Tuesday, January 30, 2007

Is Homosexuality Really That Different To Autism?

Homosexuality is often cited as an example of how the social construction of a condition can change radically in a relatively short span of time. The modern gay rights movement is believed to have started in 1969. Within four years they had accomplished a major feat: Deletion of homosexuality from the DSM-II. (It is disputed whether the gay rights movement had enough political power to achieve this, but it is clear that the social climate was shifting and not necessarily because of new scientific knowledge). Medicalized views of homosexuality have today been relegated to religious extremists for the most part.

An objection against the analogy between homosexuality and autism is that homosexuality is not disabling. That's fine. No analogy is ever going to be perfect. Some people think cancer is analogous to autism, despite the fact that cancer does not shape a person's way of being, and despite the fact that cancer gets gradually worse until the sufferer dies. Those same people who think cancer is analogous to autism are usually the ones who think homosexuality is a bad analogy. Go figure.

Incidentally, homosexuality has been compared to cancer.

Homosexuality is a disorder not in accord with Nature and, like cancer, heart disease or neurosis, is a reaction to circumstances non-existent in Nature but common in man-made circumstances.

(source)

What I was actually interested in researching is whether mainstream psychiatric opinion was that homosexuality is not disabling. I found some interesting parallels while doing so. The following is an excerpt of a 1967 letter to the British Medical Journal, by the authors of a paper on aversion therapy for homosexuality.

The argument that it is society that is wrong is very misguided. Which seems more unethical: To treat someone in distress, or to suggest to him that he waits until his practice is as socially acceptable as heterosexuality? The vast majority of our patients have been sad and unhappy individuals seeking help for a problem they see as central in their lives, and pleased with the results when these have been successful.

(source)

That is a familiar argument for sure. What are distress and sadness, except disabling? A similar view was expressed in retrospect by Charles W. Socarides in "How America Went Gay".

For most of this century, most of us in the helping professions considered this behavior aberrant. Not only was it "off the track"; the people caught up in it were suffering, which is why we called it a pathology. We had patients, early in their therapy, who would seek out one sex partner after another-total strangers-on a single night, then come limping into our offices the next day to tell us how they were hurting themselves. Since we were in the business of helping people learn how not to keep hurting themselves, many of us thought we were quietly doing God's work.


He then adds:

Excuse me. Gay is not good. Gay is not decidedly free. How do I know this? For more than 40 years, I have been in solidarity with hundreds of homosexuals, my patients, and I have spent most of my professional life engaged in exercising a kind of "pastoral care" on their behalf. But I do not help them by telling them they are O.K. when they are not O.K. Nor do I endorse their "new claim to self-definition and self-respect." Tell me: Have we dumped the idea that a man's self-esteem comes from something inside himself (sometimes called character) and from having a good education, a good job and a good family-and replaced that notion with this, that he has an affinity to love (and have sex with) other men?

(source)

Charles Socarides and Irving Bieber formed the Ad Hoc Committee Against the Deletion of Homosexuality from DSM-II in 1973 (source). Along with Edmund Bergler, these psychoanalysts were considered the last hold-outs of note against gay rights.

Edmund Bergler wrote a 1956 book whose title "Homosexuality: Disease or Way of Life?" is reminiscent of arguments we hear today portraying the autistic self-advocacy position as one stating that autism is an "alternative lifestyle". The book apparently received positive reviews, including one in Time Magazine (source). From a review elsewhere we learn of arguments that appear familiar.

He again deplores that "Kinsey's fanstastically exaggerated figures" have done a disservice by playing into the hands of certain true (compulsive) homosexuals who tend to glorify their disorder as a "superior way of life."


And then:

The author concludes that "... to counteract this we must disseminate knowledge that there is nothing glamorous about suffering from the disease known as homosexuality."

(source)

I am not sure if there really were gay people with the sort of views Bergler refers to. I suspect the following type of reasoning in Bergler's part probably has to do with it, however: If you do not think you are inferior, then you must think you are superior. Even some autistic adults seem to reason in this manner, judging by the following passage from "Send in the Idiots" by Kamran Nazeer.

What I found myself arguing...was that it was arrogant to believe that I was better because I was autistic; perhaps it did equip me well for certain things, perhaps some of these were not trivial, perhaps, for example, something of my intelligence was related to being autistic; however, I had only reached the threshold beyond which I could even have this discussion with them Thanks, surely to professional help... and a lot of consideration, and work, and care.


Edmund Bergler was a harsh critic of Alfred Kinsey, who is considered the father of sexology. To put Kinsey in historical perspective, think of him as the Laurent Mottron or Morton Ann Gernsbacher of that period. (I would mention Michelle Dawson, but it is not clear if Kinsey was gay). Kinsey argued that homosexuality was common, natural and not harmful; and that there was a sort of sexual orientation spectrum that went from "exclusively heterosexual" to "exclusively homosexual". He came up with the Kinsey scale, which attempts to measure sexual orientation. The Kinsey scale reminds me a little of the AQ Test.

Alfred Kinsey's views were attacked furiously by Bergler in a 1948 article titled "The Myth of a New National Disease". Some excerpts follow.

Consciously, these sick persons realize only their "righteous indignation," leading to self-defense and self-pity. They repress completely the fact of their own initial provocation, which began the sequence, as well as the masochistic enjoyment of self-pity. Thus the ego-strengthening illusion of "aggression" is maintained, and the dynamically decisive masochistic substructure is hidden. Those neurotics are "injustice collectors."

...

Sometimes homosexuals assert that they are completely "happy," the only thing bothering them being the "unreasonable approach" of the environment. That is a convenient blind. There are no happy homosexuals; and there would not be, even if the outer world left them in peace. The reason is an internal one: Unconsciously they want to be disappointed, as does every adherent of the "mechanism of orality." A man who unconsciously runs after disappointment cannot be consciously happy. The amount of conflict, of jealousy for instance, between homosexuals surpasses everything known even in bad heterosexual relationships.

...

Strangely enough, Kinsey sees only the antithesis: acceptance of homosexuality as a biologic fact vs. senseless segregation. He speaks disparagingly of treatment of homosexuality (he puts it ironically into quotation marks). The third possibility, namely to declare homosexuality a neurotic disease, does not even occur to him.

...

The fact remains that today homosexuality is a curable neurotic disease, requiring specific therapeutic techniques and prerequisites.

...

If these figures are only approximately correct (Kinsey sticks to percentages, and does not translate them into actual numbers), then "the homosexual outlet" is the predominant national disease, overshadowing in numbers cancer, tuberculosis, heart failure, infantile paralysis. Of course, Kinsey denies that the "homosexual outlet" is a disease in the first place. But psychiatrically, we are dealing with a disease, however you slice it.

...

Last but not least, Kinsey's erroneous psychological conclusions pertaining to homosexuality will be politically and propagandistically used against the United States abroad, stigmatizing the nation as a whole in a whisper campaign, especially since there are no comparative statistics available for other countries.

(source)

There were voices of relative reason besides Kinsey. See, for example, the work of Herbert Greenspan and John Campbell as early as 1945.

Both the psychiatric and social status of the invert is becoming increasingly more clear with the advancement of clinical psychiatry, and it is encouraging to note that society is being weaned away from the fallacy that homosexualism is a crime. We are gradually coming to the realization that the homosexual suffers from a regrettable sexual anomaly, but otherwise is a normal, productive individual, who is neither a burden nor a detriment to society. We hope that the recognition of the true nature of his problem will lead to a more rational and practical therapeutic approach, and that a more humane, understanding attitude will result.

(source)

The popular media began to take notice of social changes sorrounding homosexuality in the 1960s apparently. A 1966 Time Magazine article titled "The Homosexual in America" approaches the issue in a way that was probably considered "balanced" at the time.

That is the crux: most homosexuals apparently do not desire a cure. A generation ago, the view that homosexuality should be treated not as a vice but as a disease was considered progressive. Today in many quarters it is considered reactionary. Homophile opinion rejects the notion that homosexuals are sick, and argues that they simply have different tastes. Kinsey had a lot to do with this, for to him all sexual pleasure was equally valid. "The only unnatural sex act," he said, "is that which you cannot perform." His coauthor, Wardell Pomeroy, also argues that homosexuality should be accepted as a fact of human existence, and claims to have known many happy, well-adjusted homosexual couples.


Interestingly, the article includes some shadows of "epidemic" talk.

Whether the number of homosexuals has actually increased is hard to say.


It concludes as follows.

As such it deserves fairness, compassion, understanding and, when possible, treatment. But it deserves no encouragement, no glamorization, no rationalization, no fake status as minority martyrdom, no sophistry about simple differences in taste – and, above all, no pretense that it is anything but a pernicious sickness.

(source)

There's no question that the prevalence of overt homosexuality increased considerably at some point. In 19th century England, for example, homosexuality was extremely rare and criminalized (source). No doubt there was a "hidden horde" of gays and lesbians, if you will.

A well known medical similarity is in the type of treatment, which usually involves behavioral intervention. Some psychoanalysts claimed they could turn around 30% of homosexuals into full heterosexuals. O. Ivar Lovaas co-authored an article about the behavioral treatment of "deviant sex role behaviors" in children. The article was published in the Journal of Applied Behavioral Analysis (source).

The historical and political similarities are clearly substantial.

Monday, January 22, 2007

More Epidemiology From David Kirby

I realize I could be spending my time in more productive ways, particularly since the David Kirby show has clearly "jumped the shark". But I don't know if anyone else will feel it's worth it to take the time to verify David Kirby's numbers. Besides, I kind of like to analyze stats; it's a stim if you will.

The last time I posted, I looked into David Kirby's claims about drops in some IDEA numbers and I noted that there were discrepancies in the numbers reported by David Kirby compared to the only source he cited. I posted a request for clarification at HuffingtonPost.com, but my message was never approved apparently. I will try that again, adding a reference to this post.

On January 20, David Kirby reported (in EOHarm) that he scanned the IDEA data for drops in the autism category between 2004 and 2005. He found 4 states that show drops in the 3-5 administrative prevalence of autism between those two years: Hawaii, Iowa, Louisiana and Vermont. He adds:

The declines are modest, but noticeable, and the first ever decline in actual numbers that has ever been reported, as far as I can tell.

Well, he could not tell very far apparently. I went ahead and looked at state by state data between 2000 and 2005. After a quick glance at data for these four states only, I can see there was a big drop in the Iowa 3-5 caseload between 2000 and 2001; one in Louisiana between 2002 and 2003; and one in Vermont between 2002 and 2003. I am sure other drops can be found in other states, particularly those with small autism caseloads. David Kirby might have been close to realizing that when he said the following:

These four states have little in common and a from 4 completely different regions. The only trait they share is a relatively modest population rate. I don't know if that matters or not.

You see, the 3-5 caseload in California does not show any big fluctuations because California has thousands of children in that cohort. The four states Kirby found have less than 200 autistic children in that cohort. Fluctuations are expected statistically. I made a graph of caseload in these four states for 3 year olds only. Fluctuations are more obvious in that narrower cohort, but I chose 3 year olds because that would be the most telling cohort in terms of a drop in thimerosal exposure.


When you look at that graph, keep in mind that this is not a representative sample of states. This is a graph of four states handpicked by David Kirby based on whether their 3-5 prevalence has dropped between 2004 and 2005.

Saturday, January 20, 2007

David Kirby Toys With IDEA

David Kirby is now admitting that autistic children can in fact be missed in significant numbers, and that administrative prevalence increase can be attributed to increasing recognition of the condition. This is from his latest post at HuffPo:

But the national autism rate within IDEA is only 25 per 10,000 among 3-5 year olds, far below the estimated rate of 60 per 10,000. Ohio has only 9 cases per 10,000, Puerto Rico just 7, and Oklahoma just 4 (about 1/20th the rate of Maine).

Clearly, we need to let the diagnosing and reporting catch up before drawing any solid conclusions about autism...

I think that's a step in the right direction; a far cry from what he said just one month ago (which I won't address in this post):

With so many holes shot through their "five large studies" defense, the government lawyers will be left to argue that autism is purely genetic, that there is no environmental component, and that the rates of illness have not "really" gone up. We are simply better at recognizing and diagnosing the disorder, that's all.

My guess is that a month ago David Kirby did not know much about some of the details in IDEA, such as the fact that Maine has a special education autism prevalence of 77 in 10,000 among 3-5 year olds, whereas Oklahoma's prevalence is 4 in 10,000. I'm willing to bet this difference is not due to Maine having more crematoriums. (Oklahoma is catching up quickly too, considering that its autism prevalence has just about doubled between 2004 and 2005).

It follows that David Kirby must now also believe in the mechanism of diagnostic substitution, as documented by Shattuck (2006). Most children with autistic disorder or PDD-NOS "missed" in Oklahoma, for example, are likely in the special education system, except reported as part of other categories. These other categories are probably Mental Retardation, Specific Learning Disability, and Speech and Language Impairments. As the autism caseload rises, the caseload of some or all of these others categories can drop, and it has.

Kirby's look at IDEA comes after his prediction about the California DDS 3-5 cohort failed to materialize (a fact which he, JB Handley and others have failed to acknowledge). [ERRATA 01/22: In his recent debate with Arthur Allen, David Kirby did amit that his prediction failed and that this was in fact a blow to the thimerosal hypotheis]. Administrative prevalence of autism in the 3-5 IDEA cohort, nevertheless, is also on the rise as of the latest report. It went from 22 in 10,000 to 25 in 10,000 between 2004 and 2005. As a result, David Kirby has decided to try something new:

Even more extraordinary was the tumbling rate of 3-5 year olds entering school with speech or language impairments, which make up nearly half of ALL disabilities in the IDEA program.

In 2003 the rate was 286/10,000. In 2004 it fell to 282/10,000 and in 2005 it was 272/10,000 - a nearly 5% decline in just two years.

My readers probably know how I feel about claims by David Kirby. So I decided it was prudent to verify the claims from his latest post using data provided by ideadata.org. And I found some information of interest. Some of the numbers are mistaken, but that is not the main problem. What I have found to be wrong and misleading is the implication that these drops are unprecedented and thus possibly explained by a drop in thimerosal exposure.

Before I go on, readers should be aware that there is a caveat. Special education data are not reliable for tracking autism prevalence, as Laidler (2005) explains. The same should be true to an extent about other categories. I will do my best to cite everything so there's little room for doubt.

First, let me get the correct rate drops from the data. In the category "Speech or language impairments" (3-5), special education prevalence went from 2.77% (source) in 2004 to 2.72% (source) in 2005; not as dramatic a drop as Kirby claimed. Either way, there is a drop, and I think it's important to figure out if such a drop is expected or unexpected.

So I went and checked if there's earlier data to compare with. I found table B2A on disability prevalence for the 6-11 cohort from 1991 to 2005. This data clearly shows that (1) the administrative prevalence of speech and language impairments in the 6-11 cohort has been fairly stable throughout the 1990s and beyond, and that (2) there can be random variations in this prevalence from one year to the next. The prevalence peaked at 1.74% in 1993 and again in 2005. It had a low of 1.65% in 2001. These numbers do not support either an epidemic of speech and language impairments in the 1990s nor do they support David Kirby's claim about small drops meaning something in particular.

There is also a table of population served from 1997 to 2001, where we can see drops in the whole population prevalence of "Speech and language impairments" all throughout that period. It is easy to infer diagnostic substitution from that table, particularly from mental retardation over to autism. But it just so happens that between 2004 and 2005, the 3-5 mental retardation prevalence did not drop. I think the increase in the autism category had to have come from elsewhere.

Diagnostic substitution cannot explain the following claim by David Kirby, however:

In 2003, the rate of enrollment among 3-5 year olds in the US IDEA program was 587 per 10,000 kids, continuing a rising trend each year for over a decade. In 2004, the rate went up again, to 594/10,000 children.

But then, in December, 2005 (last year's data will be out in June) the rate fell, for the first time ever, to 580/10,000: a decline of 2.4%.


Again, let me get the correct numbers first. (I suspect whoever helped David Kirby used their own population tables, which is not necessary since the reports give prevalence). The number of 3-5 year olds served by special education system in 2004 was 5.87% of the population (source). The number served in 2005 was 5.84% in 2005 (source). The difference is 0.03% of the population. Although small, it is a drop, and it does seem to be unprecendented in the 3-5 cohort in recent times.

A reasonable explanation for this tiny drop is that the total number of children in the 3-5 cohort is starting to level off, and small fluctuations should be thus expected from one year to the next. How do I know this? Again, let's look at the 1997 to 2001 table. You will note that while the percentage of 3-5 year olds served increased steadily throughout that period, the precentage of 6-21 year olds served was fairly stable. This suggests there is probably an earlier age of diagnosis factor in 3-5 trends. You will also note the percentage of children served does drop from time to time, as it did between 1999 and 2000 in the older cohort. So there's probably no significance to the drop from 5.87% to 5.84% of the population.

A more noteworthy change is one that occurred in Maine, as David Kirby explains:

In Maine, the Special Ed rate among 3-5 year olds fell from 1,178/10,000 to 1,080/10,000 - down 3.3% in a single year.


The numbers are actually correct in this case, and the drop is pretty signicant in my opinion. An expected 1.7% of the state's 3-5 year olds are missing from the IDEA system in 2005. Special education budget cuts are a likely explanation for this drop, but let's determine why Maine might be an unusual state.

Remember how David Kirby suggested that the reason autism rates are not dropping is because we need to let diagnosing and reporting catch up to the epidemiology? Well, we don't have that problem with Maine. In 2004, the administrative prevalence of autism in the state was 66 in 10,000. That is even a little higher than the epidemiology. So it must have dropped by 2005, right? Well, no, it increased to 77 in 10,000. That is not a tiny change.

Maine is the US state with the highest administrative prevalence of autism. They must diagnose autism liberally compared to other states. But that's not all. They also have the 3rd highest proportion of 3-5 year olds served by the IDEA system in the US (after Wyoming and Kentucky). It would not be surprising if they tried (or had) to move in the direction of the rest of the country.

Maine's increase of 0.11% in the "Autism" category is matched exactly by a drop of 0.11% in the "Speech and language impairment" category. Most of the whole population drop is apparently in the "Developmental delay" category. It appears that the definition of "Developmental delay" is created by each state (source).

In conclusion, I do not believe David Kirby's latest post has a leg to stand on. But to his credit, he really does know how to muddy the waters.

Friday, January 19, 2007

Autism Speaks Wants Your Feedback (NOT)

CONFIDENTIAL. (No, just kidding).

Autism Speaks officials are probably too busy to solicit feedback on Roy Richard Grinker's "Unstrange Minds" from the Autism Hub. But I'll help them out. You can email editors@autismspeaks.org with your feedback. Even if you haven't read the book, you can give them your impressions on the "epidemic" idea, or your reactions to reviews of the book such as this one by Kev, or this one by Arthur Allen. (No big deal; EOHarmers probably haven't read the book either).

Autism Speaks has hired conspiracy theorists as consultants. Any chance they will hire, say, someone on the spectrum any time soon? I won't hold my breath.

I hear Autism Speaks' web presence has been declining for some time. I wonder why that might be.

Sunday, January 14, 2007

Forget Aluminum - Blame China and Forest Fires

I haven't yet had a chance to watch video of the Kirby-Allen debate, but there have been some informal assessments from people who were there. I hear David Kirby put on a show, albeit a fact-free one, which is not surprising. I have blogged about David Kirby's intolerable love affair with fabrications and unsubstantiated claims in the past. While Mr. Allen probably did his outmost to stay within the bounds of scientific fact and rational discourse, David Kirby apparently relied on off-topic speculation, showmanship and made-up excuses.

As widely predicted, mercury militants have not come clean after the California DDS 3-5 caseload failed to drop in 2007. The thimerosal hypothesis is officially pseudo-science, as its proponents continue to shift the falsifiability goalposts to increasingly ridiculous lengths. One of the most bewildering excuses I've seen is that the aluminum dose has increased in vaccines as thimerosal was phased out.

And it's not just David Kirby who has established goalposts he has later decided to ignore. JB Handley has said the following:

Late 2006 should be the first time that rates go down. If they don't, our hypothesis will need to be reexamined.

(Source)

David Kirby does deserve some credit for imagination. He came up with to-date unheard-of excuses that play on people's justified concerns about environmental pollution and climate change. This was in addition to the usual excuses. I will now address the whole list of excuses as recalled by Vera Smith in the EOHarm mailing list on January 13, 2007.

1. California has a lot of HMOs (50% of population) who probably continued to use mercury vaccines longer than average.

This is clearly unfounded speculation. What is the evidence that HMOs used mercury longer than average? How much longer?

2. We do not know when 25 mcg infant vaccines really made it off the shelves. When the CDC says the supply was down to 2% in 2003 (I think that was the stat) it was not official. They called vaccine providers and asked what was in the fridge -- not a definitive answer.

The information Arthur Allen provided is from the minutes of a CDC meeting held on February 20-21, 2002 at the Atlanta Marriott North Central Hotel. The following is an excerpt of the minutes:

Mr. Dean Mason presented a chart of the thimerosal-containing vaccines/toxoids in the pediatric schedule and under the C.D.C. contract (not all of which are licensed in the U.S.). N.I.P. estimated the amount of thimerosal in provider vaccine inventories in a survey conducted September 20, 2001 to February 20, 2002. The targets were a convenience sample of providers getting site visits from public health officials across the country. Inventory counts were done of all refrigerators for D.T.a.P., Hib, and hep B pediatric vaccines. The thimerosal classification was based on the lot number information, which was verified by the manufacturers.

In September 2001, 225 sites were canvassed, and 447 by February 2002. The decline in thimerosal-containing vaccine went from 5.6 percent to 1.9%, from 33,500 doses out of 63,600; to 2,796 doses out of 149,147. These were delineated by D.T.a.P., D.T.P., Hib, hep B-Hib, and hep B. Hep B rose from 4.95 percent to 7.5%; the proportion that is pediatric (10 microgram) versus adolescent versus adult (5 microgram) still requires evaluation. However, the N.I.P. thinks that most of it is pediatric.

(Emphasis mine)

David Kirby and Arthur Allen on Fox 6I wonder what part of "site visits" David Kirby got confused about. In fairness, he probably didn't even get a chance to read the minutes of the meeting. In the warm-up debate on Fox 6 it was clear that Arthur Allen surprised David Kirby with the information about the sharp decline in thimerosal uptake. Kirby looked like a deer in the headlights, but he had one whole day to make stuff up.

Was David Kirby suggesting that physicians lied about what they had in their fridges? Were they supposed to have made up lot numbers? This obviously borders on the preposterous. Besides, it is known that the lifecycle of vaccines is not too long.

Let's move on.

3. Calif has had horrendous forest fires over the last 5 years (much more so than the previous 20), and pregnant women are breathing the fumes. Forrest fires release a lot more mercury than even coal fired power plants.

Oh my. It is true that forest fires have increased in California, and this is attributed to global warming. The increase is not something that just started to happen in the last 5 years, however; rather, there is an increasing trend that starts in about 1987 (source). The forest-fires-cause-autism hypothesis lacks merit, and I suspect most people can see the utter nonsense of Kirby's proposition. For one, a substantial number of the autistic children currently diagnosed would be expected to live around forested areas in California. It is easy to verify that this is not the case. In fact, autistic children tend to be diagnosed more often in areas with high population density. Second, if this new hypothesis were true, a clear season-of-birth trend would have been noticed.

4. The horrific coal generated mercury pollution from China (as we have been reading) is getting worse and the mercury by-product is brought into CA (particularly So Cal) from the jet stream. These coal fired power plants have expontially increased since 2000.

Interestingly, mercury militants have blamed the US for "poisoning" children in China with thimerosal. Now David Kirby is blaming China for sending contaminants to the US.

It is true that pollution from China is deposited in the western US, and coal emissions are estimated to increase about 10% per year (source). Let's suppose this is currently a major cause of autism in California, which would need to be for Kirby's excuse to make sense. How would it explain large differences in the prevalence of autism from one regional center to the next? More importantly, how does it explain large differences in the current pace of caseload increase between regional centers? (The "epidemic" of autism is in full swing in the Central Valley Regional Center, for example, with an annual caseload growth rate of about 24%).

5. The CDC recommended flu shots for pregnant women and infants. As Kirby pointed out, that merucry exposure to an in-utero infant from a flu shot could be as devasting (paraphrasing here) as the entire US vaccine schedule of the 1990s given that an in-utero baby is a fraction the size of an infant. Allen refuted this argument that only 25% of California infants get the flu vaccine and only 13% of pregnant women get it.


It should be noted that the flu vaccine is not recommended for infants under 6 months of age. Even if we were to assume that all children get the flu vaccine, thimerosal exposure from this is much lower than pre-epidemic levels of exposure. Regarding vaccination of pregnant women, are we to assume a substantial portion of autistic children currently diagnosed were born from the small percentage of mothers vaccinated against the flu while pregnant? What is the evidence that this is the case? What is the evidence that the fetus receives a substantial portion of the mercury the mother is injected with? Would this mean that all children who became autistic this way have early-onset autism?

To recap, Kirby has provided a list of excuses aimed at obfuscating the evident failure of a bad hypothesis. None of the mechanisms he proposes can be correlated to changes in California autism caseload trends. The excuses are based on far-fetched, easily refuted speculation, stuff he made up that came out of nowhere, and in at least one case, an outright fabrication.

Thursday, January 11, 2007

Hell Fails To Freeze Over

The latest quarterly client characteristics report out of California DDS is out. As expected, the number of autistic clients in the 3-5 cohort has increased. There were 6,188 such clients in the Q3 2006 report and 6,348 such clients in the Q4 2006 report. Annual caseload growth in the 3-5 cohort is 11.76%, which at the moment is a fairly stable rate and still a lot higher than population growth in the state.

Let me now post the obligatory Citizen Cain quote:

Understandably, Kirby doesn't seem interested in mucking around in the data with me too extensively, or in answering my detailed questions. But in an e-mail, he did address the key point, and concede that “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.” He also conceded that total cases among 3-5 year olds, not changes in the rate of increase is the right measure.

Citizen Cain also had some interesting things to say about the scientific method:

Now we're getting somewhere! Somewhere that's something like science! We now have agreement from someone highly sympathetic to the hypothesis that thimerosal exposure contributes to autism on a means of falsifying that hypothesis.

That's right. One of the ways you tell science from pseudo-science is through falsifiability. For a moment there Kirby proposed falsifiability criteria on a hypothesis, making it potentially scientific. Will this hold up now? Probably not.

David Kirby has shifted goalposts before. My hunch is that Kirby will not own up to his prediction. From his latest blog post the strategy seems pretty clear. Autism incidence is not going down, so he's now focusing on a new syndrome he made up that he imagines underwent an "epidemic" and presumably is or was on an downward trend. On EOHarm he's also been expressing interest in the environmental pollution hypothesis, which in my opinion is flawed in exactly the same way the TV hypothesis is.

Here is a recap of other reactions you should expect to see from the mercury militia:

  • Thimerosal in the Flu vaccine is enough to sustain the epidemic on its own. (Unstated: Autism rates are not dose-dependent; there wasn't really an autism epidemic in the 1990s; autism started in 1931 but was recognized much later at current rates).

  • The epidemic was caused by thimerosal in the RhoGAM shot, not that in pediatric vaccines.

  • There is another vaccine ingredient (e.g. aluminum) which is interchangeable with thimerosal as an autism risk factor, and the dose of this ingredient was increased in a precise manner such that removal of thimerosal would not be noticed.

Clearly, it will be very difficult for the autism-thimerosal worldview to survive and continue to be one of interest in the autism community.

Addendum

The following is a graph of the 3-5 caseload for the last 18 quarters that I got from Dad of Cameron:



What exactly was the impact of thimerosal removal?

Wednesday, January 10, 2007

1 in 6 Have What Now?

From Mark Geier:

And if we have one in six children, even using their figure, that have brain damage, and we end up, there’s three hundred million Americans, and we end up with one in six of them having brain damage, that’s fifty million Americans, we’re not going to be the number one country in the world anymore.

From David Kirby:

American kids are in huge trouble. One in six has a learning disability. Asthma, diabetes, allergies and arthritis are ravaging their bodies in growing numbers. And little of this is due to "better diagnostics" or "greater awareness."


From JB Handley (Abmd, October 22, 2004):

1 in 6. 1 in 6. 1 in 6.

1 in 6 of our children are suffering from Autism, Aspergers, PDD-NOS, ADD, ADHD, Asthma, deadly food allergies, or a learning disability. 1 in 6. 2 million American children are on Ritalin. 2 million. Autism rates have jumped 80-fold in 15 years. 80-fold!!! (from 1 in 10,000 to 1 in 125).

Guys, at the very least get your story straight.

JB Handley adds:

How can this be true?

It's not, particularly when you keep using that incorrect and unsourced 1 in 10,000 figure in your website, and you keep comparing apples and oranges.

I don't doubt there is a CDC statistic about 1 in 6 children having something. But how about being careful about paraphrasing it? If you're trying to make an argument with that stat, I would think it's important to get that right.

I'll tell you what's true. About 1 in 6 of all persons fall below the 16.67-percentile in every normally distributed human capability. Maybe if you whine more, that will change.

Tuesday, January 09, 2007

About One of TACA's Taglines

If you visit the website for Talk About Curing Autism (TACA), you will note one of their taglines reads as follows:

Some of our families have been told to put their child in an institution. We're hoping for Harvard.

There's so much wrong with this tagline that I thought a full blog post was needed to address it.

To begin with, we have this common claim about how doctors have recommended institutionalization. This doesn't match my experience, but I've heard this anecdote so many times that I have to conclude some doctors still do this. It is wrong for them to continue to do this, and there are number of different reasons of various types as to why this is wrong. Some people would argue that absolutely no one should be institutionalized under any circumstances. When it comes to autistic children specifically, there is no scientific reason to recommend institutionalization, nor any reason to suppose most autistics end up institutionalized. In fact, most adult classic autistics seem to live either at home with a parent or in community care. Some live independently. The outcome of autistic individuals is rather unpredictable.

TACA is helping promote the idea that autistics belong in institutions. I am sure that is not the intent of the parents who manage TACA, but that is effectively what they are doing.

The premise in TACA's tagline is that an autistic person must be cured for them to be able to attend a university such as Harvard. There are a number of reasons why this is wrong.

First, this unintentionally promotes the idea that it is acceptable for universities to discriminate on the basis of disability. That is, if an applicant is autistic, they can be rejected on the basis of autism; because, after all, an autistic person must apparently be cured before being able to attend a university.

There is also something that seems factually wrong about the premise of the tagline. It assumes that autistics are less likely to go to college than non-autistics. I do not know if this is true. I know that outcome studies have found that some classic autistics do end up going to college. And not all non-autistics go to college. In the US looks like about 24.4% of all people end up getting a Bachelor's degree or higher (source).

Turning that around, I do not believe autism is less common inside universities than in the general population. (There's not a lot of data on the matter, but I can provide some specific details why I do not believe this).

There are non-cured autistics who teach in universities, e.g. Temple Grandin, Professor of Animal Science at Colorado State University. There is at least one non-cured autistic who has won a Nobel Prize in an academic field, Vernon Smith, Professor of Economics and Law at George Manson University. I'm only mentioning diagnosed autistics.

Autism organizations would better spend their resources trying to understand how successful autistics got to where they are in the absence of a cure, instead of pursuing dead ends such as the thimerosal hypothesis in the futile and notoriously unsuccessful search for an unlikely cure. That is part of what the petition to the NIH is about.

Finally, what is it with mentioning Harvard specifically? Hope and positive thinking are good things, for sure. But expecting that the very unlikely will come true is quite another. It's not good for the mental well-being of the person having the expectation, and it cannot be good for the person who is pressured into fulfilling the expectation. Harvard apparently admits just over 1000 students every year, and about 4 million Americans are born every year in the United States. The odds aren't too realistic, either for autistics or non-autistics. Of course, if it turns out that someone really does have a shot at being admitted there, they should definitely give it a try. That's not what I'm arguing against.

Saturday, January 06, 2007

ANN: Kirby-Allen Debate

There will be a debate titled "Vaccines and Autism: Is There a Connection?" between David Kirby and Arthur Allen. The debate will take place in San Diego, California on Saturday, January 13, at 10am. The address follows:

UC San Diego Price Center
9500 Gilman Dr.
La Jolla CA 92093

Admission is free, provided you register with TACA before January 10. (Be prepared to give out a mailing address). Or you can pay $10 on-site.

The main sponsors of the debate are apparently Generation Rescue, SafeMinds, TACA and the Autism Research Institute. As you can imagine they will surely do their best to come up with an audience hostile to Mr. Allen. If you know someone who lives around the San Diego area, who is a skeptic of the vaccine link or an autistic adult or a parent who doesn't buy into the vaccine hoopla, be sure to let them know about the debate. If you have a blog, you can help by reposting the announcement. You can also email anyone else who might be interested.

Friday, January 05, 2007

What David Kirby Never Said About "Autism Every Day"

Not everything that comes from David Kirby is crap, at least it didn't use to be. Check out this passage from a 1998 article of his titled From soft words to hard fists - anti-gay rhetoric may lead to violence:

Does rhetoric spark violence? Most gay men and lesbians would answer with a resounding yes. Many activists believe a right-wing, antigay campaign launched earlier this year fanned the flames of intolerance flint ultimately killed Matthew Shepard. They point to the remarks of Senate majority leader Trent Lott, who compared gays to alcoholics and kleptomaniacs, as well as the ex-gay ad campaign.

That Trent Lott is no doubt one of the most bigotted politicians of modern times. But at least he didn't say homosexuals attack everybody, bite their mothers and ruin property with rivers of diarrhea. And keep in mind that Lott might have been referring to, you know, a small subset of homosexuals with some syndrome he made up. No, seriously, how is what David Kirby said about autistic children any different to what Trent Lott said, or to this, or this?

Why is discourse important? Let me again quote David Kirby:

Brian Levin, a criminologist and director of Stockton College's Center on Hate and Extremism, cites a rhetorical link to all hate offenders. "They share prejudicial stereotypes that label certain groups of people as appropriate targets for attack," says Levin. "For a certain segment of impressionable, misguided, and violence-prone youth, derogatory statements made in the social and political discourse are perceived to give them license to brutalize gays and lesbians."

So what happened since 1998? Did David Kirby forget all about this? Was he unwilling to rock the boat or something? I want to give Mr. Kirby the benefit of the doubt. Maybe he never heard of the "Autism Every Day" video, since he's not really that connected to the autism community.

Wednesday, January 03, 2007

Kirby: It's About "Rivers of Diarrhea" and Kids who "Spin like Fireworks"

If you thought David Kirby's "mercury defenders" post was odd, wait until you read his latest installment titled There is no autism epidemic. Already Kev and Kristina have addressed the arguments and claims in Kirby's post, so what I want to do here is look at the likely intentions and assumptions behind the post.

Let's start by noting that this is apparently the first time David Kirby has commented on the neurodiversity movement. He feels neurodiversity advocates are among the most vocal of his critics, who he claims are trying to "vilify" him. He must be referring to rebuttals of his arguments, calls for him to source unlikely claims and to come clean on prior predictions.

These adults argue passionately that autism is neither a disease nor a disorder, but rather a natural and special variation of the chance genetic imprint left upon human behavior.
Perhaps Mr. Kirby is reading this blog. Maybe I should consider renaming it to "Natural and Special Variation". He's clearly making some generalizations. For one, the neurodiversity movement includes many non-autistic parents of autistic children. Additionally, while I do believe that various genes must be important factors in autism, there's no denying that the environment and epigenetics must also play a role (as they do in nearly everything about humans). There's also no denying that various environmental causes of autism are known, e.g. congenital rubella.

Certainly, Kirby's 2007 CDDS prediction must be on his mind. He must expect the community of bloggers who closely follow and are skeptical of the thimerosal hypothesis to be the ones to ask him to come clean on that prediction. And most of that community, surely not all, is made up of neurodiversity advocates. Under these circumstances he's decided to offer a "truce" of sorts. The "truce" consists of, get this, proposing that he's not been referring to "autism" all along, but to a new disorder he's made up called "Environmentally-acquired Neuroimmune Disorder" (END). Of course he's not being serious or candid about this, but let's play along. The criteria for the new disorder he's made up is roughly the following:

A. The child begins talking, and then suddenly never says another word. (END must thus be a subset of CDD).

B. Child may never learn to read, write, tie their shoes or fall in love. (Not really part of criteria, but an unspecified expectation about the syndrome I'm guessing).

C. Child wails in torture (usually at odd hours of the night) because something inside them hurts like a burning coal.

D. Child has inflamed, distressed gut, and bowel movements wind up in rivers of diarrhea or swirls of feces spread on a favorite carpet or pet.

E. Frequently escapes from home, and is found freezing wandering around.

F. Child spins like fireworks, and may crack head as a result.

G. Child stares at nothing and screams at everything.

H. Child bites mother.

I think he forgot "breaks mother's arm". I would suggest comparing notes with Mark Geier.

I doubt there's any validity in defining a new syndrome in this manner. But what's clear from Kirby's post is his intention to shock by means of gross descriptions such as "rivers of diarrhea". Of course autistic kids have diarrhea. More often than non-autistic kids? Maybe, I don't really know. There are no rigorous studies on the matter as far as I can tell. Has David Kirby never had a diarrhea attack?

There are obviously a number of incorrect assumptions that went into Kirby's mental gymnastics, which I think are the following:

  1. Autistic self-advocates and children of neurodiversity advocates do not have these characteristics.

    This has been debated repeatedly. See, for example, this and this.

  2. All children of mercury militants do have these characteristics.

    This is false. There are many mercury parents of kids who aren't too obviously autistic. Furthermore, children of prominent curebie parents are growing up, and some do not seem to agree with curebie-ism, as they are apparently starting to revolt.

  3. There is an epidemic of END.

    There is no way to know this, as there is no epidemiology on the characteristics Kirby describes. What is the evidence of an increase in the prevalence of these characteristics?

  4. END is caused by thimerosal.

    Those symptoms (rivers of diarrhea, spinning like fireworks) certainly do sound like symptoms reported after instances of mass mercury poisoning from historical reports, right?


It's difficult to find any merit in Kirby's latest attempt at arguing who knows what.

There's another Geierism in the post which I wanted to address:

American kids are in huge trouble. One in six has a learning disability.
Is this true? Please provide a source Mr. Kirby. It appears that the prevalence of learning disability in the US is 1.69% (source) or 1-2% (source), even though approximately 2.5% of the population scores below 70 in IQ tests (which is a stable rate, BTW). If we go back to a 1981 study, it appears that 10% of children were identified as being at risk of learning disability. That was long before the "epidemic" of neurological disorders. I have found other studies with somewhat higher rates, but nothing near 1 in 6 children.

I guess it depends on how it's defined. If you make dyslexia a learning disability, and you include every child who is even a little dyslexic, then sure, 1 in 6 is plausible.

But perhaps David Kirby is referring to the prevalence of psychiatric conditions among children, and if you consider that the prevalence of ADHD in children is about 10%, I can see how 1 in 6 might be right. But then what does ADHD have to do with the END syndrome of Kirby's post? I fail to see the connection, and in fact, it makes no sense for him to consider ADHD after stating he's only concerned about "severe" symptoms.

There's a picture of a 1926 American Eugenics Movement exhibit over at autistics.org. The exhibit reads:

  • Every 48 seconds a person is born in the United States who will never grow up mentally beyond that stage of a normal 8 year old boy or girl.

  • Every 16 seconds a person is born in the United States.
In other words, 1 out of 3 persons born in the United States had a considerable mental handicap in 1926 according to that exhibit. Mistaken and biased? Perhaps, but the type of discourse is very similar to that of David Kirby or Mark Geier, isn't it?