The Autistic Place

Reports on autism and parental age have yielded conflicting results on whether mothers, fathers, or both, contribute to increased risk. We analyzed restricted strata of parental age in a 10-year California birth cohort to determine the independent or dependent effect from each parent. Autism cases from California Department of Developmental Services records were linked to State birth files (1990-1999). Only singleton births with complete data on parental age and education were included (n=4,947,935, cases=12,159). In multivariate logistic regression models, advancing maternal age increased risk for autism monotonically regardless of the paternal age. Compared with mothers 25-29 years of age, the adjusted odds ratio (aOR) for mothers 40+ years was 1.51 (95% CI: 1.35-1.70), or compared with mothers <25 years of age, aOR=1.77 (95% CI, 1.56-2.00). In contrast, autism risk was associated with advancing paternal age primarily among mothers <30: aOR=1.59 (95% CI, 1.37-1.85) comparing fathers 40+ vs. 25-29 years of age. However, among mothers >30, the aOR was 1.13 (95% CI, 1.01-1.27) for fathers 40+ vs. 25-29 years of age, almost identical to the aOR for fathers <25 years. Based on the first examination of heterogeneity in parental age effects, it appears that women's risk for delivering a child who develops autism increases throughout their reproductive years whereas father's age confers increased risk for autism when mothers are <30, but has little effect when mothers are past age 30. We also calculated that the recent trend towards delayed childbearing contributed approximately a 4.6% increase in autism diagnoses in California over the decade.

Last week, the New York Times printed an editorial entitled A Welcome Retraction.  The article lauds the Lancet for retracting the 1998 study by Dr. Andrew Wakefield which sparked public anxiety that the MMR vaccine might have a causal link to autism.

The editorial goes on to share this quaint hope:

What is indisputable is that vaccines protect children from dangerous diseases. We hope that The Lancet's belated retraction will finally lay this damaging myth about autism and vaccines to rest.

In fact, of course, far from laying anything to rest, the retraction served as a galvanizing call to action.  Parents and other supporters of Dr. Wakefield have been active in defending the man and his work through press releases, blogs, media statements and more.

Most significantly, the potent team of Jenny McCarthy and Jim Carrey produced and delivered an impassioned statement which included this accusation:

Dr. Andrew Wakefield is being discredited to prevent an historic study from being published that for the first time looks at vaccinated versus unvaccinated primates and compares health outcomes, with potentially devastating consequences for vaccine makers and public health officials.

It is our most sincere belief that Dr. Wakefield and parents of children with autism around the world are being subjected to a remarkable media campaign engineered by vaccine manufacturers reporting on the retraction of a paper published in The Lancet in 1998 by Dr. Wakefield and his colleagues.

McCarthy and Carrey make it clear that they will be actively promoting their perspective in the weeks and months to come.  In fact, the biomedically-oriented Autism One conference planned for May, where Jenny and Jim will be keynote speakers, will also feature Dr. Andrew Wakefield.

Look for much more information to come about this conference and its outcomes.  Already, its promotional material is headlined "The World Changes in May."  Promises are made of surprise announcements.  And this rather ominous statement is included on the conference website's front page:

Together we will redefine autism as a biomedical condition that can be treated and prevented. The past has been unkind to autism. The future is ours. We'll see you in Chicago.

Lancet's Retraction of Wakefield Paper Like Gasoline on a Fire originally appeared on About.com Autism on Sunday, February 7th, 2010 at 09:57:09.

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I am unutterably frustrated to say that we don't get HBO.  As a result, though I've read and heard plenty about last night's HBO presentation of the biopic "Temple Grandin," starring Claire Danes, I was NOT able to see it.

I can tell you that, according to several interviews, Temple Grandin thought it was terrific.  From the Star-Ledger, for example:

"I just couldn't believe how she played me," Grandin says. "It was like going back in a weird time machine.

Melissa Silverstein of Huffington Post raves:

Claire Danes is revelatory as Temple Grandin animal behaviorist, best-selling author, autistic and expert in autism. This is a fascinating movie and I learned so much about this woman and about autism. Temple did not speak until she was four and if not for her mother would have probably ended up spending her life in an institution. What a loss that would have been.

Because I wasn't able to watch Temple Grandin last night, I did finally manage to rent and view Adam, the Sundance-winning film about a young man with Asperger syndrome and his romantic involvement with a gorgeous, wealthy neighbor...  I had heard great things about it, and while I did find the acting to be compelling, the story itself was a bit weak.

So how was the Temple Grandin film?  Are these reviewers really correct?  Is the movie as good as they say?  And - what do you think about the media response to Temple Grandin as a sort of emissary from the world of autism?

Share your thoughts!

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Did You See Claire Danes as Temple Grandin? Share Your Review! originally appeared on About.com Autism on Sunday, February 7th, 2010 at 07:03:38.

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The Learning and Developmental Disabilities Initiative (LDDI) released the first-ever biomonitoring report identifying toxic chemical pollution in people from the learning and developmental disability community...

The Los Angeles Times: "Twelve years after Dr. Andrew Wakefield published his research in the international medical journal the Lancet purporting that the measles-mumps-rubella vaccine causes autism, the journal on Tuesday formally retracted the paper. ... the U.K. General Medical Council's Fitness to Practice Panel concluded that [Dr...

Rae Sonnenmeier, clinical associate professor of communication sciences and disorders at the University of New Hampshire and staff member at UNH's Institute on Disability, is available to discuss the announcement yesterday (Feb...

The Lancet, a premier British medical journal, retracted a study published in 1998 that drew a link between the measles, mumps and rubella (MMR) vaccine and increased incidence of autism. Alan Percy, M.D...

If you're new to the autism/vaccine debate, you may wonder who Dr. Andrew Wakefield is.  You may also be puzzled as to why so much is being made of the revocation of a 1998 study including just twelve autistic children.  If so, you may want to take a look at these short, non-technical articles on the subject:

• Who Is Andrew Wakefield?
• Medical Journal Retracts Paper Tying MMR Vaccine to Autism
• Introduction to the Vaccine-Autism Debate
• Autism and the Vaccine Court

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Who Is Andrew Wakefield? originally appeared on About.com Autism on Wednesday, February 3rd, 2010 at 09:08:29.

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Yesterday The Lancet, Britain's premiere medical journal, revoked publication of a study by Andrew Wakefield.  That study, completed in 1998, has provided a foundation for a whole movement which sees vaccines as the cause of an explosive rise in autism.

What does all this mean?  Opinions, not surprisingly, vary.

Today's Slate.com features a rerun of an article by writer/research Arthur Allen entitled "Why There's No Dispelling the Myth that Vaccines Cause Autism."  In it, he describes a mother testifying at a Vaccine Court trial:

It is difficult to challenge a mother's knowledge of her own child. And also to fight off the staying power of the vaccines-cause-autism theory and other such notions that verge on the irrational.

On a similar note, the Left Brain/Right Brain blog comments:

The behavior of the Wakefield supporters is totally predictable. They have no science. They have no first (or second) tier researchers. They rely heavily on Dr. Wakefield. Who else has the perceived stature of Dr. Wakefield for them?

Meanwhile, journalist David Kirby takes a very different tone in the Huffington Post:

I believe that the public lynching and shaming of Dr. Wakefield is unwarranted and overwrought, and that history will ultimately judge who was right and who was wrong about proposing a possible association between vaccination and regressive autistic spectrum disorder (ASD).

Kirby ends his essay by making it clear that the retraction of Wakefield's paper by the Lancet will have no impact whatever on public opinion: "Nobody seriously thinks that the retraction of The Lancet article, and the international flogging of Dr. Andrew Wakefield, will do anything to make this debate go away. And they are right."

Do you agree?

// // ]]>

Does the Lancet's Retraction of Wakefield's Study Change Your Mind? originally appeared on About.com Autism on Wednesday, February 3rd, 2010 at 07:44:31.

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The purpose of this study was to determine the effectiveness of a 10 week water exercise swimming program (WESP) on the aquatic skills and social behaviors of 16 boys with autism spectrum disorders (ASDs). In the first 10 week phase (phase I), eight children (group A) received the WESP while eight children (group B) did not. A second 10 week phase (phase II) immediately followed, with the treatments reversed. Both groups continued their regular treatment/ activity throughout the study. Improvements were seen in aquatic skills for both groups subsequent to the WESP. Following phase I, significant social improvements were seen in group A. Following phase II, social improvements were seen for group B, whereas group A merely maintained the improvements they attained through the implementation of the WESP during phase I. Results indicate that the WESP improved aquatic skills in the participants, and holds potential for social improvements.

One of the most noticeable problems in autism involves the social use of language such as metaphor and metonymy, both of which are very common in daily language use. The present study is the first to investigate the development of metaphor and metonymy comprehension in autism. Eleven children with autism were compared to 17 typically developing children in a metaphor-metonymy comprehension task. Cross-sectional trajectory analyses were used to compare the development of metaphor and metonymy comprehension using a child-friendly story picture task. Trajectories were constructed linking task performance either to chronological age or to measures of mental age. Children with autism showed an impaired metaphor comprehension in relation to both chronological and mental age, whereas performance on metonymy was delayed and in line with their receptive vocabulary. Our results suggest that understanding of metaphors and metonyms are severely affected at all ages examined in the current study.

The aim of the study was to examine the temporal characteristics of information processing in individuals with high-functioning autism and Asperger’s disorder using a rapid serial visual presentation paradigm. The results clearly showed that such people demonstrate an attentional blink of similar magnitude to comparison groups. This supports the proposition that the social processing difficulties experienced by these individuals are not underpinned by a basic temporal-cognitive processing deficit, which is consistent with Minshew’s complex information processing theory. This is the second study to show that automatic inhibitory processes are intact in both autism and Asperger’s disorder, which appears to distinguish these disorders from some other frontostriatal disorders. The finding that individuals with autism were generally poorer than the comparison group at detecting black Xs, while being as good in responding to white letters, was accounted for in the context of a potential dual-task processing difficulty or visual search superiority.

The effectiveness of three local authority early teaching interventions for children with autism spectrum disorders (ASDs) was studied. Thirty-three children (2:6 to 4:0 years old) received one of three early teaching interventions: a 1:1 home-based programme, and two different forms of special nursery placement. Measures from the Psycho-Educational Profile, British Abilities Scale, and Vineland Adaptive Behavior Scales were taken over a 10 month period. The study showed moderate effect sizes for improvements in all scales for children attending a generalized special nursery placement, and for those attending a special nursery placement solely for children with ASDs. Children receiving a home-based 1:1 programme with similar intervention hours showed moderate effect sizes for the PEP and BAS but not for the VABS. These data show that special nursery placements can offer benefits to children with ASDs, especially in the area of adaptive behavioural functioning.

Through the use of instructional DVDs, parents of children with autism can learn how to teach their child to communicate and improve their behavior, according to research published in the January 2010 issue of The Journal of Positive Behavior Interventions (published by the Hammill Institute on Disabilities and SAGE)...

Have an opinion on Wakefield's research?  Express your opinion in today's poll!

The Lancet (the UK's premiere medical journal) has officially retracted a 1998 paper that was the cornerstones underlying the theory that the MMR vaccine is a major cause for a huge increase in cases of autism.  According to Bloomberg.com, Dr. Andrew Wakefield's paper entitled Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children "was retracted from the published record, stripping it of its scientific claims."

Here's how the action is briefly described (in a press release from the Lancet itself):

Following the judgment of the UK General Medical
Council's Fitness to Practise Panel on Jan 28, 2010, it
has become clear that several elements of the 1998
paper by Wakefield et al are incorrect, contrary to
the findings of an earlier investigation. In particular,
the claims in the original paper that children were
"consecutively referred" and that investigations were
"approved" by the local ethics committee have been
proven to be false. Therefore we fully retract this paper
from the published record.

Wakefield's paper has been discredited due to ethical concerns following an investigation by Britain's General Medical Council. It's important to note that while The Lancet's action officially removes Wakefield's work from the record, their reasons for so doing are ethical; so far, nothing in their statement supports or contradicts his actual findings.

Curious about the Wakefield story?  You might want to review some of these blogs, written as the Wakefield story progressed, or take a quick peek at this profile of the man behind the media blitz:

• Doctor Who Raised MMR Issue May Face Charges
• Andrew Wakefield, autism and the MMR: a new controversy arises
• "Dateline" Addresses Autism and Vaccines
• Wakefield Now Under Investigation
• Wakefield's Research Termed "Dishonest and Irresponsible"

Medical Journal Retracts Paper Tying MMR Vaccine to Autism originally appeared on About.com Autism on Tuesday, February 2nd, 2010 at 12:47:37.

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I once had a conversation with Asperger syndrome expert Tony Attwood.  Something he said stuck in my head, though I can't remember the precise words.  The gist was that there are times and places where people with Asperger syndrome really are no different from anyone else.  The same goes for people with high functioning or even moderately severe autism.

At the beach, in the woods, watching TV together, the autism becomes a difference that makes no difference.  My kid might use language a little differently, but heck - he's the guy who finds the starfish, notices the first robins of spring, and remembers the name of the actor who played the supporting lead.  Things seem pretty good; maybe the autism isn't that big a deal after all.

And then we go out into a school situation, or a sports event, or a family gathering... and the differences pop out in sharp contrast.

It turns out no one cares about my kid's amazing starfish.  Who would want a dumb starfish when everyone else is into video games or texting?  Only babies collect fish and seashells.  Problem is, my kid really doesn't care - or know - much about video games.  And he has no one to text, even if he had an interest in or knowledge of the technology.  Which he doesn't.

And it turns out that my kid's complete ignorance of the rules of football isn't a not-terribly-important deficiency.  It's a big honkin' deal - one that set him completely apart from every other male in the room.  Yet even if he were taught the rules, the reality is - he'd rather watch Sponge Bob (okay, so would I, but that's not the point!).

And while my son really does have an impressive ability to remember details, the details he remembers don't seem to count in the wide world.  Maybe adult birders would want to hear all about the birds he saw on vacation in Florida, but other kids want to know whether he rode the big roller coasters - and the answer is NO, he does not like the fast rides.  That's right, an American teen who doesn't care for roller coasters.

Looking at my son's differences, I find that I'm really torn.

I LIKE my son, and am proud to have a child for whom the natural world counts for more than virtual worlds.  I see no reason in the world why a person should text three friends just because he opened his locker.  And I can't imagine why riding roller coasters should be a test of social normalcy.  I really can't find it in myself to push video games, texting, roller coasters or disdain for the natural world down his throat.

Yet I know perfectly well that our world is going to make it awfully tough for a kid like mine to find a place.  I can help him; and I have a few ideas.  Certainly there are schools, jobs and careers that could be right for him.

But the reality is that it's hard to be different.  Not so much for my son, who is basically a very happy guy.  But for the people around him (like his parents and his sister) who see the differences in large screen, high def clarity, every day.

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When It's Hard to Be Different originally appeared on About.com Autism on Tuesday, February 2nd, 2010 at 07:23:37.

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A new study from UC Davis Health System identifies for the first time a brain protein called SynDIG1 that plays a critical role in creating and sustaining synapses, the complex chemical signaling system responsible for communication between neurons. The research, published in the Jan...

Children with autism would likely receive better treatment if supporters of the two major teaching methods stopped bickering over theory and focused on a combined approach, a Michigan State University psychologist argues in a new paper...