Monday, April 23, 2012

Is Obesity During Pregnancy a Risk Factor for Autism?

It is important to preface this information by stating that although this study is very interesting, this in no way proves autism is caused by obesity, or more specifically obesity during pregnancy.  There are a number of factors that most likely contribute to autism, and this is merely one such factor.

What this study did find was that women who were obese during pregnancy were about 67 percent more likely to have autistic children than women who were considered normal-weight during pregnancy.  That is a significant development, but one which needs confirmation via additional research.  If this holds true, then this is yet another piece of the puzzle which coupled with other research can lead us towards finding the true root cause(s) of autism and hopefully (eventually) to treatment programs and even a cure.

USA Today (AP): Autism may be linked to obesity during pregnancy

Full study can be found in the Journal Pediatrics:  Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders

The question remains - how can antivaxxers like Lowell Hubbs spin all of this new research to shift the blame back onto the vaccines they claim cause autism?  Can they just conveniently ignore these studies?  Can they claim obesity is caused by vaccines themselves?  Will they try to pretend the increased risk from obesity is merely a trigger and that the root cause is still vaccines?

It is anyones guess, but considering how often antivaxxers confuse correlation and causation, you might think they would be quick to recognize that as the obesity epidemic in our nation has ballooned (pardon the pun) so has the autism epidemic.  Of course I am not one to draw conclusions based upon random coincidences... but then again I'm not an antivaxxer.

Perhaps this is a good time to mention that Jenny McCarthy weighed in at 211lbs during her pregnancy with her son Evan (who she claims was autistic until she magically 'cured' him).  Considering McCarthy is 5'7" and around 125lbs, a health weight range during pregnancy would have resulted in her gaining between 28 and 40lbs.  Thus, in no uncertain terms, McCarthy was clinically obese during her pregnancy as she was carrying at least 46 extra pounds on her frame.

For the record I'm not suggesting that McCarthy's weight resulted in her son being autistic, primarily because I can't be certain her son actually is (or was) autistic in the first place.  However if her son is autistic, it seems her massive weight gain during her pregnancy was likely a significant risk factor, and as such will most likely go unmentioned by McCarthy or anyone else in the anti-vaccination camp.  Why you ask?  Because antivaxxers would never be willing to accept that their actions might contribute to their children being diagnosed with autism, and instead it is much easier to just blame vaccines or drug companies or pediatricians or hospitals.  It seems it isn't really about finding a root cause... it is about finding someone else to blame. 

Sadly, this seems to be the American way as everyone claims to be a victim and they are never to blame for something that might go wrong.  If something happens to a child, the parents look around for someone to blame.  If someone gets caught driving drunk, they blame the police or the judge.  If they are arrested for theft, they blame a substance abuse issue.  If they suffer from a medical condition or have issues controlling their rage, they look to a doctor or drug company to blame, but rarely do people actually look in a mirror and accept responsibility for their own lives.

Any way you spin it, this is not a good time to be an anti-vaccinationist, and 2012 is shaping up to be one of the worst years on record for Lowell Hubbs, Jenny McCarthy, and their antivaxxer brethren.

Wednesday, April 11, 2012

Autism Linked to Inherited Gene Mutations

Per a recent ABC News article, "[...] many scientists agree that the growing autism numbers may in part be attributed to certain genetic mutations that are most likely inherited from the father, according to the combined findings of three studies published Wednesday in the journal Nature.

The studies are the largest to date to use whole-exome sequencing, which decodes the protein in both children and their parents, an arguably more precise method of detecting genetic mutations in multiple genes that may be associated with autism.

The findings from one of the studies supports mounting evidence suggesting that the older the father, the higher the chance the child may develop some form of autism.

In another study, researchers who compared siblings with and without autism found that the sibling with autism had two different mutations of the gene SCN2A.

Genetic mutations found in the child with autism that were not found in either parent are likely not associated with autism, one of the studies concluded."

The full ABC News article can be found here:  Autism Linked to Inherited Gene Mutations, Particularly From Dad

A similar New York Times article referencing the same studies can be found here:  Scientists Link Gene Mutation to Autism Risk

And the studies can be found here (note registration is required to read some of the full studies):

De novo mutations revealed by whole-exome sequencing are strongly associated with autism

Exome sequencing in sporadic autism spectrum disorders identifies severe de novo mutations

Patterns and rates of exonic de novo mutations in autism spectrum disorders

Please don't misunderstand these studies, the articles, or my comments.  This data does not prove a root cause of autism and there is much, much more work to be done.  However these studies do show us a link, and finding more and more of these links coupled with determining other risk factors can lead us to the true cause somewhere down the road. 

Studies like this are crucial if we wish to find the true root cause of autism, however you aren't about to hear many antivaxxers talking about them because any discussion which surrounds genetic risk factors reduces the chances that their vaccination fears are justified.  The reality is we see more and more autism research coming out almost on a weekly basis, and to date none of it has ever shown a link between vaccines and autism.

Perhaps it is time some of these antivaxxers such as Lowell Hubbs started to pay attention to this research and modify their hypothesis.  Rest assured I don't suspect that will happen, but the more data and research that we have on the subject, the more foolish these antivaxxers look.  I can only assume it gets tiring for them to keep developing new and clever excuses to explain away the mountains of evidence which fly in the face of their "vaccines cause autism" unsupportable theories, but true to form you can expect them to slide the goalposts yet again as they try to spin this in their favor.

Antivaxxers are nothing if not consistently misleading and flat-out dishonest.

Autism Prevalence: One in 88?

There are times when it makes sense to draft a blog post to discuss a particular subject matter or news report so that I can offer my own take on the information, add some context, and of course a dose of commentary.  In respect to the latest CDC report that shows one in 88 American children are autistic, my previous blog post accomplished this.

Then there are other times when it makes more sense to simply link to another site which has already done their own legwork. This is one of those times, and this article written by Dr. Gorski over at Science Based Medicine does an amazing job of spelling out some of the major logical errors that originate from the anti-vaccination camp.  It is worth a read.

Via Science Based Medicine: Autism prevalence: Now estimated to be one in 88, and the antivaccine movement goes wild

Of course I do have a few points of my own to add as well. First, if the prevalence of autism is actually growing (as opposed to the rate of diagnoses growing), then it tends to fly in the face of the theory that vaccines cause autism, because antivaxxers keep telling us that more and more people are skipping vaccines in favor of more "natural methods".  Granted some of these people are dying as a result, and of course we know the claims of more and more people skipping vaccines simply arent' true, but the point is antivaxxers can't have it both ways. If they honestly believe that vaccines cause autism, and if they also believe that more and more parents are seeking vaccine exemptions for their children, then by all accounts the rate of autism diagnoses should actually be decreasing.  It is not.

So what is it? Are we to honestly believe the rate of autism is actually going up not due to better diagnoses but simply because the disease is that much more prevalent? If that is the case, then clearly antivaxxers must admit that their anti-vaccination campaign isn't working... because how else can you explain the rate of autism going up unless you believe a larger percentage of children are receiving vaccinations?

The truth is, the wild claims about the number of parents seeking vaccine exemptions simply aren't true, and although the rates of vaccination are not decreasing, they aren't actually increasing at a huge rate either. For the most part, vaccination rates haven't shifted more than 5% in recent years, thus any attempt to blame a increase in the prevalence of autism upon vaccines and/or vaccination rates seems to stumble out of the gate.

It is interesting when you examine the actual usage of vaccines during 2008 and align this with the reported rate of autism from the CDC report. The same can be done for the cohort groups from 2002 and 2006 as well. If vaccine use had actually decreased, one might think antivaxxers would have taken the time to align this usage to an decrease in autism diagnoses. However, since vaccine use has remained relatively stable (in some cases actually increasing slightly) during this time period, yet the rate of autism diagnoses has grown at a much faster rate, how do they explain the discrepancy?

Perhaps a better question is, why haven't these anti-vaccination groups performed this analysis prior to jumping on the "vaccines must cause autism" bandwagon? The data simply does not support the hypothesis... and they know it.

As you can see this becomes rather difficult to explain if you are an antivaxxer. Things become even more difficult to explain when you realize the time period this report covers occurs during the time period that thimerosal was being removed from all childhood vaccinations. This should indicate that the removal of thimerosal had no impact upon the rate of autism, and if one were to confuse correlation and causation (as so many antivaxxers commonly do), one could even go so far as to make the argument that the removal of thimerosal actually increases the rate of autism.  After all, we know the amount of thimerosal being injected into children has dropped significantly since the year 2000 almost to the point of being eliminated entirely (aside from some flu vaccines), and we also know the rate of autism is growing rapidly.  So if we were to simply base our opinion upon correlation, it stands to reason that the removal of thimerosal is directly responsible for the increase in autism.

By all means let me know when one of these antivaxxer groups comes out with that little hypothesis.

Another interesting tidbit at play here is the fact that this data comes from the Centers for Disease Control and Prevention (CDC). If you have spent more than five minutes researching the subjects of autism and/or vaccines you will know that antivaxxers are very skeptical of the CDC. They have accused the CDC of manipulating data, they have accused them of falsifying studies, they have accused them of being in the back pocket of "big pharma" and they have a severe distrust of anything that is published or released by the CDC.... until now apparently.

This is yet another example of how antivaxxers attempt to cherry pick data that flies in the face of their own wild and unsubstantiated theories. If you don't trust an organization, why is it ok to cite their data and treat it as fact when they have stated previously that CDC funded studies are worthless? Is that not the definition of hypocrisy?

It seems we are to the point that any new information about autism diagnosis is immediately pounced upon by the antivaxxer community, and unfortunately they appear to do so even before they understand the very data they are using as ammunition. Perhaps instead of jumping to conclusions using faulty assumptions and opinion the anti-vaccination crowd would be well served to take a step back, fully understand the data they are discussing, and perhaps begin to realize this is a much bigger issue, and a must more important issue, than they are trying to make it out to be.

It sort of makes you wonder... what might it take before an antivaxxer admits they might be wrong? What might it take before Andy Moulden, Sherri Tenpenny, Dr. Mercola, Andrew Wakefield, Jenny McCarthy, Lowell Hubbs, or any of the other antivaxxers I have profiled on this website actually take a step back and admit that their fears about vaccinations may very well have been unsubstantiated all along?

Sadly - I doubt we will ever know, because if there is one thing we have shown time and time again it is that antivaxxers never admit when they are wrong... they simply practice goalpost relocation as they move on to the next unsupportable and unscientific theory.  Unfortunately for them, the curtain is slowly being pulled back to expose them for what they really are, and once you look beyond the celebrity pitchmen and magical treatments, you soon realize there is no evidence or science to support their viewpoints.  This is why, for all intents and purposes, the antivaxxer viewpoint is essentially unsustainable, because at the end of the day the evidence and science speaks for itself.

Wednesday, April 4, 2012

CDC: Autism Rate is Now 1 in 88

This story hit the wire late last week and of course the Autism community has been all over it - for good reason.  There is a lot of commentary coming out and unfortunately just as much speculation and fear-mongering to match.  Because of this, it is important to discuss the facts.

According to the data, the U.S. Centers for Disease Control and Prevention (the CDC), indicates that roughly one out of every 88 American children are considered autistic. This includes children which have a condition such as Aspergers Syndrome which is considered an autism spectrum disorder (ASD).

• This most recent report is based upon data from 2008 that was collected from 14 communities and involved a total of 337,093 eight-year-old children.  Because of this sample size and the fact the data sample is several years old, it is possible the actual national rate could be higher or lower than the rate reported.

• Reported rates vary greatly from a high of one in 47 in Utah to a low of one in 210 in Alabama.  Experts said that variation likely reflected differences in awareness of the disorder (meaning how often it is recognized and/or diagnosed) rather than any true "hot spots" of autism.  It is also important to understand these rates do not mirror vaccination rates (a bit of a preemptive strike against those who will make unsubstantiated claims pertaining to vaccines causing autism).  In fact, in some cases such as the MMR and Rotavirus vaccines, vaccination rates in Alabama are actually higher than they are in Utah.  Overall the vaccination rates between the states is not statistically significant and bears no connection to the reported rates of autism.  (Refer to Table 2, pg 1174)  Sorry antivaxxers.

• From 2002 to 2008, the largest rate increases were among Hispanic (110%) and African-American (91%) children.  Yet white children are still at greater risk for being diagnosed with autism.  For the vaccine conspiracy theorists out there (aka Lowell Hubbs and his ilk), it is also important to note that vaccination rates have not changed significantly during this time period, not to mention that there is no significant difference in vaccination rates across races.  Sorry again antivaxxers - maybe it is time you developed a new theory?

• There is no definitive test to prove whether a child has autism.  Instead, physicians make their diagnosis based upon criteria laid out in the American Psychiatric Association's Diagnostic and Statistical Manual, or DSM.  These criteria have changed with time, again prompting many to suggest the perceived increase is not a "real" increase, but rather an increased based upon better diagnosis and recognition.

• CDC Director Thomas Frieden stated that "doctors have gotten better at diagnosing the condition and communities have gotten better at providing services, so I think we can say it is possible that the increase is the result of better detection."

Regardless of your take on the matter, it does seem clear we are getting better at diagnosing autism, and overall awareness is at an all time high.  Researchers continue to focus on autism, and data like this helps to keep autism at the forefront where hopefully it can attract additional funding for research, treatments, and perhaps one day an actual cure.

As I said previously there is a lot of commentary regarding this data at the time being, and I'll be adding additional data as further analysis is performed.  There are a lot of statistics available for analysis here, so I hope those with a vested interest take their time to review everything thoroughly and within the proper context before leaping to conclusions.

The moral of the story is, even though the headline makes it appear that the number of autistic children in our nation seems to be growing rapidly, all available data seems to add credence to the opinion that this growth is merely due to increased awareness and more accurate diagnoses.  In years past a child may have been simply considered to be "unique", or "reserved".  Often they were considered "strange" or a "loner".  In some cases these children were difficult to handle or even considered to be troublemakers, and in rare cases the child was simply written off as having a mental disorder or even simply referred to as "slow".  As physicians, teachers, therapists, and parents become better at recognizing the symptoms of autism hopefully we can become better at identifying it, and with identification can come treatment.

The original article that referenced the CDC data can be found here: Yahoo Shine - CDC: Autism Rate is Now 1 in 88.