UK children are nearly 5 times more likely to have autistic conditions than adults according to the results of the first ever UK government survey to assess the numbers of adults with the condition: [“Autism Spectrum Disorders in adults living in households throughout England – Report from the Adult Psychiatric Morbidity Survey 2007” The NHS Information Centre.]
But the British public were told instead that the survey shows rates in adults and children have always been the same so that that vaccines like MMR cannot be to blame for the increasing rates in children. The UK National Health Service funded the survey and made these claims.
Survey Authors Couldn’t Find Enough Adult Autistics
There were early rumours in 2008 the authors could not find numbers of adult autistic spectrum condition [ASC] cases matching numbers in children.
The survey failed to find a single case of an adult with “typical” or “classic” autism, found in approximately 30% of ASC children. “Typical” or “classic” autism is a type of ASC controversially claimed in 1998 might be associated with the MMR vaccine.
The authors also failed to find sufficient adult ASC cases overall – just 19 in 7,451 adults, being “higher functioning” ASCs – mainly Asperger’s Syndrome. This represents an overall rate of just under 1 in 300 potential adult cases and not the officially claimed 1 in 100 for children.
The authors say that if they had carried out the survey differently they might have found four times as many adults – a further 46 or 47 ASC cases to come up with the same figure as for children. Using already estimated data they claimed to be able estimate-on-the-estimate that the adult autism rate for the entire UK is the same as in children [1 in 100].
The survey’s original design meant it was highly unlikely any cases would be “missed” and instead that cases would be over-estimated. This calls into question the authors’ claims to be able to estimate such a large number of “missed” cases. The survey design was broadly based. An unlikely 72% of the adult participants were selected as potentially having one of four mental illnesses [rather than just ASC]. The study was also designed so that those most likely to have an ASC were interviewed and those unlikely to were excluded.
Whilst designed to estimate the maximum number, the survey as published was also based solely on data for Asperger’s Syndrome from the Adult Psychiatric Morbidity Survey 2007 and not other ASCs. That is not what the NHS has been telling the media and public. The study authors stated in their prior May 2008 news release that there were to be two surveys in their study, the second to cover other ASCs: University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. But neither the media nor the public were told by the NHS that the second survey had not been carried out and that no data from it was included in the final survey report.
It is not credible that for none of the other psychiatric conditions in the Adult Psychiatric Morbidity Survey 2007 it seems was it considered necessary to “estimate” “missed” cases – and particularly not an unusually high 3 out of four cases. The data used is the identical data collected from the identical subjects by the same people at the same time as part of and using the identical study design.
And therefore also the prevalence of ASCs in adults cannot be 1% in any event and also cannot be the same as in children [also contrary to the public claims made by the NHS].
On the basis of the results so far the NHS would have had to claim the prevalence of ASCs in adults is substantially greater than in children and it would have to explain how that could be.
Details of how the missed Aspergers cases were estimated were not provided. None appear in the survey report to show how the authors calculated this to arrive at an estimated overall adult ASC prevalence figure of 1 in 100.
The NHS also needs to explain of how it came to issue a news release claiming this survey was of the prevalence of adults with ASCs when it is not. This appears to show that the NHS funded a survey report, assured the Statistics Authority of its validity as “national statistics” when even the title of the report is not accurate and then used it in the media and in public to bolster a policy position when not justified in doing so.
The explanation given of the calculation of “missed cases” appears to be that of all potential cases of adults with ASCs identified by telephone interview only 630 were selected for interview. The researchers then estimated what they thought they would have found if they interviewed all “potential cases” and multiplied up the 19 cases found to arrive at 73.
Difficulties with this include the remarkably high numbers of adults identified as “potential” ASC cases – more than one in every two adults – or half [ie. 2,854 adults out of a possible 5,329 eligible for consideration]. This demonstrates the inaccuracy of the probabilities the researchers assigned to potential ASC cases and in particular the bias to substantially over estimating the potential numbers of ASC cases.
This is compounded by only 19 cases being found in those deemed most likely to have an ASC and selected for interview.
The estimate of 1 in 100 is also based on what appear the very same and remarkably inaccurate “probabilities” for selection devised by the researchers.
This does not appear scientific. It is also compounded by the same researchers claiming wrongfully that their results are for all adults with ASCs when the documented facts show the data was collected for potential Asperger Syndrome cases only. [Added 16/Feb/2010]
Autism In Children Already Higher Than 1 in 100
A further problem with the survey is that two recent formal peer reviewed journal published studies have found the rate in children is not 1 in 100 but much higher. A 2006 study [Baird] found a rate in children of 1 in 85 and a recently published study by Baron-Cohen et al of 2005 data found a rate of ASC’s in children of 1 in 64 when children not yet diagnosed were taken into account. This gives a rate of ASC in children 5 times higher than the 1 in 300 indicated by the survey’s results. Neither of these studies are mentioned in the survey although members of the same team were involved in the Baron-Cohen study, and Professor Baron-Cohen was a consultant to the survey.
Impossible for Adult ASC Rate to Be Same as Childrens’
The authors inexplicably also fail to explain how their estimate of ASC rates in adults is the same as in children when their results show ASC rates in adults and children are significantly different:-
- Aspergers Syndrome rates in adults on these results are 40% higher than in children;
- correspondingly Aspergers Syndrome cases in children compared to adults would have to have substantially decreased for this to be so;
- the rate of “classic” autism has leapt from zero in adults to 30% of ASC cases in children;
- adults with “classic” autism do not exist.
Identical Figures – A Remarkable Coincidence
The addition of the authors’ hypothetical “estimated” cases provides exactly the same rate of 1 in 100 previously accepted for children. This is despite the authors themselves warning the results should be approached with caution because of the inaccuracies. In such circumstances if rates were the same then a similar figure might be expected but not exactly the same one.
The 1% figure for children was stated in pre publicity announcing the start of survey: University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. “Author bias” in favour of finding a pre-determined figure favourable to the study funder is a well-known phenomenon in formal medical literature.
Breaching the codes of practice prohibiting the release of national statistics for government policy purposes the UK National Health Service’s publicity put out to the media on publication of the survey focussed on claiming ASC rates in adults and children were identical and that therefore the MMR vaccine did not cause ASCs. This was not the stated purpose of the survey and the authors make no mention of the vaccine-autism issue. Media stories included: Autism rates back MMR jab safety Michelle Roberts BBC Tuesday, 22 September 2009 and Autism just as common in adults, so MMR is in the clear Sarah Boseley The Guardian Tuesday 22 September 2009.
Survey Does Not Live Up To Its Title
The survey was originally announced to establish the UK adult autism rate for the first time by finding what were then being claimed to be “missed” adult cases of autism.
The publicity claimed “The new prevalence study now underway will give the first ever accurate picture of how many adults have the condition.” [Emphasis added]: University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. The purpose was to inform UK authorities in planning service provision for adults autistics.
The authors used “second-hand” data collected in 2007 which covered only potential adult cases of Asperger’s Syndrome unsuitable for the claimed purpose. The authors planned an additional part of the survey to collect data on adults with other ASCs such as “typical” or “classic” autism but failed to mention this or any resulting data or results in their recently published survey report. They stated in 2008:-
The prevalence study will make use of new data collected in 2007 by NatCen and Professor Brugha’s team to record the number of adults with Asperger’s syndrome and high functioning autism. There will also be an additional part to the study on the number of people with autism who have more complex needs and learning disabilities. The aim of the combined research will provide good epidemiological information in terms of prevalence and the characteristics and problems of this group.”
University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008.
Many Anomalies
The standard approach under what is called “DSM IV” to diagnose ASC’s was applied but the authors based their assessments on a broader test for ASCs used in a manner neither accepted or relied by other professionals nor scientifically validated. Inexplicably the survey’s results of the DSM IV diagnoses were neither used nor published.
The 1 in 100 figure for children is based on formal diagnoses using accepted methods and published in formal peer reviewed medical literature. The authors’ survey has not been independently reviewed nor has it been assessed for compliance with accepted statistical standards.
The 19 potential adult ASC cases in 7,451 participants included 17 male and 2 female, a rate of 1 in 8.5 whereas 1 in 5 cases in children are girls.
Other problems with the survey include:-
- Inclusion in the study was based on the ability of selected members of the public to answer questions on the telephone followed by cooperation with a complex psychiatric assessment. The participants were therefore self-selecting and appear unrepresentative of the general population
- The 19 cases claimed included no one from an ethnic minority, and a very low rate in females (the ratio of females with ASD is known to be 1 in 5 cases in children, but the survey results indicate it is half that in adults at 1 in 10)
- Cooperation of more than half the 14,000 households approached is a remarkable and unexplained achievement. The questionnaire screened for psychotic disorder, Asperger syndrome, borderline personality disorder, and anti-social personality disorder. Were the participants told this and would they have participated had they known?
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The survey authors give a 95% “confidence interval” to their claim their estimate of adult ASC rate is the same as in children. A confidence interval is a measure of trust in the reliability of the results but despite being the broadly based the survey failed to find the “missing” cases.
- The survey results were published despite not having been through peer review nor verified for conformance to accepted standards for government statistics
- Adults with “typical” autism [associated with the MMR vaccine] remain missing despite being a category claimed in the prior publicity to be part of the survey.
Dr Carol Stott commented on the methodology in Age of Autism:-
Whatever claims are made to the contrary this report tells us very little about the number of adults with ASDs – in England or anywhere else. The main problems with the study are with (a) case-definition, (b) ascertainment (c) diagnostic instruments (d) case identification and (e) statistical power.
There is no clearly stated case-definition anywhere in the report. The cases reported are defined loosely in terms of an initial score on a shortened unstandardised non-peer reviewed version of ascreening tool together with a semi-structured clinical interview – the Autism Diagnostic Observation Schedule (ADOS) – that was not designed to act as a stand-alone diagnostic instrument.
The sample selected is not representative of the ASD population. All participants were verbally fluent, living in ordinary households, and able to complete a self-report questionnaire.
The choice of measurement tools is inadequately justified and badly referenced. No details are provided, nor are any sources referenced, on the psychometric properties of the initial screening instrument (AQ-20). The standardized scoring criteria for the ADOS were not followed (using a total cut-off of 10 for Communication + Social Reciprocity, rather than three cut-offs (respectively) of 3, 6 and 10 for Communication, Social Reciprocity and the two combined). Additionally the authors over state the validity of the ADOS as a tool for use in adult populations. Module Four (used in the study) was standardized on a sample of only 70 adults aged between 16 and 44. Ages in the study sample range from 16 – 75.
The technical appendix, which is intended to provide information about the derivation of the AQ-20 is statistically naïve, unclear and potentially inaccurate. It is not clear for example, what is meant by the phrase on pg 16 of Appendix C “….once the final set of predictors had been selected, a regression equation was available for predicting the prevalence of ADOS.” Neither is it clear whether General Linear Modelling, Linear Regression or both were used to derive final items.
Finally, inferences are made about the lack of a significant association between age-groups and ASD prevalence without reference to statistical power. In a study of this size, with only 19 identified (unweighted) cases, the likelihood is that the study was underpowered to detect such differences.A valid and reliable study of the population frequency of a disorder requires clear and robust case definition, validated instruments, standardized procedures and adequate statistical power. An initial evaluation of this report suggests it fails on all counts.
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Filed under: ADHD, Aspergers, autism, Barak Obama, Child Health Safety, Disease Statistics, Hannah Poling, John Poling, MMR, vaccination, vaccine, vaccine court, Vaccine Damage, Vaccines | Tagged: ADHD, Aspergers, autism, Barak Obama, Child Health Safety, Disease Statistics, Hannah Poling, John Poling, MMR, Obama, vaccination, vaccine, vaccine court, Vaccine Damage, Vaccines |
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Well now, apparently one good turn deserves another. Your claim is a blatant lie and you pass it off as journalism. Intersting to say the list. Talk about credible!
Is that the same Dr Stott that left Cambridge University under a cloud following the unauthorised release of data from an incomplete study on Autism prevalence in children?
The sad thing is that this report was not produced to negate any link with autism and MMR, as you correctly state (although it does so very convincingly). It was done to highlight the number of adults with ASD that do not get the social and medical support that could dramatically improve their lives. This is genuine public health concern, and to suggest that this was somehow part of a grand conspiracy by the government and universities so that pharmaceutical companies can continue to poison children is rather distasteful. From the report:
“Perhaps most important of all is the finding that adults with ASD are socially disadvantaged, less well educationally qualified, less able intellectually and possibly under-supported by services. Much of this could be alleviated with greater involvement of existing established social, educational, welfare and health care services.”
I’m also rather confused that you link autism with MMR several times in this article, yet your previous article had a graph that clearly shows rapidly increasing autism diagnoses when MMR rates were static – and you blamed other elements of the vaccine schedule.
A couple of factual points:
1. The data from the second stage of the survey are included in the final report. I’m struggling to understand your argument that it was not.
2.The report clearly states that the 95% confidence interval for adults with autism is 0.5-2.0%, for men 0.8-3.9% and for women 0.1-0.6%. These ranges encompass both the higher value you give for children (without a confidence interval, I note) and the ratio you give of men to women.
3. The report clearly states “This measure includes Asperger Syndrome, although different subtypes of ASD can not be distinguished from the data.” How does that then imply that all of the subjects had Asperger’s?
Tell all the mothers of children with Autism that it’s just in their heads that their kids are okay and there isn’t any problem with them and you will find a bunch of people camping on your door with proof that their kids were fine till they had to have those stupid vaccines…I am a major fan of Dr Wakefield
[…] The more you read the more disbelieving you become of _anything_ the government says. We really need to check out the independent candidates at the next elections. https://childhealthsafety.wordpress.com/2010/02/10/uksurveyautismlink/ […]
The evidence is simply not there to link Autism with MMR, and there are certainly many adults with Autism. I remember visiting a Mentally Handicapped Hospital, as it was then called, 20 years ago, and seeing people, who I can now see were autistic in locked wards.
However, there is undoubtedly a growing number of people with ASC, and widening the categories so that Aspergers’ and Classic autism are not differentiated does not help.
Our son is 17, with classic autism, (which he had before he had a late MMR jab), and the real concern in the current climate is that he gets the right level of care, accommodation and education for hte rest of his life.
There is evidence to link autistic conditions to vaccinations including MMR.
You want us to rely on anecdotes of the “I remember” 20 years ago type from one person?
The categories of classic autism were not widened. The rate of classic autism in Israel over the six years prior to 1988 was 8 in 10,000 according to diagnoses carried out this decade by the Israeli military Draft Board on 178,000 potential 17 year old conscripts using standard modern diagnostic criteria and methods. There were no Asperger cases.
Can you please explain why, when the Japanese had a period of not immunising the children, the rate of autism development in the population remained unaffected.
This is just one study of a number that have shown there is no link between MMR jabs and Autism. It is more likely that the increase in Autism is due to airborn pollutants, or dietary pollutants, such as heavy metals. You’re arguments/ discussions centre solely around the effect of vaccines, and yet you have not considered any other sources. Your report is therefore biased and I’m sorry to say, should be discredited. You are doing exactly the same thing the British Media did when Dr Wakefield first published his unscientific report. Please provide BALANCED arguments and maybe we could take you a bit more seriously.
What fightens me about this continuing story is this:-
Let us assume, for the sake of argument, that this survey is correct and autism rates are equal among adults and children. The NHS admitted this is the first survey ever produced to give comparison figures – and as such it was trumpeted with “We told you so” enthusiasm.
But looked at the other way, before this report the NHS had no statistics whatever for the comparative autism rates. They say the vaccine was tested for safety but given that the standard time for looking for side effects for vaccines is 3 weeks this means nothing. Presumably if you drop dead after 4 weeks the vaccine is still considered safe!
So all their previous protestations that MMR did not cause autism were based on zero evidence. They had no idea whether MMR caused autism or not since they had no statistics. Yet they still started their MMR campaign, carrying out a multi decade experiment on millions of children. Then when this study was published they used it as “proof” that the MMR vaccine had been safe after all.
Surely this is putting the cart before the horse. Are you not supposed to prove a vaccine safe first and then embark on a long term nationwide vaccination campaign? Apparently the NHS answer to this question is “No, we vaccinate first and look for safety evidence later” (and then only under duress).
I find this approach tends to give me nightmares just thinking about it. How the JCVI members manage to sleep at night I really do not know.
Chris
I agree it is frightening. It should be said that publication itself did not refer to the MMR issue, although they certainly realised that if the figures were well below the school population there would be some explaining to do. Instead, at the press launch the NHS PR machine announced the study as vindication of the MMR, thus breaching the rules for publication of national statistics, which specify that they must not be used for political ends. Of course, the very flawed nature of the study and spurious claims which were made for it beg a lot of questions, as do a host preceding weak and flawed studies which were used for the same purpose. Raison d’état we might say.
Children diagnosed with Autism in the past did not have illness also. Now there are children with a form of Autism with high temperatures, excessive thirst, rashes, severe headaches, bowel disease, reflux problems, breathing problems, in pain most days, exhaustion, difficulty in sleeping, aggression, hallucinations, reactions to vaccines, and many more. These symptoms come and go. When the children are having an attack their Autism is much worse which leads me to believe they have a medical condition not just Autism in an otherwise healthy person. This is a new disease that seems to be connected to vaccines. There may be a predisposition to start with but we will never know unless urgent research is done. The Royal Free told me many years ago that the Department of Health had pulled funding for this research. I was told by a very reliable source at that time that funding was going to be pulled by drug companies if the research continued in the hospital.
What we urgently need to do is look at how many children and young adults in the UK are sick. How many are Autistic? How many children in schools have special needs compared to say thirty years ago and not look at the excuse of better diagnoses. These children stick out a mile. I am sick and tired of attacks on doctors and parents trying to help and find out the truth. All of these parents who gave their children their vaccines and the children had a bad reaction. This is a fact, the parents were there and saw the reaction FACT. Let’s all focus on the children now. They do exist no matter what arguments you come up with and there are thousands of them suffering. EVERY CHILD MATTERS
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Ian Howarth has a good point.
I can go further back possibly 50 years when I first visited RUBERY asylum in Birmingham and seeing EVERY patient not only INCAPABLE of looking after themselves but DRUGGED up so much that they could only just be aware of their own existence.
The later government action to let these people look after themselves in the community is yet one more TRAVESTY of justice.
A 70 year ago German government had a final solution and a ZERO number of these people.
Sadly at this time and through to today MERCURY was very much an in vogue item for everyone from doctors, scientists through to industry and communications.
I remember seeing a few tons of liquid mercury used for example by lighthouses to float their lights on etc etc.
Today the numbers of SEVERE cases is much lower but today thank goodness some people at least DO NOT want or permit the use of dangerous brain destroying things to destroy 1 child in a 100 of todays generation.
Today we continue both with MERCURY madness but also GMO madness, ASPARTAME madness etc etc.
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[…] What does that mean? It means if we always had the same numbers of autistic children and young adults before now, two thirds of them would be so severely disabled you could not miss them unless you were blind deaf or dumb or Professor Brugha and his team of “expert” autism researchers at Leicester University. […]
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