Blue Collar Scientist

It is almost too tempting to avoid making a Jenny McCarthy joke here, so I’m going to avoid it by the skin of my teeth. I’ll just point you to this bit of news.

In another sign pointing to an inherited component to autism, a study released on Monday found that having a schizophrenic parent or a mother with psychiatric problems roughly doubled a child’s risk of being autistic.

“Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism,” said Julie Daniels of the University of North Carolina, Chapel Hill, who worked on the study.

“We also saw higher rates of depression and personality disorders among mothers, but not fathers,” she said in a statement.

This study has a pretty big n - 1,227 children with autism, compared with families of 31,000 children without autism.

The result is not new; previous studies have supported the conclusions. This study appears in Pediatrics.

No one knows what causes autism, but researchers think it is likely that several genes and possibly environmental factors contribute.

There’s been quite a bit in the last few days on the science blogosphere condemning Clinton and Obama for ‘buying in’ to claims that vaccination causes autism. I thought it might be useful to go back to primary sources and see what was actually said.

Before we do that, a quick note about the issue (just skip all this and scroll down to the first quotation if you already know the history). The autism-vaccine “link” was dreamed up - or at least heavily promoted - by lawyers who want to make money at the expense of what they see as a rich pharmaceutical industry ripe for the taking¹. The plaintiff bar’s original focus was not on autism; it was on other sorts of vaccine injuries, some real, some make-believe.

Their litigation in the 1980’s essentially ended vaccine production in the United States; as a response to this critical threat to health, the government has had to take various steps to insure that vaccines are still made here, and are available to people who need them. One of those steps is the creation of the Vaccine Injury Compensation Program, put into place in 1988. It was originally a response to litigation over the pertussis vaccine, in which lawyers introduced evidence, leading to huge payouts, that was later found to be false. Under current law, the plaintiff’s bar goes after the VICP when they think that something might possibly have gone wrong with a vaccine. Although the program is paid for by a small surcharge on vaccines, the court is government-backed, and it hasn’t always remained within its budget; so in essence, every plaintiff’s award or frivolous suit through this court costs the taxpayer a bit of money. It is still, of course, better than not having any vaccines.

The vaccine-autism link doesn’t appear to have become popular until the late ’90’s, and originally the proponents of the link claimed that thimerosal, a vaccine preservative, was the cause of autism. Thimerosal was removed from vaccines given to children starting in 1999², and if this hypothesis were right, a reduction in autism should have been noted in the following years - but it hasn’t. Rather than admit that they don’t know anything about medicine, proponents of the thimerosal hypothesis have moved on to become full-blown anti-vaccination campaigners. Among the claims they’ve advanced is that vaccination is part of a vast government conspiracy to keep people in their place.

That is where we are today. Given the political muscle behind the vaccine conspiracy theorists, mainly in the form of the plaintiff’s bar - who currently have billions of dollars of autism-related claims against vaccine makers in the VICP court - and the predatory medical and quack-medical practitioners following a buck, the issue is now, apparently, one for the presidential campaign.

So here’s what the candidates actually said (with links back to sources):

Barak Obama:

We’ve seen just a skyrocketing autism rate. Some people are suspicious that it’s connected to the vaccines. This person included. The science right now is inconclusive, but we have to research it.

Note that where Obama says “this person included,” he gestured to someone in the audience - he apparently doesn’t mean “myself included.” That doesn’t excuse the fact, of course, that the science is very conclusive that there is no autism-vaccine link.

John McCain:

It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.

Strong evidence? John McCain basically accepts the conspiracy theory hook, line, and sinker.

Hilary Clinton:

Do you think vaccines should be investigated as a possible cause of autism?

I am committed to make investments to find the causes of autism, including possible environmental causes like vaccines. I have long been a supporter of increased research to determine the links between environmental factors and diseases, and I believe we should increase the NIH’s ability to engage in this type of research. My administration will be committed to improving research to support fact-based solutions, and I will ensure that the NIH has the staff and funding to fully explore all possible causes of autism.

What will you do to protect Americans, especially young children and pregnant women, from exposure to mercury through vaccines?

I will ensure that all vaccines are as safe as possible for our children by working to ensure that Thimerosal and mercury are removed from vaccines. I plan to fully invest in our research agencies so they can protect our children’s health, and so they can find the causes and cures for conditions such as autism.

There’s some more material there from Clinton, including something that I’d consider to be classical political weasel words.

Remember, folks, we live in the real world. Resources are limited. Every dollar we decide to spend researching this issue is a dollar we can’t spend some other, better way. What the candidates are talking about is the need to research an issue that has already been researched to death, with six or seven major - and expensive - studies already completed, and with thimerosal already removed from vaccines making a repetition of much of this effort pointless in the extreme.

1. Sometimes they are, and sometimes they deserve to be taken. But not over vaccines. [↩]
2. The only vaccines today that contain thimerosal are for influenza and tetanus, although if you get bitten by a snake, some antivenins contain thimerosal [↩]

The Anchorage Daily News reports that Susan Hepburn is giving a number of presentations across the state to parents and teachers on autism. Hepburn is a child psychologist and has an evidence-based view of autism, as does the Alaska Autism Resource Center, based at the SESA offices in Anchorage.

Hepburn could use some media training, to judge by the answers that the ADN printed. But she does point out the CDC and Danish data that refutes a vaccine-autism link, and correctly calls autism “highly genetic.” The delivery is a tad bungled but the message is there.

Should we expect some backlash from the Mercury Militia DAN folks biomedical people vaccines suck lobby? I don’t know. I’m just raising an FYI in case anyone is going to attend these programs. The schedule is prominent at the Alaska Autism Resource Center site.

The Bad Astronomer recently brought to my attention Jenny McCarthy’s advocacy of using nutritional supplements and dietary restrictions to treat autism. McCarthy has claimed that diet and nutritional supplements help autistic kids, saying:

“I’ve been speaking to moms across the country who are all shouting out the same thing: ‘This (diet and supplement intake) is working.’”

“It’s so heartbreaking to see the medical community not support something called diet and vitamins. And it pains us, city after city after city. I see this heartbreak on these mom’s faces.”

“Autism isn’t covered by [medical] insurance. If things like diets and supplements are working, then why not support it? These kids are getting better and I will not shut up and will not stop fighting about it.”

This parallels a larger set of claims from the DAN and biomedical folks who claim that certain interventions can cure autism. As is well known, Jenny McCarthy and her fellow-travelers are wrong. Diet and supplements don’t cure autism.

There are lots of people who don’t know this, however, and they hear the kinds of crazy things said by McCarthy, the mercury militia, the biomedical quacks, and sundry other nutjobs, and they wonder about this stuff. Occasionally, they ask, well, why couldn’t diet and nutritional supplements help?

When asked, you could trot out the data and go over the statistics. And that would be a great idea in certain situations, such as if you were addressing a conference, or if you were a physician going over the evidence for an interested parent, or if you were a genuine expert blogger who was going over the data for the rest of us.

For the rest of us, though, we encounter these kinds of questions from our acquaintances - those who know we are rational thinkers, who might be under the impression we are knowledgeable or smart, or at least who know we are likely to have an opinion. What’s the best way to respond to these people?

For my part, I admit that diet restriction and vitamin intake could help. Exercise could help. Avoiding sun exposure could help. Wearing special underwear could help. Appealing to a magic sky-god could help.

But then I change the rules of the discussion and take them on a journey through common sense. Here is what I tell them:

The question is whether it is really likely to help.

Let’s have a look at this question rationally. Autism is a neurological disorder caused by disrupted early brain development. Autistic persons’ brains are characterized by differences in size and mass, excess neurons in certain locations, abnormal synapses and dendritic spines, structural differences in mirror neurons, and a differently-functioning cingulate cortex. Genetic differences have been found in autistic persons. The biological evidence suggests the disorder is a result of genetics and environmental interaction during brain development, which results in the fetus “building” a brain which is anatomically and functionally different from that of a typical human.

Now, there are also people who, due to a combination of genetics and environmental influences, develop abnormal hands, feet, palates, noses, kidneys, pancreases, stomaches and other pieces of anatomy.

Do we find those people’s hands/feet/etc attain normality if they consume a specific diet and take vitamin supplements?

No.

As much as it would be nice if nutrients could rebuild a brain into a standard configuration, there’s no reason to think that they could, if they can’t even rebuild other, simpler organs in a similar way.

Another line of evidence makes it unlikely. We do know about thousands of chemicals that can cause the body to reorganize entire organs and body systems into new configurations. Those chemicals are (a) not nutrients, and (b) deadly. The few that aren’t deadly are highly specialized pharmaceuticals that need careful dosing so as to not cause more harm than good - and most of them work despite their tendency to cause organ development to go haywire, not because of it. Potentially, one or a combination of these chemical compounds, if given in the right dosages over a period of time, might possibly result in re-organizing the brain in such a way to ameliorate autism. The problem is, none of these kinds of chemicals are found in any significant amounts in a normal diet, or in supplements.

So the question becomes: why research nutrients? Why think they might work? There’s already tons of evidence that it would be pointless. In the meantime, there are other avenues of research that we have plenty of reason to think could be helpful. Perhaps neurological drugs could result in more-normal brain functioning. Perhaps some kind of surgical intervention could do the same. Perhaps genetic-environmental interaction research could reveal risk factors, resulting in preventive strategies to bar autistic brain development.

All of these techniques have been proven to be effective in other disorders that have origins similar to autism. Whereas nutrition has been proven ineffective in other disorders that have origins similar to autism.

In a world where resources were unlimited, I’d do formal, double-blind, large-n trials of nutrients. In the real world where resources are limited, however, I’m going to spend my money in the place that prior knowledge shows it is most likely to do good. And similarly, I’d be placing my faith in proven or at least plausible treatments, rather than disproven ones that don’t make any sense in the first place.