July 12, 2007

The California Numbers: Autism Declining Among Three Year Olds

During a presentation Kirby gave in May, he mentioned that someone had paid California to study only the three year olds and that in the first quarter of 2007 their autism rate declined.

This quarter they went down again.

And how sad is it that a private citizen had to pay California to run autism numbers on 3 year olds? If they wanted to know what was going on with the children in that state, they would have run the numbers on their own.

Is Autism Declining?
David Kirby
HuffPo
Posted July 12, 2007 | 02:28 AM (EST)

For quite some time, the American government, health establishment and mainstream media have repeated the mantra that mercury containing vaccines were eliminated "several years ago," yet the number of autism cases continues to climb - the inference being that injecting organic mercury into newborn babies has now been proven to be 100% safe.

The problem, though, is that there is no proof that mercury was eliminated "years ago" and, more importantly, now there are signs that autism rates among the youngest children might actually be falling.

On Wednesday, the California Department of Developmental Services released data from the second quarter of 2007, showing that the number of 3-5 year olds with autism in the state system increased by 169 children over the first quarter of 2007. This is about the same quarterly increase seen in the state over the past several years.

But it turns out that a private citizen has paid the state each quarter to analyze the autism numbers according to year of birth, and not just by age group. State law requires that such privately funded analyses be made available to anyone else who asks for it.

So I asked for it. What I got was rather interesting.

After breaking down the current data among 3-5 year olds by year of birth, you notice that the number of cases among children born in 2002 (who are now roughly five years old) and 2003 (or roughly four years old) continued to go up.

But among those kids born in 2004 (who are now turning three years old) the number of cases has fallen, as compared to kids born in 2003.

For example, at the midpoint of 2006, there were 2,250 children born in 2001 (or roughly, five-year olds) with autism counted in the system. By the same period of 2007, the number of kids with autism born in 2002 had risen to 2,490, an increase of 240 children, or 10.7%.

Among "four year olds," the increase was even more dramatic, with 326 more kids diagnosed with autism midway in 2007 than in 2006, a startling jump of 17%.

But among the very youngest kids counted, the story was the opposite. At the end of June 2006, there were 688 children born in 2003 with autism diagnoses. This June, the number of kids born in 2004 with autism was 632, a statistically significant drop of 56 children, or 8.1% less than last year at this time.

This marks the second drop of its kind among the youngest children in California (which tracks "full spectrum" autism only, and not milder forms of the disorder). It follows the first quarter of this year, when 251 children born in 2004 entered the system, compared with 264 kids born in 2003 who were enrolled in the first quarter of 2006 - a modest decline of 13 students, or 4.9%.

Keep in mind that these drops are being reported despite the fact that:

1) Rates among kids born just one or two years earlier continue to spiral upward

2) California has experienced a recent baby boomlet (the number of 0-4 year olds rose by 9,369 in 2002, according to census estimates; but jumped by 62,393 in 2004).

3) Legal and illegal immigration continues to rise from countries that still use the full amount of mercury in childhood vaccines.

4) Aggressive early intervention campaigns have consistently brought down the average age of autism diagnoses.

Intriguing though the numbers may be, it is far too early to know if this refreshing downward movement will turn into a bona fide trend. The deficit of 56 children could be made up by the end of the year.

But the decline does not come in a vacuum. Minnesota, for example, tracks autism among children as young as two years of age, (though the counting is done through the school system, and is considered less reliable than California's data).

The rate of two-year-olds diagnosed with autism spectrum disorder (ASD) in Minnesota peaked in 2003, at 4.45-per-10,000 kids. By 2005, the rate fell to 3.88-per-10,000, and last year it was 3.55-per-10,000, a drop of 20.2% since 2003.

We will have to wait until these kids get a bit older to see if the decline holds true.

Meanwhile, back in California at the massive Kaiser Permanente healthcare, officials reported that, among 5-9 year olds in their system in 2006, the rate of ASD was 93-per-10,000. But among the youngest kids, 2-4 years old, it was 66-per-10,000 - some 40% lower.

One would naturally expect to see fewer 2-4 year olds than 5-9 year olds with an ASD diagnosis. But in 2004, Kaiser began recommending routine ASD screening for all children at 24 months of age. Presumably, the majority of the 2-4 year olds in the system have now been screened for ASD, which must, by definition, appear before age 3 for a diagnosis to be made.

Sadly, more 2-year-olds at Kaiser will end up with ASD, and some stragglers among the 3-and-4-year-olds will also turn up. But whether they can make up the 40% deficit compared with their older siblings remains to be seen.

Are autism rates dropping? I would never say they are for sure. We simply have to wait and see.

But there are tantalizing hints that autism is indeed starting to decline among the very youngest children, born and vaccinated more recently, when mercury was transitioned out of most shots.

Which brings us to the, mercury was removed "several years ago" mantra, whose best retort is probably: "Says who?"

According to the Boston Herald, the last mercury-containing shots given to US children expired back in 1999. The Washington Post, meanwhile, put the date at 2001, the FDA said it was 2002, the Institute of Medicine and the Immunization Action Coalition said 2003, and the Council of State Governments claimed it was "early 2004."

Who's right? We may never know. But we do know that companies were still manufacturing mercury-containing shots for American kids in 2001, and most vaccines have a shelf life of about two years. And we know that 90% of flu shots given to pregnant women and infants still contain the full amount of mercury today.

The number of California kids born in 2004 who have autism is, by any measure, still too high. True, we don't know how many of those 632 children were exposed to mercury in routine vaccines overseas, or flu shots here at home. But with numbers this lofty, it's highly unlikely that thimerosal alone was responsible for the entire autism epidemic.

If mercury is but one cause of autism, there must be other causes as well.

Let's say that autism cases among three-year-olds fall by 10% or so by year's end. Could thimerosal be the cause of 10% of autism cases? That would still mean tens of thousands of Americans injured by mercury in their vaccines. Moreover, identifying the cause in just 10% of cases might help us discover what is causing the other 90%.

But I am writing way ahead of myself here.

Regardless of one's position on the mercury-autism contretemps, I hope everyone can agree that an actual drop in the numbers, no matter what the cause, would provide a welcome respite from the endless chorus of grim news we all seem to face these days.


[At the request of Kristina Chew and David Kirby I had removed the following two updates. I have since thought better of it and replaced them. I thought it was a move to keep the peace, but as no peace has been kept, I will repost it. Censorship, especially after the fact, is rarely a good idea, and I am sorry that I did it. I will be offering a full discussion on the matter in another post.

As I cannot repost the deleted comments from Ms. Chew and Ms. Clark, I invite them to repost them to the comments section if they wish.]

UPDATE: Roy Grinker, epidemic denier at GW, leaves an comment on the HuffPo piece, but doesn't use his real name. Kirby calls him out and offers a public debate.

RE: This comment on Huffpost:

“Unfortunately, Mr. Kirby continues to believe that California's DDS enrollment figures constitute epidemiological data. They do not. The author even makes a claim about statistical significance! He also introduces a new term into the discussion -- "full spectrum" -- (which he suggests is equivalent to Autistic Disorder) -- and states that the DDS counts only Autistic Disorder, not PDD-NOS, or Asperger's, or Down's Syndrome children with autism, or any other phenotype. This is absolutely wrong. Not even the best epidemiological studies are particularly good at distinguishing among the subtypes. It is truly disappointing to see the Huffington Post continue to publish phony epidemiology.”

Signed: Mfano

But “backstage” I see that his email is actually rgrink@gwu.edu

If Dr. Grinker would like to debate this subject out in the open, using his real name, I would be more than happy to take part. You would think that someone of his stature would have more pressing things to do with George Washington University’s time and bandwidth than send anonymous, erroneous comments to national political blogs.


Update: From "celiacdaughter" on the EOH list:

...If you search some of his (Mfano) previous posts you will also note that he enjoys using the third person when discussing himself:

"So Foresam, tell us: how Grinker should look for autistic adults? The woman Grinker and Chew wrote about in the blog wasn't on record anywhere as autistic. Grinker doesn't say, but she probably bit herself and smeared feces too. No one missed her. She was called mentally retarded and given lots of treatment and care. She just wasn't called autistic"...


Update: Back to the original point. A mom in Iowa says Autism rates are dropping there too.

"It seems to me, there is a story in the Iowa stats as well. Iowa being the first state to remove/ban thimerosal, with exception to influenza, and our rates reflect a 20% decrease."

http://www.vaproject.org/statistics/autism-statistics.html

National Autism Prevalence Trends from United States Special Education Data

The following is taken from the official State statistics produced by the Department of Education in the United States, for numbers of children aged 3-5 served by IDEA (Individuals with Disabilities Education Act) who have autism. It compares the increase over five years between 2000-01 and 2005-06:

State

2000-2001

2005-2006

Percentage Increase

Alabama

84

178

112

Alaska

27

X

X

Arizona

94

287

205

Arkansas

95

106

12

California

3,422

7,968

133

Colorado

53

157

196

Connecticut

152

412

171

Delaware

62

101

63

DC

16

39

144

Florida

847

1,598

89

Georgia

272

550

102

Hawaii

88

149

69

Idaho

28

86

207

Illinois

670

1,256

87

Indiana

456

777

70

Iowa

128

102

-20

Kansas

87

172

98

Kentucky

168

270

61

Louisiana

121

294

143

Maine

150

311

107

Maryland

371

641

73

Massachusetts

231

1,370

493

Michigan

631

1,212

92

Minnesota

345

1,159

236

Mississippi

34

69

103

Missouri

134

283

111

Montana

40

44

10

Nebraska

37

154

316

Nevada

89

422

374

New Hampshire

55

112

104

New Jersey

397

734

85

New Mexico

6

96

1,500

New York

2,244

X

X

North Carolina

261

780

199

North Dakota

17

39

129

Ohio

326

397

22

Oklahoma

9

57

533

Oregon

429

782

82

Pennsylvania

594

2,063

247

Puerto Rico

147

116

-21

Rhode Island

48

121

152

South Carolina

121

281

132

South Dakota

35

80

129

Tennessee

153

416

172

Texas

1,108

2,123

92

Utah

58

247

326

Vermont

14

48

243

Virginia

222

548

147

Washington

64

409

539

West Virginia

14

33

136

Wisconsin

410

485

18

Wyoming

21

37

76

Total

15,685

30,171

92

Source: Individuals with Disabilities Education Act data, US Department of Education.
X - Figures not available

8 comments:

Interverbal said...

Hi Ginger,

Thank you for an interesting post as always. A few comments and questions when you have a moment.

You say “If they wanted to know what was going on with the children in that state, they would have run the numbers on their own.”

But didn’t the CDDS put out a document saying very explicitly that their data is not to be used for incidence or prevalence calculation? Is it important to respect the limitations given by the data colelcting body?

Also, is it important that the overall 3-5 category is still increasing?

As to the special ed data. It has happended several times in the last 10 years that a State has seen a slight dip for a year, and then a resurgance the following year. Are the Iowa data indicative of a decrease right now, or merely something to watch in the next or so?

I agree with your decision to remove your updates, by the way.

Ginger said...

Hello IV,

All the data is important as far as I am concerned.

I have not looked at any of this since early 2006, so honestly you guys probably know more about what is going on with the numbers than I do.

As far as a 'not to be used for incidence' statement, that kind of makes my point for me. They have the resources to put something together that could be used specifically to answer the question, "does removing thimerosal from vaccines correlate with a lower incidence of autism diagnosis", but they just don't.

They have the identities of the children, they could screen out for levels of thimerosal received, full dose merc flu shots given during gestation, immigration status and all the messy confounders. But they don't.

They just leave us to argue about it.

I have always said, the CA numbers are not a good source for answering this question, but crappy as it is, it is the best source we have since the CDC won't allow access to the VSD.

It is all about trends and all about watching. When David mentioned the one quarter drop, I didn't think it was worth writing about. Two quarters don't make a definitive statement, but should call our attention. Four quarters would be worth of a press release by the CDC. How many quarters before we could say that there is likely a causal relationship and action should be taken?

How many quarters before the government, any government, give us a real, valid, replicateable, transparent vaccine/autism study?

ok.. now I am just venting.

Bottom line for me, I had a typical child, he regressed into Autism after vaccine reaction, he tested positive for lead and mercury, and when we chelate him (among other things) he gets better. Like that day and the next. It is stark.

He can tell you his name and how old he is, he can tell us when he is scared and when he is happy, he makes almost normal eye contact, he comes when I call him and we can go out in public and lead (almost) normal lives now.

So as much as I like to try to be open to considering all sides of issues, I have to admit that there is kinda no talking to me any more about whether or not vaccines are linked to autism or DAN methods based on that presumption abate autistic symptoms. After three years of dealing with all this day in and day out, my conclusion is that they just do.

From what I have seen, I really believe that if there were an honest, transparent, valid study done, it would say just what the Generation rescue survey and the Verstraeten first draft found, that vaccinated kids have are 2.5 times more likely to have an neurodevelopmental disorder.

But I don't want to discourage any one else from digging through all this. It should be picked apart by both sides because it is all that they will give us. But I just feel my energy can be better spent elsewhere.

I know that you put a lot of time and thought into this, does it not annoy you that no agency will offer a decent measure so this question can be answered definitively? How many years has it been now that we have been quibbling about the epidemiology?

Do you support the Maloney/Weldon bill to mandate a vaccinated v. unvaccinated study?

Interverbal said...

Hi Ginger,

Glad to hear your little one is doing so well.

As to your other points my comments will follow below.

The CDDS is a State service body, much less so a research group. They collect statistics to show lawmakers what money is being spent on. They use a system not significantly updated since 1986 to diagnose and record autism. The system uses the following terms:

0 = 'None''
1 = 'Full Syndrome''
2 = 'Residual State''
9 = 'Suspected, not Diagnosed

1’s and 2’s are recorded as “autism” in the CDDS system. 1’s alone can include both Autistic Disorder and PDD-NOS.

Some people like Mr. Kirby sometimes say that the CDDS records only “full spectrum autism”, or some variant of that, well… that is just simply false.

As to the drop in the 3 years olds, refer to some graphs of autism in the 3-5 year old category. We should expect some statistical up and down, that is just the nature of statistics. The trend has to hold for a while or one will just be repeating Geier & Geier’s (2006) mistakes and claiming an “early downward tend”, when there was an embarrassing upswing just a couple months later. That goes double, or even triple for the 3 year old category, which adds double (or more) in the later pre-school years.

The CDDS data takes no reliability data and fails to control for the 6 threats to statistical validity. It has no utility as a means to see if autism is really decreasing or not. Especially, when we are talking about a quarter or two.

“From what I have seen, I really believe that if there were an honest, transparent, valid study done, it would say just what the Generation rescue survey and the Verstraeten first draft found, that vaccinated kids have are 2.5 times more likely to have an neurodevelopmental disorder.”

If we know what the research should say, are we still doing science? Also, the GR study was failed to get a statistically significant result for autism alone. The groups were the same using a T-test. I discussed this with Mr. Handley. He shared that his group combined the data (which included much more than autism and autism like conditions) and got a statistically significant result. They didn’t advertise that result though, and for good reason. If one is going to combine multiple points of measure for a stats test, then a simple test, is no longer appropriate. They would have had to use an MANOVA or something similar, which they did not.

The Vestraeten first edition found a result that was very slightly in favor of an association, but it still was not statistically significant. Even if the authors had gone to press with the first addition, the stats people would have torn it to pieces, because they didn’t get statistical significance, let alone a powerful association.

“I know that you put a lot of time and thought into this, does it not annoy you that no agency will offer a decent measure so this question can be answered definitively?”

Of course it does. I want a firm answer. Unfortunately most of editors and scientists think it is now a closed case. And I worry that what I and people like me consider to be a real answer, is rather more demanding than, other peoples standard of proof; more on that below.

“Do you support the Maloney/Weldon bill to mandate a vaccinated v. unvaccinated study?”

Loosely, but I don’t see how they will solve the problems with ethics (vaxxed vs. non-vaxxed) and threat control. I haven’t figured a way to make this study work. However, just because I don't doesn't mean they won't, and if they do, they have my wholehearted support.

Grace said...

Ginger & Interverbal,

I have been digging thru both sides of this argument for a while now. It seems the reason we are not seeing clear-cut answers is in large part because our children are being affected in various ways by a number of factors and it is difficult, if not impossible, to sort them all out.

I have 5 children.
Only one of them fits the DSM-IV criteria for PDD-NOS (though he also fits the criteria for low level fetal mercury exposure in the EPA's mercury report & I had a filling replaced while I was 5 mos pregnant with him).

My oldest has NVLD & Tourette's. (I had my 5th filling installed just 2 mos before his conception - tics have been linked to mercury but also possibly to vax's).

My 2nd has elements of ADHD & dyslexia along with digestive issues.

My 4th & 5th both show signs of digestive allergies, (the 4th much moreso with eczema & psoriasis & other issues - he was vax'd up to 15mos), but no neurological involvement - I believe because by then I had been on omega-3 supplements for years following a miscarriage & low level depression that would not quit. The relief was so immediate (less than 48hrs) that the deficiency must have been fairly significant. (Placebo effect has been ruled out)

My 5th is the healthiest so far & he is the only one unvaxed at this point, but then he is only 15 mos so the jury is still out. (I will probably take the low & slow conservative route to vax's after he is 2 as long as his immune system is not doing anything worrisome)

And I recently was diagnosed with thyroiditis, but now that I am familiar with the disease, I recognize that the symptoms started way back before my first pregnancy.

My long-winded point is that we don't all have autism, but we do all have damaged immune systems. Seems like it would be worth taking a look at things from a broader view, ie. signs of allergy & autoimmunity in the vaxed vs unvaxed rather than autism specifically, don't you think?

kristina said...

Dear Ginger,

Please note that you are making a public record of David Kirby's violation of the privacy policy of the Huffington Post.

Ginger said...

Yes I am.

Interverbal said...

Hi Grace,

You say “My long-winded point is that we don't all have autism, but we do all have damaged immune systems. Seems like it would be worth taking a look at things from a broader view, ie. signs of allergy & autoimmunity in the vaxed vs unvaxed rather than autism specifically, don't you think?”

That would be interesting.

Joseph said...

I realize this post is old, but I didn't take the time for a rebuttal when the analysis first came out. So here it is:

It Doesn't Look Like It's Declining

I had also previously addressed claims to the effect that IDEA numbers are dropping in some states:

More Epidemiology From David Kirby