Articles

Posts Tagged Autism

A journey to alternative and integrative medicine apostasy

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

I’ve been blogging for over a decade now, a fact that I find really hard to believe looking back on it right now. I’ve told the story before, but it’s worth briefly recounting again because doing so will explain why the story I’m about to discuss caught my attention. My “gateway drug,” if you will, into skepticism was discovering Holocaust denial in the late 1990s on Usenet, a vast and sprawling conglomeration of thousands of discussion forums that began to fade away at the turn of the century with the rise of web-based forums and Google providing an interface to it to make it Google Groups. The forum where I first discovered Holocaust denial and learned to combat it, alt.revisionism, still exists, but long ago degenerated into a cesspool of racism, spam, and trolling. A couple of years later, around 2000 or so, I discovered quackery and the antivaccine movement, thanks to a Usenet newsgroup known as misc.health.alternative, which is where I honed my early skills applying science to medical claims. It’s also where I first encountered Peter Moran, a regular commenter here who greatly inspired me back then with his full-throated criticism of cancer quackery and his website that taught me reasons why cancer quackery could appear to work even when it did nothing to impact the progression of the cancer.

In December 2004, intrigued by all the news stories about blogging and having discovered a number of good blogs, I decided on one dark, gray Saturday afternoon to dip my toe in the blogosphere. On the spur of the moment I created the first iteration of my not-so-super-secret other blog on—what else?—Blogger. Much to my own amazement, over the course of a year I got my little hobby noticed, to the point where I was invited to join a blog collective; by late 2007 I had become prominent enough to be invited by Steve Novella to join this very blog at its founding, where I have remained for seven years, with no plans to move on any time soon. During my early days, though, there was one person who also inspired me, helping me to learn about the pseudoscience that undergirds the antivaccine movement and, in particular, the quackery making up what is known these days as the “autism biomed” movement. His name is James Laidler, and he was one of the ones who introduced me to this topic which I’ve written about many times both at my not-so-super-secret other blog and, of course, right here on SBM. In doing so, over the years I’ve catalogued why “autism biomed” seems compelling to many parents with children with autism, how antivaccine groups use fake “medical conferences” to sell autism biomed by giving a patina of medical respectability to rank quackery like bleach enemas, and providing a place where those selling unscientific treatments can find willing customers and where disreputable discredited “scientists” like Andrew Wakefield and Mark Geier can find adoring fans who believe their quackery.

I bring this up because last week WIRED published an excellent article about Jim Laidler, “An Alternative-Medicine Believer’s Journey Back to Science.” Appropriately enough, it’s by Alan Levinovitz, an assistant professor of religion at James Madison University. I say “appropriately enough” because, as has been noted here on a number of occasions, there are many religion-like aspects to alternative medicine in general but to the autism biomed movement in particular. Indeed, the two are often tied together, with the motivation for some alt-med being explicitly religious and belief in alt-med sharing some major characteristics with religion, particularly belief in miracles against evidence, charismatic leaders (like Andrew Wakefield) who can do no wrong, and mutually-supportive communities of believers who reinforce each others’ beliefs and ward off skepticism. Add to that the magical thinking, and it’s not for nothing that I’ve referred to the central dogma of alternative medicine as being that wishing makes it so. Indeed, it’s for good reason that I frequently point out that most “energy medicine” (particularly reiki) is basically faith healing that substitutes Eastern mysticism for Judeo-Christian religious beliefs.

In Levinovitz’s profile of Jim Laidler, we see a lot of this, and I learned some details that I didn’t know about Laidler before. Levinovitz also grasps the religion-like nature of alt-med by starting the article bluntly saying:

Jim and Louise Laidler lost their faith on a trip to Disneyland in 2002, while having breakfast in Goofy’s Kitchen.

(more…)

Posted in: Health Fraud, Neuroscience/Mental Health, Vaccines

Leave a Comment (123) →

Still No Association Between MMR and Autism

Pictured: not a risk of autism

Pictured: not a risk of autism

A new study published this week in JAMA, “Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism”, puts one more nail in the claim that the MMR is associated with autism.

You may wonder why, after years and multiple studies showing no association between the measles-mumps-rubella vaccine (MMR) and autism spectrum disorder (ASD) there would even be a need for such a study. The authors explain:

Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations.

The study is a retrospective cohort study involving 95,727 children with older siblings. They looked at whether or not the older sibling had a diagnosis of ASD, whether or not they were vaccinated with MMR, and whether or not they themselves developed ASD. They found:

MMR vaccination rates (≥1 dose) were 84% (n = 78 564) at age 2 years and 92% (n = 86 063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18;P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55).

(more…)

Posted in: Vaccines

Leave a Comment (243) →

Integrative medicine, naturopathy, and David Katz’s “more fluid concept of evidence”

The Integrative Medicine Wheel

The Integrative Medicine Wheel

Dr. David Katz is undoubtedly a heavy hitter in the brave new world of “integrative medicine,” a specialty that seeks to “integrate” pseudoscience with science, nonsense, with sense, and quackery with real medicine. In fairness, that’s not the way physicians like Dr. Katz see it. Rather, they see it as “integrating” the “best of both worlds” to the benefit of patients. However, as we’ve documented extensively here, on our personal blogs, and even in the biomedical literature (plug, plug), what “integrative” medicine means in practice is indeed what I characterized, the infiltration of woo into medicine. This infiltration seems to have started mainly in academia—hence the term “quackademic medicine” and “quackademia”—with the steady infiltration of nonsense into medical schools and academic medical centers, but has since metastasized to the world of community hospitals. This “integration” (or, as I like to refer to it, “infiltration”) has become so pronounced that a few years ago The Atlantic published an article entitled “The Triumph of New Age Medicine“, and just last December the Journal of the National Cancer Institute (JNCI) published a monograph full of articles touting “integrative oncology,” including guidelines recommended by the Society of Integrative Oncology (SIO) for the “integrative” treatment of breast cancer symptoms.

I mention Dr. Katz for two reasons. First, he’s taken another broadside at us at Science-Based Medicine in blog entry at The Huffington Postwhere else?—entitled “Holism, Holes and Poles” that I’ve been meaning to address for a while. But before I address Dr. Katz’s most recent complaint against science-based medicine (SBM), it’s necessary to step back and look at some history.
(more…)

Posted in: Clinical Trials, Homeopathy, Medical Academia, Naturopathy

Leave a Comment (170) →

Say it ain’t so, Mickey! A holiday measles outbreak makes the happiest place in the world sad

disneyland

Last week, the self-proclaimed “happiest place on earth” wasn’t so happy.

One of the disadvantages of posting once a week is that, unless I muscle in on someone else’s day I can’t respond rapidly to stories that appear early. Of course the flip side of that is that if a story appears over the weekend it’s all mine, and, besides, I have my not-so-super-secret other blog to respond to issues that occur earlier in the week. Another advantage is that, if I do decide to write about something from earlier in the week, I have the advantage of time to think.

You’ve probably figured out that what I’m referring to is the latest measles outbreak. Not surprisingly, it happened in the Los Angeles area. Surprisingly (or perhaps not so much), it happened at Disneyland. I say “not surprisingly” because it’s been well-publicized over the last few years that there are pockets of low vaccine uptake and high personal belief exemptions in California, complete with measles and pertussis outbreaks. This is thanks to pockets of affluent, entitled parents full of the Dunning-Kruger effect who think that they can learn as much about vaccines and autism via Google University as pediatricians and researchers who have devoted their entire professional careers to studying them. Of course, these parents are also facilitated by pediatricians who cater to their fears, the most famous of whom is Dr. Bob Sears, whose The Vaccine Book is a very popular, reasonable-sounding (to parents not aware of the antivaccine tropes within) bit of antivax lite, but there is also our old buddy Dr. Jay Gordon and a host of others.

So what happened at Disneyland? On January 7, the California Department of Public Health confirmed seven measles cases:
(more…)

Posted in: Public Health, Vaccines

Leave a Comment (211) →

Naturopathy vs. Science: Autism

asperger's autism

Just when I thought I was out, they pull me back in. My blogging plan was to take a break from my series of naturopathy versus science posts, where I’ve been contrasting the advice from naturopaths against the scientific evidence. From a blogging perspective, naturopathy is a fascinating subject to scrutinize as there is seemingly no end of conditions for which naturopaths offer advice that is at odds with the scientific evidence. From a health care perspective, however, reading the advice of naturopaths is troubling. Naturopaths promote themselves as health professionals capable of providing primary care, just like medical doctors. And they’re increasingly seeking (and obtaining) physician-like privileges from governments. Naturopathy seems to be getting an easy ride from regulators, despite a lack of evidence that shows naturopathy offers anything distinctly useful or incrementally superior to science-based medicine.

Defining the scope of “naturopathic” treatment is difficult. Naturopaths offer an array of disparate health practices like homeopathy, acupuncture and herbalism that are only linked by the (now discarded) belief in vitalism – the idea we have a “life force”. From this philosophy can sometimes emerge reasonable health advice, but that has little to do with the science or the evidence. As long as it’s congruent with the naturopathic belief system, it’s acceptably “naturopathic”. In past posts I’ve looked at the naturopathic perspectives on fake diseases, infertility, prenatal vitamins, vaccinations, allergies and even scientific facts themselves. An advertisement passed to me this week promoted a naturopath who claims to treat pediatric conditions like ADHD and learning disabilities: (more…)

Posted in: Herbs & Supplements, Naturopathy, Vaccines

Leave a Comment (147) →

Blaming breast cancer on autism

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link)

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link)

Gayle DeLong has been diagnosed with what she refers to as “autism-induced breast cancer”. She’s even given it an abbreviation, AIBC. Unfortunately, as you might be able to tell by the name she’s given her breast cancer, she is also showing signs of falling into the same errors in thinking with respect to her breast cancer as she clearly has with respect to autism. As a breast cancer surgeon, regardless of my personal opinion of DeLong’s anti-vaccine beliefs, I can only hope that she comes to her senses and undergoes science-based treatment, but I fear she will not, as you will see. Her brief post announcing her diagnosis and blaming it on autism, however, does provide what I like to call a “teachable moment” about cancer.

We’ve met DeLong before on this blog. For instance, she published an execrably bad study that—of course!—tried to link vaccine to autism and failed miserably, despite doing some amazing contortions of analysis, combining diagnoses willy-nilly, all in the service of the discredited vaccine-autism hypothesis. As I said at the time, it just goes to show that someone who is an associate professor of economics and finance shouldn’t be doing epidemiological research. As I also described at the time, if the sorts of analytical techniques she used in her study are acceptable in the world of economics and finance, no wonder our economy has been so screwed up for so long. Another time, DeLong wrote a broadside against the regulatory machinery that oversees vaccine development and safety that was full of the usual antivaccine misinformation, tropes, and pseudoscience and hugely exaggerated perceived “conflicts of interest” among the various parties.
(more…)

Posted in: Cancer, Neuroscience/Mental Health, Vaccines

Leave a Comment (22) →

Brian Hooker and Andrew Wakefield accuse the CDC of scientific fraud. Irony meters everywhere explode.

conspiracy-theories-everywhere

The antivaccine movement and conspiracy theories go together like beer and Buffalo wings, except that neither are as good as, yes, beer and Buffalo wings. (Maybe it’s more like manure and compost.) In any case, the antivaccine movement is rife with conspiracy theories. I’ve heard and written about more than I can remember right now, and I’m under no illusion that I’ve heard anywhere near all of them. Indeed, it seems that every month I see a new one.

There is, however, a granddaddy of conspiracy theories among antivaccinationists, or, as it’s been called, the central conspiracy theory of the antivaccine movement. That conspiracy theory postulates that “they” (in the U.S, the CDC) have known for a long time that vaccines cause autism, but “they” are covering it up. In other words, the CDC has, according to this conspiracy theory, been intentionally hiding and suppressing evidence that antivaccinationists were right all along and vaccines do cause autism. Never mind what the science really says (that vaccines do work don’t cause autism)! To the antivaccine contingent, that science is “fraudulent” and the CDC knew it! Why do you think that the antivaccine movement, in particular Robert F. Kennedy, Jr., went full mental jacket when Poul Thorsen was accused of financial shenanigans (i.e., fraud) with grant money from the federal government? It was a perfect story to distract from the inconvenient lack of science supporting the antivaccine view that vaccines cause autism. More importantly, from the antivaccine standpoint, it was seen as “validation” that the CDC studies failing to find a link between autism and vaccines were either fraudulent or incompetently performed. Why? Because Thorsen was co-investigator on a couple of the key studies that failed to find a link between the MMR and autism, antivaccinationists thought that his apparent financial fraud must mean that he committed scientific fraud. They’re the same thing, right? Well, not really. There were a lot of co-investigators, and Thorsen was only a middle author on those studies.
(more…)

Posted in: Neuroscience/Mental Health, Public Health, Vaccines

Leave a Comment (289) →

Andrew Wakefield, the MMR, and a “mother warrior’s” fabricated vaccine injury story

AWakefield

As the time came to do my usual weekly post for this blog, I was torn over what to write about. Regular readers might have noticed that a certain dubious cancer doctor about whom I’ve written twice before has been agitating in the comments for me to pay attention to him, after having sent more e-mails to me and various deans at my medical school “challenging” me to publish a link to his results and threatening to go to the local press to see if he can drum up interest in this “battle.” I’ve been assiduously ignoring him, but over time the irritation factor made me want to tell him, “Be very careful what you ask for. You might just get it.” Then I’d make this week’s post about him, even though I wasn’t thrilled with the idea of giving in to his harassment and giving him what he wants.

That’s why I have to thank the ever-intrepid investigative reporter Brian Deer for providing me an alternative topic that is way more important than some self-important little quack and a compelling topic to blog about in its own right. Brian Deer, as you might recall, remains the one journalist who was able to crack the facade of seeming scientific legitimacy built up by antivaccine guru Andrew Wakefield and demonstrate that (1) Wakefield’s work concluding that the MMR vaccine was associated with “autistic enterocolitis” was bought and paid for by a solicitor named Richard Barr, who represented British parents looking to sue vaccine manufacturers, to the tune of over £400,000; (2) Wakefield expected to make over £72 million a year selling a test for which Wakefield had filed a patent application in March 1995 claiming that “Crohn’s disease or ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids”; and Wakefield’s case series published in The Lancet in 1998 was fraudulent, the equivalent of what Deer correctly characterized as “Piltdown medicine.” Ultimately, these revelations led to Wakefield’s being completely discredited to the point where The Lancet retracted his paper and even Thoughtful House, the autism quackery clinic in Austin, TX where Wakefield had a cushy, well-paid position as scientific director, had to give him the boot. Yes, Wakefield is a fraud, and it’s only a shame that it took over a decade for it to be demonstrated.

As much as I hate how it took discrediting Wakefield the man as a fraud rather than just discrediting his bogus science to really begin to turn the tide against the annoying propensity of journalists to look to Wakefield or his acolytes for “equal time” and “balance” whenever stories about autism and vaccines reared their ugly heads, I can’t argue with the results. Wakefield is well and truly discredited now, so much so that, as I noted, his prominent involvement probably ruined any chance promoters of the “CDC whistleblower” scam ever had to get any traction from the mainstream press.

What is sometimes forgotten is the effect Wakefield’s message has had on parents. These are the sorts of parents who tend to congregate into groups designed to promote the idea that vaccines are dangerous and cause autism, such as the bloggers at the antivaccine crank blog Age of Autism, the equally cranky blog The Thinking Moms’ Revolution, or groups like The Canary Party. It is Wakefield’s message and the “autism biomed” quackery that it spawned that have led to unknown numbers of autistic children being subjected to the rankest form of quackery in order to “recover” them, up to and including dubious stem cell therapies and bleach enemas.
(more…)

Posted in: Health Fraud, Homeopathy, Neuroscience/Mental Health, Vaccines

Leave a Comment (74) →

Autism Prevalence Unchanged in 20 Years

Autism-brain-leadThat there is an “autism epidemic” is taken as a given by those who feel autism has a dominant environmental cause. The Age of Autism blog, for example, bills itself as a, “Daily Web Newspaper of the Autism Epidemic.” The term “epidemic” also implies an environmental factor, such as an infection.

The epidemiology of autism and autism spectrum disorder (ASD) has never supported the conclusion that there is an autism epidemic. There is no doubt that the number of autism diagnoses has increased in the last two decades, but the evidence strongly suggests this increase in an artifact of how autism diagnoses are made, and not representative of a true increase.

Adding to this data, a newly published study looks at autism and ASD prevalence worldwide: “The epidemiology and global burden of autism spectrum disorders“. They found:

In 2010 there were an estimated 52 million cases of ASDs, equating to a prevalence of 7.6 per 1000 or one in 132 persons. After accounting for methodological variations, there was no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs.

(more…)

Posted in: Epidemiology, Neuroscience/Mental Health

Leave a Comment (104) →

The “CDC whistleblower saga”: Updates, backlash, and (I hope) a wrap-up

Vaccinefear

Given that this is a holiday weekend here in the US and that I’m having a bit of a staycation right now, I had thought of simply not posting today or of rerunning a “classic” (if you want to call it that) blast from the past. But the topic I wrote about last week has only festered and grown bigger since Monday; so at the very least I felt obligated to do a post updating you, our readers, on the twists and turns that have occurred in the saga of the so-called “CDC whistleblower.” For those of you familiar with the story (not to mention following my not-so-secret other blog), much of this will be familiar, but, given that this is SBM, I felt that this material should be on record here for your edification and (hopefully) education. I’ll take (more or less) a chronological approach since last Monday and then finish up by trying to put this whole mess into perspective. This is going to be longer than even my usual posts, but I want to be authoritative. So, if you’re very familiar with what’s happened, you might want to skim everything before the “backlash” and “conclusion” sections to fill in what you might have missed. If you’re less than completely steeped in what happened, read every scintillating word!

But first, for those who might be entering this saga right now, let me recap a moment. I’m referring to a conspiracy theory, which has been flogged to death by the antivaccine movement for nearly two weeks now, that there is a CDC whistleblower who has made “devastating” reports that the CDC hid data that showed a 3.4-fold increased risk of autism in African American males, based on an incompetent “reanalysis” of a 10 year old CDC study that found no evidence that children with autism were more likely to have received their first MMR vaccine earlier than neurotypical controls. As I (and others) have discussed, Hooker used howlingly bad statistical methodology (for instance, analyzing case control data as a cohort study and using risibly bad statistical analyses) to torture the data until they confess that vaccines cause autism. As I said at the time, when it comes to data, call Hooker the Spanish Inquisition. Such was the weakness of what he found that, even after forcing the data to sit in the comfy chair for extended periods of time, the most damning “confession” he could get from them was a correlation between age at MMR vaccination and autism diagnoses in one small subgroup: African American males.

Based on this utterly incompetent data torture and Hooker’s apparent budding relationship with a “CDC whistleblower,” Wakefield first made a video in which this “whistleblower’s” voice was electronically altered (not to mention edited into such selective snippets that it was impossible to glean any context from his seemingly-damning statements. This video, released through Andrew Wakefield’s and Tommy Polley’s Autism Media Channel, despicably likened this CDC “cover-up” to the Tuskegee syphilis study, and finished with a flourish of Godwin-y nonsense that included Adolf Hitler (of course!), Pol Pot, and Josef Stalin, implying that the CDC’s “crimes” with respect to this alleged cover-up were just as bad. It was a breathtaking demonstration of pure stupid hyperbole. Then, a few days later, Wakefield replaced the video with the alterations in the “whistleblower’s” voice with his real voice and revealed his real name: William W. Thompson, PhD, a psychologist and senior scientist at the CDC, as well as a co-author of the study being “reanalyzed,” DeStefano et al. Now, on to the update! (more…)

Posted in: Science and the Media, Vaccines

Leave a Comment (335) →
Page 1 of 7 12345...»