The Burden of Proof: IACC Director Insel's 2009 Statement On Autism Increases

"Based on the above mentioned research, approximately 53% percent of the increase in autism prevalence over time may be explained by changes in diagnosis (26%), greater awareness (16%), and an increase in parental age (11%). While this research is beginning to help us understand the increase in autism prevalence, half of the increase is still unexplained and not due to better diagnosis, greater awareness, and social factors alone. Environmental factors, and their interactions with genetic susceptibilities, are likely contributors to increase in prevalence and are the subject of numerous research projects currently supported by Autism Speaks.

The increase in autism prevalence is real and the public health crisis is growing. More families are affected by autism today then ever before."

Autism Speaks Official Blog, October 22, 2010, 

Before the Recent CDC estimate that autism now affects 1 in 88 children.

The Neurodiversity ideologues are doing it again.  

Each announcement of increased  rates of autism diagnoses (the past year saw the CDC revise its estimate from 1 in 110 to 1 in 88) brings the same, tired refrain about increases in autism: it ain't real babe.  The Neurodiversity ideologues recycle the explanations trotted out for each announced increased in autism rates: 1994 DSM diagnostic definition changes and increased awareness being the two most prominent. 

They have done so again in an article in Discovers "big idea" blog "The Crux" by Emily Willingham. Discover is the home of Neurodiversity writer Steve Silberman and the Willingham article was immediately embraced in an article by another Neurodiversity "science" journal: Boing Boing.  Boing Boing quickly  applied its scientific expertise and  reported, based on Willingham's opinions, that "It looks like the majority of the "increase" in diagnoses can really be attributed to the process of diagnosis itself"

No one denies that the two decade old diagnostic definition change and increased awareness factors, explain part of these increases, the issue is whether they explain them entirely or to what extent and whether the increased rates also reflect real increases, increases arising from environmental factors. 

Dr. Tom Insel is known to everyone involved in autism issues as the head of the IACC, the Interagency Autism Coordinating Committee.  He can not be attacked as being an "anti-vaxxer" or as an emotional, hysterical parent of an autistic child.  Dr. Insel had this to say in a December 18, 2009 interview by David Kirby:

"It looks like about 24 percent of the California increase can be attributed to something like a change in diagnosis criteria. They are beginning to use multiple diagnoses. So that children before, who were listed simply as mentally retarded rather than autism - but they had both - are now logged in with both. But that really caps out at around 24 percent. There’s probably another piece of this, which globally could be attributed to ascertainment. But that caps out at around 16 percent, or something like that. And when you put all of that together, you are still well below explaining 50 percent of the increase.

So what does that mean? It means that, as far as I can tell, the burden of proof is upon anybody who feels that there is NOT a real increase here in the number of kids affected. Because all of the evidence we have up until now says that, well there are what we could call – I wouldn’t call them ‘trivial’ factors – but they are factors that are not related to incidence, but would be simply related to prevalence, like ascertainment. But they don’t really explain away this huge increase. "

This tells you that, you really have to take this very seriously. From everything they are looking at, this is not something that can be explained away by methodology, by diagnosis. Some piece of it can, but the whole thing can’t."" 

It fits Emily Willingham's Neurodiversity ideology to recycle the diagnostic change/substitution and increased awareness factors.  What we don't need is yet another recycling of these long understood factors which undoubtedly explain part of the increases in autism rates.  What we do need is a focused environmental research strategy as advocated for In A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities, an editorial in a recent issue of Environmental Health Perspectives, authors Philip J. Landrigan, Luca Lambertini and Linda S. Birnbaum.

Landrigan, Labertini and Birnbaum summarized the evidence for the "proof of principle" that early exposures during “windows of vulnerability” that open only in embryonic and fetal life and have no later counterpart can cause autism.  They review the large numbers of synthetic chemicals, many of them untested, some of which are known to have toxic properties. The authors proposed a strategic approach to researching possible environmental causes of autism by focusing:

"research in environmental causation of NDDs on a short list of chemicals where concentrated study has high potential to generate actionable findings in the near future. Its ultimate purpose is to catalyze new evidence-based programs for prevention of disease in America’s children."

We don't need more recycling of the known diagnostic change and ascertainment factors that undoubtedly explain part of the incredible increases in autism diagnoses. What we need is leadership by the IACC and other major autism focused health agencies to encourage a stragic approach to determine  possible environmental factors involved in causing the various autism disorders. 

What we need is to find out what has been, and still is, happening to our children.  Until we do the burden of proof is on those who push the non-environmental factors which explain only part of the incredible increases in autism diagnostic rates.

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Autism Rising: 1 in 100 US Children Have an Autism Disorder

The images above are taken from the autism section of the 2007 US National Survey of Children's Health and indicate that 1 in 100 American children in the 2 to 17 age range have an autism spectrum disorder. That figure is yet another startling indication of the existence of a real autism crisis. Those who deny that environmental factors cause, in whole or in part, autism disorders, will have less and less credibility as 1% of American children are reported autistic. The expanded definition of autism disorders to include Aspergers Disorder in 1993-1994 is irrelevant to an increase from 1 in 150 reported by the CDC in the past few years to 1 in 100 now as reported by the NSCH. The 1 in 100 figure is in line with the UK figures as well although there a recent study suggests the actual rate may be closer to 1 in 58.

This new report is startling but where is the mainstream media on this? Why is the same media that have been busy ridiculing parents who question possible vaccine autism connections silent when public authorities provide information showing dramatic increases in autism? Since my son was diagnosed with autism in 1998 the reported figures for autism have changed from 1 in 500 to 1 in 250 to 1 in 166 to 1 in 100. Does the 1993-4 diagnositc definition change really explain fully the relentless increase in reported cases of autism over the past decade from 1999 to 2009?

And why are people like Dr. Tom Insel of the Inter Agency Autism Coordinating Committee silent? Autism researcher Teresa Binstock pointed out in 1999 that autism research funding allocations had been weighted heavily in favor of the "it's gotta be genetic" model of autism research funding allocations. The authors of the recent University of California Davis study which suggested environmental factors were involved in the increasing autism numbers in California have highlighted the neglected funding for environmental autism research:

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said."

Over the past decade the numbers of autism cases have skyrocketed and yet the autism research funding still reflects the "it's gotta be genetic" model that Binstock outed in 1999. What is wrong with this picture? What is wrong with the decision makers who refuse to authorize funding to research environmental causes of autism? Do they have conflicts of interest that tie their hands or are they just too stubborn and tied to outdated paradigms to change?

In his recent appearance before Senator Harkin's subcommittee Dr. Insel desperately insisted that a comparative study of vaccinated and unvaccinated populations could not be done for ethical reasons even though unvaccinated populations already exist in the US and even though contrary statements have been made by people like Dr. Bernadine Healy, Dr. Julie Gerberding, and Dr. Duane Alexander. I DO NOT allege ANY conflicts of interest on the part of Dr. Insel. He seemed more like a true believer who does not have an open mind to arguments that challenge his views about vaccine safety.

Autism research funding has been heavily weighted toward genetic causes of autism. It is time to provide some balance as researcher Irva Hertz-Picciotto said and conduct environmentally based autism research. It is time to research all possible environmental causes of autism, including possible vaccine factors, as Dr. Jon Poling has stated.

autism

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