January 12, 2006

California Autism Numbers 4th Quarter 2005

NOTE: All the discrepancies that I was worried about have been checked out and this is the best version of the data available.

California has released their autism numbers and the increase in cases continues to drop.















The excel spread sheet that I am tracking this on is posted here if you would like to download it, check my work, make your own graphs, whatever.

There is much conjecture as to which way the trends will continue. Speculation from proponents of the mercury theory has been that the 2006-2007 will be when rates will drop more dramatically as three and four year olds, who have the highest rate of diagnosis, will have been born in 2003, when most high dose mercury vaccines had cleared the shelves. We will keep posting the numbers to see if things go this way.

The new talk is about what the CDC decree that all pregnant women and children over 6 months of age should get flu shots (most of which are full dose mercury shots) will do to the numbers if the mercury theory is indeed correct. I read that expectant mothers are shying away from getting the shot (I think the article said only 13% of moms are opting for it, but don't quote me on that) but those little ones are so vulnerable, will that 13% be effected at higher rates? We will have to wait another three or four years to find out.

Update:
Someone emailed me this question, and I thought I would post my answer here as a reminder of the context in which these should be viewed:

Ginger, To what do you attribute the percentage change (negative) in the year 2000?

I don't know what to attribute that to for sure.

California made an adjustment in diagnostic inclusion criteria at some point, resulting in fewer children receiving services, and I can't remember if it was in 2000 or not. If so that would certainly explain the dip.

But bottom line, these numbers really should only be used for looking at wide trends. If things are generally moving up or moving down. They are not broken down into new diagnosis v. adults, by birth year, by people moving into and out of the state, etc, and those are the things that we would need to have information on in order to really interpret well the impact that mercury in vaccines has on autism. These numbers are just one big blob of people who are getting autism services by the state, so looking at a big dip in one quarter will probably only tell us something about the way the numbers were collected, rather than what the true picture of autism cases are.

If you look at the huge drop in 4th quarter '98 for example and then the huge jump in 1st quarter '99, it makes me think that the computers were down in December of 1998 and people's paperwork was not processed, and they caught up in January or something. These two quarters show dramatic change, but if you averaged these two out and looked at them in context they would actually follow the trend. The same with 1999 and 2000 on the yearly graph at the bottom. The spike in 1999, the plateau in 2000, taken together they follow the trend.

I am hoping that the government will actually publish a study that looks at the number of new diagnosis charted by birth year, but I am not going to get my hopes up.


At this point we do have enough information to see that there was a trend up in the 90's and there is now a trend down. There is certianly enough information to postulate that the drop in vaccine hg correlates with the drop in the increase in autism cases, and that the two may be related. It is now the government's job to do their due dillagence and take a more detailed look at the information they already have, and see if this theory holds up when you look at the number of new diagnosis by birth year. Then if it still holds up, they need to get their asses in gear and to a Verstraeten type study, except with out the fraud this time.

Update:

From the Schafer Report:

California Reports: New Autism Cases at 4 Year Low

From California autism advocate Rick Rollens.

According to information released today by the California Department of Developmental Services (DDS), the number of new cases of professionally diagnosed full syndrome autism (NOT including any other autism spectrum disorder) entering California's developmental services system in 2005 was the smallest number of new cases since the year 2001.

The DDS year end report for 2005 documents that during 2005, California added 2,848 new cases of autism to it's system. Not since 2001 (2725 new cases) has California added less new cases of full syndrome autism to it's system. Every year since the all time record year of 2002 there has been a slow, steady decline in the number of new cases of autism entering California's 37-year old developmental services system.

Between 1979-80 and the end of 2002, California's developmental services system experienced unprecedented record increases in the number of new cases of autism every year over the previous year. The 1990s saw an explosion of new cases of professionally diagnosed full syndrome every single year culminating in the record year 2002 with 3,132 new cases.

Prior to the start of the modern day autism epidemic, autism accounted for less then 3% of all the new intakes coming into California's system which also includes mental retardation, epilepsy, and cerebral palsy. Today, autism accounts for 60% of all new intakes, and is the number one disability entering California's developmental services system. 18 years ago there were 2,773 persons with autism in the system, today there are 29,424.

Children under the age of 3 years old with full syndrome autism are NOT included in the DDS reports, but instead are enrolled in the Early Start Program.

Nearly two-thirds (2 out of 3 ) persons in the system with autism are between the ages of 3 and 13 years old, with nearly 8 out of 10 under the age of 17 years old.

(Rollens comments: For those who continue to believe in the fantasy that we have NOT experienced an epidemic of autism, might I ask one simple question: If the incidence of autism hasn't increased dramatically over the past 20 plus years, then where are all the adults with full syndrome autism? Surely if there is no real increase then we should see roughly the same number of adults with autism as we do children. I am sure it is about as easy today, as it has been in the past, to somehow misplace or not recognize thousands of adults with full syndrome autism...about as easy as missing a train wreck. Sorry but no Ph.D. or MD required to recognize either one.)

37 comments:

Craig Westover said...

Thanks for posting these numbers. What I'm waiting for is these numbers graphed by birth year. They should, I would think, show a more pronounced decline than raw diagnosis numbers.

Ginger said...

Me too.

I don't know that anyone is actually breaking them down in a form that would be more meaningful. They need to.

As of now all they are offering us is a big blob of all cases being serviced in the state.

Katie said...

Thank you so much for posting this! I put a link to it on my own blog at http://autisminthenews.blogspot.com/

I really appreciate the graphs - visuals are so powerful!

Michael "Sotek" Ralston said...

I want to see a count of total cases.

Even better would be if that count of total cases was as a percentage of the children in the system.


I just want to see if California's hit 1 in 166 yet or not.

Anonymous said...

I want to see the number of needy clients cut off from receiving services and, therefore, no longer included in the these numbers.

Interverbal said...

Ginger,

I have had a chance to carefully review your data sets and argument. I have a number of questions for you when you have time.

1. Are you aware that the total change over quarters does not constitute "new intakes" (the youngest children)?

2. Are you aware that the data from the DDS for the youngest children are available in the DDS reports (Ages 0-2 and 3-5)?

3. Is the use of total data, defensible when data for the youngest children are available?

4. Do you consider the lack of control for consistency to be problem with these data? (A PDD-NOS kid can slip in even though this is purely supposed to be Autistic Disorder)(Also the diverse people who would have to make these diagnostics and references for the DDS would have to posses high reliability).

5. Would it be useful to define incidence vs. prevalence and explain which you used and why in your post, for those who are not familiar with those matters?

6. What is the current incidence rate that can be calculated via the DDS? How does this compare to incidence for Autistic Disorder as calculated by descriptive epidemiology? And how does this compare for the whole spectrum?

So, when you find some time:

Jonathan Semetko

A student said...

Rick Rollens always broke out the numbers by age, which you can do with these same stats. There are so many people added as autistics at age 6 and up that the DDS numbers could reflect anything, and unless we know if the MR and CP stats are following the same slowing rate of increase, these numbers are even more meaningless.

Even if you see a decrease there's no way you can link it to thimerosal without finding out if these kids got thimerosal by asking, and also asking what else happened to make the numbers slow down.

California still hasn't hit 1 in 166 for kids with autism. So where's the epidemic?
Also, these data are not counts of "new" intakes. The DDS has made that clear. The fluctations of numbers are not caused just by new intakes.

The CHARGE study is a legitimate epidemiology study being done in California. That's what will answer your questions. This business is a waste of time, but feel free to watch the numbers. I think Rick Rollens may have decided to leave them alone, but I could be wrong.

Among legitimate scientists it is old news that there has been no epidemic. There has been no epidemic, and some people just don't want to hear that, apparently.

Kev said...

A few comments:

1) Aren't these the figures across all ages? According to a few people, including David Kirby, we should be looking only at 3 - 5 year olds. What do those graphs look like?

2)Isn't this merely a confirmation that the rate of autism is still increasing? There is, in the last quarter, a fluctuation. If I may again invoke David Kirbys name and quote something he emailed to me recently:

As for the California numbers, I think it is too early to declare a trend. The net gain in the 3-5 year old category indeed fluctuates from quarter to quarter.

3) Once more quoting David Kirby, he has admitted that whats important is the changes in actual case numbers, not changes in rate. Are you disagreeing with him Ginger?

4) As I understand it, California has not even hit the alleged 1 in 166 prevalence rate yet. What authenticity do you think that removes from these figures as indicative of an autism epidemic?

5) As I also understand it, California DDS are adamant that their figures cannot be used in the way that they seem to be being used here. A quote from the DDS states:

Although the source of information for many reports on autism for California is the Department of Developmental Services (DDS)' "Quarterly Client Characteristics Report", the numbers reported by DDS are often misunderstood and misrepresented by others. Except for Table 2 of the Report, only persons with a Client Development Evaluation Report (CDER) on file who have "active" status in the DDS system are counted in the report tables. So, numbers reported do not represent all persons with developmental disabilities in the State of California. The numbers can not be used to report the incidence of autism, for example.

Thats from AD's blog on a thread you commented on. You said:

...my understanding then is that it can be a representation of how many cases the state is servicing, but not of how many new young children are being diagnosed.

When we tie that to David Kirby's (correct) opinion that its actual cases in 3 - 5 year olds that matters, not prevalence then I think that tells us all we need to know about the validity of these stats.

To my unscientific mind it seems pretty clear - if the number of actual cases fell then we'd have to think again but all these figures tell us is that there are fluctuations in the the rate of increase but that autism numbers in California are still on the rise.

And actually now that I think about it - why is there all this attention on california? Why is it supposed that California accurately reflects the trend for all countries in the world that use thiomersal in vaccines?

Ginger said...

Jonathan,

All good questions.

Are you aware that the total change over quarters does not constitute "new intakes" (the youngest children)?

Yes, and I noted that above. Again, this is a big clumsy measure and needs to be broken down to be given a better measure of how vaccines affect autism cases.

Are you aware that the data from the DDS for the youngest children are available in the DDS reports (Ages 0-2 and 3-5)?

I don’t see that information broken down for Autism, only for disabilities as a whole if I am reading it right. If you know where that information is, let me know and I will take a look at it. Better yet, if you could go ahead and graph it, it would be helpful for the debate. This thing took me a few hours and I don’t have tons of time.

Also, DDS does not track autism cases under age 3. These are only cases that have received a 299.0 diagnosis from the state via the Regional Centers that serve Californians with disabilities. Regional Center services begin at age 3. Before that children are served by the Early Start program, and are treated based on symptoms, but not given an autism diagnosis by the state (even if a child has one through UCLA for example, the state does not recognize the diagnosis until the child turns 3 and is evaluated at a Regional Center). Autistic children diagnosed at a hospital or at a private clinic whose parents choose not to try to get services from the state are not included in this.

Just one of many confounders to using these numbers to try to get a measure of actual prevalence.

What the DDS does offer though is a stable measure of autistic people being served by the state, and this subset of autistic people is somewhat “stable” (for the purposes of this narrow question anyway). You can assume that it is measuring the same thing (whatever that thing is) over a 37 year period, factoring in the changes in inclusion criteria and changes in migration in and out of the state (if there is a way to check that).

Is the use of total data, defensible when data for the youngest children are available?

Again, this information is only useful in context. Data for specific ages is a better measure. Let me know what you can find.

Do you consider the lack of control for consistency to be problem with these data? (A PDD-NOS kid can slip in even though this is purely supposed to be Autistic Disorder)(Also the diverse people who would have to make these diagnostics and references for the DDS would have to posses high reliability).

I consider this a problem, among many other problems. This is why I continue to caution that we should not look to these numbers to give us a definitive answer, merely to show us trends. If we see a trend, we then have to sort through all the possibilities to see what has caused changes in the trend. This trend only tells us that the link to vaccines is possible.

Would it be useful to define incidence vs. prevalence and explain which you used and why in your post, for those who are not familiar with those matters?

It would be very useful, but again, this is not included in the DDS numbers. They give raw incidence numbers (how many cases are being served in the state) but not as compared to the percentage of children in California.

What is the current incidence rate that can be calculated via the DDS? How does this compare to incidence for Autistic Disorder as calculated by descriptive epidemiology? And how does this compare for the whole spectrum?

By all means, go forth, young grad student and answer these questions! I charge all the bright young unencumbered youth to drive to Sacramento and get the state to give you access to all their numbers so you can roll around in them, bathe in them arrange them in all possible measures to get a clearer picture of what is going on. And don’t stop there. Get a bunch of your friends together and take a road trip to Atlanta and tango with the VSD!

Bartholomew Cubbins said...

"By all means, go forth, young grad student and answer these questions! I charge all the bright young unencumbered youth to drive to Sacramento and get the state to give you access to all their numbers so you can roll around in them, bathe in them arrange them in all possible measures to get a clearer picture of what is going on. And don’t stop there. Get a bunch of your friends together and take a road trip to Atlanta and tango with the VSD!"

Nice pat on the tush. I can imagine Jesus is laughing his robe off right about now.

Ginger said...

Dear Student,

Rick Rollens always broke out the numbers by age, which you can do with these same stats.

Again, if you know where to find these numbers, let me know. Rollens did put out a piece today, I posted it above, but it does not mention ages.

There are so many people added as autistics at age 6 and up that the DDS numbers could reflect anything, and unless we know if the MR and CP stats are following the same slowing rate of increase, these numbers are even more meaningless.

I don’t think it would make the numbers more “meaningless” as much as it would give them greater meaning by putting them in the context of what is going on with disabilities in general in the state.

Again, I charge you, young student who does not have to change diapers, to take the spread sheet that I linked to, and spend a weekend replacing the numbers for the last 15 years using the data that is available on the DDS web site for MR and CP.

Even if you see a decrease there's no way you can link it to thimerosal without finding out if these kids got thimerosal by asking, and also asking what else happened to make the numbers slow down.

Please read above. Repeating, this only shows us trends that mean that the thimerosal link is possible and tells us that closer study is warranted.

Ginger said...

Hi Kevin,

Some of this I have already commented on, but I feel that the theme of your, and the previous two commenters, questions are, “hey… these numbers have limitations”. If that is what you guys are looking to hear from me, I can state that confidently. These measures have limitations. If someone wants to prove the thimerosal case using this, they can’t. They can only say that if the mercury theory is correct, then these numbers are what one would expect to see. Rates of increase peaking in 2003, plateauing and beginning to drop 2004 and 2005, dropping more sharply in 2006 and 2007 and maybe coming up a little in 2008 from flu shot use, then making real declines beginning in 2009 and after with the ban on high dose mercury in vaccines for pregnant women and children under three that will go into effect this July (if it stays in effect and is implemented).

But again if the mercury theory is correct, environmental mercury will be a confounder as the Houston study shows us.

1) Aren't these the figures across all ages? According to a few people, including David Kirby, we should be looking only at 3 - 5 year olds. What do those graphs look like?

Can someone please point me toward the 3-5 year old numbers please?

2) Isn't this merely a confirmation that the rate of autism is still increasing?

Yes, but you would not expect it to actually start decreasing until you have a cohort of 4 year olds who were born after the high dose mercury vaccines had cleared the shelves (and whose mother’s had not gotten the hg containing Rhogam shots that were discontinued in 2002). That has not happened yet.

There is, in the last quarter, a fluctuation. If I may again invoke David Kirbys name and quote something he emailed to me recently:

As for the California numbers, I think it is too early to declare a trend. The net gain in the 3-5 year old category indeed fluctuates from quarter to quarter.


I am assuming that he is referring to a trend in young children with new diagnosis. I will defer to him here as I have not seen 3 to 5 year old numbers.

3) Once more quoting David Kirby, he has admitted that whats important is the changes in actual case numbers, not changes in rate

I think that both are important in context. I think that what people do with big studies like this one is to try to make a “case closed” type of argument, as the IOM did with Verstraeten and Denmark, when these things should only be used to shape more specific questions. What would really be “important” would be a real study quantifying all of this down into true random samples of children and measure thimerosal exposure to autism rates. As I mentioned above, Verstraeten minus the statistical shenanigans.


4) As I understand it, California has not even hit the alleged 1 in 166 prevalence rate yet. What authenticity do you think that removes from these figures as indicative of an autism epidemic?

I don’t even think that you can make that assumption using these numbers. They do not measure true cases of 299.0 autism, much less cases of ASD. If you are an autistic individual not being served by the state, you aren’t counted.

5) As I also understand it, California DDS are adamant that their figures cannot be used in the way that they seem to be being used here. A quote from the DDS states:

Although the source of information for many reports on autism for California is the Department of Developmental Services (DDS)' "Quarterly Client Characteristics Report", the numbers reported by DDS are often misunderstood and misrepresented by others. Except for Table 2 of the Report, only persons with a Client Development Evaluation Report (CDER) on file who have "active" status in the DDS system are counted in the report tables. So, numbers reported do not represent all persons with developmental disabilities in the State of California. The numbers can not be used to report the incidence of autism, for example.


Reiterating how I am using the numbers here. I am not using them to represent all autism cases in California. I am only comparing the database of clients served to itself. Year by year. I feel like I have made that pretty clear. (See my previous comment that this is only a stable measure of “something”, but not “actual” autism cases. The database is considered largely “stable” as it will make the largely the same variations from “actual cases” every year, except when a recorded change in diagnostic criteria is made and that can be noted.)

Thats from AD's blog on a thread you commented on. You said:

...my understanding then is that it can be a representation of how many cases the state is servicing, but not of how many new young children are being diagnosed.


That is still my stance.

When we tie that to David Kirby's (correct) opinion that its actual cases in 3 - 5 year olds that matters, not prevalence then I think that tells us all we need to know about the validity of these stats.

To my unscientific mind it seems pretty clear - if the number of actual cases fell then we'd have to think again but all these figures tell us is that there are fluctuations in the rate of increase but that autism numbers in California are still on the rise.


Again, at this point you would see a slow in the rate of increase, but not yet a decrease.

And actually now that I think about it - why is there all this attention on California?

“Why California” is that, as poor as it is, it is the best tracking system we can find. Much better than Denmark, that made dramatic changes in its service data base, much better than Verstraten which is writtled with, well, just a total mess. No one is offering us any better measure of how thimerosal contributes to autism in American children, or any children for that matter. No one is offering us a legitimate breakdown of the VSD for example. No one is even offering us a measure of “actual cases” in California.

I think that the second most dramatic statement that this post, and subsequent comment thread, makes is that this poor measure of the link between thimerosal and autism is the best that we can get our hands on. This is an EXTREMELY important question, and the Powers That Be, that could put this whole debate to rest with the information that they have, are not doing it.

It is just another reminder that the Center for Disease Control is more concerned with controlling communicable diseases than it is with controlling neurological disorders.

Why is it supposed that California accurately reflects the trend for all countries in the world that use thimerosal in vaccines?

It isn’t. We are Americans, Kevin! You know we only care about American Autism. ;)

Anonymous said...

Oh my gosh Ginger...I just read this quote from you when you were talking about the epidemiology stuff:

"The sample size of the study was only 956 children. That is the number of people that their disability database had on record as being diagnosed with autism in Denmark between 1971 and 2000. 956 people in 29 years. That is 33 people a year in the entire country. [Hyperbole warning] I have that many autistic kids in my kitchen right now"!

-That is the funniest quote that I've heard in awhile... Truly hilarious (in a sick sort of way).

Sorry, I digress...
-Sue M.

Anne said...

Here, Ginger:

DDS Quarterly Reports

You have to look at the reports for each quarter separately.

There is a separate page for each regional center and for each category of disability broken down by age group.

Interverbal said...

Hey Ginger,

Fair enough....

I think Anne answered you data access question. Check near the bottom, you will start to see age groups.

I will work on it this weekend and compare to the appropriate census stuff. I will let you know when it is done.

The young, unencumbered grad student's road trip to Atlanta with friends will have to be delayed until the Spring when we present our various research efforts at a conference there. It would be a shame to not have a look at the CDC, although I don't think they will give me access to the VSD, maybe if I ask nicely...

Ginger said...

Thanks to Ann and Jonathan,

...for the link. I was looking at a version that only had the county numbers on it.

I plugged in the numbers that they had on the site for 3-5 year olds, but they only went back to mid 2002 so it does not go back as far as we need.

2004 was down from the previous year by 4.72% and 2005 was down from the previous year by 3.85%. So at least we know that the increase is slowing for 3-5 year olds, but the quarter to quarter numbers vary much more widely for this group. But then again it is a much smaller sample so that is expected I guess.

There is a phone number listed on the page to call for more data.

Jonathan, I uploaded the excel file that I started here if you want to just take it and add to it as you get the numbers for years past. Probably also useful to chart 6-9 year olds as well as they still get booster shots.

The numbers on the sheet in red are the ones that need to be replaced. I just filled in the last number that I had for all of them to flatten out the graph for those dates.

Thanks for shouldering some of the burden with this. Lemme know how it goes.

Ginger said...

... and here is the 6-9 numbers.

They show 100 fewer increase in cases each year for the last two years. 2004 down by 11.07% in 2004 and 15.59% in 2005.

Be sure to check my numbers as I am getting tired and did not double check them.

A student said...

Shouldn't there be no 2 year olds with autism at this point? Shouldn't someone have noticed this by now?

They are doing "baby sibs" study's you know. They keep finding new baby autistics in California for some reason, even if they aren't in the DDS databanks yet.

Considering the fact that most moms with a 7 year old autistic kid probably haven't vaccinated any following kids there should be NO baby sibs, right?

They can spot autistic babies in these baby sib studies at 4 mos, even, and surely by 2 because the best trained eyes are watching these babies like hawks.

If your graph is only the roughest measure then what I see is a flat line not a downward turn. Has anyone done a statistical analysis. Anyone doing a chi-square?

Rollens sure ain't.

Worldwide, autism rates are entirely not correlated to thimerosal use, so why should that be different in California? I know, because you believe it is different in California, because you believe that there has been an autism epidemic and that is all that matters. You can graph CP, and MR and seizures, and "the 5th category" with those same data, be my guest, this is your PR game, not mine.

You would send us students off into the "belly of the beast", my you really must hate us. We know what you think about the CDC and it's level of satanic rage at the health of children. What would they do to us poor students trying to uncover the truth? Blast us with Ebola? For shame.

Kristina Chew said...

Meanwhile, we need to keep doing everything we can for the children (soon to be adults) with autism. We can't let any bureaucrats turn declining numbers into declining services.

Kev said...

excellent point Kristina. Thats something I've been concerned about for awhile now.

G - I'll get back to you on your response (am typing one handed, balancing a baby at the moment!) but this looks like a bit more light might be forthcoming in the international area:

http://breakingnews.iol.ie/news/story.asp?j=168927444&p=y689z8y5x

Aaron Kristie and Aidan said...

Hi Ginger,
Thank you so much for these numbers. I do have a comment. My son was given the diagnosis code 299 (Autism) through the Regional center here in San Bernadino county. We met with their behavioral psychologist on December 1, 2005. My son was aged 2.6 at this time and was given the diagnosis through them. He is a client of the regional center or the Early Start Program right now. I guess my question is or misunderstanding is this: Would he be included in the numbers EVEN THOUGH he is not yet age 3 but has been given the autism 299 diagnosis in the year 2005 through the regional center? This is what I am confused about. Perhaps you know this answer. Again I love your thoughtful posts and comments. Take care and God bless.
Kristie
mommy to Aidan 2.7

Interverbal said...

Ginger,

I have carefully double checked your work and your math. They are both correct.

I made a phone call to the listed number but, the relevant person is out of the office until tuesday.

I hunted down the census numbers which are: Ages 0-4= 2,481,946
5-9= 2,716,016. These are for year 2000 in California. It will be inportant to note that the actual total population will have altered since then to a small extent.

I calculated the Autistic Disorder prevalence in the years post 2000 at 23.06 (1 per 434)(based on the decriptive epidemiology from (Fombonne, 2003). This is nearly the same as the Census/DDS numbers of (1 per 436) from the most recent report in the DDS. The DDS Dec, 2005 numbers are well withing the error range of my caluclation of the Autistic Disorder epidemiology.

However, some recent quarters had some variation that would be outside the confidence interval.

I am a big fan of simple descriptive stats. I should finish my write up by the end of today. I plan to directly show the raw celeration between one quarter to the next (June to Sept, Sept to Dec, and so on). I will also show raw prevalence as varation is present, and should be shown.

I will post a notification when done.

Anne said...

Meanwhile, we need to keep doing everything we can for the children (soon to be adults) with autism.

My child is already an adult. According to Rick Rollens he doesn't exist. It's hard to get services when you don't exist.

Interverbal said...

Ginger,

My graphs and write up are done at my blog.

jess wondering said...

http://interverbal.blogspot.com/2006/01/review-of-california-department-of.html

Looks like there has been no slacking in the intakes of autistic kids. Ginger will you retract what you have written about the supposed decline in intakes of little kids?

Ginger said...

Jonathen,

Sorry for the delay in getting back with you. I have tried to look at your piece a few times and the kids weren't so much into me doing that.

I will try to get back to the blog tonight or tomorrow morning.

G

Interverbal said...

Hi Ginger,

I got access to the 3-5 year old data from 1992 onwards today. I will start the analysis this weekend (providence willing).

hollywoodjaded said...

Thanks, Jonathan, for your all your hard work and dedication to this project.

Ginger said...

Looks like there has been no slacking in the intakes of autistic kids. Ginger will you retract what you have written about the supposed decline in intakes of little kids?

Well no.. what have I said about little kids that you feel should be retracted?

The only comment I made was to add up the numbers and report that the rate of increase of incidence of autism in the database has gotten smaller in the last couple of years for these two age groups. Jonathen responded that my math was correct.

He is looking at prevalence, the number of cases as it relates to the whole population. I was merely commenting on the incidence. How many raw cases were reported.

Joseph said...

Of course the rate of increase has to decrease at some point. I don't understand why most people don't get this. Population growth in California is close to 2% per year. Normally, with any condition handled by the DDS, the rate of growth in the caseload should be about the same as population growth. With autism it's much higher. Evidently, that must go down from about 10% now to less than 2% some time in the future.

Anonymous said...

Where is the charts on 2006 figures--it is now July 2006.

Joseph said...

Ginger: Could you please either retract this post or add an addendum or a comment or something? First of all, at this point I think it's well recognized that the "new cases" metric is not a meaningful epidemiological metric, as I explain here. Second, the pattern didn't even hold after 2006, although eventually "new cases" must obviously drop to match population growth in the state.

Your post is confusing people and I've seen others cite it to demonstrate autism rates are dropping in California.

Ginger said...

Just trolling my site Joseph?

I actually don't talk about 'new cases' in my post, and even mention that the numbers don't sort out new from existing cases and mentions that I hope they will do that.

I, however, quote the Schafer report that does not seem to make the distinction between the two.

I think it is pretty clear that I am saying that there is a problem and no one can say 'new cases'. I think it would be redundant to post another disclaimer about it.

Can you point out an exact statement of mine that seems to infer it? I thought it was clear that there was a slowing in the increase, not an actual drop.

I do want to be clear on that, so let me know if you seen anything specific.

Joseph said...

No, I'm being serious Ginger. You might not use the term "new cases", but the numbers in your graphs are exactly that: the difference between the caseload one quarter and the previous one.

I don't think anyone is claiming this is a metric that means anything these days, not even David Kirby.

"Speculation from proponents of the mercury theory has been that the 2006-2007 will be when rates will drop more dramatically"

Come on. More dramatically than what? You're clearly implying there's a drop. Even though you specify there's a drop in the increase, people who come to this page assume there's simply 'a drop'.

You don't explain that drops in the increase don't indicate anything unusual. They are actually unsurprising and expected, unless you think that all of California will be autistic eventually.

"We will keep posting the numbers to see if things go this way."

At the very least you could do this.

You do also post something from the Schafer report about 'new cases'.

The metric that most everyone (including David Kirby) has agreed is the key metric is the 3-5 caseload. Not the increase in caseload or the increase of the increase or anything like that. Simply the 3-5 caseload.

Let me appeal to your intellectual honesty. Why don't you add a link to Autism Street's graph, for example?

Ginger said...

Joseph,

I wasn't being flip. I am taking this seriously.

I discuss through out that this is a broad and unwieldy measurement and even call it a 'big blob'.

And one of my strongly held, repeatedly espoused beliefs is that epidemiology bites in trying to prove the causes of autism, and we should only use it as a divining rod to point us in the right direction. (especially because there are so many other sources of mercury, and they fluctuate so wildly from one area/time period to another)

So far from claiming that this measurement is the end all be all, I am constantly discussing how weak it is.

And I am right there with you on the 3-5 year olds, most specifically the 3 year olds that California is now tracking. Which still bites, but bites a tiny bit less. I went on to discuss those measurements following this one.

But children are vaccinated into their teens, so looking at the whole population is not with out merit either.

I will make a note on the Schafer report section. Let me know what you think it should say even.

As for your question, "More dramatically than what?"... more dramatically than the current phenom being discussed. I don't think anyone reading the whole thing can take that one sentence out of context and claim that I am claiming a drop. If they do, then they are just seeing what they want to see and anyone can do that with any document. (17th century "Christians" used to pull random things from the Bible, and completely ignore most of the rest of it, to claim that God was OK with slavery, for peets sake).

Bottom line for me is that this is a two year old post and the discussions (and measurements) have progressed beyond this now. You have linked to counter points, and I have not even been following the California numbers for the last couple of years because I have been so focused on my sons health and functioning.

Which, by the way, is improving dramatically because we have implemented CaEDTA chelation this summer for his lead and mercury.

And if I have not been clear enough in my beliefs, if we are gonna stack epidemiology against case studies, I will take the case studies.

Ginger said...

also..

"We will keep posting the numbers to see if things go this way."

At the very least you could do this."

I could, and should, and might, as it occurs to me that the 3rd quarter numbers for 2007 should be out in the next week or so, and the 3 year olds need to be check to see if it dropped for a 3rd quarter.

It is unlikely though. I have Chandler's IEP next week and we are in a new state and I have to re learn the whole system on my own because my last case worker didn't correctly file the paperwork to transfer us to the new case worker, so we have no advocacy and I have so much more on my plate than I can handle right now.

On top of that my doc told me last week that I have developed high blood pressure. "Time for you to start taking better care of yourself", she says. "Sure, no problem!", I say. I'll just take a month of and go to the spa.

So as much as I would like to be fully involved in this discussion, blogging is really far down my list.

Joseph said...

I understand. But I did miss this in the last read through the post:

"At this point we do have enough information to see that there was a trend up in the 90's and there is now a trend down. There is certianly enough information to postulate that the drop in vaccine hg correlates with the drop in the increase in autism cases, and that the two may be related."

Come on. You can't really draw conclusions about causation from changes in caseload growth.

Also, you probably saw my post on the 3 year old caseload. David Kirby and you seem to be pinning your hopes on random fluctuations of low popupation cohorts.