Washington loves to dump its bad news on a Friday afternoon, and on October 2 it confirmed that 1 percent of American children (and by extension, perhaps 1-in-58 boys) has an autism spectrum disorder.
On a hastily arranged telephone "visit" with US Health and Human Services Secretary Kathleen Sebelius and the autism community, the health chief announced that "the prevalence of autism might be even higher than previously thought." But, she added, "We don't know if it has gone up, and we are hoping to unlock these mysteries."
The Secretary then declared autism "An urgent public health challenge," proclaimed that President Obama was "right to make it one of our top health priorities," including research into "treatments and a cure" for the disorder, and then promptly ended her visit.
Helping to fill in some of the details was Dr. Thomas R. Insel, Director of the National Institute of Mental Health (NIMH), and Chair of the Interagency Autism Coordinating Committee, who confirmed that CDC data to be published later this year will estimate the current childhood ASD rate at 100-per-10,000 children.
The data, collected from the Center for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, shows a significant uptick in ASD prevalence estimates in just two years.
According to ADDM, the average rate of autism among eight-year-olds across all study sites was 67-per-10,000 in 2000 (the 1992 birth cohort), and 66-per-10,000 in 2002 (the 1994 birth cohort). Only six sites were included in both studies, and their average prevalence rate increased by 10%, from 67-per-10,000 to 74-per-10,000.
Now, CDC has announced that among the 1996 birth cohort, the estimated rate of ASD is 100-per-10,000 -- a staggering 50% increase over the 1994 birth cohort.
It is easy to understand why the Feds would call autism an "urgent" issue, but any sense of urgency by the officials on the phone was clearly absent, at least from my perspective. In fact, much of the discussion was centered around providing services and education to the growing ranks of Americans with ASD, an entirely laudable goal, to be sure.
But no one expressed any alarm that up to 1-in-58 boys in this country is now on the autism spectrum. The officials on the call seemed to think that wider diagnostic criteria - such as adding Asperger Syndrome and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) -- to the concept of an "autism spectrum disorder" vastly inflated the rate of ASD in the United States.
There was no alarm, and little time for questions from the community that was invited to "visit." After about 15 minutes, questioning was cut off, and the call abruptly ended. I tried three times to ask a question (via a telephone switching system) and so did many other people on the call, which lasted a total of 39 minutes.
And so, here is my (expanded) question, directed to Dr. Insel:
Dr. Insel, thank you for arranging this call. I understand that the estimated average ASD rate increased from 66-per-10,000 to 100-per-10,000 between the 1994 and 1996 birth cohorts. Officials on this call believe this increase could be attributed purely to expanding diagnostic criteria and greater awareness, though they don't know for sure.
But how could you attribute a 50% increase in just two years to wider diagnostics, especially when the 1994 cohort would have been diagnosed, on average, in 1999 and the latter cohort in 2001? The expansion of the ASD definition to include Asperger and PDD-NOS occurred in the early 1990s, so how can you explain this sudden and delayed explosion in the numbers?
Also, you have declared that the vaccine-autism link has been disproven, yet all the studies you cite have only looked at MMR and thimerosal. But why is the IACC, which you chair, not investigating the possible role of Hep-B vaccine, given the following facts?:
1) An abstract just published in the Annals of Epidemiology said that giving Hepatitis B vaccine to newborn baby boys more than triples the risk of ASD.
2) A study just published in Neurotoxicology reported that infant male primates who received one dose of the Hepatitis-B were far more likely to display developmental delays than unvaccinated controls.
3) A study last year in Toxicological and Environmental Chemistry showed that boys getting the 3-shot HepB vaccine series were eight times more likely to require early intervention services than boys who did not have the series.
4) A study in the journal Neurology found that children who received Merck's Engerix B brand Hepatitis B vaccine series were 74% more likely to develop "central nervous system inflammatory demyelination" than children who did not receive the vaccine.
Finally, why did you jettison the vaccinated-vs.-unvaccinated study that your own committee had previously voted to recommend, and why are you spending only 39 minutes speaking with the community that represents, according to your boss, one of the nation's "top health priorities?"
I am also sending this question to HHS, to see if I can get a proper response. But I am not holding my breath.