Olmsted on Autism: 1 in 10,000 Amish

Managing Editor's Note:  Dr. Max Wiznitzer of University Hospitals in Cleveland is an expert witness for the government against the families who file in the National Vaccine Injury Compensation Program.

 By Dan Olmsted

It is unanimous, apparently -- the rate of autism among the Amish is low. Really, really low. So low that if it were the same in the rest of the population, we wouldn't even be talking about the subject. Shockingly low.
 
But not so shocking that anyone feels compelled to follow up on the information or its logical implications -- not four years ago when I first pointed it out, not today when the clues it contains are more intriguing than ever -- in fact, never, never, never.
 
In April 2005 I wrote a UPI column called The Amish Anomaly that began this way: "Where are the autistic Amish? Here in Lancaster County, heart of Pennsylvania Dutch country, there should be well over 100 with some form of the disorder. I have come here to find them, but so far my mission has failed ..."
 
In case anyone had any lingering doubts about the virtual absence of autism among the Amish, they were effectively put to rest on Friday night's Larry King segment when Dr. Max Wiznitzer -- defending the vaccine program, arguing autism has not increased and insisting it is a genetic disorder preset from birth, said the rate of autism in northeastern Ohio, the nation's largest Amish community, was 1 in 10,000. He should know, he said: "I'm their neurologist."

So in a nation with an autism rate of 66 per 10,000 -- cut that in half if you want, to focus just on full-syndrome, classic, Kanner autism -- we're looking at a population with one-sixty-sixth, or one thirty-third, or one-whatever, the going rate. Heck, let's just say the autism rate in the USA were only 10 per 10,000; for some reason, the Amish autism rate would still be an order of magnitude lower. That, as they say in the medical journals, is statistically significantly. Massively so, I would say.
 
That leaves, it seems to me, two questions: Why is the rate so much lower, and why doesn't anyone in mainstream medicine seem to care, other than to fling it out as a debating point to demonstrate -- what, exactly?
 
Dr. Wiznitzer said those Amish were vaccinated. Well, OK, interesting. That's half right, according to what I reported about that same area back in June of 2005:
 
"The autism rate for U.S. children is 1 in 166, according to the federal government. The autism rate for the Amish around Middlefield, Ohio, is 1 in 15,000, according to Dr. Heng Wang.
 
"He means that literally: Of 15,000 Amish who live near Middlefield, Wang is aware of just one who has autism. If that figure is anywhere near correct, the autism rate in that community is astonishingly low.
 
"Wang is the medical director, and a physician and researcher, at the DDC Clinic for Special Needs Children, created three years ago to treat the Amish in northeastern Ohio.
 
"I take care of all the children with special needs," he said, putting him in a unique position to observe autism. "The one case Wang has identified is a 12-year-old boy."
 
He said half the children in the area were vaccinated, half weren't. That child, he said, was vaccinated, but let's not split hairs here. Either vaccinated or unvaccinated, that's a low rate -- 1 in 5000. The question I didn't think to ask at the time but will soon, is, exactly how were those half vaccinated? Flu shots for pregnant moms? Hep B at birth? Chickenpox and MMR on the same day at one year? Rotavirus, Hep B, Hep A, and on and on? Or did it look more like the less intense, less front-loaded schedule in place in the rest of the country back before the autism epidemic began? The kind Jenny and Jim and J.B. and Jerry (hey, the four J's!) keep harking back to when the autism rate was, like, 1 in 10,000 and we still managed to stave off wholesale plagues.
 
Let's even stipulate that the vaccine schedule for every single Amish child is now fully loaded and follows the CDC to a T. What is Wiznitzer's point? That the Amish genes protect them? Well, good for them, then, let's find out why. Or, that some kind of other environmental risk is absent? In that case, autism is a genetic vulnerability with an environmental trigger, and something about the Amish world is not triggering it, which puts us back about where I started four years ago. There would have been plenty of time to have the answer right now if Julie Gerberding weren't still filibustering the question by talking about numerators, denominators and getting more research into the pipeline as fast as bureaucratically possible (meaning never, never, never). 
 
Critics of the Amish Anomaly -- like critics of the idea that vaccines might be implicated in autism -- want to have it every which way. First, they want to say I just plain missed all the autism cases -- droning on about the Clinic For Special Children, which refused to speak with me over a period of many months. When one of their doctors did finally talk to a blogger whose stated purpose was to tear my reporting apart (a "fraud," he called me), that doctor said, oh yes, they do see Amish kids with autism -- but then went on to say those were ONLY kids with other identifiable genetic disorders. In other words, risk factors. He specifically said they DO NOT  see "idiopathic autism," a basically nonsense phrase that he used to mean autism without any other accompanying disorders. In other words, they don't see the kind of autism now running at a rate of 1 in 100 or so in the rest of the country. The kind no one can figure out. The kind that is destroying a generation and their families and our future along with it. ("You don't have an affected child," people tell me. Yes, but I have an affected world.)
 
By asserting the Amish have an autism rate of 1 in 10,000 Wiznitzer is in fact scoring a point -- they call it an "own goal," an "oops, I didn't mean to tap the other team's shot in." The point he's accidentally but effectively reinforcing is the one made by the unfailingly intelligent Bernadine Healy -- that there are so many, many obvious studies being left undone by those afraid to do them, even as they sneer and snarl at the rest of us. The Amish are just one study left undone among -- well, one among ten thousand or so.

Dan Olmsted in Editor of Age of Autism.

Comments

[JPettit]

The Amish only marry within and started from a group of about 200 people, that could explain why they have a lower rate if genes have anything to do with autism.

[Curtis Maybin]

Great stuff on autism looking forward to more.

Thanks
Curtis Maybin

[Holly Legros]

I've just read much of this discussion and I can tell you I know there is some connection between environmental exposures & sensitivities, radiation and emf exposure with emf sensitivity, food intolerances with gut problems and immune issues with neurological injury/damage & pain,inflammation ,brain function,and many other symptoms similiar to autism; even for adults. My trigger was severe mold exposures along with lifetime solvent exposures, hydrocarbons pesticides and many other neurotoxins while having genetic weakness in methylation and glutathione enzymes and another impaired cyp1a1 gene/enzyme. I'm an adult with lots of neurological problems and I had chemical injury from the final exposure of mycotoxins while remodeling a home. I became sensitive to most chemicals and all molds and I have myelin sheath antibodies and brain lesions like MS but don't have MS.
Exposure to EMF is really difficult symptom-wise and even the phone burns in my arthritic hand, but the more wireless and the more toxins I am exposed to (esp neurotoxins) the worse the emf reactions. So it all works together once your body has been overwhelmed. Many like me went to live with the Amish and got better because of the low toxin exposures. Here in MN the somalis are having a huge amt of autism and they (esp the women) are on their cells tuckeds into their scarves and have low Vit D. It all plays a role and these people may have also some genetic susceptability.
So the point is you aren't likely to find ONE answer in all autism cases but it may break down to the total load with genetics, nutritional status, Mother's exposures(emf and mercury etc), and the mechanism of a toxic-laden vaccine being the initiating trigger to overwhelm the nervous system creating multiple symtoms and behaviors.
I hope all the Mom's keep questioning and learning and challenging the mainstream md's as they refuse to open their minds, most of them.
I am trying to get a low sars rating phone for less rads exposure along with the protective earpiece with the hollow tube. Also, there is a new Minnesota-designed behavior therapy that is getting raves. Best of luck to families w autism to find your answers and make a difference in solving this difficult health challenge. HL

[Craig Willoughby]

Really Herb? If that's true, then why is it that in identical twins, there are cases of autism in one twin, but not the other? Since the twins are effectively genetically similar, wouldn't both be autistic?

[Natasa]

Herb, the genetic input if most likely the SENSITIVITY/susceptibility/predisposition to environmental factors.

Identical twins share not only identical prenatal environment (and very similar postnatal one) but their genetic make up will predispose them to the same reaction to those environmental factor.

They should have thought you that in medical school.

[Jack]

Or it shows that people with identical genetic makeups respond to the same environment insult in a similar manner.

If my identical twins fall on the brick steps, both their knees bleed. 100% concordance. Is bleeding knees genetic? Does the brick step play no role?

I'm sick of this line of reasoning.

[Herb Wagemaker, MD]

according to twin studies the concordance rates in identicle twins is 90% NIMH and 70$ CDC. This shows a very genetic imput in Autism

[Patty Martz]

On the same scale, we could also compare elements such as physical activity and stress levels. What is different about the physical activity and stress levels of the Amish? How does their lifestyle and community contribute to overall health and wellness?

[Patty Martz]

Various shades of grey.
If you view the Amish as a gradient. There is much variation within the community itself. Elements of diet and medical care, environmental toxins in the home, varying degrees of exposure to outside influences. We still have a point of reference. What can be learned from the Amish? Does it reach beyond selecting individual variables and making assumptions? We could map the individual pieces. What factors are absent or present in an Amish household, a community? Perhaps, the combination and degree of exposure to various elements is implicated. If you can make a generalization based on the population as a group, then what factors do the group share in common...and, How is this different from the general population? All of the pieces listed may contribute in one way or another; however, other components to consider might be food preparation and use, medical practices, household cleaning supplies, personal care products, construction materials, materials used in construction of furniture and furnishings, clothing, use of dyes in clothing, use of plastics and synthetics in the home, level of environmental toxins in the Amish themselves, and elements in diet that may aid in elimination, parasites, pest management, vaccinations, electromagnetic exposure...essentially, any item of suspect, could be tested against the gradient scale of the Amish. Old Order Amish have fewer exposures to certain environmental factors than New Order Amish. Are there significant variations in health between Old Order and New Order Amish? Compared to the general population, their exposure rates to a myriad of environmental toxins may still be statistically significant.

[Chris W. Houghton]

Dear Mr. Olmsted,

“Even so, some flu vaccine -- that shipped in multi-dose vials -- contains thimerosal, a mercury preservative”

I read a couple of articles that you wrote saying that Thimerosal had been phased out of vaccines back in 1999. If you check the FDA website, you will see that they allow Thimerosal to be in vaccines of the multi-dose type even now in 2009. The makers of the vaccines very much desire to use Thimerosal, and if you look around, you will find much evidence that it is still in use. There are probably also many doses of vaccine laying around with Thimerosal in them, and the owners would be glad to sell them off without talking about the contents.

Seeing that you are editing 'Age of Autism' and not working in UPI anymore, I suspect you have learned the above by now... :)

Keep up the newsletter, it's well done and of great use to people.

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