HOLLAND ON THE OMNIBUS AUTISM PROCEEDING: 5/28
DAVID KIRBY: RIP TIM RUSSERT

HECKENLIVELY ON THE OMNIBUS AUTISM PROCEEDING: 5/28

Kent_legalDr. Fombonne isn’t a “Monkey Person”, but he Does Play One in Court – The Omnibus Autism Proceeding – Second Set of Hearings (Thimerosal & Autism) – Day Twelve – May 28, 2008

By Kent Heckenlively, Esq.

In the testimony of Drs. Catherine Lord and Eric Fombonne the government comes up against what I believe is the Achilles heel of the government’s assertion that vaccines have no connection to the autism epidemic.

Parents report changes in the children following a vaccination.  Animal and biological studies provide indications that mercury can have devastating effects on living organisms.  Medical professionals using vaccine-damage as a starting point to recover children make startling progress in some cases.  The government says all this is smoke without a fire.  Indeed, the government doesn’t even seem to think the ground is warm.

Personally, I think all of this evasion is starting to wear on the Special Masters.

Direct Examination of Dr. Catherine Lord (Expert Witness for the Government)

Dr. Lord is a clinical psychologist with numerous publications and has worked with about 4,000 children and adults with autism in her career.  She is an expert in behavior and development and regression in autism.  Part of her work has involved developing the DSM-IV to diagnose autism.

Parents come to her every day with questions about vaccines and autism.  She does not believe vaccines have anything to do with autism.

She believes regression occurs in autism.  It used to be thought the main loss was words, but what appears to be even more common is the loss of social skills.  The lost skills generally recognized by parents include loss of speech, loss of social routine, smiling, and understanding humor.

She can’t define the regression as gradual or precipitous, but says it’s variable.  She also states that most children who lose words eventually regain them.  She believes all children with autism improve, but the amount is highly variable.

Curiously, she doesn’t believe autism is associated with one gender more than any other.

While she believes pediatrician’s records are the best available information, she thinks they are very problematic.

She was one of the principal authors of the Richler study which tried to determine if a clear, regressive phenotype could be found in autism in relation to the MMR vaccine.  She found a minor correlation with autism and gastro-intestinal issues, but couldn’t find any relationship between MMR and autistic regression.

Dr. Lord is not aware of any evidence that the etiology of children with regressive autism is different than the general population of people with autism.

She does not believe Dr. Kinsbourne’s over-arousal model of autism accurately describes autistic behavior.

Cross-Examination of Dr. Lord (Expert Witness for the Government)

While Dr. Lord believes autistic regression can be a striking phenomenon she doesn’t believe there is a distinct phenotype for regressive autism.  She agrees that autism itself is a symptomatic diagnosis, without any clear bio-markers.

Dr. Lord agrees that the diagnosis of autism usually involves some abnormalities in communication, social reciprocity, and play skills.  Her study didn’t really look at play skills, although among the children with autism there was an increasing amount of non-functional play.  She wasn’t able to give a sense of what percentage of the children she studied had normal development prior to regression.

Dr. Lord does believe genetics are a significant factor in autism.  In the past she has stated that autistic regression does not appear to run in families, but now she’s saying she doesn’t know.

She doesn’t know if individual genetic combinations might combine with environmental exposures to cause autism.  However, her recently formed National Institute of Health committee is considering looking at potential environmental factors.

She did not participate in the 2007 Institute of Medicine Environmental Factors and Autism workshop.  Besides her study on the MMR, she’s not aware of any other published studies looking at a link between thimerosal-containing-vaccines and autism.

The Richler study referred to in her direct testimony has not yet been peer-reviewed and is not yet published.  Some of her funding for the study came from the National Institute of Health.

Redirect Examination of Dr. Lord (Expert Witness for the Government)

Dr. Lord is not a geneticist.

The NIH committee on which she sits will be looking at environmental factors in autism.

She does not think looking at the loss of play skills is helpful in diagnosing autism because of what may be observed in a 45 minute session in a doctor’s office.

The Richler study which was previously discussed looked not just at MMR, but also if they could determine some common pattern to autistic regression.

Recross Examination of Dr. Lord (Expert Witness for the Government)

Dr. Lord could not give a number on the children in her study who experienced regression across all three domains normally observed in autism; communication, social reciprocity, and play skills.

She did not review the medical records of William Meade or Jordan King.

Direct Examination of Dr. Eric Fombonne (Expert Witness for the Government)

Dr. Fombonne is a professor of psychiatry at McGill University and specializes in the epidemiology of autism.  He’s director of child psychiatry at McGill, serves on editorial boards, and publishes in peer-reviewed journals.  Last year he diagnosed somewhere between 250 to 300 new cases of autism.

He spent a good deal of time explaining epidemiology and many of its relevant terms.

Dr. Fombonne said that the current rate of autism in the United States is 66 per 10,000 children or approximately 1 in 166 children.  Curiously, there is a significant difference between the states with New Jersey being three times higher than in Alabama.  He attributes that to better ascertainment in New Jersey than in Alabama.

Dr. Fombonne spent a good deal of time discussing various epidemiological studies; the Vidd study from Denmark, the Verstraeten study from the United States, the Green study looking at Scandanavia, the Madsen study, Dick and Hay, Heron, his own in Pediatrics, the Schecter study, and Thompson.  None of these studies showed any association between thimerosal and autism.

According to Dr. Fombonne, the only study which showed any association was the one done by Mark and David Geier.  He has problems with their methodology.

Depending on how you define regression, it appears to be present in 15% to 41% of the cases.

He does not have any disagreement with the criticism of Dr. Greenland that none of the studies to date have looked for a uniquely susceptible subpopulation.  However, epidemiology never tests for any particular subgroup unless they have some preliminary evidence that such a subgroup exists.

Dr. Fombonne is critical of Dr. Greenland’s assertion that because in the Richler study (the previous government Dr. London was one of the chief authors) they found that 72% of autistic children displayed pre-regressive abnormalities, that the remaining 28% of the children were normal.

Fombonne reviewed the medical records of Jordan King and William Mead and agrees with their diagnosis of autism.  However, he doesn’t believe their thimerosal-containing vaccines had anything to do with their autism.

He does not believe that any conclusion can be drawn Jordan’s significant improvements since he was simultaneously doing speech therapy, ABA, as well as diet, supplements, and bio-medical treatments.

Special Master Questions

The Special Master tried to get Dr. Fombonne to provide more information on why nothing could be concluded from the improvement of William Mead and Jordan King.  Dr. Fombonne’s testimony was that so many different things were tried that it was difficult to disentangle the effect of one from the other.

While it was nice to hear about William’s progress in language, he is unaware of any research which supports chelation, and as far as secretin, randomized clinical trials have not shown it to be effective in restoring neural development.

Cross-Examination of Dr. Fombonne (Expert Witness for the Government)

Dr. Fombonne believes autism rates are roughly similar around the world, but evidence shows they are increasing.  On the question of whether rates were lower in the past, he says it’s difficult to answer that question.

Despite the fact that primates have most of our other diseases, he’s not aware of there being any studies looking at autism in primates.

Dr. Fombonne says there is no good evidence of an increase in autism.  He admits that exposure to the rubella virus in the womb can increase the risk of autism, as can exposure to the drugs thalidomide and tributalene.  He believes the question of whether there has been a true increase in autism is unanswered.

He admits that his slide for autism prevalence in California in 1995 is 6 of every 10,000 children, less than 10% of the current rate of autism.  He believes that the 1995 rate is because of an approximately 10-fold underestimation of the true rate of autism.  However, he still believes the numbers can be used to show thimerosal had nothing to do with autism.

The Madsen numbers from Denmark show an incidence rate of .2 or .3 per 10,000, while in later years it was around 67 to 70 per 10,000.  Fombonne still believes that despite a 99% underestimation rate that these numbers can be used to show no connection between vaccines and autism.

Fombonne was unaware that the Young-Geier study was published in the official journal of the World Federation of Neurologists associated with the World Health Organization, a fully peer-reviewed publication.  He does not have an opinion on  about the fact that the CDC approved the Youg-Geier protocol and that it passed the Institutional Review Board of Kaiser Northwest and Kaiser Northern California.

Fombonne was unaware that Young and Geier were not allowed to compare total vaccines for any one child, or to access any data beyond the year 2000.

He did not know that the data sets used by Young and Geier are fully available to the government.  He did not look at them in preparing his report.

Fombonne admits that his use of the term “definite regression” is not used in any standard text.  There is also no accepted definition of “regressive autism.”

He agreed that the Leinhart study which he cited said that environmental events may act in an additive or second hit fashion to individuals with a genetic vulnerability to autism.
Dr. Fombonne does not believe there is any good evidence upon which to base a study comparing mercury exposure and autism.  In his opinion, studies should not be undertaken unless there was a convincing starting point. 

He has looked at the studies of mercury exposure and the effects on primates, but says he’s not a monkey person. 

Fombonne agreed that detailed parental accounts are the most reliable historical information on a child, but that there are other ways this could be measured in the future.

The family attorney then went over various parts of the parental testimony about the reaction of their children to the vaccines.  He agrees that there is nothing in the medical records to indicate Jordan King or William Mead had any autistic behaviors before the age of 18 months.

Redirect Examination of Dr. Fombonne (Expert Witness for the Government)

Fombonne went over again that there is no generally accepted distinct phenotype of regressive autism.

Questions from the Special Masters

There was some further clarification that there are difficulties in rating the types of skill loss seen in children with autism.

The changes seen in William Mead and Jordan King after 18 months were similar to what he has seen in children in his practice.

Closing Thoughts on this Day of Testimony

I keep trying to figure out how the government thinks they’re going to win this case. 

Dr. Lord, the government’s expert witness on regression in autism can’t find any specific phenotype for regressive autism.  She believes genes are involved, but not the environment.  However, her NIH committee is considering the gene-environment interaction in relation to autism. It’s a little like O.J. vowing to find the “real killers” of his wife and Ron Goldman.

Dr. Fombonne, the government’s expert witness in the epidemiology is comfortable saying that previous studies must have underestimated the prevalence of autism by a 99-fold factor, but can’t provide any support for his own belief that autism rates have remained stable over time.  I guess we’re supposed to believe all of those other epidemiologists couldn’t count.

He doesn’t believe there is any evidence to even examine the possibility of mercury and its relation to autism, although when confronted by primate studies showing neurological damage as a result of mercury exposure he backs off by claiming he’s “not a monkey person.”

I’ll bet the Special Masters have their own opinions about who the monkeys are in this case.

Kent Heckenlively is Legal Editor for Age of Autism.

Comments

Rachel Ford

I want to get some information to Kent Heckinlively in the hopes that he can pass it on to the plaintiffs and their attorneys as I believe it is germane to their thimerosal alone/autism case.

My son, Matthew regressed into autism (diagnosed by three teams of experts, including the prestigious, UNC-Chapel Hill Center) after his 15 mos. shots which included the flu shot along with 5 other vaccines (the Dtap contained mercury as well). This was in Decemenvber of 2003. In early July of 2004 I had Matthew's blood tested for mercury and he tested positive! I had myself and my other son tested for mercury as well and we came back negative. Matthew had never eaten even a taste of fish, nor did I consume fist at all while I was pregnant. Anyway, at the same exact time he regressed in all of the typical areas of autism--language (lost all of it) , gestures and pointing, play skills, and slipped into his own world, he engaged in lots of stimming in the form of loud, constant gibberish, running in circles and arm flapping. He never had the MMR because I had always been concerned about that shot. Anyway long story short, we began the gf/cf/sf diet and detoxification regimen (under DAN doctors Anne Hines. MD and then Mary Megson, MD) when he was just 2. We also did speech and OT. His initial IQ at 2 1/2 just before we fully started the diet was 50. Five months on he diet/detox. and it increased to 68 and by age 4 it was 85. Now, his overall IQ is above average and his teacher says he is at the top of his "regular" class. He no longer displays any symptoms of autism and in a "blind" analysis by a speech pathologist, she noted that he had "very good social skills". He has lots of friends and enjoys everything from playing on a soccer league to going on sleepovers!

Anyway, I think our story is relevant for 4 reasons with regard to the thimeroal-only test case(s):

1. He never had the MMR.
2. He regressed into autism at the same time as his blood registered the presence of mercury--even his regular ped. admitted there was mercury in the shots (implying that this may have been the reason for the blood level). No one else in the family tested positive for mercury. In Aug. of 04 he also tested as having very low glutathione.
3. He recovered from autism (vaccine injury) thorough biomedical interventions.
4. I have saved all of these records, LOTS of before and after video clips and pictures, and I would be happy to testify and to have the special masters meet Matthew if desired.

I certainly think the MMR can be a cause of autism as well (with or without thimerosal in accompanying shots) -- I just think our case shows that it can occur with thimeraosl alone

Fil Navarra

Kent,
Is it possible to slip a note to the lawyers and have them submit the question....."How much did the Pharma companies contribute to Fombonne's latest research project?
Or, How come one of your patients, that your clinic says is autistic, now no longer qualities for that label.....because they took it upon themselves to follow the DAN protocol (Diet,mB12 etc.) when your clinic did nothing.

Elizabeth

Isn't the CDC due for their own trial? An internal investigation (inspector general?) for conspiracy?

Richard

I guess the lesson here is it is really difficult to defend the the indefensible and look intelligent in the process.

Holly H.

Here's one for Mark Blaxill. How many vaccines do you have to mandate so that each $0.75 surcharge which goes to the compensation fund will pay for all the autism the vaccines caused? Me thinks the government may have to raise the surcharge.

Kevin Barry

Dr. Lord has long been affiliated with Cure Autism Now's AGRE (Autism Genetics Resource Exchange) program.

Her autism projects are now funded by the NIH, Autism Speaks and the Simons Foundation.
http://www.ns.umich.edu/htdocs/releases/story.php?id=3085

Dr. Lord should watch the before and after video of Katie's son Christian if she wants to see what regression after vaccination looks like.

SAM

"I still waiting for somebody on the government side to provide safety data, per USP biological, cytotoxicology, and physiochemical testing protocols, showing once and for all that thimerosal is SAFE to inject into a human infant, or a monkey, or an ass, at any level."

Me too, Harry! Maybe I watched too much tv when I was young (Matlock, Murder She Wrote :-), but I want "our" atty's to put someone from pharma or the gov. on the stand and show a bottle of thimerasol with the skull and crossbones, then read it's own MSDS. Then ask - if this is poison, when does it become poison? How do you know how much is safe, if any? When you say it may cause mental retardation, what do you mean? Where is the testing on that? Who became mentally impaired? What happened to them? How were they mentally impaired? Where is the safety testing on babies? etc...

I still don't understand why "we" have to prove harm when "they" admit thimerasol causes harm right on it's own MSDS!

Harry Hofherr

I still waiting for somebody on the government side to provide safety data, per USP biological, cytotoxicology, and physiochemical testing protocols, showing once and for all that thimerosal is SAFE to inject into a human infant, or a monkey, or an ass, at any level.

Until they can show it is safe via their own lab testing standards, all of this is simply pissing in the wind.

wow

In addition, for reimbursement of expenses of the Department of Justice associated with processing cases under the National Childhood Vaccine Injury Act of 1986, not to exceed [$6,833,000] $7,833,000 to be appropriated from the Vaccine Injury Compensation Trust Fund. (Department of Justice Appropriations Act, 2008.)

WOW!

The Civil Division requests an increase in reimbursable authority of 13 workyears and $2,305,000 for the Vaccine Injury Compensation Program to handle the exponential growth in vaccine injury claims alleging injuries caused by thimerosal. Nearly 2,500 cases were filed in FY 2003, compared with just 213 filings in FY 2001, representing an increase of more than ten-fold in workload. The Court of Federal Claims has place these cases on a fast-track. It is the Civil Division's job to ensure that valid claims are approved, invalid claims are dismissed, and damage awards are not excessive. Failure to do this will lead to the depletion of the National Vaccine Injury Trust Fund -- a key facet in the United States's program to ensure an adequate supply of vaccines vital to public health. Total FY 2005 current services resources for this initiative are 28 workyears, (17 attorney workyears) and $4,028,000. There are no direct positions associated with this initiative.

David Taylor

It's fun and even satisfying to see how "our" attorneys were able to make monkeys out of Lord and Fombonne.

But ultimately I was saddened by how closed off they are to any alternative views of this subject they have devoted their professional careers to. They are so fully invested in their positions that their conscious minds will not allow them to reconsider them. This is the dark psychology revealed in these proceedings for me.

I agree with you that the Special Masters seem incredulous at times regarding the monkeys led out by the government. I am impressed by their seeming open-mindedness and curiosity.

And hopeful.


Twyla

I can't see what is the point of Dr. Lord's testimony. All she says is that there is no clear-cut demarcation between phenotypes. She is a psychologist. She has not studied biological underpinnings of autism and has not studied these individual claimants. She is not a toxicologist, immunologist, or any other sort of medical doctor.

Since vaccines begin on the day of birth, some kids may be affected from early on and others may be reach their tipping point later. For some the effects may start as mild and then worsen, for others there may be a dramatic change at some point. Autism is a spectrum. All of this is consistent with the theories and evidence of vaccine injury.

As always, thanks so much, Kent and Mary.

SAM

Can someone please explain to me why everyone seems to be so fixated on whether or not the child was completely "normal" before 12 mo.s of age (because I don't think anyone disputes that there was regression somewhere in the second year of life).

If thimerisol is to blame, I'm sure these boys (just like my ds and most others) received TCV's on the first day of life, 2 mo., 4 mo., 6 mo. and then sometime after 12mo. I know mercury accumulates, but I don't think it's unreasonable to think it could start doing damage at first exposure. Then, the more the child gets, the worse he gets.

My own ds had 15 words at 12 mo. old and lost them all after his 14 mo. shots, but in his first year of life, he did seem to regress after each vaccination. I certainly remember him arching his back and that sort of thing, that I personally think (in retrospect) was damage being done.

Am I missing something here?

Tanner's Dad

http://www.hawaiireporter.com/list.aspx?s=Vaccination

Will this have any bearing on the case?

Jeanne

"She did not review the medical records of William Meade or Jordan King."

Of course she didn't.

"He has looked at the studies of mercury exposure and the effects on primates, but says he’s not a monkey person."

No, but he is a horse's ass.

"It’s a little like O.J. vowing to find the “real killers” of his wife and Ron Goldman."

Okay, my coffee just came out of my nose!

Reading these recaps reminds me of the Arthur Allen/David Kirby debate. I was struck by the nonchalance of Arthur Allen. He was flippant and acted as if he was wasting his time by participating in the debate. He rushed through his "proof" and then left the stage - if my timing was correct, well before his alloted time was up. Seems these "expert" witnesses have the same attitude.

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