Sunday, June 25, 2006

One More Time on "New Cases" for David Kirby and Others

Incidence In California Not Dropping - A Recap

Since 2001 all vaccines routinely recommended in the U.S. have contained only trace amounts (< 1 µg) of thimerosal. Thimerosal hypothesis proponents naturally expected the incidence of autism to drop as a result. In the absense of detailed ongoing epidemiological studies on autism incidence, they turned to administrative data, particularly that provided by the California Department of Developmental Services (CDDS) on a quarterly basis. CDDS, however, only publishes data on population sizes (caseloads), not data that could be used to determine incidence, such as numbers of clients entering the system every quarter.

Nevertheless, thimerosal hypothesis proponents came up with the notion that substracting the caseload one quarter minus that of the previous quarter is equivalent to the number of clients entering the system. This naive understanding of population dynamics led to claims that the incidence ("rate") of autism was beginning to show modest drops in California. These claims were quickly picked up by the press, which repeated the error verbatim.

The net difference in the numbers between quarters was dubed "New Cases", implying that this is roughly the number of children diagnosed in a quarter. Unfortunately, caseload numbers in the quarterly report represent only clients with active status. As CDDS itself explains in a document titled Data Interpretation Considerations and Limitations, differences in the numbers from quarter to quarter represent the net changes between newly reported clients and drop-outs. The significance of drop-outs should not be understated. Drop-outs include clients who have died, who have moved out of the state, who have been found to no longer be eligible for services, who have decided to no longer pursue eligibility, or who have had a change in their CDER category.

In fact, there is a report titled Active Status Population: Growth Analysis by California State University, Sacramento. It documents number of "New" clients and number of those who "Leave", from 1999 to 2004 (see page 7). The report shows that the number of clients who leave the system is not insignificant and was growing as of 2004. There is a small drop of 2.7% in new clients between 2002 and 2003, but this number grows again by 3.6% in 2004. The small drop in 2003 corresponds to a California law change (CA AB1762, W&IC 4512) specifically crafted to depress autism caseload growth. (Many children likely lost their CDDS eligibility after this law passed).

A good analogy for "New Cases" is "Number of Births" defined as the difference in the population one year minus that of the previous year. If "Number of Births" is defined this way, imagine what the "Number of Births" per year might be in a country with a constant population size.

We also know that the autism caseload in California is currently growing at a rate of about 10% annually, whereas the California population grows at a rate of 1.3% or so annually. It is unlikely that autism incidence is dropping given this fast caseload growth rate.

Nevertheless, caseload growth (what thimerosal hypothesis proponents call "New Cases") must drop necessarily. Let us imagine that annual caseload growth remains at around 2,500 indefinitely. Given population growth in the state of California, autism caseload would stabilize at about 192,000 in 64 years, which is highly unlikely. It is more probable that autism caseload will stabilize in about a decade at 40,000 to 50,000 with an annual caseload growth of 520 to 650 (130 to 162 quarterly).

Another way to tell that incidence is not dropping is to look at the 3-5 cohort caseload. Numbers in this cohort should change quickly in response to incidence changes. Consider that 5 year olds in the cohort will no longer be in the cohort next year. So it is necessary for many children to enter the cohort every year to maintain the caseload. We can see in the CDDS data that annual caseload growth in this cohort is about 10%. So it is highly unlikely that incidence is dropping.

Now that we have established that the incidence of autism is almost certainly not dropping in California, and that gradual drops in caseload growth are expected and not remarkable, let's see what thimerosal hypothesis proponents have said and continue to say about this issue.

David Kirby

On August 11, 2005, Citizen Cain attempted to inform David Kirby on the difference between 'entries' and 'net gain'. The post is long already, so let's just say David Kirby finally agreed to the following:

If the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis.

Note that Kirby accepts it should be a drop in the total number of 3-5 year olds, not a drop in the growth, or a drop in the growth of the growth, or any such nonsense. Yet, right after the Q1 2006 CDDS report came out, Kirby decided to grasp at straws and claimed in EOHarm that "yearly trends for 3-5 year olds are down" based on gradual drops in caseload growth in the 3-5 cohort. Again, he agreed there should be drops in the caseload. Drops in caseload growth are not meaningful.

And as Kevin Leitch points out, at the latest Autism One conference David Kirby apparently forgot what he told Citizen Cain. I have to wonder if this is honest forgetfulness or something Kirby feels he needs to do as the author of Evidence of Harm.

Geier & Geier

Epidemiological studies generally discuss prevalence or incidence. It was thus surprising that the journal JPANDS, a purportedly peer-reviewed journal, accepted a paper by Geier & Geier where they used the flawed "New Cases" terminology instead.

After I pointed out the significance of this error to the Editor-In-Chief of JPANDS, and my comments were forwarded to the authors, Mr. David Geier requested data on "new consumers with autism" (true new cases) from CDDS, in what appeared to be a frantic move. I was excited CDDS would release this data after it was funded, because this data would settle the issue (and would've been great blogging data). Unfortunately, months passed, and CDDS could not complete the work because it was not funded. Clearly, Geier & Geier either could not make the payment (which was probably less than what they charge a single client of theirs) or they were not interested in having this data become public.

A response to a commentary in JPANDS shows that Geier & Geier had decided instead to try a new party line. They would now tacitly admit to the error but claim that the "New Cases" calculation is an acceptable approximation on the basis that drop-outs are probably not significant:

Note than once a patient officially enters into the CDDS program, he is entitled to benefits for life. This method of analysis does not adjust for potential increases or decreases in the number of persons with the diagnosis of autism owing to factors other than a new diagnosis, such as population migration or death. While such events occur, it is highly unlikely that their frequency is changing from year to year in a manner that would account for the observed trends.


Geier & Geier must not be aware of the University of California active status population report, where we can see that drop-outs are significant and do change significantly from year to year. Further, Geier & Geier fail to note changes in eligibility and diagnostic category. Of course, if they had gone ahead and funded the work they requested CDDS to do for them, we could discuss this issue with better facts at our disposal.

Rick Rollens

Rick Rollens is perhaps the anti-thimerosal activist who has more often used the flawed "New Cases" terminology to claim that autism rates are dropping in California. To his credit, this is probably just honest ignorance. I do not believe he has strayed from this script, and has used this terminology up until the very last report from CDDS.

Wade Rankin

I don't know for sure what Wade Rankin thinks of the "New Cases" issue but he has said the following:

On a policy note, Rick Rollens addressed the California numbers and, more importantly, the California response to those numbers. The California DSS numbers are undeniably controversial and subject to various interpretations. But a sensible look at them indicates that something is indeed going on, and Californians should be grateful that people like Mr. Rollens are there to see that society doesn't simply bury its collective head in the sand.


For this to be about something that is "going on" in the present tense, he must be referring to claims of an incidence drop. Sensible things can usually be explained. I hope Wade can come by and explain the sensible reasoning by which we can arrive at the conclusion that "something is indeed going on" in California.

Summary

Thimerosal hypothesis proponents tend to use a flawed "New Cases" terminology to claim that the incidence of autism is dropping in California, when in fact we don't have data on incidence at our disposal, at least not after 2004 (when incidence was on an upward trend still). Some of them are aware of the flaw, but do not appear to mind repeating it. This raises some questions about the intellectual honesty of certain proponents of the thimerosal hypothesis. One might hope – but not expect – these people to come forward, explain their position and openly debate the issue.

Sunday, June 18, 2006

Autistic and Proud

Today is Autistic Pride Day. I understand 2006 is only the second year for this celebration. Not surprisingly, I get the feeling that we have not come to terms with what "autistic pride" should be about. I sense some caution in the part of the autistic community, as if the appropriateness of autistics being proud of ourselves is unclear.

Some debate has already occurred. Joel Smith made some good points regarding what autistic pride should not be, and suggested appropriate ways to celebrate it. Ballastexistenz explained that autistics.org did not snub Autistic Pride Day in 2005, and also echoed Joel's points in the broader context of disability pride.

To try to conceptualize the issue, I have looked up what "pride" means to other movements.

Gay Pride.- "The gay pride or simply pride campaign of the gay rights movement has three main premises: that people should be proud of what they are, that sexual diversity is a gift, and that sexual orientation and gender identity are inherent and cannot be intentionally altered." (Wikipedia)

Black Pride.- "Black pride is a slogan used interchangeably to depict both the movement of and concept within politically active black communities, especially African-Americans in the United States. The slogan has been used by African-Americans to denote a feeling of self-respect, celebrating ones heritage, and being proud of one's personal worth. Black pride as a national movement is closely linked with the developments of the American Civil Rights Movement, during which noted figures such as Martin Luther King, Jr., Malcolm X, A. Philip Randolph, Stokely Carmichael, and others protested the conditions of the United States' segregated society, and lobbied for better treatment for people of all races... A related movement in the 70s to dispel the notion that black people's natural features, skin color and hair was inherently 'ugly.' The movement asked that men and women stop straightening their hair attempting to lighten or bleach their skin to 'look more white.'" (Wikipedia)

Disability Pride.- "Fundamentally, Disability Pride represents a rejection of the notion that our difference from the non-disabled community is wrong or bad in any way and is a statement of our self-acceptance, dignity and pride. It signifies that we are coming out of the closet and are claiming our legitimate identity. It's a public expression of our belief that our disability and identity are normal, healthy and right for us and is a validation of our experience." (Disabledandproud.com)

Deaf Pride.- "My own definition is that: *deafness is a disability which is so unique, its very nature causes a culture to emerge from it.* Participation in this culture is voluntary (I enlisted in 1989). Being a part of this culture has given me a sense of pride. I am no longer alone. I share a language, ASL, with many other people in the Deaf community. I share a history of struggle which is well-documented; not only are stories related to growing up deaf passed along within the Deaf community, but there are countless books as well (my personal favorite is Jack Gannon's Deaf Heritage). I enjoy ASL poetry and Deaf puns/jokes which cannot be translated into written English; they are unique in that they can only be understood within the framework of ASL. I enjoy attending plays and community events which focus on many Deaf issues. I also share many of the mannerisms of other Deaf people: the "deaf applause" cheer, a repertoire of visual expressions and signs which relay concepts far quicker than mere words ever could, a tendency to be more physically-oriented (i.e. tapping my foot, tapping someone's shoulder, blinking lights, etc, to get someone's attention), and so on. Last but not least, I bask in pride when I see Deaf people becoming more and more successful in the world..." (Ldpride.net)

I find the parallels with all these other communities remarkable. In this context, let me try to define what I believe autistic pride is:

Autistic Pride is a movement based on the following premises: (1) That autistics should be proud, not ashamed of who they are; (2) That neurological diversity a gift and a necessary part of human nature; (3) That autism is inherent and pervasive, and cannot be removed without also destroying the autistic person; (4) That autistics have worth and are valuable members of society; (5) That autistics should not be forced to act "normal"; (6) That efforts aimed at curing, defeating and exterminating autistics are inherently misguided.


I also sense there is some doubt as to whether it's appropriate to feel proud of autistics who have done well for themselves, because not all autistics reach this level of achievement. But I don't see anything wrong with celebrating Nobel-prize winner Vernon Smith, for example. Or even someone like Bill Gates (if he were to come out of the closet). This is no more wrong than it would be wrong for the Black community to celebrate Martin Luther King on the basis that not every black person gets to be like Martin Luther King.

And we should be proud of our strengths and talents, which are unique to each autistic individual. There is nothing wrong with this either.

Finally, I want to emphasize that pride is the opposite of shame. We should not be ashamed of who we are. We should not be ashamed of what others perceive as quirks or shortcomings. There is no reason to be ashamed of hand-flapping, fidgeting, rocking and so on. In the words of Autism Diva, the kid is rocking, not robbing a bank!

Saturday, June 10, 2006

Could Lawsuits Intimidate Autism Advocates?

[Before I start, let me congratulate Kathleen Seidel on some excellent investigative work. She uncovered a "fallacious" affiliation claim by David Geier in a paper that was recently accepted by Hormone Research. After the journal learned of the affiliation claim error, the paper was removed from the electronic version of the journal, and its PubMed abstract also disappeared. You can read all about it in Significant Misrepresentations: Mark Geier, David Geier & the Evolution of the Lupron Protocol (Part One). Bartholomew Cubbins has video of the Geier paper when it was on PubMed.]

Because autism is a medicalized way of being at the moment, it's not surprising that much of autism advocacy consists of debating science, debunking junk science, and investigating the motivations and conduct of autism researchers. The formal mechanism for dealing with scientific criticism consists of submitting commentary to medical journals, i.e. rebuttals. This mechanism forms much of the basis of the scientific principle of self-correction. Even with criticism posted on science blogs, it's usually possible to post a comment, or at least a rebuttal on a different blog.

What if researchers decided to use defamation lawsuits instead or in addition to rebuttals in order to deal with scientific criticism? Clearly, this would be anti-scientific in principle, and scientific criticism is speech that should have the utmost protection under the law. Such lawsuits would not have the slightest chance of being won either way. But what might their impact be on autism advocates, and on scientific criticism in general?

This is not just a theoretical question. Enter Geier et al v. Department of Health and Human Services (DHHS). [Thanks to Kathleen for finding and posting this information, which I should note is part of the public record.]

Geier & Geier's complaint against DHHS cited "(1) defamation, (2) interference with contract, (3) interference with prospective business advantage, (4) review of adverse agency action, and (5) interference with and deprivation of Constitutional rights arising from publication by Defendants of article falsely accusing Plaintiffs of fabricating scientific data."

The paper in question is "Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data" (Pediatrics, 2004) by Parker et al. The "accusations" claimed to exist in the paper can be found in the following paragraph:

Substantial questions regarding the accuracy of the denominator data for the incidence calculation also exist. The denominator requires the total number of children in the United States who received thimerosal-containing DTaP (exposed) and the total number who received thimerosal-free DTaP (unexposed). The authors indicated the source of these data as the "Biological Surveillance Summaries of the CDC." However, CDC reports only aggregate doses distributed for DTaP and other vaccines and provides no manufacturer-specific data. It is unclear how the authors estimated manufacturer-specific data because, on the basis of agreements with manufacturers, CDC does not release these data. No source is cited in the publication. The authors provided no details on how total DTaP doses distributed were translated into number of children vaccinated with specific thimerosal-containing or thimerosal-free vaccines, which is particularly problematic for a vaccine administered in a 5-dose schedule over a 4- to 5-year period.


In other words, saying that "it is unclear" how authors obtained data was construed as a defamatory accusation. It should be noted that the Geiers had explained how they obtained the data, and Parker et al published a retraction of the statement in question. Geier & Geier, nevertheless, saw it necessary to bring about this lawsuit in spite of the retraction.

This paper is one that has been repeatedly used to refute Geier & Geier in court proceedings. Clearly, this paper must have been hurting them financially, as the complaint explains:

20. Given the expertise they have attained on vaccine injury and given the demand for their services as expert witnesses, the Geiers dedicate a substantial amount of their time and resources to their role as expert witnesses. Dr. Mark Geier has appeared in approximately 100 cases and has participated in the review of approximately 1,000 claims.


The stakes involved are also made clear by the complaint:

35. It has been estimated that if thimerosal was determined to be a cause of the various neurological disorders, civil damages for the injury to hundreds of thousands of children could reach in to the multiple billions of dollars, either paid for under the NVICP or in private civil litigation.


The case was initially dismissed with prejudice following a motion from the American Academy of Pediatrics, and "no opposition having been timely filed by the plaintiffs." Geier & Geier subsequently filed a motion to dismiss without prejudice after "being unable to find qualified counsel to represent them in this matter." DHHS opposed the motion stating that the "case borders on the frivolous" but this opposing motion was later stricken from the record. In the end, the judge granted the order to dismiss without prejudice.

Without much legal expertise, it's not hard to see that a case like this would be very difficult to win. Is it likely that Geier & Geier expected to win this case? If not, why bring it about?

Upon learning about this case, autism advocates might react with caution, and might consider toning down criticism of Geier & Geier and other researchers. This would be an unfortunate outcome, as it would play into the hands of those who would rather keep us quiet. Prior advocacy movements have had to deal with much worse than silly lawsuits, and these movements did not retreat in the least bit. We need to continue pursuing these matters, now more than ever. Of course, there is no need to expose ourselves unnecessarily. Protect yourselves as best you can. And most of all, we need to back each other up when bad things do happen.

Let me now restate what others and myself have said about Geier & Geier:



The autism community demands answers to these questions. The appropriate way to answer these questions is not to bring about frivolous lawsuits. It is simply to answer them. And I want to make clear that I invite Geier & Geier to defend themselves in the comments section of any of my posts or elsewhere. And as usual, I explicitly invite anyone who agrees with Geier & Geier to try to answer these questions as well.

Sunday, June 04, 2006

Effectiveness of Chelation Therapy

Nothing is known for certain about the effectiveness of Chelation Therapy as a treatment for autism. Jim Adams, a professor of chemistry at Arizona State University and parent of an autistic daughter, is conducting the first double blind, placebo controlled study on chelation. It's expected to be completed by the winter of 2006. The study was featured by Dateline on Sunday June 4, 2006.

Jim Adams is a DAN! doctor. But I trust that Dr. Adams will conduct this research in a proper manner, following all the rules required of a double-blind study. He's got a prior study on vitamin supplements, where he documents some significant improvement in gastrointestinal and sleep problems, but negligible improvement in autistic symptoms.

[Note: I just finished watching the Dateline segment. They used the "devastating" word and showed some kids who were said to be recovered from autism. It wasn't at all obvious that they were no longer autistic. And it wasn't at all obvious that they were severely affected before chelation. After watching Jim Adams, I'm sure many bloggers at Autism Hub would easily imagine why his daughter is autistic. I immediately thought of the fictional researcher from Apology from an autism researcher. His daughter is verbal and I wouldn't say she's "low functioning" from what little was shown. At this point it appears that Jim Adams is pretty close to the acceptance phase regarding his daughter. He's one of those parents who'd been told that he would have to institutionalize his daughter. Dateline did mention the CDC thimerosal studies, chelation deaths, and interviewed a researcher who said chelation is useless in autism.]

What should we expect of the chelation study? Probably nothing remarkable. In the past, Chelation Therapy has been touted as beneficial for a number of conditions, but placebo-controlled studies have failed to substantiate anecdotal accounts.

I will list some studies below. I'm only including studies that have a control group on placebo. Feel free to list any studies I've missed in the comments section.

Neurological & Behavioral Problems

Dietrich et al (2004) - Lead Exposure - Succimer
"Chelation therapy with succimer lowered average blood lead levels for 6 months but resulted in no benefit in cognitive, behavioral, and neuromotor endpoints... Chelation therapy with succimer cannot be recommended for children with blood lead levels between 20 and 44 µg/dL (0.96-2.12 µmol/L)."

Rogan et al (2001) - Lead Exposure - Succimer
"Treatment with succimer lowered blood lead levels but did not improve scores on tests of cognition, behavior, or neuropsychological function in children with blood lead levels below 45 microg per deciliter. Since succimer is as effective as any lead chelator currently available, chelation therapy is not indicated for children with these blood lead levels."

Liu et al (2002) - Lead Exposure - Succimer
"The improvement in scores in the placebo group only implies that factors other than declining blood lead levels per se are responsible for cognitive improvement; it is possible but less likely that succimer, the active drug, impairs cognition."

Arthur et al (1997) - Cerebral vasospasm in rabbits - Deferiprone
"The present study demonstrates that deferiprone is effective in attenuating experimental cerebral vasospasm. Because of its stability, lipophilicity, and ability to penetrate the blood-brain barrier, deferiprone represents an attractive candidate for the treatment of cerebral vasospasm."

Gordeuk et al (1992) - Coma due to cerebral malaria - Deferoxamine
"Iron chelation therapy may hasten the clearance of parasitemia and enhance recovery from deep coma in cerebral malaria."

McLachlan et al (1993) - Alzheimer's - Desferrioxamine
"The trivalent chelating agent desferrioxamine (DFO), 125 mg i.m. twice daily five days per week, was used in a randomized single-blind, oral lecithin, placebo-controlled clinical trial in 48 patients with AD... Analysis showed that the treatment and no-treatment groups were closely matched at entry into the trial but that the rate of decline, as measured by the VHB over 2 years of observation, was twice as rapid in the no-treatment group compared with the DFO-treated group."

Ziegler et al (2004) - Diabetic Polyneuropathy - ALA
"The results of this meta-analysis provide evidence that treatment with alpha-lipoic acid (600 mg/day i.v.) over 3 weeks is safe and significantly improves both positive neuropathic symptoms and neuropathic deficits to a clinically meaningful degree in diabetic patients with symptomatic polyneuropathy."

Growth

Peterson et al (2004) - Growth - Succimer
"Although succimer lowers blood lead in moderately lead-poisoned children, it does not have a beneficial effect on growth and may have an adverse effect."

Lasky et al (2001) - Growth in Reshus Monkeys - Succimer
"Growth in weight, length, and head circumference did not vary significantly as a function of blood lead levels. Succimer chelation therapy did not significantly affect weight, length, or head circumference through 2 years of age."

Hearing

Lasky et al (2001) - Auditory Function in Reshus Monkeys - Succimer
"Finally, the auditory evoked response at levels from the auditory nerve to the cerebral cortex did not significantly differ as a function of succimer treatment."

Apparent Heavy Metal Toxicity

Grandjean et al (1997) - Symptoms Attributed to Amalgam Fillings - Succimer
"Immediately after the treatment and 5 to 6 weeks later, most distress dimensions had improved considerably, but there was no difference between the succimer and placebo groups. These findings suggest that some patients with environmental illness may substantially benefit from placebo."

Sandborgh Englund et al (1994) - Alleged Mercury Poisoning - Succimer
"No treatment effect of DMSA was apparent on subjective symptoms and mood state. One statistically significant treatment effect was noted - a decrease in fatigue-inertia in the DMSA-group - but there was no demonstrable correlation with increased urinary excretion or decreased blood concentration of mercury. Three subjects showed hypersensitive reactions, probably DMSA-specific, at the end of the treatment period. This placebo-controlled study provides no scientific support for diagnostic or therapeutic administration of DMSA for symptoms allegedly associated with chronic mercury exposition from dental amalgam fillings."

True Heavy Metal Toxicity

O'Connor & Rich (1999) - Lead Poisoning - Succimer
"All children with BPb, in the range studied here, should receive environmental evaluation and remediation; DMSA does not improve long-term blood lead levels."

Mazumder et al (2001) - Arsenic Poisoning - 2,3-Dimercapto-1-propanesulfonate
"3-Dimercapto-1-propanesulfonate treatment caused significant improvement in the clinical score of patients suffering from chronic arsenic toxicity. Increased urinary excretion of arsenic during the period of therapy is the possible cause of this improvement."

Cardiovascular Disease

van Rij et al (1994) - Intermittent claudication - EDTA
"Multiple reports of excellent results in large numbers of patients have encouraged the use of this regimen... CONCLUSIONS: Chelation therapy has no significant beneficial effects over placebo in patients with intermittent claudication."

Knudtson et al (2002) - Ischemic Heart Disease - EDTA
"There is no evidence to support a beneficial effect of chelation therapy in patients with ischemic heart disease, stable angina, and a positive treadmill test for ischemia."

Chen et al (2006) - Blood Pressure - Succimer
"Overall, there is no association between blood lead and blood pressure in these children with moderately high lead exposure, nor does chelation with succimer change blood pressure."

Summary

Chelation therapy is somewhat effective in the treatment of true heavy metal toxicity, but does not appear to have discernible effects in cases of minor exposure (as would be the case with Pica) or after significant time passes following exposure.

Iron chelation (with agents specific for this purpose) seems to be beneficial in Cerebral vasospasm and in Coma due to cerebral malaria. But these conditions result in severe neurological damage that can ultimately cause death, and they are not caused by iron poisoning.

Padhye (2003) hypothesizes that "excess dietary iron is the root cause for increase in childhood autism and allergies." But this hypothesis appears to be falsified by Latif et al (2002) which found a high prevalence of iron deficiency in autistic children. Chelating iron out of autistic children does not seem advisable.

There's a finding of interest about Alzheimer's and chelation of aluminum, but it was a single-blind study that apparently has not been replicated.

Alpha Lipoic Acid (ALA), an anti-oxidant which is also used as a mercury chelating agent, appears to be helpful in diabetic neuropathy. This leads me to wonder if ALA could be treating peripheral neuropathy induced by excessive vitamin B6 supplementation.

In general, prior chelation studies in combination with prior placebo-controlled autism studies suggest that anecdotal accounts of improvement need to be taken with a grain of salt. There is no good reason to suppose that Dr. Adams will find anything of significance regarding chelation therapy and autism, particularly given what is known about autism in regards to heritability, neurobiology and cognition. Even if Dr. Adams does find a positive correlation, this would not necessarily implicate mercury, thimerosal or poisoning for that matter.

It does not appear advisable to try chelation at the moment "just in case" considering its potential adverse effects. And I do hope Dr. Adams documents negative placebo effects and adverse effects in his study.

Further Reading

- Green, Saul. Chelation Therapy: Unproven Claims and Unsound Theories. Quackwatch.

- Laidler, James. Can Chelation Help Autism?. Reproduced with permission at Neurodiversity weblog.

- AP. Boy With Autism Dies After Chelation Therapy. MSNBC.

- Leitch, Kevin. Chelation: Dangerous & Experimental. Left Brain/Right Brain Blog.

- DeNoon, Daniel. Experts: Chelation Therapy Not Worth the Risk. MedScape Today.