By Anne Dachel
I read the cover story, A Spectrum of Disorders, The urgent search to understand the biological basis of autism, by Ashley Pettus in the current HARVARD MAGAZINE for January - February 2008. I printed out the eight page article and looked through it for details about autism.
Ashley Pettus writes about the "urgent search to understand" autism, but what we were given in her report hardly indicates that autism is anything to really be concerned about. Lots of theories are mentioned at length with impressive-sounding terms like "genomics," "spontaneous genetic change," and "cognitive deficit," but if readers picked up the article thinking that they'd learn anything new to explain why autism is now an epidemic, they'd be sadly disappointed.
The writer devotes much of the article to convincing us that genes cause autism and that the disorder has been misdiagnosed in the past. We're given the history of autism back to the 1930s and it seems that until the 80s, experts just didn't understand it. Pettus writes, "In the ensuing years, the predominant view of autism as a discrete psychoemotional condition gave way to the idea of a continuum of biologically based autistic syndromes, requiring greater diagnostic specificity. By 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) listed detailed criteria for five 'pervasive developmental disorders' (PDDs), including Asperger's, that comprised the 'autism spectrum.' "
Pettus furthers explains, "The increased awareness of autism's related conditions and their symptoms corresponded to a steep rise in diagnoses in the early 1990s." At another point in the piece we are told, "Much of this increase stems from a broadening of the diagnostic category. Clinicians now recognize a 'spectrum' of autistic disorders that encompasses children with mental retardation and little or no language (low-functioning autism) as well as those with high IQs and precocious vocabularies (Asperger's syndrome)." This expanded definition of autism would seem to account for the surge in autism.
Pettus points to the need for early diagnosing and intervention. She even cautions that this may lead to some degree of over-diagnosing of autism. At the end of the article we're left with the thought that there's much work to be done. Pettus writes, "Huge challenges lie ahead -- from teasing out combinations of genes to determining the developmental mechanisms and the role of the environment - but the necessary teams of investigators are finally in place to begin to make the connections."
Pettus refers autism as a "puzzle" in her article and a puzzle is certainly nothing to get really worried about. We hear again that the rate of autism hasn't increased even though most adults couldn't name even one child they grew up with who was labeled autistic or who displayed the characteristics of autism. The fact that everyone now knows someone with an affected child shouldn't be a worry however. The number of autistic students overwhelming our schools are merely the result of better diagnosing and an expanded spectrum of autistic disorders. This has also been the constant mantra of the Centers for Disease Control and Prevention. They've been counting children with autism for over ten years and they still don't know if more children have autism or if the numbers are because of greater awareness.
It should be noted that writers like Ashley Pettus who tell us that autism has always been around like this -- doctors just weren't able to recognize it -- never have to prove it. Why isn't there even one study that can show us the adults with autism at the same rate we see in our children? The signs of autism are clearly outlined in the diagnostic criteria, why can't we find those misdiagnosed/undiagnosed adults?
Pettus shows no concern over all the special needs students in our schools that weren't there just twenty years ago. If children always had autism like they do today, what did we do with them? It's a little hard to miss an autistic child, even a mildly affected one. Why are schools facing bankrupting costs educating so many disabled children and why are there endless waiting lists for services?
Pettus makes one reference to environmental factors as a reason for the surge in autism.
She writes, "There is a growing sense among researchers and clinicians that the real incidence of autism is on the rise and that environmental triggers likely play a role. The potential factors range from chemicals in food and cosmetics to parental age, stress, and reproductive technologies-offering no clear indication of where epidemiological studies might begin."
While Pettus concedes that chemicals in food or in cosmetics might be involved in autism, we're hastily told that the deadly element mercury used as a preservative in vaccines isn't a possible cause and neither is the MMR vaccine. Pettus writes, "Many parents became convinced that the escalating numbers of cases stemmed from exposure to thimerosal, a mercury-based preservative used in childhood vaccines. Another theory linked the measles/mumps/rubella (MMR) vaccine, in particular, to the onset of autistic symptoms. Numerous epidemiological studies have failed to substantiate these claims, and in 2004 the Institute of Medicine of the National Academies found no causal relationship between either mercury or MMR vaccine and autism."
With a total of three sentences in the eight page article, Pettus dismisses the most heated controversy in medicine today. As proof she points to the numerous studies done on vaccines along with the famous IOM report of 2004.
In truth, many in the autism community are much better informed than Pettus. They'd be quick to respond that these epidemiological studies are the same type of population studies that were used by the tobacco industry in the 1940s and 50s as proof that smoking didn't cause lung cancer.
Pettus claims that only parents link autism to the vaccinations children receive. This is disingenuous and it ignores the mounting research by many well-credentialed scientists from leading universities that does connect the tripling of the vaccine schedule since the 1980s to the explosion in autism in our children.
The CDC has provided endless epidemiological studies on vaccines and autism. Since this is the agency that runs the vaccine program, it's pretty likely that the results will always show vaccines don't cause autism. The IOM Report from 2004 was done under the direction of the CDC and it settled nothing. The CDC is the agency where hundreds of individuals have conflict of interest waivers because of their direct financial ties to the vaccine makers. Any findings coming from them will be suspect.
In addition, there is no explanation given in the article for why so many of our children have concomitant health issues like severe allergies, epilepsy, asthma, and bowel disorders. The emphasis is that genes cause autism and the only way this claim can work is if there's been no recognized increase in the rate of autism. Genes can't cause an epidemic, therefore it's important to stress that we're always had so many children with autism, they just didn't have the right diagnosis.
The real proof of how wrong Ashley Pettus and others are will be evident in the next five to ten years as the generation of children with autism becomes the generation of adults with autism, dependent on the taxpayers for their support and care. This surge in disability claims will happen at the same time the post WWII generation starts to retire.
I would ask Ashley Pettus to look into the findings by Harvard researcher Michael Ganz. Ganz made a chilling prediction of the future cost to our society as more and more of these children become adults. He found that it will cost about $3.2 million to take care of an autistic person over his or her lifetime. These figures are felt by others to be a gross underestimate of the eventual autism price tag. Read his findings HERE.
Pettus seems unconcerned about the actual autism rate in her piece. In fact, she gives us incorrect numbers. In the second paragraph she writes, "In recent years, diagnoses of autism have soared: to as many as one for every 166 children in the United States, according to recent estimates published by the Centers for Disease Control."
"Recent estimates"? If Pettus had really looked into this, she'd have discovered that last February the CDC gave us the new official autism rate of one in every 150 children in the U.S., including one in every 94 boys and that's only an average. Places like New Jersey have much worse numbers. There one in every 94 children is affected -- specifically one in every 60 boys.
These numbers didn't cause more than a ripple of concern at the CDC and they attributed the increase to their own "better studies." I'm sure Ashley Pettus would agree.
Anne Dachel is Media Editor for Age of Autism.