Search Results for "autism"

Nov 11 2014

Glenn Beck’s Medical Narrative

Recently Glenn Beck has revealed that he has been struggling with medical issues for the last five years or so. On his show he states:

“Tonight’s show is not for the casual fan or, really, anyone in the press,” Beck said. “This is a one-on-one between friends. No one in the media ever does a show like this, because it is crazy. … But I believe that by not talking with you openly, it destroys everything of real meaning and value — namely, our trust.”

What follows is a common narrative we have heard before. Beck was very sick with a mysterious illness. His symptoms were mainly pain and numbness in the hands and feet, lack of sleep, mental fog, muscle problems, and vocal cord paralysis. He saw many doctors, who were unable to make a definitive diagnosis, while he slowly deteriorated.

Finally he saw a maverick doctor with unconventional treatments. He was able to explain all of Beck’s symptoms, and gave him a comprehensive treatment program which has reversed Beck’s illness. Now Beck is back with a “clean bill of health.”

Even though I am a neurologist and I have my suspicions about what was really going on, I am not going to attempt to diagnose Beck from afar. What I want to discuss is the issue of public figures using their own health to tell a moral narrative. It’s very problematic for several reasons.

The first is that medical stories, especially those involving a complex or difficult-to-diagnose condition, are, well, complex. There are often many nuances to such stories and they are not easily captured with simplistic narratives. For example, it is very difficult to know what Beck’s various physicians were thinking without either talking to them directly or having access to his medical record. Second-hand reports of the what other doctors are thinking are never, in my experience, accurate.

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Sep 30 2014

Dr. Oz, Autism, and GMOs

It is no longer news that Dr. Oz has long ago abandoned any pretense to scientific rigor and is simply another scaremongering hawker of snake oil and nonsense. Still, it’s hard not to marvel when he sinks to a new low.

On a recent show Oz’s target was genetically modified organisms (GMO). This is not new for Oz, he has hosted anti-GMO activists in the past, warning his audience about non-existent health risks.

This time around Oz and his guest are claiming that pesticides used with certain GMO varieties may cause autism. Why is it always autism? It’s likely at least partly due to the fact that awareness of autism has been increasing in the last 2 decades, creating the false impression that autism itself is increasing. This leads to numerous false correlations (most famously with vaccines) and the assumption of cause and effect (often to support a preexisting bias). As you can see from the graph, however, the rise in autism diagnoses tightly correlates with increased organic food sales – but I guess you have to cherry pick the correlation you want.

The narrative that Oz spun for his audience was this: GMO is tied to pesticide use. Those pesticides are hazardous to your health, and specifically might cause autism. Organic food is pesticide free, and going organic can actually cure autism.

Every link in that chain of argument is misleading or patently wrong.

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Sep 22 2014

Vandana Shiva and GMOs

Published by under General Science

A recent New Yorker article by Michael Specter does an excellent job of putting the activism of anti-GMO campaigner, Vandana Shiva, into perspective. Shiva has since written a very critical response to Specter, and The New Yorker has responded to Shiva. The exchange is very enlightening.

Shiva is a dedicated anti-GMO activist, perhaps the most widely known and successful in the world. Specter paints a picture of Shiva as more than an ideologue – a “demagogue” who has created a dramatic narrative that is meant to frighten the public about GMOs, but has little to do with reality. For Shiva, her anti-GMO stance is part of a broader economic and social ideology. In her vision of the world, local farmers would feed the world with organic farming, without fertilizer or corporate involvement. The actual science about GMOs seems to be irrelevant to her narrative.

Specter illustrates several example. There are definitely religious undertones to her activism. For example, Specter quotes her from a speech earlier this year:

“G.M.O. stands for ‘God, Move Over,’ we are the creators now,”

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Aug 12 2014

Tocco’s Anti-vaccine Narrative

Part of the scientific approach to knowledge is to integrate information at various levels. It’s important to get the tiny facts correct, but you also have to put those facts into progressively broader and deeper frameworks. Theories are informed by facts which in turn make sense only in the context of the theory.

I try to take this approach with topics on this blog, by not only spending time addressing specific facts but also trying to see the big picture. For example, Mary Tocco, who is an anti-vaccine activist, was recently given space for a guest column on Michigan Live. I will go through and deconstruct her specific claims, but it’s also helpful to view her article in the broader social context.

Tocco is part of Michigan Opposing Mandatory Vaccination, or MOM (how can you not love “mom”). In her article she writes:

“The authors labeled Michigan Opposing Mandatory Vaccines an anti-vaccine group. Our organization is about protecting parental right to choose whether or not to use vaccines as a method of health care for themselves and their children.”

From this one paragraph we can see many of the threads currently weaving through culture. The big picture is that there is an ideological struggle going on between those who take a science-based worldview and believe that rational regulations should be based on the best science available, and those who wish to promote some other agenda that is not science-based.

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Jul 03 2014

Vaccine Safety Systematic Review

A new systematic review of adverse events from vaccines used in the US was recently published in the journal Pediatrics: Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review. (Full text pdf) This systematic review is actually an update and expansion to the 2011 Institute of Medicine (IOM) report on vaccine side effects.

The review looked at the best evidence available, active surveillance studies with controls, identifying 67 relevant studies. Overall they found that vaccines were very safe. There were a few associations with serious adverse events, but these were all very rare. From their conclusions:

Our findings may allay some patient, caregiver, and health care provider concerns. Strength of evidence is high that MMR vaccine is not associated with the onset of autism in children; this conclusion supports findings of all previous reviews on the topic. There is also high-strength evidence that MMR, DTaP, Td, Hib, and hepatitis B vaccines are not associated with childhood leukemia.

Evidence was found for an association of several serious AEs with vaccines; however, these events were extremely rare: absolute risk is low. For example, strength of evidence is moderate for association of vaccines against rotavirus with intussusception. Although 1 large US epidemiologic study found no association, a recent analysis of the US PRISM program found both RotaTeq and Rotarix associated with intussusception in the short term. Estimated rates were 1.1 to 1.5 cases per 100 000 doses of RotaTeq and 5.1 cases per 100 000 doses of Rotarix.

So a few vaccines are associated with rare AEs. Given the rhetoric of the anti-vaccine movement, there are a few points worth emphasizing here.

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Jun 26 2014

Pesticides and Autism

A study has been making the rounds on social media claiming an association between prenatal exposure to pesticides and the risk of autism and developmental delay. This means that I am getting asked by many people what the study actually shows. Spoiler alert – not much. But let’s break it down.

Autism spectrum disorder (ASD) is a neurological disorder involving brain development resulting in decreased communications among neurons in the brain and characterized by reduced social ability. Our current scientific understanding is that ASD is largely a genetic disorder. While environmental factors cannot be ruled out, it seems that genes are the primary factor. It’s reasonable to search for environmental risk factors, but so far none have been clearly established.

Those who feel there likely is an environmental factor also tend to believe that there is an autism epidemic – that the incidence of autism is increasing in a way that is not easily explained by genetics, and therefore suggests and environmental factor. While it is uncontroversial that the number of ASD diagnoses has been increasing over the last two decades, this does not necessarily mean that the true incidence of ASD has been increasing.

The evidence actually shows that diagnostic substitution, broadening of the definition of ASD, and increased surveillance account for much of the increased recorded incidence. It’s possible that changes in diagnostic behavior entirely accounts for the apparent increase. It’s also possible that a subset is due to a true increase, but that has not been clearly established.

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Jun 13 2014

Moms for Pseudoscience – Roundup Edition

Published by under General Science

I really resent groups that transparently try to take the moral high ground, or appropriate an entire category of people, to bolster their personal ideology. The Thinking Moms Revolution (TMR) is one such group. Sorry, you don’t speak for moms, and your group is certainly not based on thoughtfullness.

A recent blog post in the HuffPo is clear pro-organic propaganda, borrowing the “mom” meme from TMR and another such group, Moms Across America. The theme of the blog is that glyphosate, the active ingredient in the herbicide Roundup, is a horrible toxin that is destroying our health, but luckily these plucky moms are going to take on the EPA and demand safety for our children (because the EPA obviously can’t do their job without help from non-scientist ideologues).

I went through a couple of overloaded irony meters reading the post, especially with this section: “Swaying Decision Makers With Science.” The article, rather, is a series of anecdotes, misrepresentations, and cherry-picked factoids masquerading as science for the purpose of ideological advocacy. No, eating organic is not going to cure your child of autism.

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Jun 06 2014

PETA Responds

Last week on Science-Based Medicine I wrote an article about the embrace by PETA (people for the ethical treatment of animals) of pseudoscience – in this case they are engaging in a fearmongering campaign linking dairy products to the risk of autism or increasing the severity of autism.

Yesterday I received an e-mail from PETA, essentially doubling down on their prior embrace of pseudoscience:

Dear Steven,

I want to follow up on your story last week about PETA’s campaign that points out how a dairy-free diet may help children with autism. PETA’s website and campaign serve to provide parents with potentially valuable information, albeit mostly anecdotal, from families’ findings—for example, just this week, the editor of Autism Eye magazine, Gillian Loughran, who has a 14-year-old son with autism, contacted us in support of our campaign and wrote a letter to the editor on our behalf (see below). Until such time as there is a large study into whether there is a dairy-autism link (and one we hope will not be funded by the dairy industry), it seems unwise to overlook a growing body of anecdotal information supporting that removing dairy and gluten from the diet of a child with autism may improve the child’s sleep, behavior, and concentration. We hope this letter will change your mind about PETA’s campaign—or, at least, that you will share this letter with your readers so that they can arrive at an informed opinion.

Thank you for your time.

Best regards,

Heather 

There are multiple problems with this position.

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Mar 27 2014

When Does Autism Begin?

One common feature of unscientific belief systems is that they do not change in the face of new evidence. They tend to evolve like cultural beliefs or marketing campaigns, but do not appear to be affected by scientific evidence in any meaningful way.

One great example of this is the idea the autism is linked to vaccines (to be clear up front, it isn’t) This idea had a few important factors in its origin. The first was simply the existing anti-vaccine movement searching for anything to blame on vaccines. The second, and perhaps decisive, factor was the now discredited and withdrawn study by Andrew Wakefield linking autism to the MMR vaccine.

Even as the MMR claim was dying, the anti-vaccine community was moving onto the next target – mercury (specifically the preservative Thimerosal). This was the target of the book Evidence of Harm by David Kirby. This also created common cause between the anti-vaccine movement, and separate “mercury militia” blaming many modern ills on mercury, and some environmentalists (most prominently Robert Kennedy Jr.) who are keen to blame medical problems on any environmental exposure, including mercury and/or vaccines.

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Mar 07 2014

Health of Vaccinated vs Unvaccinated

One of the new realities of social media is that old news can be dredged up and spread around. In this way old memes can keep coming back to life like the Terminator, and we have to kill them over and over again.

The antivaccine crowd, for example, has their narrative of conspiracy and evil and their cherry-picked factoids to support their narrative. In their world vaccines don’t work and are all bad all the time, and only corporate evil and public malfeasance can support them. They scour the internet for anything to support their beliefs, and then splash it around as if it’s news.

In this case, they have resurrected a terrible survey from 1992. The survey was conducted in New Zealand by the Immunization Awareness Society. Unsurprisingly, when this anti-vaccine group surveyed their own anti-vaccine members, they found a higher incidence of disease among vaccinated children compared to unvaccinated children.

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