I mentioned the blog Child Health Safety last post, alluding to Wakettism of the first order.

I recently commented under the post Wakefield and MMR – Brian Deer fails to answer. Apparently my observations deserved an entire blog post, headed Autism Figures – Existing Studies Show Shocking Real Increase Since 1988. This was copied and pasted back as a reply ignoring the content of my comment. The thrust was to debunk my claim of no real autism epidemic. I’d used Brugha et al. “Epidemiology of Autism Spectrum Disorders in Adults in the Community in England.” Archives of General Psychiatry  –  doi:10.1001/archgenpsychiatry.2011.38. This paper uses today’s diagnostic criteria and shows adults have autism at a rate of 9.8/1000 in adults.

Today’s rate is difficult to ascertain, but can be 10/1600 to 10/1000 in children. The latter is the more common – 1%, although this is probably high given other estimates. Brugha concludes no epidemic exists, but that diagnostic criteria has changed, suggesting he alludes to the 10/1000 figure. Many who point to large scale increases also support the reality of changing diagnostic criteria. Brugha’s paper is discussed here on Ars Technica, Autism Epidemic? More likely we’re just better at diagnosis which also uses the 10/1000 – or 1% figure today. Other publications discuss the findings: “Most adults with autism go undiagnosed” AlphaGalileo. “University of Leicester researchers present further evidence from first ever general population survey of autism in adulthood.” Disabled World

Our Wakette at Child Health Safety is claiming a 1200% increase in autism frequency in eight years. He chose an Israeli study – as is plain if you read his post above, with 0.84 cases per 1000 – Advancing Paternal Age and Autism by Reichenberg et al. Then he uses Baird’s well known figure of 11.6/1000 to get his 1200% increase. Just one lone paper no doubt chosen to sustain this 1200% increase claim. The three variables impacting on frequency are criteria, age of cohort and geographical location. Age and location impact on our friends mythical 1200%.

So, over to this new post I went. Now, you may wonder what the relevance of a comment stream is. However, I found this typical of antivaccination lobbyists particularly those who seek to maintain the autism myth. I’ve always wondered what made the crackpots behind this site tick. They have “secrets” on Wakefield. Brian Deer and the BMJ are the real fraudsters. “Governments” have been exposed. Typical conspiracy central meanderings.

Rather than address the clear challenges we find a challenging tone and combative presentation. Combined with false dichotomies by association, censoring of comments by deletion then eventual banning. I actually began by apologising below for sending them off in a huff. One comment (under a piece defending Wakefield) that nailed them left them pleading inability to understand. Anyway, I commented;

I’m sorry but you’re markedly in error.

You quote Reichenberg et al’s Israeli study from the Archives of General Psychiatry to “set a benchmark”, which you then compare to Baird’s UK figures. Yes both use DSM IV. But the genetic and environmental differences in two races/nations present challenges to your theory. No offence but you can’t just make up relationships between unrelated data sets without correcting for other variables. You need to show statistically why the individual sets relate to your argument. This is a common flaw. Genetics, environment, parental education and rearing techniques… etc.

Still, let’s go with it. 8.4:10,000 or 0.84 per 1000. Then Baird’s UK figures of 116.1:10,000 or 11.6 per 1000. From this you argue a 1200% increase insinuating vaccination. Yet Baird had written.

“Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear.”

Thus, you make conclusions from Baird’s work that even he did not. I shall argue you selected the lone Israeli paper for it’s dramatic impact. Now onto research that seeks to determine if any increase at all has occurred. We can stay in the UK eliminating the genetic and environmental confounding variables of Israel data. Let’s examine adults using the same diagnostic criteria.

Epidemiology of Autism Spectrum Disorders in Adults in the Community in England – Arch Gen Psychiatry. 2011;68(5):459-465. doi:10.1001/archgenpsychiatry.2011.38

We find 9.8 per 1000 (95% confidence interval, 3.0-16.5). The author’s write:

“The prevalence of ASD in this population is similar to that found in children. The lack of an association with age is consistent with there having been no increase in prevalence and with its causes being temporally constant.”

It’s documented by Baird that younger children – indeed younger subjects often have a higher score in diagnosis. Using this reality we expect to see significant decreases in adults. But we have Baird’s 11.6 and Brugha’s 9.8 per 1000. Given the approximation of these figures using today’s diagnostic criteria and the huge age difference one may assume autism is falling as we’d expect to see a much lower rate in adults. More so, in 2003 Baird himself writes in Diagnosis of autism – BMJ;

“… several factors account for the increase–for example, changing conceptualisation to a spectrum rather than a core categorical condition; changes in diagnostic methods; …”

That’s probably enough. Although consider:

1 in 150 (1988-1995; Bertrand et al., 2001)
1 in 175 (1990-1991; Baird et al., 2000)
1 in 85 (1990-1991; Baird et al., 2006)
1 in 150 (1992; ADDMN, 2007)
1 in 160 (1992-1995; Chakrabarti & Fombonne, 2001)
1 in 150 (1994; ADDMN, 2007)
1 in 58 (1993-1997; not published)
1 in 170 (1996-1998; Chakrabarti & Fombonne, 2005)

– which is markedly inconsistent with the myth of an epidemic. it is consistent with methodology. Selecting data to suit your argument will not change reality.

I apologise for having such fun with your bag of errors. It was an appalling reply and a ridiculous blog post however. The above post is very plain in showing that you’re inventing a phenomena not supported by research nor even by Baird himself. Autism rates have not changed. Diagnosis has. A decrease is most likely.

Thank you.

And;

Your comment in blue above:

We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.

… is meaningless. I stressed this in another comment but you couldn’t answer. Let me be quite plain. Compensation for encephalopathy or general brain disease is due to vaccination. It may be accompanied by…. autism. It may also be accompanied by blue eyes, blonde hair or bad breath. None of these are due to vaccination. This comment is one of many that stress compensation for vaccine induced autism has never occurred. Even Poling had a predetermining mitochondrial disorder.

As I stressed elsewhere. Only reading something like; “This child was compensated due to autism developing directly as a result of vaccination”, will sustain the allusion above. As I said elsewhere, defeating your ability to reply – Even the recent Pace Law school student foray into 21 VCIP cases and over 60 biased phone call interviews offered “it strongly suggests” a link. (Quoting Danielle Orsino media rep).

That paper is “Unanswered Questions from the Vaccine Injury Compensation Program: A review of compensated cases of vaccine induced brain injury”. But as Orsino says, there’s a “suggestion”. Period.

You contention is demonstrably flawed on many levels.

Thank you.

Apparently no point to answer exists;

Paul @ 2011/08/20 at 2:01 am

I’m sorry but you’re markedly in error.

Really? In an earlier comment elsewhere you drew our attention to the letter in the peer reviewed Journal of the Israeli Medical Association which draws attention to the figures from the Paternal Age paper. Thanks for that. We did not know and have added a reference to this article so it now can draw on authority of a peer reviewed journal.

You seem not to be able to agree with any medical experts. That’s fine. We are letting you let off steam here.

And;

Paul @ 2011/08/20 at 3:02 am

“Your comment in blue above:

We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.

… is meaningless.”

Oh dear. You just cannot trust governments can you? The US Health Resources Services Administration give a quote to a journalist of a national TV news broadcast network confirming the US government has compensated cases of children who developed autistic conditions from vaccines and paid out lots and lots of dollars to them and it turns out to be meaningless.

LOL. Back to the drawing board for everyone.

I replied;

I think you have seen the flaw. That comment is all over the place here. Yep – meaningless.

“Autistic conditions” are not vaccine induced autism. You’re at least changing language – the first step in accepting facts. Sadly, there’s no LOL. I’m glad you think it’s funny. One in 1 million children suffer encephalitis from vaccine reactions. They are compensated as is just. Many have autism. The comment is debunking the very untruth you seek to make.

“…. may be accompanied by an array of symptoms”.

Until you can produce “compensated because of their autism”, you have no case. The facts and government positions are against you. Global research is against you. From ethyl mercury to vaccines to numbers of vaccines no link can be shown.

Accept it.

Thanks again.

Then horror upon horror, they clicked on my URL and delivered;

LOL, Rant on Paul.

We are content to rely on a peer reviewed journal. Thanks for drawing our attention to it – so we could add the link to the article.

You might as well let everyone know you are a friend of Peter Bowditch and the “skeptics” crowd who are happy to victimise and attack people personally on the web, spread misinformation lose legal actions and then claim they have not. Similarly Terry Polevoy – Terry Polevoy vs Ilena Rosenthal.

Birds of a feather flock together. What a lot of flockers.

Those nasty skeptics all linked up like a hive… I tried again;

I thought this was about debating and/or defending the premise of your post?

I think given the tone and lack of substance of your replies, it’s clear I’ve upset your apple cart here. Again I ask that you refute my sources. Eg; Baird 11.6/1000 in 2006 followed by Brugha 10/1000 in 2007 shows a 13.7% decrease in just one year. Why can’t you address this simple reality? The above reply is most unbecomming.

Yes I know of Peter and enjoy the skeptic community. So, you clicked a link to my site. Welcome. I’m ignorant as to the case you refer to or Polevoy. I do know Peter posts everything on his site so is unlikely to spread misinformation. Either way I could be head of GSK yet I still have a valid argument you avoid. No laughing matter. Autism is decreasing if we involve your figure from Baird.

Also, go back to my original comment. You have much work to do. Don’t feel embarrassed – science is all about being proven wrong. No need to turn aggressively defensive. I’m not judgmental.

I await your reply with eagerness.

All the best now.

Next, missing the point of Brugha’s comparison to contemporary childhood figures;

Paul @ August 21, 2011 at 2:04 am

Again I ask that you refute my sources. Eg; Baird 11.6/1000 in 2006 followed by Brugha 10/1000 in 2007 shows a 13.7% decrease in just one year.

Shame you have not read either paper or maybe you have and you know you are talking rubbish. Comparing chalk and cheese just like your mates Bowditch and Polevoy to lie about the facts. Baird was dealing with children. Brugha was dealing with adults. So you are saying the same children Baird covered became adults in one year and 13.7% of them simultaneously were cured.

LOL. Nice one.

Pretty good refutation we think. But then that is just the style of Bowditch, Polevoy and friends.

The old, “tar ’em with the same brush trick”, eh? I continued self flagellating;

I may have been generous with my stats. It’s a 13.79% decrease. My bad… apologies.

Pretty much a 14% decrease in autism in the same nation in one year. Geographic location is a plus. Age is a plus. Criteria is a plus. The 3 variables effecting frequency of autism. You still need to address your “theory” using Israeli data to compare to a different location & age group.

All the best.

Things deteriorated along those lines. More allusion to “Bowditch and Polevoy” and whatever case of which I had no knowledge. Sadly, my dear comment protagonist first began censoring comments that refuted his ongoing claims, then banned me altogether. Perhaps referring to “the awesome Ben Goldacre” was pushing my luck. Back in 2007 he’d written an excellent article. Clearly whomever it is holding the reins at Child Health Safety has a thing about Polevoy and dear Peter Bowditch. He/she/they did have one point. I mentioned Brugha as “citing” the 10/1000 figure of todays frequency vs his adult findings of 9.8/1000. I was in error. Brugha studiously avoids picking any of the many autism frequencies out there today.

Yet Brugha’s 9.8/1000 in adults advanced as showing no change to todays child frequencies of 10/1000 (the widely used 1%) leads me conclude it’s safe to argue with the 10/1000 figure. That’s rather clear in the post deleted but found here. Also Brugha et al. wrote;

The prevalence of ASD in this population is similar to that found in children. The lack of an association with age is consistent with there having been no increase in prevalence and with its causes being temporally constant.

From Alpha Galileo we have;

Dr Brugha said the new scientific article confirms the already published report from the survey (2009) that 9.8 per thousand adults in England meet official diagnostic criteria for autism spectrum disorder. There was no evidence of an ‘autism epidemic’ of marked increase in people with the condition.

He said: “Overall our findings suggest that prevalence is neither rising nor falling significantly over time. This favours the interpretation that methods of ascertainment (case finding) have changed in more recent surveys of children compared to the earliest surveys in which the rates reported were considerably lower”.

I could have chosen the 10/1600 figure, rendering Brugha’s finding more compelling. It’s fascinating to consider that adults today may present at 9.8/1000 vs children at as little as 10/1600. Knowing that increases in cohort age correlate to a reduction in frequency diagnoses, and adults have learned many skills that also lower overall score, we’re left to consider an actual drop in autism over the last generation. How wonderful if that were true and perhaps due to the protection from measles induced encephalitis due to MMR vaccination.

In conclusion, this poor author has unwittingly proven my point. Had he shown the courtesy of reading my sources he’d have noted studies devoted to examining the very question, don’t support an epidemic. Had he even read Baird’s papers he’d have seen Baird herself doesn’t claim an absolute increase but stresses causes are unclear and changing diagnostic criteria are a variable. I guess what got up my nose is fishing for an obscure study, comparing it to Baird’s work and using this to conclude there’s a 1200% increase in autism due to vaccination.

Not only is this not repeated anywhere no attempt was made to eliminate confounding variables. No understanding of using unrelated data sets or attempt to justify correlation between them exists. Just a very low figure plucked out and used “as a benchmark”.

Moving away from Baird and Brugha we find a range of diagnostic papers that fail to support the contention of a steady increase. I’ll give the last word to Ben Goldacre from 2007, writing About that surge in autism, in The Autism Crisis;

Autism advocates are free to seek that recent surge in autism–that catastrophic epidemic–in anecdotes, in education numbers or the CDDS, in sensationalist headlines and so on. This is all in keeping with the rotten standards of science and ethics they’ve imposed on autistics, and with their own steadfast resistance against verifiable information. But on the off-chance anyone’s interested in the published, peer-reviewed data, I thought I’d go fetch some. If anyone finds any factual errors in the information I’ve presented, I’d greatly appreciate knowing. Accurate information is always good for autistics.

Indeed.