Autism listed as adverse event on DTAP vaccine insert on fda website.. - Page 4

[tessie]

Originally Posted by ema-adama

I honestly don't know what is causing the autism epidemic.

I think a lot of it is that autism is a relatively new diagnosis. Fifty years ago a kid with autism would just have been described as mentally disabled and stuck in an institution.

[ema-adama]

Originally Posted by tessie

I think a lot of it is that autism is a relatively new diagnosis. Fifty years ago a kid with autism would just have been described as mentally disabled and stuck in an institution.

Very generally, I find that people who believe in vaccination as the cornerstone to public health are more inclined to hypothosize that improved diagnosis accounts for the astonishing increase in numbers. While improved diagnosis might account for *some*, I personally find it hard to believe that that number of people were institutionalised 50 years ago. Where are they today?

Trying to say that nothing has actually changed in the last 50 years with regards to the numbers of children being diagnosed with autism, only serves to ignore the very real pain and frustration of many families and turn a blind eye to the reality that something is dreadfully wrong with the health of children today. Thankfully there are some people who are concerned and trying to unravel just what is going on. Denial really has no place.

I do not know if anyone can be 100% certain of the etiology of Autism - mostly because I do not think there is one cause. It seems to be an individual mix of genetics and environment.

However, there are parents here who are living with children on the spectrum who know much more than I do. I have only tried to understand how vaccines came to be accused of the steep increase in Autism.

As an aside, I do find it curious that it is on the DTaP insert and not the MMR insert. I have seen much more concern about the link between MMR and Autism than the DTaP and Autism. If large numbers of parents are reporting Autism post MMR vaccination, why is that not listed on the insert - if the policy is to list anything from teething to death in a car accident?

[Jugs]

Originally Posted by tessie

I think a lot of it is that autism is a relatively new diagnosis. Fifty years ago a kid with autism would just have been described as mentally disabled and stuck in an institution.

So they were around all along, just nobody saw them; that's convenient. Autism itself isn't new, just the expanded diagnostic criteria. Either way, I find it hard to believe that a such large numbers of children were quietly hidden away in institutions for decades and nobody noticed or questioned it.

[tessie]

Originally Posted by ema-adama

Very generally, I find that people who believe in vaccination as the cornerstone to public health are more inclined to hypothosize that improved diagnosis accounts for the astonishing increase in numbers. While improved diagnosis might account for *some*, I personally find it hard to believe that that number of people were institutionalised 50 years ago. Where are they today?

Dead or still in a care facility, I would imagine. It was very common 50+ years ago to put children with a mental or physical disabilities in a home either at birth or as soon as the disability became apparent. In fact the most recent I know of happened to a child in the seventies. The 'different', including people with disabilities, psychiatric patients, unmarried mothers etc were routinely hidden as a dirty little secret.

How can people not be aware of this?

[Jugs]

People are aware of this, but some of us do not believe it explains away the idea that there really isn't a drastic increase in autism compared to decades ago.

[tessie]

Originally Posted by Jugs

People are aware of this, but some of us do not believe it explains away the idea that there really isn't a drastic increase in autism compared to decades ago.

Hang on, you just said,

I find it hard to believe that a such large numbers of children were quietly hidden away in institutions for decades and nobody noticed or questioned it.

So which is it?

[Jugs]

I am not disputing the fact that children and adults diagnosed with mental illnesses were often institutionalized, I am disputing the idea that it was ocuring in such volume. There are approximately 24,000 new autism diagnosis each year in the US, roughly half of whom are diagnosed with classic (Kanner's) autism; I would love to see documention of anywhere near 12,000 children per year being institutionalized for mental illnesses and/or severe developmental disabilities during the time period in question.

[JamesMama]

wow...

I noted the SIDS thing too...that's kinda scary.

[ema-adama]

Originally Posted by tessie

How can people not be aware of this?

I am aware of this. As I have studied the shift from institutional care to community care and the change in social perceptions around disability. Not read about it on the internet, studied it as part of my degree - if that makes a difference.

What I find hard to believe is that is was happening in such huge numbers. Do you have anything to back up that kind of a hypothesis?

[carriebft]

All of the major studies on this that I can think of have found that diagnostic reasons are the MAIN reason for the rise in autism but that there may be an environmental factor as well.

http://www.ncbi.nlm.nih.gov/pubmed/1...d_Discovery_RA

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/1...d_Discovery_RA

I know I have a few from last year, too...just have to find them.

[ema-adama]

RESULTS: The true incidence of autism spectrum disorders is likely to be within the range of 30-60 cases per 10 000, a huge increase over the original estimate 40 years ago of 4 per 10000. The increase is largely a consequence of improved ascertainment and a considerable broadening of the diagnostic concept. However, a true risk due to some, as yet to be identified, environmental risk factor cannot be ruled out. There is no support for the hypothesis for a role of either MMR or thimerosal in causation, but the evidence on the latter is more limited. CONCLUSION: Progress in testing environmental risk hypotheses will require the integration of epidemiological and biological studies.

I do not have acess to the full text - I would be interested in what data was used. This study is from 2005. With the numbers increasing anually from what I understand. Are health care providers improving their diagnostics from year to year?
I would be interested to see any subsequent biologocal studies.

Rates of diagnosis of autism have risen since 1980, raising the question of whether some children who previously had other diagnoses are now being diagnosed with autism. We applied contemporary diagnostic criteria for autism to adults with a history of developmental language disorder, to discover whether diagnostic substitution has taken place. A total of 38 adults (aged 15-31y; 31 males, seven females) who had participated in studies of developmental language disorder during childhood were given the Autism Diagnostic Observation Schedule--Generic. Their parents completed the Autism Diagnostic Interview--Revised, which relies largely on symptoms present at age 4 to 5 years to diagnose autism. Eight individuals met criteria for autism on both instruments, and a further four met criteria for milder forms of autistic spectrum disorder. Most individuals with autism had been identified with pragmatic impairments in childhood. Some children who would nowadays be diagnosed unambiguously with autistic disorder had been diagnosed with developmental language disorder in the past. This finding has implications for our understanding of the epidemiology of autism.

How conclusive can a study of 38 people be? Perhaps indicative of a trend, but far from conclusive. (One of the 'problems' with the Wakefield study is that it was done on 12 children - enough to perhaps indicate a trend, but nothing conclusive ). Again, I don't have access to the full text.
This is the newsest of the 3 studies posted by Carrie, and is a study done in the UK from what I can understand in the abstract. I wonder if a similar study done in the USA would be draw the same conclusions?

METHODS: Literature review and interpretation.

I would like to see what literature was reviewed, but don't have access to the full text

CONCLUSIONS: There has (probably) been no real increase in the incidence of autism. There is no scientific evidence that the measles, mumps and rubella (MMR) vaccine or the mercury preservative used in some vaccines plays any part in the aetiology or triggering of autism, even in a subgroup of children with the condition.

From the study that reviewed literature.

I am still trying to get my head around this. I find it quite weird that these studies seek to establish no true increase in the incidence of autism while simulatneously seeking to establish no link between autism and vaccines, specifically thimerosol and MMR. And those who have read the studies proving thimerasol to be just fine know how flawed they are.
The information available really is a mess.

I am not yet sure for myself that there is no true increase in the incidence in autism. If there were no true increase what would that mean? Who stands to gain by a study that finds no increase in incidence?

I also did not see who funded the studies. That might help answer some of my questions.

It does seem to be fairly well established that the environment for the fetus and newborn are critical. It just looks dishonest to not try and figure out if vaccines are not an environmental trigger for some chidren. Including vaccinating pregnant women. And a perception of dishonesty will undermine trust in the scietists who keep concluding there is no link, with highly flawed studies.

Some more dreaming, But I think the quickest and most cost effective way to improve parent trust in vaccination is to compare unvaccinated children with vaccinated and see if anything significant emerges. Speak to parents who are concerned and ask them what answers they are looking for - design the study in conjunction with them and take it from there. Trying to intimidate and mandate is only going to work to the disadvantage of those who view vaccination as essential to public health. It shouts "I do not have any real facts, but I am going to bully you anyway"

[carriebft]

I think you are missing the point on the language one; the idea is that there is ample evidence of disorders that were called something else then are now autism/disorders that are included in other stuff now being included in autism.

You also seem to be missing the parts where they are saying it is not all diagnostic criteria changes-- you seem to think I am arguing that it is?

found one of the newer ones

http://pt.wkhealth.com/pt/re/lwwgate...00901000-00016

Again, she says that diagnostics is the main reason but that there is room for an environmental cause as well.

[carriebft]

http://www.ncbi.nlm.nih.gov/pubmed/14695031

http://pediatrics.aappublications.or...act/117/4/1028

[ema-adama]

I am getting that there is an increase in incidence in part due to improved diagnosis and decreased stigma and in part to due environmental causes that have yet to be identified.

I seem to be overly sensitive to people saying or implying that it is just not true that there is an increase in incidence from anything other than improved diagnosis. I am sorry if you thought I was boxing you in with a group of people who deny any true increase in incidence.

[carriebft]

no problem-- just wanted to make sure that was clear-- pretty much every study I have read on this gives diagnostic as the main reason but most seem to mention room for environmental factors as well.

[ema-adama]

Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder?

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum
Med Hypotheses. 2009 Aug 20.

A survey of the research literature identified 9 environmental factors for which increased pre-conceptual exposure appears to be associated with increased risk for autism. Five of these factors - mercury, cadmium, nickel, trichloroethylene, and vinyl chloride - are established mutagens. Another four - including residence in regions that are urbanized, located at higher latitudes, or experience high levels of precipitation - are associated with decreased sun exposure and increased risk for vitamin D deficiency. Vitamin D plays important roles in repairing DNA damage and protecting against oxidative stress - a key cause of DNA damage. Factors associated with vitamin D deficiency will thus contribute to higher mutation rates and impaired repair of DNA.

A mix of genes and environment, an interesting line of enquiry.

[ema-adama]

http://www.precaution.org/lib/autism...eal.090101.pdf

Conclusions: Autism incidence in California shows no sign yet of plateauing. Younger ages at diagnosis, differential migration, changes in diagnostic criteria, and inclusion of milder cases do not fully explain the observed increases. Other artifacts have yet to be quantified, as a result, the extent to which the continued rise represents a true increase in the occurrence of autism remains unclear.

(Epidemiology 2009;20: 84 –90)

I do not know what other people think of this study, but it is from 2009 and covers many of the reasons put forward to hypothesize that there is no true increase in incidence. It studies data from California from 1990 through 2006.

[VolDad]

Originally Posted by tessie

I think a lot of it is that autism is a relatively new diagnosis. Fifty years ago a kid with autism would just have been described as mentally disabled and stuck in an institution.

You might try reading this article if you believe that:

http://www.ucdmc.ucdavis.edu/newsroo...able=published

[felix23]

This was an interesting study about the rate of adults with autism.

http://www.medicalnewstoday.com/articles/164936.php#