Jon Poling, MD
March 13, 2009
For the million plus American families touched by autism, like mine, there is real urgency to find scientific answers to help loved ones and prevent future victims. Unfortunately, some doctors still fail to even accept the increasing autism rate as real, rather than their own better diagnosis.
The collateral damage of “better diagnosis,” the idea that we are simply better at detecting autism, is the abandonment of families coping with autism by the medical establishment, government and private insurance companies.
Beyond the high emotional toll autism takes on a family, many have been financially ruined. Public school systems are drowning in the red ink of educating increasing numbers of special-needs students.
Fortunately, the ‘better diagnosis’ myth has been soundly debunked. In the 2009 issue of Epidemiology, two authors analyzed 1990 through 2006 California Department of Developmental Services and U.S. Census data documenting an astronomical 700 to 800 percent rise in the disorder.
These scientists concluded that only a smaller percentage of this staggering rise can be explained by means other than a true increase.
Because purely genetic diseases do not rise precipitously, the corollary to a true autism increase is clear – genes only load the gun and it is the environment that pulls the trigger. Autism is best redefined as an environmental disease with genetic susceptibilities.
We should be investing our research dollars into discovering environmental factors that we can change, not more poorly targeted genetic studies that offer no hope of early intervention. Pesticides, mercury, aluminum, several drugs, dietary factors, infectious agents and yes – vaccines – are all in the research agenda.
An inspiring new text, “Autism-Current Theories and Evidence,” has successfully navigated the minefield of autism science without touching the “third rail,” as Dr. Sanjay Gupta aptly describes the vaccine-autism debate.
Dr. Andrew Zimmerman, who has studied autism for decades, prophetically writes, “The clinical heterogeneity of this disorder, together with the inherent dynamic changes during children’s growth and development, confound static, linear models and simplistic, unilateral approaches.”
Zimmerman’s book is dense with cutting-edge science on cell biology, metabolism, oxidative stress, neuroinflammation, auto-immunity and brain pathology. That’s right – autism isn’t simply a genetic program for brain development gone awry. Dr. Martha Herbert, of Harvard Medical School, writes the final chapter defining autism in the larger framework of a multiple organ system disease with potentially reversible impairments.
As an affected parent, I am left with a sense of hope that these professionals will produce results to stem the tide of new autism cases and ameliorate symptoms of those currently suffering.
On the other hand, Dr. Paul Offit, the vaccine inventor whose Rotateq royalty interests recently sold for a reported $182 million, has written a novel of perceived good and evil called “Autism’s False Prophets.”
The tome is largely a dramatic account of why Offit, who self-admittedly is not an autism expert, feels vaccines should be exonerated in the autism epidemic. In the story, Offit takes no prisoners, smearing characters in the vaccine-autism controversy as effortlessly as a rich cream cheese.
“False Prophets” has curiously garnered support from several senior physicians in respected medical journals.
After Offit’s drama is complete, these cheerleaders fail to realize they have traveled the road labeled “Dead End – No Through Traffic.” In his epilogue, Offit credits autism parents who have likewise gone down the dead end path to autism acceptance, without search for cause or cure.
As both parent and doctor, I cannot fathom turning my back on a child nor science, in order to avoid inconvenient questions about vaccine safety or any other reasonable environmental factor.
President Obama has recognized that “we’ve seen just a skyrocketing autism rate” and plans to appoint an “autism czar” to coordinate his policy efforts. Science is moving forward to connect the three dots of environment, genes and plasticity of a developing child’s brain circuitry. In the end, logic and reason will prevail over politics and profits.
Dr. Jon Poling, an Athens neurologist, is an assistant professor at the Medical College of Georgia. His daughter, Hannah Poling, has been a successful petitioner in the National Vaccine Injury Compensation Program.