Tuesday, April 11, 2006

CDDS Q1 2006: No Nonsense Details

The California DDS Quarterly Client Characteristics Report for the quarter ending March 2006 was posted some time today. Let's compare this quarter to Q4 2005:

Table 1: State-Wide Comparison of Q4 2005 with Q1 2006.
QuarterCaseloadGrowth
(False New Cases)
Annual Growth3-5 Age Range
Q4 200529,42470010.72%5,680
Q1 200630,18175710.50%5,827


As we can see, CDDS autism caseload continues to have strong growth. There's an unexpected increase in the caseload growth this quarter (what's usually referred to as "New Cases" by mistake). The prior tendency was for population growth to stabilize. Annual growth (calculated against the corresponding quarter the year before) has dropped a bit, but it still has a long way to go before it matches population growth in the state of California, about 1%, as would be expected in the long run.

There is strong growth in the 3-5 age range, which suggests there is no drop in administrative incidence.

Central Valley

The regional center with lowest administrative prevalence of autism is Central Valley (Fresno). They are basically at the beginning of the 'epidemic'. Let's see what's going on there.

Table 2: Comparison of Q4 2005 with Q1 2006 in Fresno.
QuarterCaseloadGrowth
(False New Cases)
Annual Growth
Q4 20058293323.00%
Q1 20068805123.94%


Looks like Fresno, not surprisingly, is experiencing very strong caseload growth; more than twice that of the state. Fresno has a long way to go to catch up with other regional centers, however.

Westside

The regional center with the highest administrative prevalence of autism is Westside (West Los Angeles). In fact, it's well known that most of the 'epidemic' in California has occurred in the LA area so far. Let's see what's going on in this regional center.

Table 3: Comparison of Q4 2005 with Q1 2006 in Westside.
QuarterCaseloadGrowth
(False New Cases)
Annual Growth
Q4 20051,653198.32%
Q1 20061,687348.70%


Caseload growth in Westside is not as high as that of the state, but it's still considerably higher than population growth in the LA area. A bit of a surprise is that caseload growth is increasing in Westside at the moment, but that doesn't necessarily mean anything when comparing two quarters. This regional center is the one we'd expect to stabilize first.

Has Thimerosal Removal Done Anything?

Despite law changes (Lanterman Act, 2003) specifically aimed at decreasing caseload growth, it's clear administrative prevalence will continue to increase for a long time to come, perhaps one more decade. Trends in the 3-5 age range do not support an incidence drop following removal of thimerosal from vaccines. I recommend Dr. Geier's paper be renamed to "Upward Trends in Neurological Disorders Remain Strong Following Removal of Thimerosal from Vaccines" if the paper is to be salvaged in any way.

David Kirby had said that if the caseload in the 3-5 age range was not declining by 2007, he'd admit he was wrong. I'd point out to Kirby that 3 quarters are not going to make a difference. Not only is the caseload in that age range not declining, but it's still showing strong growth. Additionally, if you understand the reasons why caseload grows (which I have explained in detail) the only way there could be a substantial decline in administrative incidence is either by magic, massive genocide, or through extremely strict law changes.

It's time for a concesion from our opponents in this debate. If they had a modicum of intellectual honesty, they should admit being mistaken.

18 comments:

  1. Joseph,
    You were fast off the mark! I looked early this morning and the numbers weren't there yet!

    Two questions: How did you calculate the annual growth? In table 2 first line, shouldn't it be 100*4*(33/829) = 15.9%?

    Second, you refer to the "prevalence" in Central Valley and Westside. Doesn't that make the implicit assumption that the total population being served by these two centers is the same? Isn't it also possible that Westside serves a population twice as big as Central Valley? I don't mean the population of disabled people, but the total census population of the area served.

    These questions don't impact your analysis very much. The fact is that the 3-5 year old group continues to increase steadily in size. I can't wait to see how Rick Rollens tries to spin this. I expect silence from him this time.

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  2. Hi Joseph,

    Dang, I saw the numbers and hammered off a very brief analysis.

    Then I thought, you know, I bet Joseph has these done too.

    Cheers Joseph,

    John

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  3. Hi Jennifer,

    Two questions: How did you calculate the annual growth? In table 2 first line, shouldn't it be 100*4*(33/829) = 15.9%?


    I substract the caseload in the quarter shown with the caseload in the same quarter a year before, then divide by the latter. (Your approximation would match if caseload growth were roughly the same in the last 4 quarters).

    Second, you refer to the "prevalence" in Central Valley and Westside. Doesn't that make the implicit assumption that the total population being served by these two centers is the same?

    I don't determine that prevalence is the highest in Westside and lowest in Fresno because of caseload. I use the ratio to Epilepsy to determine that. Ratio to Cerebral Palsy or Mental Retardation would do as well.

    I can't wait to see how Rick Rollens tries to spin this. I expect silence from him this time.

    I expect silence as well, simply because the caseload growth has unexpectedly increased. Otherwise he would've been saying that the "New Cases" have dropped once again!

    I dare Rollens and company to say anything about this report this time around.

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  4. Here's a link to Jonathan's graph of 3-5 caseload growth. This growth should be expected to match population growth in that age range as well at some point. This is a long time off it looks like. We'll have 'autism epidemic' for a while yet.

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  5. Here's a song Rick Rollens is singing today

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  6. http://www.sacunion.com/pages/california/print/5424/
    Published: July 13, 2005
    The number of new cases of autism in California has fallen for the first time in more than 10 years in what may be a bellwether for autism rates nationwide, according to new data compiled by the state Department of Developmental Services.

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  7. laughing at Kev's comment over on left brain/right brain.

    On EoHarm: "Has anyone anaylzed the new quarterly dds numbers?"

    (crickets)

    I have predicted silence from Rollens before and he surprised me. He had to misrepresent what was there, maybe more than usual, but he did came up with a way to say that a rise was a fall.

    Remember when Ginger posted that it was a "fall" and then never corrected her post when it was pointed out to her that she was wrong?

    Still no word on the epidemic task force from the MIND... this should make it easier for them to make up their minds about the faux epidemic...

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  8. My guess is someone will try to blame the flu shots, which will be laughable because:

    A.) the inclusion of flu shots to the CDC’s schedule for kids 6-23 was only a recommendation and only happened a couple of years ago

    B.) flu shots aren’t required for daycare or school entry so uptake is still nominal

    C.) a fairly substantial percentage of children who got flu shots under the VFC program would’ve gotten thim-free shots because that’s all most states were supplied with

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  9. Kirby posted this to EoHarm instead of waiting for Rollens, I guess. I haven't had a chance to get the raw data out and look at it. I can't tell how he's spun it.
    I also can't align the numbers like he had them on the group site.

    "Thanks for the post. Keep in mind that the numbers go up and down
    from quarter to quarter, and the 1st quarter of each year is typically (though not always) the heaviest in terms of "new" 3-5 year old cases (or rather, "net gain in cases," which is more accurate). It is the annual figures that really matter.

    In the first quarter of 2006, there were a total of 5,827 3-5 year olds in the system, a net gain of 147 over the previous quarter, in which the total was 5,680. (The net gain between 3Q 2005 and 4Q 2005, meanwhile, had been 141 - see below)

    In the first quarter of 2005, the net gain over the previous quarter
    was 151; in 1Q 2004 it was 182 and in 1Q 2003 it was 189, so one could
    argue that these are the lowest 1st quarter numbers in a few years. But I wouldn't do that. It is too early to read a whole lot into these numbers, especially quarter to quarter, and obviously, a drop in the net gain this quarter (instead of an increase of 6) would have been more supportive of the thimerosal theory. Then again, keep in mind that most of these kids are 4 and 5 years old, born between 2000 and the first
    quarter of 2002 (someone correct me if I got that wrong) and it is
    impossible to know exactly what thimerosal exposure rates were during that period in California, except to assume that they started to come down, perhaps gradually.

    Below are two slides on the subject - I am not sure how they appear
    on
    this post, but they can also be found toward the end of my powerpoint presentation at www.evidenceofharm.com
    http://www.evidenceofharm.com/

    Hope this helps a little.

    All best

    David Kirby

    --------------------

    3-5 year olds - quarterly numbers are mixed

    QUARTER Total # children Net gain Change in 3-5 years old
    net gain


    * 1Q 2003 4228 189
    +81
    * 2Q 2003 4466 238
    +49
    * 3Q 2003 4558 92
    -146
    * 4Q 2003 4611 53
    -39

    * 1Q 2004 4793 182
    +129
    * 2Q 2004 4894 101
    -81
    * 3Q 2004 4997 103
    +2
    * 4Q 2004 5156 159
    +56

    * 1Q 2005 5307 151
    -8
    * 2Q 2005 5446 139
    -12
    * 3Q 2005 5539 93
    -46
    * 4Q 2005 5680 141
    +48

    * 1Q 2006 5827 147
    +6

    -----------------------------------------------

    But yearly trends for 3-5 year olds are down.

    Year Net Gain % Change
    ages 3-5

    2003 572 n/a*

    2004 545 -4.72%

    2005 524 -3.85%"

    If the numbers fall dramatically, the line is that it's because they took out thimerosal. If the numbers go up it's because of the fraction of thimerosal left in the vaccines used statewide. They have it all covered. If the numbers shoot up it's because the diabolical CDC has loaded thimerosal back into vaccines without anyone knowing. (cue the spooky music)
    Life is easy when you believe in conspiracies.

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  10. Then again, keep in mind that most of these kids are 4 and 5 years old, born between 2000 and the first
    quarter of 2002 (someone correct me if I got that wrong) and it is
    impossible to know exactly what thimerosal exposure rates were during that period in California, except to assume that they started to come down, perhaps gradually.


    These kids were born between 2001 and 2003. They were vaccinated between 2002 and 2005.


    Year Net Gain % Change
    ages 3-5

    2003 572 n/a*

    2004 545 -4.72%

    2005 524 -3.85%"


    So annual growth is declining slowly. Maybe he can explain why we should expect annual growth in the 3-5 range to be maintained indefintely unless thimerosal is removed.

    There needs to be a decline (not just slower growth). If there's no decline they don't have an argument.

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  11. The thing is that the regional centers do keep track of developmentally "off" 2 year olds. They should be firing therapists now as there should be no 2 year olds who look like they could be autistic, or certainly way less than half there were 5 years ago. There would still be CP, MR, blindness, deafness in toddlers, maybe epilepsy in toddlers and so forth, but there should be no kids regressing following a vaccine. If regressions were caused by this *supposedly* *alleged* dangerous-heinous-massive-toxic dose of thimerosal that the kids got in the 1990's.

    The MIND institute is recruiting toddlers/preschoolers for it's autism phenome project all we have to do is ask if they are finding any 2 year olds on the spectrum. It's harder to spot some spectrum kids, but they are getting more accurate in doing differential diagnoses between speech delay and autism... they say.

    Really there's no need to watch the DDS numbers if Amaral is watching for toddlers in California to bring into his phenome study. Ask Dr. Amaral.

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  12. By now there should be many parents with ASD kids who did not get vaccinated with thimerosal. This probably contributes to the decline in VAERS reports.

    They will always have MMR to blame. But it's impossible to remove MMR in order to prove this hypothesis wrong as well.

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  13. Yeah, but Wakefield has a patent or a patent application for a substitute measles vaccine, so they could get rid of the old MMR and replace it with the Wakefield version and see..... nah... that would be dumb. Wakefield's vaccine might cause blindness or who knows what.

    I'm thinking I might go to the MIND tomorrow, not sure. If I do, I'll see if I can talk to Dr. Amaral about his finding 2 and 3 year olds or not finding them, though he must have thought that he would find them....

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  14. Rollens in SAR:

    According to information released today by the California Department
    of Developmental Services (DDS), the number of professionally diagnosed
    cases of full syndrome DSM IV autism in California's developmental services
    system has, for the first time in it's 37 year history, exceeded 30,000
    persons.....nearly 80% are children under the age of 17, with 2 out of 3
    persons are between the ages of 4 and 13 years old. No children under the
    age of three years old are included in this reporting system.
    In 1987 there were less then 2,800 cases statewide, today there are
    30,181. During the latest reporting period between January 4, 2006 and April
    4, 2006 DDS reports that an additional 757 new cases were added to the
    system, that is, on average, nearly nine new children a day, seven days a
    week entering California's developmental services system with full syndrome
    autism, and does NOT include any persons with any other autism spectrum
    disorder such as PDD, NOS, or Asperger's Syndrome.
    Autism not only continues to be the number one disability entering
    California's developmental services system, but now constitutes a record
    setting 63% of all persons entering the system, with the remaining 37% of
    the intakes being the COMBINED number of new intakes with mental
    retardation, cerebral palsy, epilepsy, and other conditions that have mental
    retardation as a component of the condition.

    Between April 2002 and April 2003 there were 3,595 persons added to
    the system.
    Between April 2003 and April 2004 there were 3,088 persons added to
    the system.
    Between April 2004 and April 2005 there were 3,015 persons added to
    the system.
    Between April 2005 and April 2006 there were 2,869 persons added to
    the system.

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  15. Rollens is apparently going back to his 'sky is falling' rethoric. He doesn't mention, for example, that the mental retardation caseload in the CDDS is over 3 times that of autism. And that, amazingly, whatever is causing the 'epidemic' of autism has not caused an administrative prevalence increase in mental retardation, epilepsy or anything else.

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  16. Oh, and he's still using the "new cases" terminology in the same erroneous manner as ever. Will he ever stop?

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  17. Kirby's case is pretty weak. There's nothing the least bit statistically significant about the variation in caseloads among 3-5 year olds over the last few years. If thimerosal plays any meaningful role in autism, there should be substantially greater drops.

    Going to the tired "was thimerosal really out of vaccines by 2002" argument is predictable. There's little evidence (other than the autism-mercury's own anecdotes) that thimerosal was in vaccines much past the end of '01. It's certainly not in pediatric vaccines today other than SOME doses of the flu vaccine.

    By contrast, Rollens' latest spin is so utterly laughable that I'm not sure where to even start.

    I think the reality is that thimerosal is being removed from vaccines and nobody's able to prove new cases of autism are in any way declining.

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