivax claims, while giving equal time to experts in the field and the likes of Jenny McCarthy. Now that a relentless onslaught of evidence refuting antivax claims and the Wakefield case have opened reporters/editors' eyes, the media has been demoted to whipping boy.
"Many of the Big Pharma-sponsored studies I've read have incredible logical fallacies, usually dancing skillfully around the fact that they really didn't study the question at issue at all ("We studied dolphins for five years, and we found NO EVIDENCE that lions eat people" - technically true but logically absurd.)
Any examples (hopefully having something to do with vaccines and autism)?
"If there are errors in her methodology, by all means point those out, but to bash DeLong purely because she raises the issue is exactly what gives her argument credence."
Errors pointed out - yes.
Bashing DeLong purely for raising the issue - haven't seen it.
Speaking of irony, citing Orac and others for supposedly beating on poor Ms. DeLong for "raising the issue" and then claiming that somehow gives her argument credence, is one hell of a logical fallacy.
@Dad: you obviously didn't read the original post or you would have seen that Orac points out the errors in methodology and the fallacies in the introduction. Try commenting again after you read the FULL post.
@Dad
Citation showing Pharma fallicies?
DeLong used inappropriate data to reach inappropriate conclusions. She publishes to her audience, not science.
Dad, much like Simpson Wood above you claim logical fallacies or flaws but you do not actually cite a single paper or describe any of the specific instances of these fallacies. Can you at least give a few examples?
Why does someone getting bashed give their argument any sort of credence? Even if people did bash her simply because of the point she raised it would not make her arguments more right or wrong. But luckily no one is doing that. This article, and others, have pointed out plenty of specific things to complain about that have nothing to do with the author themselves but the shoddiness of the work.
@ Dad:
Let's also note that "raising the issue" is pretty much like "raising the issue" of whether the Earth is round or flat. In other words, raising it demonstrates that the person doing so hasn't the faintest clue.
"Dad" (not my Dad - he knows better) claims:
As so many others have asked, I'd also appreciate a concrete example of a study where this sort of "fallacy" was in evidence. Just one example, with an explanation of why "Dad" thought they didn't "study the question at issue".
I suspect that what "Dad" is objecting to is that nobody has found the results he expects, not that they haven't studied the "issue". Or, possibly, he's complaining that nobody has studied the "issue" in the way he thinks is appropriate (e.g. a "vaccinated vs unvaccinated" study). Either way, if "Dad" isn't satisfied, it's not because the research was "flawed" or fallacious, it's because "Dad" doesn't like the answer.
Strangely enough, the studies that meet "Dad's" definition of studying dolphins and opining about lions are those studies that claim to find a connection between vaccines and autism. For example, studies that found a high oxidised:reduced glutathione ratio in the plasma (or serum) and claimed that this indicated autistic children had "oxidative stress" from their vaccines.
Or - just picking an example at random - a study that compares a steady rise in administrative autism prevalence (lasting nearly thirty years) and an abrupt rise in vaccine "compliance" after a change in vaccination schedule (lasting 2 - 3 years) and claims that increasing vaccination leads to increasing autism.
So, I'll be waiting eagerly for "Dad" to provide an example, but I won't be holding my breath. I don't look good in blue.
Prometheus
Ya know, my younger sister had a speech impediment, she couldn't say the R sound properly and literally talked like Elmer Fudd. She didn't have autism, wasn't vaccinated so that couldn't have been a factor and it wasn't even a genetic SLI but brain damage from when she nearly strangled to death when she was a year and a half. She had speech classes in elementary school, but they ended after that when she didn't improve. She did eventually out grow it as now it's nearly impossible to tell she ever had a problem. My guess though, given that she was receiving speech therapy in school, if she was still in school of course, is she would have been included in this study because she had an EIP. She didn't have vaccines though so maybe she wouldn't have been selected as it would have been a mark against the results they were trying to achieve. How much of the data wasn't blind data but was hand picked to make the point?
Why do the anti-vax people have to include other, non-related issues when doing studies about autism and ASDs? Why can't autism and ASDs stand alone to prove their point? Well, because they simply don't prove their point, that's why...
Due to the bashing Dad has received I suppose we should now give their claims credence despite the lack of evidence in their post.
As an economist working in the same field (banking and finance) as Ms. DeLong, I am embarrassed for her and our profession. She should stick to studying areas where she has some comparative advantage. I thought the same thing a couple of years ago when a several economists published a study showing a link between watching TV and autism. IIRC, that study was bogus too.
This is only tangentially related in that it has to do with recent Autism news. Apparently a new study boosts the idea that the disease is genetic. I was looking for coverage of this on science blogs.
My big question is this: the media seems to want to simplify autism to one specific genetic state. There always seems to be the assumption that a couple of mutations will cause the disease consistently and that B(autism) implies A(a specific set of genetic mutations. This seems to be a logical falacy. Since autism is a diagnosis on phenotype, ie. a person behaves a specific way that we have established as a pattern (and given the pattern a name), we should make no assumptions that underneath that phenotype is always the same mechanism. The result that "it's complicated" given in the coverage of these papers should be expected. Afterall, if you see an amputee, you don't say "oh, he must have had a staph infection." There are lots of reasons you might need to have your leg cut off.
I would not be surprised if there were many genetic pathways to the same symptoms, especially with mental disorders since most of these are diagnosed exclusively on phenotype.
In this case, the result "there are tons of genes that might have a role in autism" is totally expected.
I required a couple of years of speech therapy for a stuttering problem, and I'm certainly not autistic either.
Some people receive speech therapy at school because the teachers think they have a weird accent. Or so I hear from a friend.
usually dancing skillfully around the fact that they really didn't study the question at issue at all ("We studied dolphins for five years, and we found NO EVIDENCE that lions eat people" - technically true but logically absurd.) If there are errors in her methodology, by all means point those out
Amusing, then, that a glaring error in DeLong's paper is precisely that it "didn't study the question at issue at all". In Dad's analogy, it is as if she studied shark attacks for five years and concluded that dolphins kill people (because an unknown proportion of those sharks might have been misidentified dolphins).
@ Prometheus
I think I can answer for Dad and say "all of them". Clearly there were logical fallacies in just about every study ever done, because they all came to conclusions counter to Dad's beliefs.
So clearly I did not need to go beyond my MBA and get those pesky psych graduate degrees, I could have just done my own 'research' and never mind learning how to conduct proper research.
Good grief. Just absolutely boggles the mind.
OK, Dad @35
So, because someone has pointed out that her argument is weak, including detailing exactly how itâs weak, that makes her argument stronger?
I just don't get it.
I've been slumming again...at Age of Autism. Of particular interest is today's lead story "An Honorary Medical Degree for Autism Parents"
The story is a hatchet job about Autism Speaks and its founders Bob and Suzanne Wright...and a good deal of animosity for this foundation, endowed by the Wrights...which has become a major force for reliable information about autism.
I also thoroughly read the May 26th article entitled "The Facts and Fiction of Autism Research"...authored by Katie Wright, the parent of the grandchild that inspired the Wrights to form their foundation. IMO opinion, Katie is a mindless twit/tool of J. B. Handley, but I give her points for "getting it."
Katie's article...her usual rant-type...takes off on the work of the IACC (Interagency Autism Coordinating Counsel) and their agenda for studies that do not fit into the agenda of Age of Autism. She also did some PubMed searches for recent studies...few of which have anything to do with environmental causes of autism.
"Getting it" for Katie means that the majority of the recent studies and proposed studies funded by Autism Speaks and the IACC are research topics such as genetics, subtle brain anomalies seen on MRIs, maternal and paternal age at time of conception, IVF procedures that result in high order births, co-morbidities in older mothers, alcohol intake, drug intake during pregnancy (street and prescribed) and premature births. She also realizes that "environmental studies" for the most part investigate the prenatal environment and its impact on the developing fetus.
There's a lot of anger over at Age of Autism because they no longer can influence politicians and set the agenda for autism research. I am delighted.
Anglachel,
Thanks for putting into words what's been on my mind for a while. The anti vaccine movement, as well as being scientifically baseless, promotes a horrible view of autism. People with ASD need to learn how to adapt to the non ASD world and the non ASD world needs to meet them halfway.
I'm guessing/hoping that DeLong funded her own study, because if I find out Autism Speaks or some other venue funded it, I'm going to be really steamed.
Interesting new study out this month:
http://stm.sciencemag.org/content/3/86/86ra49.abstract
It looks preliminary and I'm not sure I like their overreach towards assigning protein interaction with all of ASD by studying only a portion of the spectrum, but it might be interesting.
And now because of Orac and SBM the only thing I can think of while reading them is "how do vaccines play into this research?" Or maybe I'm just trying to understand how the fools at AoA would view it.
Thanks for the shout-out, Orac, but the link on my name really should be to Neuroskeptic or Vaccines Cause Autism, Until You Look at the Data
Dear KWombles:
I believe the correct terminology is the movement for the advancement and spread of vaccine-preventable disease (MASVPD).
Did you click on the link? :-)
I did...I just thought that Neuroskeptic rather than I should get the Googlejuice.
In other news, I think Travis's idea is really useful.
Anybody want to pitch in?
This is great, have you seen it?
http://www.sciencedaily.com/releases/2011/06/110608122543.htm
Good idea, Travis and Liz!
An additional consideration: anti-vaxxers raucously call out SBM's COI's: Big Pharma, AMA, government sponsorship, corporately-controlled university research,ad nauseum...
However, wouldn't it be fun to point out the anti-vax faves' own COI's-
obviously Wakefield- single vax patent/ lawyers;
AoA- supplement manufacturers, compounders, "treatment" providers, selling books, lawyer enablement
Legal providers- at your service
Woo-meisters- websites selling supplements, books, treatments. When they write or talk vax, numbers go up on sites or on shows... or else they wouldn't repeat it so much!
Although they would want us to believe they're doing it out of the kindness of their hearts, concern for the children or the "Truth": it's all about the Benjamins!
When I was going to elementary school I had to take speech therapy because I had difficulty pronouncing "sh" and "r" sounds; had nothing to do with autism.
@Dangerous Bacon:
Well, obviously the Big Pharma bureaucracy works slowly, and it took them a while to get around to bribing the media.
Homeopathic Logic of Arguments: the weaker (more diluted) the argument, the stronger it is.
I wish my bank balance worked that way.
My daughter's not autistic, but she was born 3 months premature and didn't say her first words until she was 19 months old. She graduated from speech therapy at age 3 and now she won't stop talking (yay!). It irkes me that her stats would be used to "make a case" (albiet a poor one) against vaccination. She is fully vaxed, including flu vaxes and RSV shots during her first two winters. She has yet to catch a VPD and here's to hoping she never does!
To give Dad the faint amount of credit he deserves for the tiny bit that he did get right - there is some sense to the idea that bashing a study for something other than actual flaws in the study provides inductive support for the study's quality. Â If we can take for granted the following premises:
1. Commenter X hates the conclusions of study Y and will attack it in the most devastating way they can manage;
2. It is more devastating to reveal actual flaws in a study than it is to target peripheral or irrelevant matters;
3. Commenter X has targeted only peripheral and irrelevant matters concerning study Y;
they lead logically to the conclusion that commenter X could not find actual flaws in the study. Â It is not deductive proof that such flaws do not exist, of course, but when someone fully motivated to find such flaws cannot, it does inductively suggest the study's quality to be high. Â When AoA cultists attack Brian Deer for not being a parent of a child with autism, or for supposedly being the 'complainant' in the Wakefield case (which of course he isn't), or for supposedly having a vendetta against Wakefield, don't we take that as an indication that, try as they might, they cannot actually refute any of Deer's evidence?
It's too bad for Dad, of course, that even though the principle of his argument may be partially valid (for inductive rather than deductive logic) his premises are in this case completely false. Â DeLong was not "bashed ... purely because she raises the issue", as anyone with reading comprehension could tell; she was bashed because her methodology is grossly flawed. Â It's a pitiful irony that Dad even spells out a fallacy that must reflect poorly on anyone trying to employ it and completely ignores that it is one of the ones that DeLong herself employed. Â She tries to say she studied the question of why autism rates went up, but what she actually measured was rates of autism with problems other than autism added in for no good reason! Â What, is that how you think science should be done, Dad? Â "We tried to figure out whether warmer currents could be causing a rise in the dolphin population, so we decided to add together dolphins and seahorses for no good reason and call them all 'dolphins' and try to correlate water temperatures with the numbers of 'dolphins.'" That's the sort of thing you think is entirely legitimate to do, Dad - that is, for anyone except Big Pharma to do?
Add me to the list of people who were in speech therapy but not autistic - I had speech therapy from the age of 3 all the way through 5th grade. When I started I couldn't form hardly any of my letter sounds right; when I finished the only real problem was that I talked too fast. So, it worked, and I am a huge cheerleader of speech therapy. They wanted me to start it up again in 8th grade to learn to talk slower but I said no way, I'd had enough. Instead I made myself do theatre and debate team to force myself to slow down and not be embarassed about my speech. Now when I tell people I was in speech therapy for all those years they don't believe it (although people still tell me to slow down when I talk).
My dad taught special needs children all through my childhood; so I'm pretty sure if there was an intellectual disability or autism he would've picked it up and made sure it was treated. Nope - In my case, just a series of early childhood ear infections that affected my hearing and, in turn, affected my speech development.
dude, I didn't even successfully complete speech therapy, but instead dropped out in seventh grade! (my adult self with virtually permanent residual deficits would like to smack my younger self upside the head). And while I may be many, many things I am not autistic. I was fully vaccinated, however. Could it be that the genes that cause speech sound disorders cross over with the genes that cause parents to take reasonable action to protect their kids from polio?
My brother quite possibly will be one of the 5% of kids who loose their PDD diagnosis. This may happen purely due to the nature of the DSM, not because he all of a sudden won a ticket on the typicially developing train. A kid can go from stacking and lining up toys all day, having very limited and echolaic speech, and making no eye contact to being near indistinguishable to an untrained individual.
dude, I didn't even successfully complete speech therapy, but instead dropped out in seventh grade! (my adult self with virtually permanent residual deficits would like to smack my younger self upside the head). And while I may be many, many things I am not autistic. I was fully vaccinated, however. Could it be that the genes that cause speech sound disorders cross over with the genes that cause parents to take reasonable action to protect their kids from polio?
My brother quite possibly will be one of the 5% of kids who loose their PDD diagnosis. This may happen purely due to the nature of the DSM, not because he all of a sudden won a ticket on the typicially developing train. A kid can go from stacking and lining up toys all day, having very limited and echolaic speech, and making no eye contact to being near indistinguishable to an untrained individual. I would imagine a lot of kids who are considered cured by biomed interventions are like my brother, and would have improved with even minimal intervention.
Having said that, appearing normal but strange and being one criteria short of an autism spectrum disorder according to the dsm-v diagnosis does not a typical child make.
Isn't this whole thing straight out of How to Lie with Statistics? You want to show that X is correlated with Y, but you can't demonstrate this directly, because it isn't. So you hunt around for a Z which sounds vaguely X-ish to the layman, and which is correlated (more or less) with Y. You'll probably be able to turn up something suitable, if only from pure coincidence, especially if you're a bit creative with how you measure correlation. Then you simply act as if X and Z were equivalent and trust your audience not to notice the difference.
tamakazura, I'd like to reassure you that whatever impression you get from the media, autism researchers do not believe that all autism has a single cause. Indeed, the consensus in the field is that while there is overwhelming evidence that autism is mostly, perhaps entirely, genetic, if there were a single gene, or even a small number, responsible for most autism, it/they would already have been found. The hypotheses being considered are "bad" combinations of common gene variants which individually have only small effects, or else numerous rare gene variants. The two best establishsed genetic causes of autism--Rett Syndrome and Fragile X--fall into the latter category.
And people forget that Autism isn't a single, easily identifiable diagnosis (like measles, mumps or even things like Downs or MS). You have an entire range that covers everything from the severely autistic to those that may just be a "little off" but hit some points of the current scale.
Since we are talking about an entire range of symptoms and all kinds of different responses to conventional therapies, etc - trying to lay blame on a single source is just ludicrous.
After reading the introduction, I'd have to say that any ethical, competent reviewer would have recommended rejection of the manuscript out of hand pending drastic revision of the Introduction, due to misleading citation of only publications that support the authors' hypothesis, while completely failing to acknowledge contrary publications and scientific opinion. This is a huge no-no in science. You don't have to agree with the prevailing opinion, but you are not permitted to sweep it under the rug. Even if I agreed with the study's conclusions, I'd have to recommend rejection simply on this basis. Any honest reviewer who bothered to do even the most basic due diligence would do the same. Either the reviewers were amazingly incompetent and lazy, or else they had major conflicts of interest similar to the author's, to the point of rendering them incapable of providing an ethical review.
Just for fun!
PRM Propaganda
We love your blog, thank you Orac :)
@ Lawrence: It never fails to amuse me how pseudo-scientists ( and those who love them)can't appreciate how much diagnoses are linguistic systems not physical** entities carved in stone! They must have an *interesting* concept of how the brain works!( I've also seen them do some odd things with symptoms/ syndrome *comme* part-whole**) Thus when the number of *diagnoses* increased ( post DSM IV) they believed that an onslaught of "damage" occured. The lines dividing categories shifted. When DSM V arrives, should the line shift back a notch, will they cry,"Cure!" Somehow, I don't think so.
** which tells us about their own mental processing- problems woth abstractions, problems with part-whole...
i have been working on a paper that shows 100% correlation between vaccines and "autism." **
i just have to find some reputable journal to publish it it.
** by "autism" i mean children with one of more of the following diagnoses:
AUT, SLI or any child that has a pulse and who may or may not like naps and/or graham crackers with milk.
@Rob: The Journal of Toxicology and Environmental Health will be contacting you shortly. I hear they have an expedited peer-review process.
More evidence for genetics:
http://www.foxnews.com/health/2011/06/09/autism-explained-genetic-mutat…
@ Rob: I want to be one of the anonymous reviewers of your paper at the Journal of Toxicology and Environmental Health. Any other takers?; please take a number.
As a special education teacher I can say from experience that a SLI diagnosis on an IEP can be particularly misleading. As mentioned in the post, only the child's primary diagnosis is listed. A child with an array of impairments may be classified as SLI because that is considered to be the most important impairment affecting the child. An SLI classification is appropriate for most children identified as such, that is often their only issue. They recieve therapy (even up to or beyond the age of eight), get older and become perfectly fluent adults. But for a pretty significant percentage, there is much more going on.
Also parents of a child with what appears to be primarily a cognitive disability (MR) often press for a diagnosis of SLI because it is a "softer", less stigmatizing diagnosis. Or they may press for an autism diagnosis because even that is considered less stigmatizing them MR (how many "retard" comments do you hear almost every day?). Especially if the child is young, he or she is often given it and then it never gets changed. IEP designations are often inaccurate and are a very poor basis for research. They can probably be twisted anyway that a bad "researcher" wishes to use them. I'm not surprised at all that the anti-vaxxers are trying to manipulate them to fit their ridiculous theories.
Several things can be said with certainty:
1) Autism in children is indeed linked to exposure to neurological toxins that impair normal brain development. There are a wide variety of such toxins (many industrial and agricultural) and exposures vary even more widely. Other neurological ailments (Parkinson's, say) have also been linked to things like pesticide exposure in agricultural zones.
2) Some vaccines produced in the 1990s contained an organic mercury preservative whose action against microbes was based on the production of ethylmercury (the chemical cousin of methylmercury), a well-known neurotoxin. The agenda was to extend the shelf life of these vaccines and allow them to be packaged in multi-use bottles (rather than as more expensive filter-sterilized single-shot packages). The only rationale for doing this was corporate cost-cutting.
3) There are many other sources of mercury and organic mercury in the environment (coal and natural gas production, leading to contaminated fish, etc.) but these are not easy to trace back to their sources (in the legal sense). Laywers, however, saw opportunity in the vaccine case because records had been kept.
4) Organic mercury preservatives have now been banned from use in vaccines, right?
5) Every vaccine is different. They should always be given under a doctor's supervision, and a small percentage of negative reactions is expected with any vaccine. Only a few vaccines are truly necessary, however - many of the newer ones have been overly hyped by for-profit corporations with far more interest in the bottom line than in scientific accuracy.
Indeed, the vaccine scare could have been entirely avoided if pharmaceutical corporations hadn't been so eager to cut costs in their vaccine production lines. However, the situation has now degenerated - on one side are hysterical corporate promoters, on the other are hysterical autism activists, and the only thing that unites them is their ignorance about basic scientific issues.
@ ike:
1) SOME cases seem to have (prenatal) environmental exposure links. As a blanket description of autism causation, to the extent anything can be said with certainty it's that your statement is false.
2) "The only rationale for doing this was corporate cost-cutting" is a ludicrous statement. Yeah, reducing the price of their products is OBVIOUSLY done as some nefarious scheme as opposed to a benefit to the consumer. Also entirely irrelevant to autism.
3) True but irrelevant to autism.
4) As a result of scaremongering with no basis in fact.
5) How do you define "truly necessary?" Reducing death, disability, and suffering certainly seem admirable goals to me.
I'd love to see your basis for this. The "vaccine scare" didn't stem from the use of thimerosal. The MMR Wakefield chose to publish his fraud about didn't contain it, for instance. It's not about thimerosal. It's not about aluminum. It's not even about autism. It's always, always, about the vaccines and nothing else. Those hell-bent on blaming vaccination for all ills will always find some way to assert some sort of link.
Orac,
I won't respond to the personal attacks, but I will correct one error. The Herbert reference in the paper is incorrect. The correct citation is: Herbert and Kenet (2007) Brain abnormalities in language disorders and in autism. Pediatr. Clin. North Am. 54:563-583 (abstract: http://www.ncbi.nlm.nih.gov/pubmed/17543910). The paper shows that brain injury of people with autism is similar to brain injury of people with speech and language disorders. Another paper that makes much the same point is Herbert et al. (2002) Abnormal asymmetry in language association cortex in autism. Ann. Neurol. 52:588-596 (abstract: http://www.ncbi.nlm.nih.gov/pubmed/12402256).
Speech impairment is such a fundamental symptom of autism that the two conditions cannot be separated, especially when the child has a speech/language impairment that is strong enough to be classified as a learning disability.
@ice solem:
[citations needed]
Almost everything you said was wrong, according to today's accepted research.
Anti-vax people did not start with thimerosal and will not end with thimerosal (as we have already seen happening with so much talk of aluminium and too many too soon etc.). The whole mercury issue was just another thing to latch onto in order to justify their dislike of vaccines.
This is just wrong. Autism includes speech impairment, therefore speech impairment implies autism? Seriously. Think about it for two seconds.
"Speech impairment is such a fundamental symptom of autism that the two conditions cannot be separated."
Well that should save the guys a lot of time with DSMV. It is definitional of Asperger's disorder that language is not significantly impaired.
And I assume this means that Ms DeLong did not include any AS cases in her research? Did she exclude ASD because the stats didn't show what she wanted? I think she should tell us what her definition of autism was and how she dealt with AS.
@Gayle DeLong
Neck/back pain, muscle tenderness and fatigue are such fundamental symptoms of polio that these conditions cannot be separated. That must mean that I get polio the days after a strenuous workout.
@ Gayle DeLong: Our esteemed host goes out of his way to mention that non-scientists are *not* necessarily wrong and that you "tarnish" your own reputation and publication record *in another field*- this doesn't sound like a personal attack to me. I believe he could be much less charming. He critiques your *ideas* and usage of some very shakey "studies" that are often waved about at AoA. While my grad degrees are in psych, I also have grad work in....econ.... believe me, they're not the same, research implies a whole different set of considerations.
Listen to Orac: he means you no harm and is a person who would support research that ultimately helps kids with ASD's and their families. Me too. I think that many at AoA are merely spinning wheels and spitting venom. You're probably bright, use his criticism.
@Gayle: Are ASD diagnosis 100% correct? Could a brain injured child that did not undergo scans be misdiagnosed as autistic? Or visa versa? Do you have a test that is 100% accurate in diagnosing ASD?
A discussion of the misdiagnoses and delayed diagnosis of ASD across race:
Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., Diguiseppi, C., Durkin, M. S., Giarelli, E., ... Kirby, R. S. (January 01, 2009). Racial/Ethnic Disparities in the Identification of Children With Autism Spectrum Disorders. American Journal of Public Health, 99, 3, 493.
Mandell, D., Ittenbach, R., Levy, S., & Pinto-Martin, J. (January 01, 2007). Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 37, 9, 1795-1802.
With so many mistakes made in diagnosis, as well as the fact that ASD is a wide arching net, it is clear that Gayle's study used data that was practically worthless, making her conclusions worthless. How many ways does this need to be said?
Gayle DeLong comments (#80):
The logical fallacy involved in this statement has already been addressed above, so let me add an example:
In my son's class, there is a child who has a terrible stutter. He can be very fluent when he sings or if he is talking spontaneously with peers, but if he tries to read aloud or answer a question in class, he is often unable to begin speaking.
This child - according to his mother - has been classified as having SLI and has an IEP, which would qualify his speech impairment as a "learning disability". Yet, he shows no signs of autism. In fact, dysfluency (stuttering and other conditions) isn't a typical sign of autism, yet it makes up (according to the school speech therapist) the bulk of SLI.
Ms. DeLong, your assumption that a classification of SLI is "inseparable" from autism is simply wrong. Not only are there people with SLI who aren't autistic (the great majority, in fact), but the speech/language problems of autism are also quite distinct.
Prometheus
Gayle DeLong, PhD! It is so good you dropped by.
I want you to meet Lisa. She also apparently has a PhD (in something), and is worried about the aluminum in come vaccines. She seems to be having trouble finding evidence that it is bad, yet she just knows it is bad for kids.
I thought it might be a good idea for you to bring her under your wing, and you both find out how dangerous aluminum adjuvants are in vaccines. You'll like her, she is part of the "Canary Party."
Oh, for other folks, the "Canary Party" is a new political movement that believes that autistic children are just like dead canaries. [sarcasm] Isn't that sweet? [/sarcasm]
Given that Gayle DeLong is is a petitioner in vaccine litigation, I don't think it's in her financial interest to listen to one word of what Orac has to say, nor would I expect her to.
She could at least try to convince us of the soundness of her data analysis, but I wouldn't expect that either.
She also seems to be a signatory to the "We Support Andrew Wakefield" petition, which tells you all you need to know about her objectivity and judgment.
@Gayle DeLong
"Speech impairment is such a fundamental symptom of autism that the two conditions cannot be separated, especially when the child has a speech/language impairment that is strong enough to be classified as a learning disability."
Wrong.
*Language* impairment is a fundamental symptom of autism.
*Speech* impairment is not.
If you don't know the very real, very significant difference between language impairment and speech impairment, you have no business citing a study of either one as proof of anything.
Specific Language Impairment =/= Speech/Language Impairment. The one is a particular disorder with very specific diagnostic criteria. The other is an umbrella term used to describe a wide variety of disorders with widely divergent diagnostic criteria.
Ms. DeLong:
Does this also include those who are deaf? Does this also include Marlee Matlin?
Ms. De Long you finally have some peer review of your study here at this site; too bad you did request peer review prior to publishing it. You could always "save face" and retract the study. I think that would be your best course of action and leave the studies for people who really know the difference between speech and language impaired. They won't be "cooking" up numbers and lumping speech impaired, language impaired and autism in one smoldering heap.
BTW, your two citations linked at your # 80 posting are inaccurate....lead to nowhere.
I personally would be leery of any statements regarding economics that you make, because of your poor research skills and not knowing the basics of autism diagnoses.
The editor of the Journal of Toxicology & Environmental Health, Sam Kacew, is also the North American editor of Toxicological & Environmental Chemistry. Both are Taylor & Francis journals.
Over the past four years, Kacew has become one of Mark & David Geier's biggest enablers in academic publishing, placing five of their papers in JTEH and two in T&EC. Kacew was aware of the makeup of the Geiers' DIY "IRB of the Institute for Chronic Illnesses," and knew that the IRB was incapable of providing adequate ethical oversight over their research before he published "A Case Series of Children with Apparent Mercury Toxic Encephalopathies Manifesting with Clinical Symptoms of Regressive Autistic Disorders" in early 2007. I know this because I corresponded with him about it, including sending him a copy of the IRB registration; his response to the information was curt and defensive. Just a few months after publishing the case series, he put out another one of the Geiers' self-supervised human subjects studies. Both of the studies citing ICI IRB oversight mentioned their IRB registration number, which nobody includes in their papers; for all the supposed "full disclosure," they didn't bother to inform their readers that the IRB didn't have a corresponding Federal-Wide Assurance. The prominent display of the IRB number was a patent attempt to fool their readers into thinking that their research complied with the Common Rule.
The Geiers have since shifted to using the for-profit Liberty IRB; their first study published in JTEH after they made the switch included the bizarre and generally-unnecessary statement, "This IRB was utilized because the Autism Treatment Center routinely uses this IRB to approve its studies." Which is total BS -- they obviously dropped the idea of DIY ethical review because they'd been found out by enough editors who cared about that sort of thing. Though it would seem that Sam Kacew wasn't one of them.
Now, how could I have left out the detail that the second JTEH study citing ICI IRB approval was "A prospective study of mercury toxicity biomarkers in autistic spectrum disorders," cited by Ms. DeLong in her paper? And how could I have failed to express my curiosity about whether this SafeMinds board member was unaware of the many problems with the Geiers' human subjects research? Any researcher who is aware of these problems, and who nonetheless cites to reports on their experiments on autistic children, is being completely irresponsible.
My library doesn't have access to that article, yet, but somehow I'm thinking she didn't include this reference:
Laidler, J. R. (January 01, 2005). US Department of Education data on "autism" are not reliable for tracking autism prevalence. Pediatrics, 116, 1, 120-4. DOI: 10.1542/peds.2004-2341
OT- ( but are references to our esteemed and gracious host's "friend's" research *ever* _truly_ OT @ RI?) Didn't think so.
Today @ AoA: Teresa Conrick presents a series of confused and confusing hypotheses that appear to be dependent upon more plot twists than a Stieg Larsson trilogy, if that's even possible. Spoiler alert: refers to Sweden as well.
Actually, I feel sorry for Dr. DeLong. It's not fair to expect that someone who has never published a scientific paper before would recognize all the pitfalls that a biased author can fall into. Her problem appears to be that she only speaks to groups of the true believers in the vaccines-are-caused-by-autism camp. Once you have accepted that this is the truth, then it's just a matter of finding data to confirm that what you believe is indeed true, and a prestigious-enough sounding journal that will publish your work. I doubt that she found JTEH by accident. Most likely she's been corresponding with the Geiers, or Jim Adams, or some of those other fringe scientists that have found a Kachew's journal a credulous venue for their publications.
@ Denice Walter: Talk about way out theories and the mixture of way out theories.
Interesting that the Age of Autism editors "moderate" the comments for (their) political correctness, yet never, ever, do cursory editing of articles that appear on their site.
Attention trolls: consider submitting articles with your "unique" theories to Age of Autism. They won't be rejected and in turn the posters will heap tons of praise on you for your intelligent insightful reporting.
To clarify my earlier post at 91:
The word "speech" is properly used to refer to the physical act of pronouncing sounds and words, and includes the domains of voice, fluency, and articulation, while the word "language" refers to the content of what is said or understood and includes such domains as vocabulary, grammar, and pragmatics.
A layperson on the street is unlikely to know the difference, and can reasonably be expected to use the terms interchangeably. For a person with even a small amount of expertise in communication disorders, however, the distinction is absolutely fundamental, and mixing them up is as glaringly absurd as saying "deaf" when you really mean "blind."
In other words, the confusion of speech vs. language, and of the two meanings of the acronym "SLI" are completely understandable if made by a parent, or by someone whose expertise is in some field other than communication disorders (like, say, finance). But for someone attempting to contribute to the study and understanding of communication disorders, it is a fatal error and an unmistakeable sign of someone tremendously unaware of their own ignorance.
You have to give Ms. DeLong credit at least for making comments here.
But, as to the paper, that is not something that deserves credit.
The idea that SLI and autism can can't be separated is obviously wrong as has already been discussed here. I will add a couple of points. First, if this were true, the prevalence of "autism" would be much higher than already reported (as much as 10% based on the data in her paper).
One very strange bit about trying to lump these together. The vast majority of kids with SLI are under 10 years old. This is not due to some "epidemic" of SLI. The same distribution is seen year after year. Kids with SLI are either getting better or moving into some other category (like SLD)
Does that sound like autism? Kids grow out of it by age 10?
Some good points raised by borealys and Matt Carey about "confusion" or mixing up speech impairments and language impairments. Laypersons without kids or parents who not have children with actual or perceived developmental delays could reasonably confuse the two. For the parent who may have valid concerns about about their child's developmental milestones, those differences are quite easily explained to them.
I'm quite certain that Ms. Delong deliberately confused them... and deliberately linked speech impairments and language impairments with autism...after all she has two children on the Spectrum, she is affiliated with notorious anti-vax groups and is involved in litigation on behalf of her children for remuneration due to "vaccine-induced" injuries.
Her choice of "experts" such as the Geiers and her continued support of the discredited Wakefield as well as her submission of this horrendously researched and badly executed study to the Journal of Toxicology and Ecology are also proof positive of her agenda.
This Ph.D-Economics has produced a totally abysmal "scientific" study...not ready for prime time and not ready for publication in any peer reviewed journal.
Gayle DeLong: ""Speech impairment is such a fundamental symptom of autism that the two conditions cannot be separated, especially when the child has a speech/language impairment that is strong enough to be classified as a learning disability."
Any member of the "corporate media" who is wondering whether DeLong's "research" should be reported uncritically (or at all) needs to pay attention to the above statement. It is so incredibly ignorant as to signal the need for close scrutiny of her data and conclusions by researchers who know what they're doing.
As to the statement made by another poster that DeLong is a "petitioner in vaccine litigation" - this if true, along with her SafeMinds involvement and being a parent of autistic children needed to be listed in the Journal of Toxicology and Environmental Health as potential conflicts of interest. Was anything along these lines cited by the Journal?
This does not seem to be in accord with accepted medical opinion. Can you cite any published cliical studies to support the contention that autism and SLI cannot be reliably separated? Or is this only your personal opinion?
Also, a few technical questions regarding the statistical approach::
1. Was the association of vaccination with SLI alone statistically significant?
2. Was the association of vaccination with autism alone statistically significant?
3. Did you examine pooliing of autism diagnoses with any other conditions that overlap with autisim, and which may be difficult to separate, such as ADHD or mental retardation? If so, was the association with vaccination statistically significant?
Belatedly delurking here because I am boggling so much that someone would study all kids with speech/language issues and use that to talk about autism. The prevalence of persistent developmental stuttering alone is higher than the highest estimate I've seen for ASDs (1% of the population) and that's in adults; if you're looking at children that's going to be several times higher because 80% of kids who stutter for a prolonged period recover. And like Prometheus I've never seen any data implying even a correlation between stuttering and ASDs, and I've looked (I have both so I have a vested interest and it seemed like a plausible possibility.)
So that alone says that chances are her "autistic" group contains more non-autistic kids than autistic, and that's only from the specific speech disorder of stuttering. I went to speech therapy the entire time I was in US schools (so, uh, I'm one of the kids who was probably categorised as SLI and had an ASD, sorry for destroying the non-autistic anecdata chain) and there were tons of kids there and I remember being the only one who stuttered. Even later when I was seeing an independent speech therapist, I think I was her only stuttering patient and it was her full-time job. There are *all sorts* of speech disorders and all sorts of reasons a kid might end up in speech therapy that have nothing to do with autism whatsoever.
Austism is primarily a communication disorder so it's not unreasonable to lump it in with language disorders. In fact lumping the two disorders together makes the measurement more robust and reliable. Are there people with speech/language disorders who don't have autism? Yes. But there are also people diagnosed with autism who don't have autism and people never diagnosed who do. The diagnosis is very subjective so using multiple measures is wise. Autism is a vaguely defined elusive trait and it sounds like most of the criticism here is definitional not substantive.
Autism is primarily a communication disorder so it's not unreasonable to lump it in with language disorders. In fact lumping the two disorders together makes the measurement more robust and reliable. Are there people with speech/language disorders who don't have autism? Yes. But there are also people diagnosed with autism who don't have autism and people never diagnosed who do. The diagnosis is very subjective so using multiple measures is wise. Autism is a vaguely defined elusive trait and it sounds like most of the criticism here is definitional not substantive.
Autism is primarily a communication disorder so it's not unreasonable to lump it in with language disorders. In fact lumping the two disorders together makes the measurement more robust and reliable. Are there people with speech/language disorders who don't have autism? Yes. But there are also people diagnosed with autism who don't have autism and people never diagnosed who do. The diagnosis is very subjective so using multiple measures is wise. Autism is a vaguely defined elusive trait and it sounds like most of the criticism here is definitional not substantive.
@ cuddle: Here are the "language" deficits, one of which must be present to fit the diagnostic criteria of ASD, according to the DSM IV:
2. qualitative impairments in communication as manifested by at least one of the following:
1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
There is nothing here that indicates a speech impairment such as stuttering..or even lisping or mispronouncing some words are part of the communications impairments observed in children who meet the diagnostic criteria for ASD.
Of particular note is (1.) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
Now Ms. De Long obviously knows the diagnostic criteria and yet chose to lump kids diagnosed with speech impairment to bolster the facetious argument about the autism epidemic...clearly her own misinterpretation of the communication impairment (not speech impairment) observed in children on the spectrum.
Try reading the article for comprehension.
A diagnosis for hearing loss is not subjective, and those children get speech/language intervention under the Speech/Language Impairment label (actually any good referral for speech/language issues would first include a trip to the audiologist).
Now try to spin that information, in triplicate, into saying all kids with hearing impairments are autistic. Which is equivalent to what DeLong, Phd in economics and finance is doing.
previous comment was directed at cuddle