K. Fritz: Imus and autism -- Vaccines are safe for children

[Guest guest]

After reading this, I need to confess that I don't

like K. Fritz..and I don't feel a bit

guilty....

http://tinyurl.com/9jnut

K. Fritz: Imus and autism -- Vaccines are safe

for children

01:00 AM EDT on Friday, September 30, 2005

I HAVE a guilty pleasure that I feel the need to

confess: I listen to Imus in the Morning on the radio

as I drive to work every day. The guilt stems from my

inability to reconcile my image of myself as a mature,

thoughtful child psychiatrist with Imus's

self-absorbed, insulting, misanthropic, chauvinistic,

patronizing, ranting radio persona.

The pleasure, which far outweighs the guilt, is

derived from his willingness to say anything, his

adolescent humor, and his endless series of irreverent

interviews with politicians of every hue.

I am also fascinated by the influence he seems to

wield -- the reason, no doubt, that so many public

figures tolerate his questions and his abuse.

Of late, however, I've been cringing at the

recognition that Imus's influence is being applied to

counterbalance the best scientific understanding we

have of autism. Imus and an increasing number of

Americans seem convinced that a) there is an autism

epidemic and it is caused by childhood

immunizations.

My best reading of the available evidence suggests

that neither is true.

It is a fact that more children than ever are being

diagnosed as autistic. On the face of it, that fact is

grounds for concern about an autism epidemic.

However, much of the change in prevalence has to do

with the broadening of the definition of autism. When

the categorization of autistic-spectrum disorders was

improved and expanded, the numbers were sure to rise,

even if nothing else changed.

In addition, the stigma associated with all

psychiatric disorders has been decreasing. And thanks

to the advocacy of parents, autism has progressed

especially far toward destigmatization. So

professionals are asked about it more often, training

programs provide better education on how to recognize

and treat autism, and school systems screen for it

more frequently.

The bottom line is that there is more evidence for

better recognition of previously missed cases than for

an actual increase in the number of autistic children

in the United States.

A recent study by Fombonne and colleagues,

published in June in The American Journal of

Psychiatry, looked at the question in an important

way: They redid a careful epidemiologic study of a

large population of children in Stafford, England. The

initial study, of 16,000 children born between 1992

and 1995, was repeated on 11,000 children in the same

location born between 1996 and 1998. The two studies

employed the same rigorous, exhaustive methods to

evaluate the same diagnostic criteria. Overall, the

prevalence rate of pervasive developmental disorders

was 63 per 10,000 children in the first study and 59

per 10,000 in the second (the apparent decrease was

not statistically significant). Further, there were no

significant differences between subtypes of pervasive

developmental disorders (autism, Asperger's disorder,

PDD-NOS, etc.).

Imus is publicizing the view that mercury in

thimerosal, a preservative used in vaccines, is

causing the purported autism epidemic. To accept this

proposal, one must discount a number of studies that

have diligently sought to prove the connection: None

has found a theoretical, clinical, or epidemiologic

link.

One must also believe that the Institute of Medicine,

the Centers for Disease Control and Prevention, and

the American Academy of Pediatrics, in their review of

the data, are orchestrating a coverup to protect the

companies that make vaccines. I find this incredible,

but for many people, Imus's dogmatism is more

convincing than scientific evidence.

Chelation therapy for autism is now a cottage

industry, and at least one child has died in the

course of such treatment. In addition, some parents

question the wisdom of immunizing their children

because of " the risk of autism " -- even though

thimerosal is now almost totally gone from vaccines.

That one's child has an autism-spectrum disorder is

usually heartbreaking news, and the impact on family

life can be devastating. And though we mental-health

professionals work hard to provide important treatment

and lots of coping advice, we don't know the cause of

autism, so we can't yet cure it.

Thus, it's no surprise that desperate parents --

supported by the good intentions and passion of social

icons such as Imus -- embrace unproven but " hopeful "

advances. It is human nature to want to replace the

unknown with understanding, and when science lacks the

answers, people turn to forcefully voiced opinions. In

Imus's case, it's also good for ratings.

K. Fritz, M.D., an occasional contributor, is

editor of The Brown University Child and Adolescent

Behavior Letter, a Brown professor of psychiatry,

medical director of Bradley Hospital, and director of

child and family psychiatry at Hasbro Children's Hospital.

__________________________________

- PC Magazine Editors' Choice 2005

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