Autism, Anti-depressants, epidemics and prevalence, oh my!

There have been 3 recent studies in the news - I have issues with 2 of them. I’m a scientist myself, so when I read a study I examine it very critically –it’s just part of who I am (a link to my research can be found in the About the Author section of this website). Let’s start with the one I don’t have an issue with.

A study done in Korea finds the prevalence of autism to be almost double than what was thought, 1in38 children were autistic.  The children in this study were all between the ages of 7-12 years old, from middleclass families, from the same city, in a country with universal healthcare and education.  They tested a whopping 488,509 children.  They looked at everychild, in person, and used a standardized testing method for behaviors and IQ tests.  The study found the prevalence of autism to be much higher than anyone would like at 2.6% (instead of the 1% cited by most other reports).  The study was designed well with a large data pool.  It was controlled for variables – all these children had similar environments, healthcare, education system, and were tested the same way. This study was science at its best. Will we find this high of a percentage in our country?  The CDC uses special education records to pool their data from students all over. There’s no control for environment, and many without access to healthcare are being missed altogether. Sorry, but the CDC – Centers for Disease Control – really has done a shabby job of things.

According to the NY times, “Dr.Marshalyn Yeargin-Allsopp, chief of developmental disabilities at the National Center on Birth Defects and Developmental Disabilities of the C.D.C.,acknowledged that her agency’s records-based approach probably missed some autistic children — especially among the poor, among racial minorities and “potentially among girls” — and said the agency was interested in taking part in a population-based approach like the Korean study”.

Better late than never, I suppose, but it’s been over 20 years since autism rates started to really climb upward.  What exactly is the reason behind the foot-dragging?  And, what is the true prevalence in the United States? The most often quoted ratio is 1:100, but since the way it is estimated leaves out so many children the true prevalence of autism in this country is surely to be quite a bit higher. The “egg on the face” award goes to the CDC.  The “high-fives all around” award goes to the organization, Autism Speaks, for funding the study (that should have been done by the CDC long ago) and to the researchers of the many leading institutions (Yale, George Washington University, etc) that came together to design such a detailed research plan.  They are expecting to expand their research to even more refined areas of interest, such as the role of environmental factors. I'm looking forward to their results.

 Speaking of environmental factors, the second article is about the proposed link between anti-depressants and autism. Basically, they found that, ‘ . . . 6.7 percent of women taking antidepressants gave birth to a child with an autism spectrum disorder, compared to 3.3 percent of women who weren’t taking antidepressants.”  That is a tiny, tiny risk. Let’s put this another way . . . over 93% of women on an anti-depressant while pregnant will NOT have a child with autism.  Yet the headlines scream there’s a link and subtly suggest it’s not only a huge cause of autism but also that it’s all mom’s fault . . . again.  The CDC did the funding of this study by Kaiser Permanente.  The researchers only looked at 298 children with ASD and used 1,507 control children drawn from their Northern California membership – hmmm .. .. They then examined the medical records to obtain information on mom’s use of antidepressants and then looked at the differences between a mom with a normal child and a mom with an autistic child. Was mom taking a selective serotonin reuptake inhibitor (SSRI)? And  did mom take said SSRI (Prozac, Zoloft, etc) before becoming pregnant or while pregnant? That's it . . .that's all they did.

This is a crappy study.  The population was not controlled very well and the findings even if true do not carry much weight.  I could do a study and probably find a link between the number of banana and peanutbutter sandwiches eaten by pregnant moms and the risk of having an autistic child simply because by looking at such a small number of women.  Ever hear of the correlation between the number of pirates and global warming?  The basic math is this; as the number of pirates grew fewer in the world, the temperature of the world got warmer.  Yep, it’s true.  Does that mean that by eliminating pirates we have doomed our world to global warming? Of course not!  Just because you have a small group that seems to show a miniscule rise in risk due to anti-depressant drugs doesn’t mean there actually is a risk at all.  What if the real miniscule risk is the clinical depression? – which can be hereditary. Heredity (genes) by the way, has been shown to account for a whopping 90% of the autism risk.

What’s really awful about this shoddy study is the accusatory tone the media has given it.  Mother’s are again the suspect. Finger pointing will again be directed at the mother just as it was during the “refrigerator mother” hoax. Mom’s around the globe will now be looked upon as the bearers of autism upon their children and suspected as drug abusers.  I award this study the “irresponsible crap award” . . . for obvious reasons.

 The last article of research, if you can even call it research, is the United Kingdom study on autism prevalence that found no autism epidemic exists. Clinical assessments of only 618 adults suggested that 1 percent of Britons over age 16 have autism, which is similar to the percentage being diagnosed in the children.  They go so far as to declare that the number of people developing autism has not changed in over 70-80 years.  Does anyone believe this?  Anyone at all?  Those that hide their head in the sand will want to cite this study in order to call into question whether the United States has had an increase in autism.  When my son was diagnosed he was 1:10,000. Currently the prevalence is given at 1:100 and its probably closer to the 1:38 (according to the researchers who did the study in Korea).  Now they want to back away from that alarming statistic by trying to convince us that no increase has occurred because they looked a group of 618 adults . . . ?

One of the researchers even went so far as to say, “What we found is that there is a very low level of recognition of autism in adults, which means that rates may not be increasing, people may just be better at recognizing it."  If you are reading this and have an autistic child I would like to ask you this question: Did you notice something was wrong with your child or did someone have to recognize the problem for you?  For me, it was quite obvious there was problem with Matt.  I started the ball rolling.  That was 23 years ago and if I could recognize a problem and doctors could diagnose autism well enough back then, then why weren’t more children diagnosed?  Parents are not stupid or blind – but this study thinks we are. I give the “bullshit award” to the researchers in the UK for their latest “study”.

So there we have it - a run down of the latest research and their worth as science.  The Korean study outshined any previous study and we need to prepare ourselves to see the actual number of autistic people go up. As for the others? I think shoddy scientific studies make all science look bad and suggest to parents of autistic children that the true cause must be kept secret, fueling conspiracy theories and more bad science.  It’s a shame we can’t just force all scientists to follow the evidence.  Some (many) are in for the money or are lazy – after all, every profession has their money grubbers and slackers.  But it is the field of science we rely on to find out the answers to all of life’s problems and so we must hold them to a higher standard. We must call “foul”when we feel the science is bogus and the researchers inept.  I call FOUL on the UK and Anti-depressant studies.

Be critical of what you read – be prepared to call “foul” when the science smells bad and rejoice in the studies that really look at the problem at hand.  If you donate to autism research you’ll want to be sure it’s really research.

Our children’s future literally depends on it.