You ask for me to share the basis of my expertise: I am a general pediatrician whose undergraduate training was in neurobiology. That undergraduate passion never left me and I have stayed fairly up to date in the basic science of autism research.
As to my hypotheses - well, I’ve already given what I think is the biggest factor: an appropriately broader use of the diagnostic label. The result of more active case-finding by MDs and of pressure from Early Intervention programs (it is easier to qualify for more aggressive intervention with the autistic spectrum disorder label than with other developmental delays.) Is it possible that there is a real increase in the number of kids equally affected? Sure, it is possible, but there is no solid evidence for that. If so, what could be the cause? Well, I’ve heard speculation that it may have to do with nerds reproducing with nerds. It is a serious speculation. Could be any of a hundred thousand chemical exposures that have increased over the past several decades. Could be some unidentified untreated infectious trigger. Could antibiotic exposure in residual in foods, or otherwise. Could be some autoimmune factor (all autoimmune diseases have increased over the past several decades). The list of potential posibilities is endless. IF there really are more cases rather than more cases identified.
Personally, I do not think of autism as a single disease. It is a collection of phenotypes that share certain commonalities that are caused by a wide variety of genotypes and potentially other triggers. The most interesting current research implicates dysfunction in the cerebellum and limbic systems …
We need to develop better early identification techniques and more standard approaches. We need to understand the means by which this massively nonlinear system of the human brain determines that a particular state becomes the stable baseline. Not jump on whatever is the current simplistic fad to blame for a complex disorder.
Let me see if I understand you: are you suggesting that autism is better viewed as a syndrome, rather than as a definite disease, and that, as such, it might have a variety of etiology rather than a disease that has a distinct causative agent, i.e., cholera or syphillis?
And is there any single cure for Republicanism, or would you favor the time honored palliative therapies of sex, drugs, and rock 'n roll?
And as for the etiology of Republicanism … well I had once speculated that Bill Clinton was a cause of autism. The rates went up significantly during his saty in office, and Al Gore acts pretty much like a classic Asperger case (a form of autism with spared verbal abilities but poor social skills and narrow range of interests)
anyone got any info on whether this site is right or not? If it is and if the Danish vaccinations did not all contain thimerosal, then they are comparing apples with oranges. The argument is that thimerosal builds up in the children and if they are comparing Danish children whose first exposure to thimerosal is in the MMR to US children who have been exposed repeatedly in several vaccinations, then the conclusions of that study do not carry across tidily.
DSeid said that it was improved diagnostics which have led to the increase in autism – in fact the Californian study cited above does not agree with him. There is a serious increase in the number of autistic children but when diagnosis is compared longitudinally it is not different. Practitioners were using the same criteria even when separated by years.
Lastly autism is a spectrum disorder, not a disease state. It’s a syndrome which is subjectively diagnosed. A fascinating process in itself when you’re a parent.
And note that over the years practioneers started caring about finding cases of autism and finding them early. Do you really think that subjective critera are applied the same when you do not think that it matters to diagnose something that you barely know about as they are years later when you are actively case finding? An analysis in Pediatrics found that the increase was mainly in those edge of the spectrum cases. Ten years ago parents with kids diagnosed (at 4 to 6 years old) had bemoaned that no one heard them telling them that their kids’ development had been off since early on. And these were classical autistic kids. That isn’t the complaint anymore. Now a wide spectrum is being labelled and before two years old.
As to the link. The most recent study is just one of many that cleared the MMR in multiple populations. They changing the accusation though. Its the measles component. Its all of them at once. Its culmative mercury. Its a delayed effect. And on and on … More studies defending good medicine, less money left for the basic research. AGAIN THIMEROSOL IS GONE from the routine shots. The best test will be to see if there is a significant decline in cases over the next year … or if they blame a different shot component.
I think you should read them in the order they were written. I always do that, if I can, with multiple books by the same author, even if they are not related in subject. To this day I tell people to read the Chronicles of Narnia in the original order, not the strictly chronological order presented in modern printings.
The Hobbit is the lesser of the two works. But it is a work intended to stand on its own, and it gives you a home, in the Shire, when others are just visitors. You care more about it, when it is threatened, if you see it through Bilbo’s eyes. And you can understand how great the power of the ring is, when it manages to become more important to Frodo that the Shire itself. Now that is evil.
Tris
“In a hole in the ground, there lived a Hobbit. Not a nasty dirty wet hole, filled with the ends of worms, and an oozing smell, nor yet . . .” ~ J. R. R. Tolkien ~
There is no compelling evidence that thermisol causes autism, or any other disease. There is a fairly large body of evidence that vaccination of any sort does not cause autism in particular. There is no absence of folks desperate to find someone to be at fault for their child’s disability. Lawyers get paid by both sides, and their opinions on this, or any subject is suspect by even the most benign characterization.
None of that changes the possibility that Republican legislators are repaying favors to Drug Companies, and using the fear of terrorism to further their unrelated political ambitions. They won, and they have political debts to pay. Assumptions of innocence are no more reasonable in this case than would be so if the Democrats had won. Politicians are allowed to take bribes, and pay them back out of the National Treasury. It might not be honest, but it is entirely legal, and expected. All that needs to happen is that the money be channeled through parties, and that the occasional personally involved legislator simply vote against it, with the collusion of an alternative party member who wishes to curry favor for reciprocal acts at a later date.
We, the voters love this sort of representation, obviously, since we know about it, and routinely reelect the participants, and continue to buy from the corporations that are the source of the money. If we didn’t like it, surely we would do something to stop it.
Tris
“The road to truth is long, and lined the entire way with annoying bastards.” ~ Alexander Jablokov ~
This is a complete misunderstanding of modern medicine. The literature is chock full of associations and reactions that happen in a test tube or even in a rat that don’t happen the same way (or at all) in humans. Far more numerous still are those things that happen in tubes and rats that happen the same way in humans, but not in such a way as to amount to anything.
The statement is exactly backwards–only epidemiologic studies can show whether the MMR or any other vaccine plays a role in autism. The biologic studies might suggest a link or demonstrate the mechanism of such a link, but if good epidemiologic studies don’t demonstrate a link, it just ain’t there. That’s what evidence-based medicine is all about.
Misunderstandings like this probably lead to a whole lot of poorly-placed research funds, as DSeid was lamenting earlier.
Umm, last I checked currently the MMR vaccine does not contain thimerosal but furthermore it’s never actually contained it.(Something about you can’t use it with a live vaccine if I remember right.) Sounds like they’re using nogic to reach their conclusions.(Of course I guess I’m biased since I actually want to be a physician one of these days:-)
Obviously, you are not familiar with the whole ‘silicone breast implants cause autoimmune diseases!’ scare. There is NO evidence that links silicone breast implants to an increased risk of autoimmune diseases - but Dow Corning (the manufacturer of the implants) was eventually forced to file for bankruptcy none the less, and fewer and fewer companies are willing to manufacture medical grade silicone for sale in the United States, for fear of litigation (which may become a significant problem, given how many crucial medical items use it ).
Trial lawyers don’t evaluate prospective cases based on scientific evidence - they evaluate them based on whether they think they can convince a jury to believe their plantiff’s side. And when it comes to vaccines, the equation they see is “brain-damaged kid requiring expensive medical care + “expert” willing to testify that this is due to a vaccine = big bucks!” Whether the “expert’s” evidence is actually scientifically valid is a moot point to them. Most people who sit on a jury are not scientifically knowledgable, and the current trial system can exploit that fact - often to the detriment of society at large.
Actually, artemis, trial lawyers care a great deal about whether the science supports their cases and scientific evidence carries great weight in their assessment of potential cases. Prosecuting cases with medical allegations are expensive, and it isn’t worth a trial lawyers time if they are going to lose a Daubert hearing and never even see a jury.
That said, I’ve heard their reasons for taking thimerosal cases and I don’t think they are compelling. The reasoning goes something like this: Thimerosal is a mercury containing preservative that the human body metabloizes to ethylmercury and thiosalicyte. Methylmercury is bad for humans. The comparitive toxicities of ethylmercury and methylmercury have not been defiinitively established, but in one study, the FDA considered them equivalent in its risk evaluation. Then there was a report by the IOM’s Immunization Safety Review Committee released on October 1, 2001, that concluded their was insufficient evidence to accept or reject a causal relationship between thimerosal and autism.
So, they say such a link hasn’t been disproved. I’m not terribly familiar with all the science involved here, but I’m not conviced by what I’ve heard.
Regardless, the vaccine manufacturers likely don’t need immunity from lawsuits right now, as the suggested course of action for those looking to take such cases is to plop them into the Vaccine Compensation Program.
What would a fast-food restaurant have to fear from some idiot suing because she spilled coffee on herself? Isn’t it pretty obvious that that would be irrational nonsense, too?
Plus, it’s the fear of the unknown. No manufacturere can be certain of what would happen in a lawsuit, so it’s safer to simply exit the business of manufacturing vaccines. Businesses in general do NOT like risk.
An interesting development: according to an article in today’s New York Times the amendment has no formal sponsor, no one’s fingerprints are on it. It seems to have been left on the doorstep of the House by a band of legislative gypsys.