Gardasil and the Deadly Scam

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Making the rounds of Facebook is an article published on The Daily Sheeple (“Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam,” 2014) about Gardasil, the Human Pappilloma Virus vaccine.

If what Sheeple are saying is correct, then Gardasil is a deadly scam!  We’ve all been conned into believing that Gardasil and other HPV vaccines were safe, and useful in protecting our children from cervical cancer, when really it doesn’t do anything but make money for Merck, that multi-billion dollar global tyrant, while our children wither and die.

True to the form of paranoid extremists everywhere, Sheeple uses hysterical accusations and mistruths in a breathless promotion of fear and ignorance.  The only deadly scam going on here is Sheeple’s.

Lets break down the article by Sheeple a little, then lets look at the facts from the peer-reviewed literature, not misquotes from misquotes.

Sheeple quotes an article on a similarly extreme blog, which took the quotes from another extremist blog.  It alleges that Dr Harper believed that Gardasil was pointless, and harmful, even more harmful than cervical cancer which it was designed to prevent.  The article alleges that there were 15,037 adverse reactions and 44 deaths.  They quote Harper to CBS stating that, “‘The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC’s Dr. Barbara Slade) were 3.4/100,000 doses distributed,’ Harper tells CBS NEWS.  ‘The rate of serious adverse events on par with the death rate of cervical cancer.’”

The truth is that the rates of serious adverse reactions to the HPV vaccine are incredibly small.

The CDC Morbidity and Mortality Weekly report from the 26th July 2013 states that, “From June 2006 through March 2013, approximately 56 million doses of HPV4 were distributed in the United States … During June 2006–March 2013, the Vaccine Adverse Event Reporting System (VAERS) received a total of 21,194 adverse event reports occurring in females after receipt of HPV4” (Centers for Disease Control and Prevention, 2013).  That’s an adverse events rate of 0.04%.

The vast majority of vaccination side effects are a red, sore arm and fainting, which are not exclusive side effects to HPV vaccinations, but to all vaccinations in adolescents (Centers for Disease Control and Prevention, 2013; Harper & Vierthaler, 2011).  In large trials, the rate of vaccine side effects was comparable to the rate of side effects from the placebo (Centers for Disease Control and Prevention, 2013; Gee et al., 2011; Lu, Kumar, Castellsague, & Giuliano, 2011; Rambout, Hopkins, Hutton, & Fergusson, 2007).  So the vaccine is not the problem, it’s the histrionic teenagers.

In terms of deaths from the HPV vaccine, there aren’t any.  Rambout et al. (2007) wrote, “The meta-analysis demonstrated that, overall, the incidence of serious adverse events and death was balanced between the vaccine and control groups … Most deaths were reported as accidental, and none of the deaths was considered attributable to the vaccine.”  National Centre For Immunisation Research and Surveillance (2013) states that, “HPV vaccines are approved for use in over 100 countries, with more than 100 million doses distributed worldwide … No deaths reported in safety surveillance systems data in Australia or overseas, have been determined to be causally related to either of the HPV vaccines.”

Compare that to the current Australian road toll, which currently stands at 5.2/100,000 (Road Deaths Australia, December 2013).  It’s safer to have a HPV vaccination than it is to drive a car.

The Sheeple article also fails to correctly report the benefits of the HPV vaccine, which has already shown a dramatic drop in the rate of HPV infection (Lu et al., 2011) and the incidence of genital warts (Ali et al., 2013).

Given all of this, did Dr Harper really suggest that the HPV vaccine was useless and harmful?  I doubt she said anything of the sort, since in 2011 in a formal paper in a peer-reviewed journal, she said, “Should vaccination be an option that women choose for their cervical cancer protection, Cervarix is an excellent choice for both screened and unscreened populations due to its long-lasting protection, its broad protection for at least five oncogenic HPV types, the potential to use only one-dose for the same level of protection, and its safety.” (Harper & Vierthaler, 2011)

One final word about every woman’s favourite health check, the pap smear.  Australia does have a low death rate from cervical cancer, compared to the rest of the world, even before the introduction of the HPV vaccine.  The national co-ordinated approach to cervical screening with pap smears is the reason why.  “Vaccination is not an ‘alternative’ to Pap tests; together these two approaches provide optimal protection. The National Cervical Screening Program recommends routine screening with Pap tests every 2 years for all women between the ages of 18 (or 2 years after first sexual intercourse) and 69 years.” (National Centre For Immunisation Research and Surveillance, 2013)

Is there a giant deadly scam behind the Gardasil vaccine?  Only from those who oppose it.  The same people wouldn’t think twice about letting their teenagers in a car, which is far more dangerous.  When it’s their turn, I’ll have no hesitation in having my children vaccinated for HPV.  If you disagree, that’s ultimately your choice.  But examine all the facts first.  Don’t let your children’s health rest on a baseless Internet meme.

References

Ali, H., Donovan, B., Wand, H., Read, T. R., Regan, D. G., Grulich, A. E., . . . Guy, R. J. (2013). Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ, 346, f2032. doi: 10.1136/bmj.f2032

Centers for Disease Control and Prevention. (2013). Human papillomavirus vaccination coverage among adolescent girls, 2007-2012, and postlicensure vaccine safety monitoring, 2006-2013 – United States. MMWR Morb Mortal Wkly Rep, 62(29), 591-595.

Gee, J., Naleway, A., Shui, I., Baggs, J., Yin, R., Li, R., . . . Weintraub, E. S. (2011). Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink. Vaccine, 29(46), 8279-8284. doi: 10.1016/j.vaccine.2011.08.106

Harper, D. M., & Vierthaler, S. L. (2011). Next Generation Cancer Protection: The Bivalent HPV Vaccine for Females. ISRN Obstet Gynecol, 2011, 457204. doi: 10.5402/2011/457204

Lead Developer Of HPV Vaccines Comes Clean, Warns Parents & Young Girls It’s All A Giant Deadly Scam. (2014). The Daily Sheeple.  Retrieved Jan 17, 2014, from http://www.thedailysheeple.com/lead-developer-of-hpv-vaccines-comes-clean-warns-parents-young-girls-its-all-a-giant-deadly-scam_012014 – sthash.lDJcsFRt.dpuf

Lu, B., Kumar, A., Castellsague, X., & Giuliano, A. R. (2011). Efficacy and safety of prophylactic vaccines against cervical HPV infection and diseases among women: a systematic review & meta-analysis. BMC Infect Dis, 11, 13. doi: 10.1186/1471-2334-11-13

National Centre For Immunisation Research and Surveillance. (2013). Human papillomavirus (HPV) vaccines for Australians | NCIRS Fact sheet: March 2013.   Retrieved Jan 17, 2014, from http://www.ncirs.edu.au/immunisation/fact-sheets/hpv-human-papillomavirus-fact-sheet.pdf

Rambout, L., Hopkins, L., Hutton, B., & Fergusson, D. (2007). Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials. CMAJ, 177(5), 469-479. doi: 10.1503/cmaj.070948

Road Deaths Australia, December 2013. (2014).  Canberra, Australia: Commonwealth of Australia. Retrieved from http://www.bitre.gov.au/publications/ongoing/rda/files/RDA_Dec13.pdf.

Dr Caroline Leaf and the myth of optimism bias

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“What are little girls are made of?  Sugar and spice, and all things nice.”

It sounds sweet doesn’t it?  We like to connect with these rosy little memes that warm our cockles and make us feel good about the world and ourselves.  We think of all of the examples in our own experience, which seems to confirm the saying.  We may think of a few examples that don’t quite fit, but they’re just the exception that proves the rule.

It doesn’t seem to matter what the saying or proverb is, we usually just assume it’s true.  Think of some other examples:
“Blondes have more fun.”
“Women can’t read maps.”
“White guys can’t dance.”

In all of these things, we tend to experience what psychologists call confirmation bias (Princeton University, 2014), our own mini-delusion in which we fool ourselves into believing a half-truth.  It looks right on first glance, and we can easily think of a few confirming examples, so without deeper inspection, we assume it must be true.

When Dr Leaf proclaims that,

“Science shows we are wired for love with a natural optimism bias”

the same process kicks in.  But in truth, science doesn’t show anything of the sort.  What science shows is that we learn love and fear, and our genetics influences the way we see the world, our personality.

We are prewired to LEARN to love and fear.  It doesn’t come naturally.  We require exposure to both love and to fear for these emotions to develop.  The Bucharest Early Intervention Project is a study looking at the long-term psychological and physical health of children in Bucharest, one group who remained in an orphanage, and the other, a group of children that were eventually adopted.  Analysis of the cohort of the two groups of children showed that negative affect was the same for both groups.  However positive affect and emotional reactivity was significantly reduced in the institutionalised children (Bos et al., 2011).  This shows that children who lived in an institution all of their lives and given limited emotional stimulation had lower levels of positive affect (ie: love, happiness) compared to a child that was adopted.

The children in the institution did not have high positive affect because they were not shown love.  Those children who were adopted were higher on positive affect because they were shown love by their adopted parents.  Both groups were exposed to distress and fear during their time in the orphanage, so their negative affect was the same across both groups.  Thus, love and fear don’t come naturally.  They need to be learned.

Personality is “the combination of characteristics or qualities that form an individuals distinctive character.” (“Oxford Dictionary of English – 3rd Edition,” 2010) As Professor Greg Henriques wrote in psychology today, “Personality traits are longstanding patterns of thoughts, feelings, and actions which tend to stabilize in adulthood and remain relatively fixed. There are five broad trait domains, one of which is labeled Neuroticism, and it generally corresponds to the sensitivity of the negative affect system, where a person high in Neuroticism is someone who is a worrier, easily upset, often down or irritable, and demonstrates high emotional reactivity to stress.” (Henriques, 2012) Personality is heavily influenced by genetics, with up to 60% of our personality pre-determined by our genes (Vinkhuyzen et al., 2012), expressed through the function of the serotonin and dopamine transporter systems in our brain (Caspi, Hariri, Holmes, Uher, & Moffitt, 2010; Chen et al., 2011; Felten, Montag, Markett, Walter, & Reuter, 2011).

So some people *ARE* natural optimists – their genetic heritage blessed them with a rosy outlook and their early life experiences cemented it in.  These naturally optimistic people, and the people who know them, are the ones who take Dr Leaf’s word as truth because they see it in themselves or their friends.  But the fact that some people are naturally wired for pessimism or a neurotic personality disproves Dr Leaf’s assertion.

Its important that Dr Leaf’s misleading meme is seen for what it is.  If we assume that we’re all pre-wired for love and optimism, then those who are pessimistic must be deficient or deviant, and the fact they can’t change must mean they are incompetent or lazy.  If we know the truth, those who are less optimistic won’t be unnecessarily judged or marginalised.

I should point out that what I’ve said isn’t a free licence to be cranky or sullen all the time.  The natural pessimist still needs to be able to negotiate their way through life, and being a misery-guts makes it hard to get what you need from other people in any business, social or interpersonal relationship.  We have the ability to learn, and the person with a neurotic personality can still learn ways of dealing with people in a positive way.

But if you naturally see the glass half-empty, don’t tell yourself that you’re abnormal, or that you aren’t good enough.  You are who you are.  Accept who you are, because while there are weaknesses inherent to having neurotic personality traits, there are also strengths, such as the enhanced awareness of deception, or protection from gullibility (Forgas & East, 2008).

A good thing to have when searching for the truth.

 References

Bos, K., Zeanah, C. H., Fox, N. A., Drury, S. S., McLaughlin, K. A., & Nelson, C. A. (2011). Psychiatric outcomes in young children with a history of institutionalization. Harv Rev Psychiatry, 19(1), 15-24. doi: 10.3109/10673229.2011.549773

Caspi, A., Hariri, A. R., Holmes, A., Uher, R., & Moffitt, T. E. (2010). Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. Am J Psychiatry, 167(5), 509-527. doi: 10.1176/appi.ajp.2010.09101452

Chen, C., Chen, C., Moyzis, R., Stern, H., He, Q., Li, H., . . . Dong, Q. (2011). Contributions of dopamine-related genes and environmental factors to highly sensitive personality: a multi-step neuronal system-level approach. PLoS One, 6(7), e21636. doi: 10.1371/journal.pone.0021636

Felten, A., Montag, C., Markett, S., Walter, N. T., & Reuter, M. (2011). Genetically determined dopamine availability predicts disposition for depression. Brain Behav, 1(2), 109-118. doi: 10.1002/brb3.20

Forgas, J. P., & East, R. (2008). On being happy and gullible: Mood effects on skepticism and the detection of deception. Journal of Experimental Social Psychology, 44, 1362-1367.

Henriques, G. (2012). (When) Are You Neurotic?  Retrieved from http://www.psychologytoday.com/blog/theory-knowledge/201211/when-are-you-neurotic

Oxford Dictionary of English – 3rd Edition. (2010)   (3rd edition ed.). Oxford, UK: Oxford University Press.

Princeton University. (2014). Confirmation bias.   Retrieved January 10, 2014, from http://www.princeton.edu/~achaney/tmve/wiki100k/docs/Confirmation_bias.html

Vinkhuyzen, A. A., Pedersen, N. L., Yang, J., Lee, S. H., Magnusson, P. K., Iacono, W. G., . . . Wray, N. R. (2012). Common SNPs explain some of the variation in the personality dimensions of neuroticism and extraversion. Transl Psychiatry, 2, e102. doi: 10.1038/tp.2012.27

My patient, Kev

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I meet a lot of people in my job. Some are not particularly memorable, and some I truly wish to forget. But every now and then, I meet a person who’s memorable for all the right reasons. Kev was one of those people.

Once upon a time, Kev was a business man, a corporate manager who started in the postal service in his late teens, but got more experience and moved into the Commonwealth Bank, where he quickly moved through their ranks and became a regional manager. Towards the end of his career, he moved industries to become the CEO of one of the smaller private hospitals in Brisbane in the 1980’s.

After he retired, his wife developed dementia, and he cared for her at home for many years, before he became too weak. They both moved into a nursing home, but his wife succumbed a couple of years later.

When I met Kev in early 2013, he was dying. His heart and his lungs were failing, and he couldn’t walk ten metres without gasping or needing oxygen. He was gaunt and frail, and extremely thin. I was worried that if he fell, he might snap.

But his intellect remained untouched by the disease ravaging the rest of his body. He was quick-witted, jovial, and always polite. He was the consummate professional – always showing respect, and earning it. I could see why he was so good as a businessman. He was a pleasure to be around – so much so that I spent extra time with him every week just chatting, when I should have been finishing off my work.

In the week before he died, the last time I saw him, as I sat in his room listening to some more of his stories, he looked me in the eye and said,

“Don’t sweat the small stuff. You don’t have to do everything. Let people flow in the things they can do. There are more important things in life.”

He smiled as he looked at the photos on his wall of his wife and kids.

I smiled and shook his hand. “I’ll see you later, Kev”, I said. I never did see him again.

I still remember him now, skinny and breathless, but with a big smile on his face and a sparkle in his eyes every time I entered his room. And I remember his advice on living a life driven by values.

New Years Day is a time to start afresh, a celebration of new beginnings, a focal point to take stock and refocus. But if we’ve learnt anything at all from our previous attempts at New Years resolutions, it is that they don’t work. Don’t be mislead by the occasional partial successes. I sometimes hit a golf ball straight, but that still doesn’t mean my golf swing is any good. New Years resolutions are the same – they are fundamentally flawed, in spite of the accidental successes that we sometimes have.

The truth is that etherial statements, or short term goals for self-improvement don’t help us. We don’t need New Years resolutions, we need New Years re-evaluations.

Values are different to goals. A goal is like a destination, where as a value is like a direction. Our individual values are like the direction of the breeze. It’s easier to sail with the breeze of our values than against it.

We often get goals and values confused. Goal orientation means that we move from place to place, sometimes travelling in the same direction as our values, but sometimes against them. When we live according to our values, the goals seem to set themselves as we live according to what we truly believe in, what truly motivates us.

A few things can acts as guides to help us learn what our values are. What are your passions or what makes you mad? Is it justice, or injustice? Is it relationships? Is it children, or family? The environment? What is it that gets your juices flowing?

Another way of understanding your values is to do the eulogy exercise. It’s a little morbid, perhaps. But simply, the eulogy exercise involves writing your own eulogy. What is it that you want others to remember you for? What do you want your epitaph to say?

The eulogy exercise helps us to plan our lives with the end in mind. When you’re on your death bed, will you regret not finishing that report, or will you regret whether you lived according to your values, your deepest desires. Putting your values into perspective makes it much easier to let things go that aren’t truly important. It’s a lesson I’m continually working at too.

May 2014, and the rest of your life, be about the important things. Don’t sweat the small stuff.

I hope you have a happy new year.

Cheers, Kev.

Prayer Proof?

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In Wisconsin, USA, Leilani Neumann is found guilty of second degree reckless homocide of her 11-year-old daughter Kara.  During her recent trial, the prosecution alleged that she ignored the worsening symptoms of Kara’s undiagnosed diabetes for two weeks, and chose prayer instead of seeking medical advice.  Even during the last hours before Kara’s death, Leilani stood with her husband and Bible study members praying for her.  Witnesses said that it was only when the comatosed girl stopped breathing that someone called paramedics.  Neumann family supporters state that the trial was misconducted, without a single witness called for the defense, and an appeal is planned.

Across the other side of the US, Billy is a graduating student of the Bethel School of Ministry, in Redding, California.   He reported on a recent trip to Ecuador where he prayed for a seven year old boy with leg deformities from birth. It was hard for the boy to walk and impossible for him to run, which made him the target of taunts when he tried to play soccer.  Despite their best efforts, doctors had failed to correct the deformities.  Billy prayed for him three times, and after the third prayer, the boy said he saw “the hand of God come down” and touch him.  He took a few tentative steps, and his legs became straighter and straighter.  His mother tearfully confirmed that her previously lame son could now walk and run.  The last thing Billy saw as he was driving away from the crusade was the boy running up and down the car park, staring in wonder at his perfectly straight legs.

Same act of prayer, same God, but two contradictory results.  It is a conundrum that has confused the church for centuries.  Why does God answer some prayer with miracles, and why are some prayers for healing seemingly unanswered?  What is the effectiveness of prayer?

There have been some attempts to measure the effects of prayer scientifically.  One of the first published clinical trials of intercessory prayer was a 1988 study by Randolph Byrd.  Almost 400 patients over a period of time were randomized to receive prayer from born-again Christians, while the other half received no prayer.  The results showed a positive outcome for prayer in six of the twenty-nine variables observed.  Unfortunately, the study was plagued by problems in the construction of the trial, and many feel that the positive results were because of study bias, not the prayer itself.

There have been better studies since then.  The “Study of the Therapeutic Effects of Intercessory Prayer” (“STEP”) was a well conducted trial that took 10 years and $US2.4 million.  1800 patients, all admitted to hospital for the same condition, were divided into three groups: one received prayer and knew they were prayed for, another group received prayer without knowing about it, and the last received no prayer.  The prayer was performed by committed Christians experienced in praying for the sick.  The results were not encouraging for intercessory prayer, with the two groups receiving prayer actually having poorer outcomes than those not prayed for.

On the surface this does little to help the dilemma of prayer for healing.  On deeper analysis, there may have been confounding factors.  Those in the control group (without prayer in the study) may have been praying themselves.  Or perhaps the answer to prayer in those studied came outside of the study’s parameters.  Perhaps God wants us to trust in him and his word, the raw power of faith, rather than in the science of a clean-cut clinical study that “proved” the benefits of prayer.  When it comes to the studying of prayer, Christians and clinicians have noted that prayer is not an easily quantifiable substance.  And neither is God for that matter.  When God works supernaturally, he works super-naturally, literally above the laws of nature.  Prayer, then, cannot be studied scientifically since the scientific method relies on observing and controlling variables within the natural order.

In fact, I personally think that God delights in performing miracles that are beyond our reasoning.  The miracles of Jesus provide many good examples – he placed mud, made out of the mixture of dirt and his saliva, onto a blind mans eyes.  He touched lepers.  He told Peter to find tax money in the mouth of a fish.  These sort of miracles perplex yet inspire us.  Scientifically quantifiable or not, they still move us to worship the greatness of God.

How do we find the wisdom to know when to choose medicine or miracle?  Two of Jesus’ miracles come to mind that might shed light on this delicate balance.  The woman with the issue of blood (Luke 8:43-48) had “spent all her living upon physicians, neither could be healed of any.”  She touched Jesus and was healed, and Jesus told her “thy faith hath made thee whole.”  The lame man at the pool of Bethesda (John 5:1-9) waited patiently near the waters edge and tried as best he could to make it into the waters to be healed but was unable to get there by himself.  When Jesus told him to walk, he got up instantly and was healed.

Both stories are of people in need who didn’t wait passively for healing.  Each did whatever was in their power to find healing, and were at the point where their effort was not enough.  The woman pursued Jesus, whereas Jesus came to the man, but in both cases their faith engaged God and they received healing.  I think the same is true in modern day life.  Healing is by the grace of God.  We do nothing to earn it.  But like many things in the kingdom of God, we also need to ask, to seek and to knock.

I understand that my profession as a GP makes me a little biased, but the healing or prevention of many diseases is available simply by following modern medical advice, or by using simple therapies like vaccinations or antibiotics.  For Kara Neumann, the answer to prayer was in the insulin and fluids that doctors would have given her had they been called in time.  Perhaps it’s because we are so used to the benefits of medicine that we do not see immunizations or pharmaceuticals as miracles, or answers to prayer.  But imagine if you could go back in time one hundred years with some of todays basic medicines like penicillin.  You would be able to cure diseases like syphilis or pneumonia, in that time untreatable and fatal, and you would be labelled as a miracle worker.  Modern medicine is miraculous.

But when modern medicine cannot touch a sickness, either because of limited access to medicine or the limits of medical science itself, the “miraculous” can take place.  Like the boy in Ecuador, or the woman with the the issue of blood, physicians could not heal them, but God did, when personal faith touched his power and grace.

It would be absurd to stand outside in a thunderstorm and pray for God to shelter us when we could just walk inside our house.  In the same way, common sense dictates that we thank God for modern medicine and use it appropriately, because it is just as much a gift of God as our houses are.  Medicines sit along side the astounding phenomena of supernatural power that we define as “miraculous.”  And while the power of prayer may not be quantifiable or reproducible like modern pharmaceuticals, it is nevertheless tangible, just like the love of God that has provided them both.

(Originally published in Alive Magazine, June/July 2009)

Autism Series 2013 – Part 3: The Autism “Epidemic”

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Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

It seems that autism is on the rise.  Once hidden away in institutions or just dismissed as odd, society is now faced with a condition that it is yet to come to grips with.  Some out in the community believe that it must be a toxin, or vaccines or mercury.  Others accuse doctors of simply giving in to the unreasonable demands of pushy parents to defraud the system of money – “Things have reached the point these days where any kid that’s not a charming little extrovert will be accused of being, ‘on the spectrum.’”[1]

So is there an epidemic of kids who are “not charming little extroverts”?  It depends on who you ask.

Take, for example, two articles written in the year 2000.  In the first, titled “The autism epidemic, vaccinations, and mercury”, Rimland said,

“While there are a few Flat-Earthers who insist that there is no real epidemic of autism, only an increased awareness, it is obvious to everyone else that the number of young children with autism spectrum disorders (ASD) has risen, and continues to rise, dramatically.”[2]

The other, written by Professor Tony Attwood, a world authority on Aspergers Syndrome, said,

“… is there an epidemic of people being diagnosed as having Asperger’s Syndrome? At present we cannot answer the question, as we are unsure of the diagnostic criteria, the upper and lower levels of expression and the borders with other conditions. Nevertheless, we are experiencing a huge increase in diagnosis but this may be the backlog of cases that have been waiting so long for an explanation.”[3]

I don’t think it’s very often Prof Attwood is lumped with ‘flat-earthers’.  But you can see the change in perspective from one side looking objectively to the other who need for there to be an “epidemic” of autism in order to strengthen their case.

So who’s right?  To see if this autism “epidemic” hypothesis has any real merit, we need to delve into some numbers.

First, some basic epidemiology – because part of the confusion in looking at the autism numbers is defining exactly what those numbers represent.  Here are some important epidemiology terms from the “Physicians Assistant Exam for Dummies”[4]:

Incidence: For any health-related condition or illness, incidence refers to the number of people who’ve newly acquired this condition.

Prevalence: Prevalence concerns the number of people who have this condition over a defined time interval.

Most autism figures are for prevalence, or often more specifically, point prevalence – “the number of people who have this condition at any given point in time.”

The other thing to remember from my last blog is that initially autism was only diagnosed on the strict rules of Kanner, and was considered to be a single disease caused mainly by bad parenting [5].  So through the 1960’s and 1970’s, only the most severe children were diagnosed as having autism because the high-functioning autism would not have met Kanners criteria, and even if they did, most parents didn’t want the label for fear of the social stigma.

So then, what are the numbers?  The early prevalence was estimated to be less than 5/10,000 or 1 in 2000[6], although in surveys done after 1987, the numbers began to rise past 7/10,000[7].  In the 1990’s, Autism prevalence climbed into the teens and the latest prevalence has been documented for autism is 20.6/10,000[7].

But that’s only about 1 in 485.  The CDC estimated a prevalence of 1 in 88 (113/10,000)[8].  Where did the other 400 people go?

This is where the importance of definitions is highlighted.  Autism is considered part of a spectrum, and at the time of the surveys reviewed by Fombonne, DSM III then DSM IV considered conditions like Pervasive Developmental Disorder and then Aspergers Disorder to be part of that spectrum.  Adding in the rate of PDD and you have a figure of 57.7/10,000 and adding in Aspergers gives you a combined rate of 63.7/10,000, or 1 in 157 people surveyed[7].

And yet even then, who you measure and how you measure makes much more of a difference, because a recent, rigorous study targeting all 7 to 12 year old children in a large South Korean populous found a prevalence of 2.64%, which is 264/10,000 or 1 child in every 38.  The authors noted that, “Two-thirds of ASD cases in the overall sample were in the mainstream school population, undiagnosed and untreated. These findings suggest that rigorous screening and comprehensive population coverage are necessary to produce more accurate ASD prevalence estimates and underscore the need for better detection, assessment, and services.”[9]

So if there has been a fifty-fold change in prevalence (from 5 to 264 cases per 10,000 people) in just thirty years, isn’t that an epidemic?

Well, no.  As much as some might ignorantly deny it, there is no real evidence for it.  Remember the definitions from the “Physicians Assistant Exam for Dummies”[4]:

Incidence: For any health-related condition or illness, incidence refers to the number of people who’ve newly acquired this condition.

Prevalence: Prevalence concerns the number of people who have this condition over a defined time interval.

It’s the rapid rise in the number of new cases diagnosed that defines an epidemic, which is the incidence and not the prevalence[10].  While the prevalence has changed a lot, the incidence has been fairly stable.  From Nature, “Christopher Gillberg, who studies child and adolescent psychiatry at the University of Gothenburg in Sweden, has been finding much the same thing since he first started counting cases of autism in the 1970s. He found a prevalence of autism of 0.7% among seven-year-old Swedish children in 1983 and 1% in 1999. ‘I’ve always felt that this hype about it being an epidemic is better explanation’, he said.”[11]

Fombonne agrees. “As it stands now, the recent upward trend in estimates of prevalence cannot be directly attributed to an increase in the incidence of the disorder.”[7]  He said later in the article that a true increase in the incidence could not be ruled out, but that the current epidemiological data which specifically studied the incidence of autism over time was not strong enough to draw conclusions.

While there’s no epidemic, there is the real issue of the genuinely increasing prevalence.  Why the rise in those numbers?  Fombonne went on to explain, “There is good evidence that changes in diagnostic criteria, diagnostic substitution, changes in the policies for special education, and the increasing availability of services are responsible for the higher prevalence figures.”[7]  Nature published a graph from the work of Professor Peter Bearman, showing that 54% of the rise in the prevalence of autism could be explained by the refining of the diagnosis, greater awareness, an increase in the parental age, and clustering of cases in certain geographic areas.

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4. (Adapted from King, M. and Bearman, P., Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 2009. 38(5): 1224-34 AND King, M.D. and Bearman, P.S., Socioeconomic Status and the Increased Prevalence of Autism in California. Am Sociol Rev, 2011. 76(2): 320-46.)

Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4. (Adapted from King, M. and Bearman, P., Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 2009. 38(5): 1224-34 AND King, M.D. and Bearman, P.S., Socioeconomic Status and the Increased Prevalence of Autism in California. Am Sociol Rev, 2011. 76(2): 320-46.)

From Nature: “The fact that he still cannot explain 46% of the increase in autism doesn’t mean that this ‘extra’ must be caused by new environmental pollutants, Bearman says. He just hasn’t come up with a solid explanation yet. ‘There are lots of things that could be driving that in addition to the things we’ve identified,’ he says.”[11]

There is no autism epidemic, just medical science and our population realising just how common autism is as the definition becomes more refined, people become more aware, and some other biosocial factors come into play.

What can we take from the numbers?  That we’re being overtaken by Sheldon clones?  That soon there will be no more “charming little extroverts”?  If the CDC figure is accurate, then one person in every hundred is on the spectrum, so the world is hardly being overtaken by autism.  But the take home message is that Autism Spectrum Disorders are more common that we ever thought, and there are more people on the spectrum “hiding in plain sight”.  If the study from South Korea is accurate then one person in every thirty-eight is on the spectrum, but two thirds of them are undiagnosed.

Should there be more funding, more resources, or more political representation for people on the spectrum?  Perhaps, although the public and research funds are not unlimited, and other health concerns should also be treated fairly.  But since autism is life long and impacts on so many areas of mental health and education, understanding autism and managing it early could save governments billions of dollars into the future.

Rather, I think that the climbing prevalence of ASD is a clarion call for understanding and tolerance.  If we learn to tolerate differences and practice discretionary inclusion, then both the autistic and the neuro-typical can benefit from the other.  That’s a world which we’d all like to live.

REFERENCES

1. Bolt, A. If the autistic don’t get full cover, where’s the money going? 2013  2013 May 11]; Available from: http://blogs.news.com.au/heraldsun/andrewbolt/index.php/heraldsun/comments/if_the_autistic_dont_get_full_cover_wheres_the_money_going/.

2. Rimland, B., The autism epidemic, vaccinations, and mercury. Journal of Nutritional and Environmental Medicine, 2000. 10(4): 261-6.

3. Attwood, T., The Autism Epidemic: Real or Imagined, in Autism Aspergers Digest2000, Future Horizons Inc: Arlington, TX.

4. Schoenborn, B. and Snyder, R., Physician Assistant Exam For Dummies. 2012: John Wiley & Sons.

5. Pitt, C.E. Autism Series 2013 – Part 2: The History Of Autism. 2013  [cited 2013 2013 Aug 15]; Available from: https://cedwardpitt.com/2013/08/15/autism-series-2013-part-2-the-history-of-autism/.

6. Rice, C.E., et al., Evaluating Changes in the Prevalence of the Autism Spectrum Disorders (ASDs). Public Health Reviews. 34(2).

7. Fombonne, E., Epidemiology of pervasive developmental disorders. Pediatric research, 2009. 65(6): 591-8.

8. Baio, J., Prevalence of Autism Spectrum Disorders: Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 61, Number 3. Centers for Disease Control and Prevention, 2012.

9. Kim, Y.S., et al., Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry, 2011. 168(9): 904-12.

10. “Epidemic vs Pandemic”. 2013  [cited 2013 Sept 03]; Available from: http://www.diffen.com/difference/Epidemic_vs_Pandemic.

11. Weintraub, K., Autism counts. Nature, 2011. 479(7371): 22-4.

 

Dr Caroline Leaf – Contradicted by the latest research

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This is my most popular post by far.  I truly appreciate the support and interest in this post, but I’ve discovered and documented a lot more about Dr Leaf’s ministry in the last two years.  I welcome you to read this post, but if you’d like a more current review of the ministry of Dr Caroline Leaf, a new and improved version is here:
Dr Caroline Leaf – Still Contradicted by the Latest Evidence, Scripture & Herself

* * * * *

Mr Mac Leaf, the husband of Dr Caroline Leaf, kindly took the time to respond to my series of posts on the teachings of Dr Leaf at Kings Christian Centre, on the Gold Coast, Australia, earlier this month. As I had intended, and as Mr Leaf requested, I published his  reply, complete and unabridged (here).

This blog is my reply.  It is heavily researched and thoroughly referenced.  I think it’s fair to say that while Dr Leaf draws her conclusions from some scientific documents, there is more than enough research that contradicts her statements and opinions.  I have only listed a small fraction, and only on some of the points she raised.

In fairness, the fields of neurology and neuroscience are vast and rapidly expanding, and it is impossible for one person to cover all of the literature on every subject.  This applies to myself and Dr Leaf.  However, I believe that the information I have read, and referenced from the latest peer-reviewed scholarly works, do not support Dr Leaf’s fundamental premises.  If I am correct, then the strength and validity of Dr Leaf’s published works should be called into question.

As before, I welcome any reply or rebuttal that Dr Leaf wishes to make, which I will publish in full if she requests.  In the interests of healthy public debate, and encouraging people to make their own informed decisions on the teachings of Dr Leaf, any comments regarding the response of Mr Leaf, Dr Leaf or myself, are welcome provided they are constructive.

This is a bit of a lengthy read, but I hope it is worthwhile.

Dear Mr Leaf,

Thank you very much for taking the time out to reply to some of the points raised in my blog.  I am more than happy to publish your response, and to publish any response you wish to make public.

ON INFORMED DECISIONS

I published my blog posts to open up discussion on the statements made by Dr Leaf at the two meetings that I attended at Kings Christian Centre on the Gold Coast.  As you rightly point out, people should be able to make informed decisions.  A robust discussion provides the information required for people to make an informed choice.  Any contributions to this discussion from either yourself or Dr Leaf would be most welcome.

I apologise if you interpreted my blogs as judgemental, or if you believe there are any misunderstandings.  You may or may not have read my final two paragraphs from the third post, in which I acknowledged that I may have misunderstood where she was coming from, but that I would welcome her response.  If there were any misunderstandings, it is likely because Dr Leaf did not make any attempt to reference any of the statements she made on the day.  You may argue that she was speaking to a lay audience, and referencing is therefore not necessary.  However, I have been to many workshops for the lay public by university professors, who have extensively referenced their information during their presentations.  A lay audience does not preclude providing references.  Rather, it augments the speakers authority and demonstrates the depth of their knowledge on the subject at hand.

YOUR DEFENCE

It’s interesting that you feel the need to resort to defence by association, and Ad Hominem dismissal as your primary counter to the points I raised.

Can you clarify how attending the same university as Dr Christaan Barnard, or a Nobel laureate, endorses her arguments or precludes her from criticism?  I attended the University of Queensland where Professor Ian Frazer was based.  He developed the Human Papilloma Virus vaccine and was the 2006 Australian of the Year.  Does that association enhance my argument?

Can you also clarify why a reference from a colleague was preferred to letting Dr Leaf’s statements and conclusions speak for themselves?  Dr Amua-Quarshie’s CV is certainly very impressive, no doubt about that, although he doesn’t list the papers he’s published.  (I’m assuming that to hold the title of Adjunct Professor, he’s published peer-reviewed articles.  Is he willing to list them, for the record?)

Whatever his credentials, his endorsement means very little, since both Dr Leaf and Dr Amua-Quarshie would know from their experience in research that expert opinion is one of the lowest forms of evidence, second worst only to testimonials [1].  Further, both he and Dr Leaf are obviously close friends which introduces possible bias.  His endorsement is noteworthy, but it can not validate every statement made by Dr Leaf.  Her statements should stand up on their own through the rigors of critical analysis.

On the subject of evidence, disparaging your critics is not a substitute for answering their criticism.  Your statement, “By your comments it is obvious that you have not kept up to date with the latest Scientific research” is an assumption that is somewhat arrogant, and ironic since Dr Leaf is content to use superseded references dating back to 1979 to justify her current hypotheses.

DR LEAF’S EVIDENCE

In the blog to which you referred, Dr Leaf makes a number of statements that are intended to support her case.  These include the following.

“A study by the American Medical Association found that stress is a factor in 75% of all illnesses and diseases that people suffer from today.”  She fails to reference this study.

“The association between stress and disease is a colossal 85% (Dr Brian Luke Seaward).”   But again, she fails to reference the quote.

“The International Agency for Research on Cancer and the World Health Organization has concluded that 80% of cancers are due to lifestyles and are not genetic, and they say this is a conservative number (Cancer statistics and views of causes Science News Vol.115, No 2 (Jan.13 1979), p.23).”  It’s good that she provides a reference to her statement.  However, referencing a journal on genetics from 1979 is the equivalent of attempting to use the land-speed record from 1979 to justify your current preference of car.  The technology has advanced significantly, and genetic discoveries are lightyears ahead of where they were more than three decades ago.

“According to Dr Bruce Lipton (The Biology of Belief, 2008), gene disorders like Huntington’s chorea, beta thalassemia, cystic fibrosis, to name just a few, affect less than 2% of the population. This means the vast majority of the worlds population come into this world with genes that should enable the to live a happy and healthy life. He says a staggering 98% of diseases are lifestyle choices and therefore, thinking.”  Even if it’s true that Huntingtons, CF etc account for 2% of all illnesses, they account for only a tiny fraction of genetic disease.  And concluding that the remaining 98% must therefore be lifestyle related is overly simplistic.  It ignores the genetic influence on all other diseases, other congenital, and environmental causes of disease.  I will fully outline this point soon.

Similarly, “According to W.C Willett (balancing lifestyle and genomics research for disease prevention Science (296) p 695-698, 2002) only 5% of cancer and cardiovascular patients can attribute their disease to hereditary factors.”  Science is clear that genes play a significant role in the development of cardiovascular disease and most cancers, certainly greater than 5%.  Again, I will discuss this further soon.

“According to the American Institute of health, it has been estimated that 75 – 90% of all visits to primary care physicians are for stress related problems (http://www.stress.org/americas.htm). Some of the latest stress statistics causing illness as a result of toxic thinking can be found at: http://www.naturalwellnesscare.com/stress-statistics.html”  These websites not peer-reviewed, and both suffer from a blatant pro-stress bias.

You’ll also have to forgive my confusion, but Dr Leaf also wrote, “Dr H.F. Nijhout (Metaphors and the Role of Genes and Development, 1990) genes control biology and not the other way around.”  So is she saying that genes DO control development?

EVIDENCE CONTRADICTING DR LEAF

Influence Of Thought On Health

Dr Leaf has categorically stated that “75 to 98% of all illnesses are the result of our thought life” on a number of occasions.  She repeated the same statement in her most recent book so it is something she is confident in.  However, in order to be true, this fact must be consistent across the whole of humanity.

And yet, in a recent peer-reviewed publication, Mara et al state, “At any given time close to half of the urban populations of Africa, Asia, and Latin America have a disease associated with poor sanitation, hygiene, and water.” [2]  Bartram and Cairncross write that “While rarely discussed alongside the ‘big three’ attention-seekers of the international public health community—HIV/AIDS, tuberculosis, and malaria—one disease alone kills more young children each year than all three combined. It is diarrhoea, and the key to its control is hygiene, sanitation, and water.” [3]  Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years [DALYs]), and poor-quality drinking water is an important risk factor for diarrhoea.” [4]

Toilets and clean running water have nothing to do with stress or thought.  We live in a society that essentially prevents more than half of our illnesses because of internal plumbing, with additional benefits from vaccination and population screening.  If thoughts have any effect on our health, they are artificially magnified by our clean water and sewerage systems.  Remove those factors and any effects of thought on our health disappear from significance.  Dr Leaf’s assertion that 75 to 98% of human illness is thought-related is a clear exaggeration.

Let me be clear – I understand the significance of stress on health and the economy, but it is not the cause of 75-98% of all illnesses.  I’m not sure if there is a similar study in the US, but the latest Australian data suggests that all psychological illness only counts for 8% of visits to Australian primary care physicians [5].

In terms of cancer, I don’t have time to exhaustively list every cancer but of the top four listed in the review “Cancer Statistics 2013” [6] , here are the articles that list the gene x environment interactions:

  1. PROSTATE – There are only two risk factors for prostate cancer, familial aggregation and ethnic origin. No dietary or environmental cause has yet been identified [7].  It is most likely caused by multiple genes at various loci [8].
  2. BREAST – Genes make up 25% of the risk factors for breast cancer, and significantly interacted with parity (number of children born) [9].
  3. LUNG/BRONCHUS – Lung cancer is almost exclusively linked to smoking, but nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. COLORECTUM – Approximately one third of colorectal cancer is genetically linked [11].

So the most common cancer is not linked to any environmental factors at all, and the others have genetic influences of 25% to more than 50%.  This is far from being 2% or 5% as Dr Leaf’s sources state.

Also in terms of heart disease, the INTERHEART trial [12] lists the following as significant risk factors, and I have listed the available gene x environment interaction studies that have been done on these too:

  1. HIGH CHOLESTEROL – Genetic susceptibility accounts for 40-60% of the risk for high cholesterol [13].
  2. DIABETES – Genetic factors account for 88% of the risk for type 1 diabetes [14].  There is a strong genetic component of the risk of type 2 diabetes with 62-70% being attributable to genetics [15, 16].
  3. SMOKING – nicotine addiction has a strong hereditary link (50-75% genetic susceptibility) [10].
  4. HYPERTENSION – While part of a much greater mix of variables, genetics are still thought to contribute between 30% and 50% to the risk of developing high blood pressure [17].

So again, while genes are a part of a complex system, it is clear from the most recent evidence that genetics account for about 50% of the risk for cardiovascular disease, which again is a marked difference between the figures that Dr Leaf is using to base her assertions on.

Atrial Natriuretic Peptide

I am aware of research that’s studied the anxiolytic properties of Atrial Natriuretic Peptide.  For example, Wiedemann et al [18] did a trial using ANP to truncate panic attacks.  However, these experiments were done on only nine subjects, and the panic attacks were induced by cholecystokinin.  As such, the numbers are too small to have any real meaning.  And the settling is completely artificial.  Just as CCK excretion does not cause us all to have panic attacks every time we eat, ANP does not provide anxiolysis in normal day to day situations.  Besides, if ANP were really effective at reducing anxiety, then why do people suffering from congestive cardiac failure, who have supraphysiological levels of circulating ANP [19] , also suffer from a higher rate of anxiety and panic disorders than the general population? [20]

The Heart As A Mini-Brain

As for Heartmath, they advance the notion of the heart being a mini-brain to give themselves credibility.  It’s really no different to an article that I read the other day from a group of gut researchers [21] – “‘The gut is really your second brain,’ Greenblatt said. ‘There are more neurons in the GI tract than anywhere else except the brain.’”  The heart as a mini-brain and the gut as a mini-brain are both figurative expressions.  Neither are meant to be taken literally.  I welcome Dr Leaf to tender any further evidence in support of her claim.

Hard-Wired For Optimism

As for being wired for optimism, the brain is likely pre-wired with a template for all actions and emotions, which is the theory of protoconsciousness [22].  Indeed, neonatal reflexes often reflect common motor patterns.  If this is true, then the brain is pre-wired for both optimism and love, but also fear.  This explains the broad role of the amygdala in emotional learning [23] including fear learning.  It also means that a neonate needs to develop both love and fear.

A recent paper showed that the corticosterone response required to learn fear is suppressed in the neonate to facilitate attachment, but with enough stress, the corticosterone levels build to the point where amygdala fear learning can commence [24].  The fear circuits are already present, only their development is suppressed.  Analysis of the cohort of children in the Bucharest Early Intervention Project showed that negative affect was the same for both groups.  However positive affect and emotional reactivity was significantly reduced in the institutionalised children [25].  If the brain is truly wired for optimism and only fear is learned, then positive emotional reactivity should be the same in both groups and the negative affect should be enhanced in the institutionalised cohort.  That the result is reversed confirms that neonates and infants require adequate stimulation of both fear and love pathways to grow into an emotionally robust child, because the brain is pre-wired for both but requires further stimulation for adequate development.

The Mind-Brain Link

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do anti-depressant medications correct depression or anxiety disorders?  There is high-level evidence to show this to be true [26-28].  The same can be said for recent research to show that medications which enhance NDMA receptors have been shown to improve the extinction of fear in anxiety disorders such as panic disorder, OCD, Social Anxiety Disorder, and PTSD [29].

If the mind controls the brain and not the other way around as Dr Leaf suggests, why do some people with acquired brain injuries or brain tumours develop acute personality changes or thought disorders?  Dr Leaf has done PhD research on patients with closed head injuries and treated them in clinical settings according to her CV.  She must be familiar with this effect.

One can only conclude that there is a bi-directional effect between the brain and the stream of thought, which is at odds with Dr Leaf’s statement that the mind controls the brain and not the other way around.

FURTHER CLARIFICATION

One further thing.  Can you clarify which of Dr Leaf’s peer-reviewed articles have definitively shown the academic improvement in the cohort of 100,000 students, as you and your referee have stated?  And can you provide a list of articles which have cited Dr Leaf’s Geodesic Information Processing Model?  Google Scholar did not display any articles that had cited it, which must be an error on Google’s part.  If her theory is widely used as you say, it must have been extensively cited.

I understand that you are both busy, but I believe that I have documented a number of observations, backed by recent peer-reviewed scientific literature, which directly contradict Dr Leaf’s teaching.  I have not had a chance to touch on many, many other points of disagreement.

For the benefit of Dr Leaf’s followers, and for the scientific and Christian community at large, I would appreciate your response.

I would be grateful if you could respond to the points raised and the literature which supports it, rather than an Ad Hominem dismissal or further defense by association.

Dr C. Edward Pitt

REFERENCES

1. Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107.

2. Mara, D., et al., Sanitation and health. PLoS Med, 2010. 7(11): e1000363.

3. Bartram, J. and Cairncross, S., Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med, 2010. 7(11): e1000367.

4. Hunter, P.R., et al., Water supply and health. PLoS Med, 2010. 7(11): e1000361.

5. FMRC. Public BEACH data. 2010  16JUL13]; Available from: <http://sydney.edu.au/medicine/fmrc/beach/data-reports/public&gt;.

6. Siegel, R., et al., Cancer statistics, 2013. CA Cancer J Clin, 2013. 63(1): 11-30.

7. Cussenot, O. and Valeri, A., Heterogeneity in genetic susceptibility to prostate cancer. Eur J Intern Med, 2001. 12(1): 11-6.

8. Alberti, C., Hereditary/familial versus sporadic prostate cancer: few indisputable genetic differences and many similar clinicopathological features. Eur Rev Med Pharmacol Sci, 2010. 14(1): 31-41.

9. Nickels, S., et al., Evidence of gene-environment interactions between common breast cancer susceptibility loci and established environmental risk factors. PLoS Genet, 2013. 9(3): e1003284.

10. Berrettini, W.H. and Doyle, G.A., The CHRNA5-A3-B4 gene cluster in nicotine addiction. Mol Psychiatry, 2012. 17(9): 856-66.

11. Hutter, C.M., et al., Characterization of gene-environment interactions for colorectal cancer susceptibility loci. Cancer Res, 2012. 72(8): 2036-44.

12. Yusuf, S., et al., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004. 364(9438): 937-52.

13. Asselbergs, F.W., et al., Large-scale gene-centric meta-analysis across 32 studies identifies multiple lipid loci. Am J Hum Genet, 2012. 91(5): 823-38.

14. Wu, Y.L., et al., Risk factors and primary prevention trials for type 1 diabetes. Int J Biol Sci, 2013. 9(7): 666-79.

15. Ali, O., Genetics of type 2 diabetes. World J Diabetes, 2013. 4(4): 114-23.

16. Murea, M., et al., Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabet Stud, 2012. 9(1): 6-22.

17. Kunes, J. and Zicha, J., The interaction of genetic and environmental factors in the etiology of hypertension. Physiol Res, 2009. 58 Suppl 2: S33-41.

18. Wiedemann, K., et al., Anxiolyticlike effects of atrial natriuretic peptide on cholecystokinin tetrapeptide-induced panic attacks: preliminary findings. Arch Gen Psychiatry, 2001. 58(4): 371-7.

19. Ronco, C., Fluid overload : diagnosis and management. Contributions to nephrology,. 2010, Basel Switzerland ; New York: Karger. viii, 243 p.

20. Riegel, B., et al., State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 2009. 120(12): 1141-63.

21. Arnold, C. Gut feelings: the future of psychiatry may be inside your stomach. 2013  [cited 2013 Aug 22]; Available from: http://www.theverge.com/2013/8/21/4595712/gut-feelings-the-future-of-psychiatry-may-be-inside-your-stomach.

22. Hobson, J.A., REM sleep and dreaming: towards a theory of protoconsciousness. Nat Rev Neurosci, 2009. 10(11): 803-13.

23. Dalgleish, T., The emotional brain. Nat Rev Neurosci, 2004. 5(7): 583-9.

24. Landers, M.S. and Sullivan, R.M., The development and neurobiology of infant attachment and fear. Dev Neurosci, 2012. 34(2-3): 101-14.

25. Bos, K., et al., Psychiatric outcomes in young children with a history of institutionalization. Harv Rev Psychiatry, 2011. 19(1): 15-24.

26. Arroll, B., et al., Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev, 2009(3): CD007954.

27. Soomro, G.M., et al., Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev, 2008(1): CD001765.

28. Kapczinski, F., et al., Antidepressants for generalized anxiety disorder. Cochrane Database Syst Rev, 2003(2): CD003592.

29. Davis, M., NMDA receptors and fear extinction: implications for cognitive behavioral therapy. Dialogues Clin Neurosci, 2011. 13(4): 463-74.

Mac Leaf responds to “Dr Caroline Leaf – Serious Questions, Few Answers”

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Mr Mac Leaf, the husband of Dr Caroline Leaf, kindly took the time to respond to my series of posts on the teachings of Dr Leaf at Kings Christian Centre, on the Gold Coast, Australia, earlier this month.  As I had intended, and as Mr Leaf requested, here is his reply, complete and unabridged.  My further response is posted here.

In the interests of healthy public debate, and encouraging people to make their own informed decisions on the teachings of Dr Leaf, any comments regarding the response of Mr Leaf or my reply are welcome provided they are constructive.

Hi Dr C. Pit,

It is a pity you did not seek to clarify the comments you have posted above with us before you posted them. We hope you allow our comments to be displayed so that your readers can make informed decisions and not to judge Dr Leaf as you have done without getting accurate information. By your comments it is obvious that you have not kept up to date with the latest Scientific research.

Dr Leaf can call herself a Cognitive Neuroscientist because of her field research (published in peer evaluated Journals) …see the Science articles in the media/downloads section at drleaf.com. If you require, we can also send letters from her peers in the field of Neuroscience

She also developed the Geodesic Information Processing model theory.

Yes she does read a lot as the field of Neuroscience is constantly evolving and one has to be as informed as possible.

Some research links re the correlation between illness and thought are presented in Dr Leaf’s November the 30th blog at drleaf.com…blog. There are many more statistic correlation research links.

Dr Leaf has listed references differently in the different books and has a full list of references in the ‘thought life’ section at drleaf.com. The references were listed simply in that book for the lay person. This is an accepted literary format for the lay person. Subsequent books have fuller references.

The mini brain in the heart research can be found at Heartmath.org

Heartmath and Dr Don Colbert both reference the effect of ANF

The wired for optimism bias research has been evidenced by various scientific researchers
For easy access to this research please see the Google links to TED talks and Time Magazine’s article.

Please send us your E-mail address so that we can send you further documentation.

BELOW IS A LETTER OF REFERENCE FROM A MEDICAL PROFESSIONAL ENDORSING DR CAROLINE LEAF
My name is Dr Peter Amua-Quarshie and I am presently a full-time Adjunct Professor (lecturer) at the University of Wisconsin-Stout in Menomonie, Wisconsin. I have a B.Sc (Hons) in Medical Sciences (specializing in Neuropathology) and a Masters of Public Health (MPH), both degrees from the University of Leeds (UK). Additionally I have a medical degree (MB ChB) from the University of Ghana Medical School, Accra, Ghana, and a Master’s of Science (MS) in Behavioral and Neural Sciences from Rutgers University, Newark, New Jersey. I started teaching anatomy in the University of Leeds Medical School in 1996. I have taught Neurochemistry to graduate students and Neuroscience to undergraduates at Delaware State University and the University of Wisconsin respectively. I have known Dr. Caroline Leaf since 2006 and have worked closely with her since 2008 on various projects in the field of cognitive neuroscience.
Caroline Leaf received her training in Communication Pathology (BSC Logopaedics) at the University of Cape Town, South Africa. The University of Cape Town has produced many outstanding graduates, including Max Theiler, a Nobel Prize laureate in Physiology or Medicine and Christaan Barnard, the first person to successfully transplant a human heart. Caroline Leaf was a contemporary to the eminent neuroscientist Henry Markram, director of the Blue Brain Project and the new one billion Euro European Union Flagship Project, the Human Brain Project. As well having to study the cognition, she had to endure the rigor of the first 2 years of the medical course, in which she had to study neuroanatomy and neurophysiology. Dr. Leaf also holds a Master’s degree and PhD in Communication Pathology from the University of Pretoria, South Africa. In her Master’s degree her dissertation concentrated on cognitive neuroscience of Traumatic Brain Injury (Closed Head Injury). In developing her groundbreaking Geodesic Learning™ Theory (brain-compatible learning) in her ground breaking PhD thesis, she examined cognition and neurobiology of thinking. The Geodesic Learning™ Theory has been implemented among approximately 100,000 students in South Africa with great success. I have personally helped implement her Geodesic Learning™ Theory in a School District in the USA and was able to demonstrate quantitative improvement in scholastics across the board among the students. She is widely published in journal, book, DVD, television and the internet in the field of cognitive neuroscience in South Africa, USA and other parts of the world.
I have discussed neuroscientific subjects with her for multiple hours many times and have been thoroughly impressed with her knowledge and insight in neurobiology. However what really thrills me is revelation God gives her about the brain. She is an example to me of a neuroscientist who glorifies God in her pursuit of understanding the brain, and who is able to demonstrate that we are truly fearfully and wonderfully made (Psalm 139:14).

DR LEAF’s BIOGRAPHY

Since 1985, Dr Caroline Leaf, a Communication Pathologist and Audiologist, has worked in the area of Cognitive Neuroscience. She holds a Bsc Logopaedics with focus on in Neuroscience, Neuronanatomy and anatomy, Communication Pathology, Psychology, linguistics and audiology) , Masters in Communication Pathology She specialized in Traumatic Brain Injury and PhD in Communication Pathology (TBI) and Learning Disabilities focusing specifically on the Science and neuroscience of Thought as it pertains to thinking and learning. She developed a Cognitive Neuroscientific theory called the Geodesic Information Processing Theory for her PhD research and did some of the initial research back in the 1990’s showing how using non-traditional techniques, based on neuroscientific principles of neuroplasticity and neuropsychological principles, that the mind can change the brain and can effect behavioural change as seen academically, behaviorally and emotionally. A large part of her research in recent years has been to link scientific principles with scripture showing how science is catching up with the bible.

She applied the findings of her statistically proven research in clinical practice for nearly 20 years and now lectures and preaches around the world on these topics. She is a prolific author of many books, articles and scientific articles. She has been a featured guest of Enjoying Everyday Life with Joyce Meyer, and LIFE TODAY with James and Betty Robison, Marilyn Hickey, Sid Roth and TBN Doctor to Doctor, amongst many others. She has her own show on TBN called Switch on Your Brain.

Her passion is to help people see the link between science and scripture as a tangible way of controlling their thoughts and emotions, learning how to think and learn and finding their sense of purpose in life.

Caroline and her husband, Mac, live in Dallas, Texas with their four children.

Dr Leaf’s Qualifications

Web page: http://www.drleaf.com has my full qualifications and links to the Universities where I studied

Dr Leaf’s Reference list

1. Leaf, C.M. 1985. “Mind Mapping as a Therapeutic Intervention Technique”. Unpublished workshop manual.

2. Leaf, C.M. 1989. “Mind Mapping as a Therapeutic Technique” in Communiphon, South African Speech-Language-Hearing Association, 296, pp. 11-15.

3. Leaf, C.M. 1990. “Teaching Children to Make the Most of Their Minds: Mind Mapping” in Journal for Technical and Vocational Education in South Africa, 121, pp. 11-13.

4. Leaf, C.M. 1990. “Mind Mapping: A Therapeutic Technique for Closed Head Injury”. Masters Dissertation, University of Pretoria.

5. Leaf, C.M. 1992. “Evaluation and Remediation of High School Children’s Problems Using the Mind Mapping Therapeutic Approach” in Remedial Teaching, Unisa, 7/8, September 1992.

6. Leaf, C.M., Uys, I.C. and Louw, B. 1992. “The Mind Mapping Approach(MMA): A Culture and Language-Free Technique” in The South African Journal of Communication Disorders, Vol. 40, pp. 35-43.

7. Leaf, C.M. 1993. “The Mind Mapping Approach (MMA): Open the Door to Your Brain Power; Learn How to Learn” in Transvaal Association of Educators Journal (TAT).

8. Leaf, C.M. 1997. “The Mind Mapping Approach: A Model and Framework for Geodesic Learning”. Unpublished D.Phil Dissertation, University of Pretoria.

9. Leaf, C.M. 1997. “The Development of a Model for Geodesic Learning: The Geodesic Information Processing Model” in The South African Journal of Communication Disorders, Vol. 44, pp. 53-70.

10. Leaf, C.M. 1997. “The Move from Institution Based Rehabilitation (IBR) to Community Based Rehabilitation (CBR): A Paradigm Shift” in Therapy Africa, 1 (1) August 1997, p. 4.

11. Leaf, C.M. 1997. ‘”An Altered Perception of Learning: Geodesic Learning” in Therapy Africa, 1 (2), October 1997, p. 7.

12. Leaf, C.M., Uys, I. and Louw. B., 1997. “The Development of a Model for Geodesic Learning: the Geodesic Information Processing Model” in The South African Journal For Communication Disorders, 44.

13. Leaf, C.M. 1998. “An Altered Perception of Learning: Geodesic Learning: Part 2” in Therapy Africa, 2 (1), January/February 1998, p. 4.

14. Leaf, C.M., Uys, I.C. and Louw, B. 1998. “An Alternative Non-Traditional Approach to Learning: The Metacognitive-Mapping Approach” in The South African Journal of Communication Disorders, 45, pp. 87-102.

15. Leaf. C.M. 2002. Switch on Your Brain with the Metacognitive-Mapping Approach. Truth Publishing.

16. Leaf, C.M. 2005. Switch on Your Brain. Understand Your Unique Intelligence Profile and Maximize Your Potential. Tafelberg, Cape Town, SA

17. Leaf, C.M. 2008. Switch on Your Brain 5 Step Learning Process. Switch on Your Brain USA, Dallas.

18. Leaf, C.M. 2007. Who Switched Off My Brain? Controlling Toxic Thoughts and Emotions. Switch on Your Brain USA, Dallas.

19. Leaf, C.M. 2007. “Who Switched Off My Brain? Controlling Toxic Thoughts and Emotions”. DVD series. Switch on Your Brain, Johannesburg, SA.

20. Leaf, C.M., Copeland M. & Maccaro, J. 2007. “Your Body His temple. God’s Plan for Achieving Emotional Wholeness”. DVD series. Life Outreach International, Dallas.

The end of the sugar obsession?

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I was flicking through Facebook this evening as I usually do, hoping to vicariously share someone else’s joy in life, when I came across this little tidbit, “You know what? Don’t quit sugar.”

The link was to a blog on mamamia.com.au (http://www.mamamia.com.au/health-wellbeing/you-know-what-dont-quit-sugar/) which asked if the tide of the quit sugar obsession was starting to recede.  It discussed the recent post of Sarah Wilson, a journalist for Fairfax and the author of several books on quitting sugar, which have become immensely popular by tagging on the coat-tails of David Gillespie’s “Sweet Poison” books.

In her blog, Wilson confessed to a barely forgivable sin of giving in to peer pressure and eating two chocolate croissants, then emotionally self-flagellating for the rest of the day.  That the symptoms that she described fitted nicely into the category of an anxiety neurosis didn’t seem to register with Wilson, who carried on like she had ingested a large goblet of hemlock.

Credit to the mammamia team who published some of the comments of real nutritionists like Cassie Platt, and eating-disorder counsellors like Paula Kotowitz, who said,

“Being harsh on ourselves, not only does not help, but makes us feel so much worse in the long run because it deconstructs our sense of self and causes us to beat up on ourselves. Isn’t it possible that there is a happy medium in there somewhere? It’s not crack. Just food.”

Platt, who is about to release a book titled, “Don’t Quit Sugar”, says,

“Your food choices should be based on biological and metabolic needs. What we eat should fuel our cells, facilitate growth, repair and reproduction and, most importantly, enable your body to function at its very best.”

Platt said that she has previously tried removing sugar from her diet and that she had to “claw” her way back to health.

The mamamia writing team summed up by saying,

“The benefits of reducing sugar intake are widely accepted in the scientific community but the idea of avoiding it altogether remains an issue of serious contention. And the possibility that these sorts of diet programs can mask dangerous eating disorders, is particularly worrying.”

They asked the question, “Has the sugar-quitting backlash begun?”  For the love of all things sacred, I seriously hope so.

About a month ago I wrote a piece about the quit sugar fad, and posted evidence that eating an extremely low carbohydrate diet is no better than eating a low fat diet, because it’s calories, not sugar, that makes all the difference to weight gain or loss.

A balanced, low calorie diet has been pushed by nutritionists and doctors ad nauseum for decades, but consistently neglecting to use words like “poison”, “toxin” or “death” has meant that the message is nowhere near as stimulating as the current whim.

Is it possible to have your cake and eat it too?  Absolutely.  My hero of nutritional science, Dr Rosemary Stanton, spoke at a Brisbane conference a couple of years ago and succinctly debunked Gillespie, Wilson and their ilk.  She also explained the concept of feasting, the long forgotten art form of having exceptionally good food once in a while, and enjoy it with friends, rather than eating substandard food every day by yourself, which is the modern trend.

Rather than gorging on sugar every day to compensate for your loneliness and despair, Dr Stanton advocated a diet high in vegetables and little or no processed food on a daily basis.  But then once a month or two, she advised to enjoy your favourite food, no matter what it might happen to be – cheesecake, ice cream, chocolate croissants – anything you like.  The only rules were to make sure that it is really good quality, the best that you can afford, so that it is worth savouring and looking forward to next time, and enjoy it with friends, since the social aspects of the food we eat are as important as the nutritional value.  Sage advice from someone who has been researching nutrition for longer than I’ve been alive.

I’m sure that by now, Sarah Wilson will have got over her sugar intoxication.  She may not have enjoyed it, but I hope that ends up being a pivotal moment in correcting the imbalance in our relationship to sugar, and living by the facts, not the latest fad.

Autism Series 2013 – Part 2: The History Of Autism

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“We can chart our future clearly and wisely only when we know the path which has led to the present.” Adlai E. Stevenson

I always thought history was boring, and I must admit, If you want to put me to sleep, start reading early Australian history to me. “Convicts … first fleet … zzzzzz.”

But as Stevenson wrote, the key to the future is the past. With autism, I don’t want to see a future as checkered as its past. In this series of essays, I want to help our community see a future in which autism is recognised and appreciated for its strengths. To properly lay the groundwork, I want to look at the history of autism. This will help provide context for the current understanding of autism, which will then give a framework for understanding the autistic person, and for a glimpse into the future as new research unfolds.

The autistic spectrum has been present for as long as humans have. But to our knowledge, one of the first specific descriptions of someone who met the characteristics of the autistic spectrum was in the mid 1700’s. In 1747, Hugh Blair was brought before a local court to defend his mental capacity to contract a marriage. Blair’s younger brother successfully had the marriage annulled to gain Blair’s share of inheritance. The recorded testimony describes Blair as having the classic characteristics of autism, although the court described him at the time as lacking common sense and being afflicted with a “silent madness”.[1]

Isolated case reports appeared sporadically in medical journals. John Haslam reported a case in 1809, although with modern interpretation, the child probably had post-encephalitis brain damage rather than true autism. Henry Maudsley described a case of a 13 year old boy with Aspergers traits in 1879. There were no other reports of children with autism in the early literature, although at the turn of the 19th century, Jean Itard reported on the case of an abandoned child found roaming in the woods like a wild animal. This child, called Victor, displayed many features of autism, although he may have simply had a speech disorder. Either diagnosis was obscured by the effects of severe social isolation.[1]

Others described syndromes which shared autistic features, but without describing autism itself. The names given to each syndrome reveals how autistic features were regarded in the 19th century: Dementia Infantalis, Dementia Praecocissima, Primitive Catatonia of Idiocy.[1]

Around 1910, Eugen Bleuger was a Swiss psychiatrist who was researching schizophrenic adults (and as an aside, Bleuger was the person to first use the term ‘schizophrenia’). Bleuger used the term ‘autismus’ to refer to a particular sub group of patients with schizophrenia, from the Greek word “autos,” meaning “self”, describing a person removed from social interaction, hence, “an isolated self.”[2]

But it wasn’t until the 1940’s that the modern account of autism was articulated, when two psychiatrists in different parts of the world first documented a handful of cases. Leo Kanner documented eleven children who, while having variable presentations, all shared the same pattern of an inability to relate to people, a failure to develop speech or an abnormal use of language, strange responses to objects and events, excellent rote memory, and an obsession with repetition and sameness[3].

Kanner thought that the condition, which he labelled ‘infantile autism’, was a psychosis[1] – in the same family of disorders as schizophrenia, although separate to schizophrenia itself[2]. He also observed a cold, distant or anti-social nature of the parents relationship towards the child or the other parent. He thought this may have contributed (although he added that the traits of the condition were seen in very early development, before the parents relationship had time to make an impact)[3]. True to the influence of Freud on early 20th century psychiatry, Kanner said of the repetitive or stereotyped movements of autistic children, “These actions and the accompanying ecstatic fervor strongly indicate the presence of masturbatory orgastic gratification.”[3]

Despite the otherwise reserved, cautious discussion of possible causes of this disorder, the link with schizophrenia and “refrigerator mothers” took hold in professional and lay communities alike. In the 1960s and 70s, treatments for autism focused on medications such as LSD, electric shock, and behavioral change techniques involving pain and punishment. During the 1980s and 90s, the role of behavioral therapy and the use of highly controlled learning environments emerged as the primary treatments for many forms of autism and related conditions.[2]

Unbeknown to Kanner, at the same time as his theory of ‘infantile autism’ was published in an English-language journal, a German paediatrician called Hans Asperger published a descriptive paper of four boys in a German language journal. They all shared similar characteristics to the descriptions of Kanner’s children, but were functioning at a higher level. They shared some aggression, a high pitched voice, adult-like choice of words, clumsiness, irritated response to affection, vacant gaze, verbal oddities, prodigious ability with arithmetic and abrupt mood swings. Asperger was the first to propose that these traits were the extreme variant of male intelligence[4].

But the full impact of Asperger wasn’t felt until 1981, when British psychiatrist Lorna Wing translated Aspergers original paper into English. By this time, autism had become a disorder of its own according to the DSM-III, the gold-standard reference of psychiatric diagnosis, but it was still largely defined by the trait of profound deficit. Aspergers description of a ‘high-functioning’ form of autism resonated amongst the autism community, and a diagnosis of Aspergers Syndrome became formally recognised in the early 1990’s with the publication of the DSM-IV.

The most recent history of autism comes in two parts. The first was the revision of the DSM-IV. For the first time, rather than two separate diagnoses, Autism and Aspergers have been linked together as a spectrum and collectively known as the Autism Spectrum Disorders (although autism self-advocates prefer the term ‘conditions’ to ‘disorders’).

The second part is a highly controversial chapter that will stain the history of autism research and scientific confidence, into the next few decades. Chris Mooney, in a piece for Discover Magazine, sums it up nicely:

“The decade long vaccine-autism saga began in 1998, when British gastroenterologist Andrew Wakefield and his colleagues published evidence in The Lancet suggesting they had tracked down a shocking cause of autism. Examining the digestive tracts of 12 children with behavioral disorders, nine of them autistic, the researchers found intestinal inflammation, which they pinned on the MMR (measles, mumps, and rubella) vaccine. Wakefield had a specific theory of how the MMR shot could trigger autism: The upset intestines, he conjectured, let toxins loose in the bloodstream, which then traveled to the brain. The vaccine was, in this view, effectively a poison.”[5]

Inflamed by a post-modern distrust of science and a faded memory of what wild-type infectious diseases did to children, the findings swept through the internet and social media and lead to a fall in vaccination rates (from about 95% to below 80% at its lowest)[6].

But the wise words, “Be sure your sins will find you out”, still hold true, even in modern science. In 2010, Wakefield was found guilty of Serious Professional Misconduct by the British General Medical Council, and was struck off the register of medical practitioners in the UK. In the longest ever hearing into such allegations, the GMC considered his conduct surrounding the research project, the medical treatment of his child subjects, and his failure to disclose his various conflicts of interest to be dishonest and professionally and clinically unethical[7]. There is evidence that he also selectively chose his subjects to confound the results, misrepresented the time course of their symptoms related to the vaccinations, misrepresented their diagnosis of autism, and altered the reports of their bowel tests[8, 9].

For the record, this isn’t a comment on the science of Wakefield’s rise and fall, but the history. I am not suggesting that the proposed autism/vaccination link should be discounted solely on the basis of Wakefield’s scientific fraud. Rigorous science has already done that. The science for and against the proposed link between autism and vaccinations deserves special attention, and will be discussed in a future post. Rather, lessons need to be learned from what is one of the most destructive cons in the recent history of medicine.

The losers of this hoax are twofold. Thousands of children have unnecessarily suffered from preventable infectious disease because of a fear of vaccines that has turned out to be unfounded, and those who actually have autism miss out on actual funding because it was syphoned off into Wakefield’s pockets and into research disproving his rancid theory. As the editorial in the BMJ stated, “But perhaps as important as the scare’s effect on infectious disease is the energy, emotion, and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it.”[6]

As with all good history, there are lessons for the future. Autism is still largely misunderstood. The vacuum of definitive scientific knowledge is slowly being filled, gradually empowering people with autism and the people that interact with them to truly understand and communicate. Each breakthrough and revision of the diagnosis has lead to more sophisticated and more humane ways of living with autism. But there is still a need for caution – people will use the gaps in knowledge and the pervasive distress that can come from the diagnosis, to manipulate and exploit for their own ends.

I’ll continue with the series in the next week or so, looking at the modern “epidemic” of autism.

REFERENCES:

1. Wolff, S., The history of autism. Eur Child Adolesc Psychiatry, 2004. 13(4): 201-8.
2. WebMD: The history of autism. 2013  [cited 2013 August 14]; Available from: http://www.webmd.com/brain/autism/history-of-autism.
3. Kanner, L., Autistic disturbances of affective contact. Acta Paedopsychiatr, 1968. 35(4): 100-36.
4. Draaisma, D., Stereotypes of autism. Philos Trans R Soc Lond B Biol Sci, 2009. 364(1522): 1475-80.
5. Mooney, C., Why Does the Vaccine/Autism Controversy Live On?, in Discover2009, Kalmbach Publishing Co: Waukesha, WI.
6. Godlee, F., et al., Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ, 2011. 342: c7452.
7. General Medical Council. Andrew Wakefield: determination of serious professional misconduct, 24 May 2010. http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf
8. Deer, B., How the case against the MMR vaccine was fixed. BMJ, 2011. 342: c5347.
9. Deer, B., More secrets of the MMR scare. Who saw the “histological findings”? BMJ, 2011. 343: d7892.

Autism Series 2013; Part 1 – Why it matters.

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What do you think of when you think about autism?  Is it a TV character like Jake, from Kiefer Sutherland’s recent series ‘Touch’, or perhaps Sheldon from ‘The Big Bang Theory’?  Or is it a movie character like the savant that Dustin Hoffman played in ‘Rain Man’? They are common stereotypes, but they only depict a tiny fraction of the autism that is all around us every day.  Chances are, you would run into people every day who have autism.  Would you be able to pick them?

The current point prevalence rate of autism is given by various international health bodies including the World Health Organization, as one person in a hundred.  With a prevalence of one percent of the population as having autism, you would think it would be better known, better dealt with by teachers, better handled by public officials, better screened and managed by health workers, and better resourced in terms of assistance to families and in terms of research dollars.

But while funding and recognition are important, the greatest impact that the lack of autism awareness has is the human cost.  It is the cost that can’t be measured in terms of dollars, caused by the maligned stigma that having autism brings.

Autism at the less severe end, what used  to be called ‘high functioning’ autism, or what I prefer to classify as (the now unofficial diagnosis of) Aspergers Syndrome, doesn’t make a person look that much different on the outside.  But it makes their behaviour somewhat odd to everyone else.  They have quirks.  They have strange mannerisms.  They have rigid ways of doing things.  They have very narrow interests.  They misread social cues.

“Normal” people don’t like odd.  Especially children.  If you don’t fit in to their particular group-think view of the world, their intolerant tormenting can be merciless and unrelenting.  Some people never grow up though, and many adults with autism can be marginalised by their adult peers. Every barb, joke and isolating experience eroding at the soul of a person with autism until there is nothing left.

This is the most destructive of all. It is death by a thousand insults.

I am writing this series of blogs because I want to help assist in whatever way I can to reduce the ignorance surrounding autism.  There is still so much ignorance out there – simple ignorance because the message is still diffusing through our social networks, and  obstinate ignorance, by people who use pseudoscientific scare mongering to promote their views, or promote bogus treatments for the sole purpose of taking advantage of the desperation of some of those who live with autism.

No matter which form of ignorance is out there, ignorance is ignorance and it does the same damage.  It needs to be stopped.

When I was a little boy, I was odd.  It took me a while before I started talking.  I had an obsession with vacuum cleaners and watches.  I was the misfit, or the loner.  I was incessantly bullied in the latter half of primary school and almost all the way through high school.  I didn’t want to go out and be with large groups of other kids.  My parents made me go to marshall arts training, cub scouts, church groups and school holiday excursions.

I hated those social outings.  I had huge anxiety being in these large groups.  Even when I wasn’t being mocked or belittled, I still felt anxious because I didn’t naturally fit in with the other kids.  The leaders of the group would go out of their way to include me but that had the opposite effect of highlighting how much of a social misfit I was.  The anxiety was disabling when I was in middle high school.

Thankfully I was smart, mainly in maths and science.  Academic achievement was my only positive, so I took refuge in studying.  I graduated in the top percentile in my state, and made it into medical school.  I did a whole medical degree, five years in hospitals including several in subspecialty paediatrics, and a fellowship in General Practice, and another eight years of GP experience, before my son was diagnosed as being on the autistic spectrum.

Despite years of medical training, It’s only been since my son’s diagnosis that I have been realising just how much of my quirky behaviour and social dysfunction was due to the fact that I’m on the spectrum too.  All those years, I thought I was retarded, socially incompetent, a freak.  All those years, I was bullied, harassed and made to think I was stupid, just because I didn’t naturally understand the unspoken social codes , but no one explained them to me.

That’s nearly forty years of living with self-doubt, low self-esteem, low self-confidence, and various mental health issues, because I never knew, because no one else knew, because of ignorance and intolerance.

So it stings when I hear people spread mistruths about ASD, and it pains me when the mistruths are spread by people who should know better.  It makes me mad when the mistruths come from self-titled ‘experts’.

I don’t want my son going through the same stigma and denigration, or anyone else on the spectrum for that matter.  The truth about autism – what it is, what it is caused by, and what strengths autism bestows, need to hold sway so that death by a thousand insults is no longer tolerable in our progressive society.

I will publish further blog posts over the coming days to weeks on what autism is, on why it seems to be increasing, and the latest scientific evidence on what autism may be caused by.  I will devote a whole blog (or two) to the misinformation surrounding vaccines and autism.  So stay tuned.