Sunday, May 8, 2011

Jabberwocky of the Day : Fun With Words Edition

Flickr photo by madmolecule
From the "I want to be like former President Clinton" department, we have Left Brain/Right Brain bringing us the fun with word edition of Jabberwocky of the Day.

First up we have the we have to ask ourselves, what does the word "escalating" mean to you?  LBRB presents a new paper on autism in the elderly and using is to push the idea that there is no "autism epidemic".  They say (in part) -
You see, nobody working the field of geriatric psychology has any doubt that there is a large population of autistic people within the geriatric population
Lets ignore the use of the word "nobody" because one review published in one journal can't possibly have polled the entire field of geriatric psychology and established that not a single person in the field doubts the existence of a "large population of autistic people".  The entire statement is absurd on its face, even by LBRB standards.

Nor is there any support for the idea that there is a "large population" of adults with autism.  What LBRB quotes to support their statement is -
At present, one of the major challenges is that the majority of the currently older individuals with ASD has not received a formal diagnosis of ASD, and this would be diffcult to establish using the currently recommended diagnostic assessments, because for many of them, neurodevelopmental history would be hard to obtain. 
The idea is that most of the older individuals with autism don't have a formal diagnosis, not that there is a large group of adults without a diagnosis.  These are two different concepts.

What I think the point is this follow up statement -
As also published recently, it is becoming clearer that there is in fact, no ‘autism epidemic’ and that, in point of fact, research shows...
They are referring to another study, but we will come back to this study in a minute.  Focus on the idea that there is "no autism epidemic".  Now go read the results section of abstract of the first study -
With escalating numbers of ASD individuals with disability reaching old age, provision of care is the paramount issue that is only beginning to be addressed in a few European communities and in the USA. How ageing affects cognition in such individuals as they reach an age no longer consistent with parental care is unknown, lacking any published evidence, and there is a clear need to design cognitive and behavioural assessment tools appropriate to ageing in ASD individuals with disability, as was the case with respect to dementia as a whole. Although there is a growing body of evidence on pathological, imaging, neuropharmacological and other key brain abnormalities in ASD, these are, to date, confined to children and young (only rarely to middle aged) adults.
I read this paragraph to mean that there in an increasing number of elderly people with autism and that there is currently a complete lack of understanding of what is going to be needed to deal with the problem.

But see the first sentence?  Let me highlight the interesting part "With escalating numbers of ASD individuals with disability reaching old age".  You wouldn't typically see the word "escalating" used to a condition that is stable.  Last time I checked, the word "escalating" implies that something is increasing.

But even if you took a more literal reading of the sentence and assumed that the authors meant that more individuals are "reaching" (think surviving)  to older age that still doesn't tell us that there are a large number of them already there.  If anything, more people with autism surviving to older age has to mean that the number is increasing.

So no matter how you read it, if a condition like autism is "escalating" that says that there are more cases - not a stable level of them.  And if there are more cases, doesn't that mean that the increase of cases might be approaching an epidemic?

But no, according to LBRB, the word "escalating" now means a stable level of adults with autism,  therefore "vaccines haven’t caused an epidemic of autism because an epidemic of autism does not in fact exist."

Wait, were did the rate of autism in children and any data on vaccines come from?

Lets go back to that other study showing a stable level of autism in adults.  I haven't had a chance to get the study text yet but it looks like the same data that was put out over a year and a half ago.  I talked about it quite extensively back then and the long and short of it is that the result is somewhat flawed.  The data shows 19 adults who might have autism out of 7,461 (0.25 percent) and extrapolates that one percent of the population - a four fold increase.  Yet when you look carefully at how the extrapolation was done, I am not quite sure that it is valid.  I am sure that I will be writing about it in the future after I read the "new" research.

The funny part here is that LBRB presents this as some sort of new data.  I guess if you stare at the same thing over and over again, everything old becomes new again and the old new becomes "clearer".

Moving along, LBRB attempts to split hairs in the war against the evil "anti-vaccine" fringe.  Consider the following two statements -
vaccines can cause encephalopathy that causes autism
The government has never compensated, nor has it ever been ordered to  compensate, any case based on a determination that autism was actually caused by  vaccines. We have compensated cases in which children exhibited an  encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.
Some children who have been compensated for vaccine injuries may have shown signs of autism before the decision to compensate, or may ultimately end up with autism or autistic symptoms, but we do not track cases on this basis.
To me, these statements are more or less equivalent.  The second may be much more nuanced and full of weasel words, but the theme is the same -

1. A vaccine caused encephalopathy (brain damage).
2. Encephalopathy is "accompanied by" autism.

In this context, "accompanied" has a very specific meaning, mainly -
Be present or occur at the same time as (something else).
- the illness is often accompanied by nausea
Most rational people would conclude that if brain damage is "accompanied by" a neurological condition like autism that there might just be a connection there.  I mean, after all, how much of a leap is it if there is damage to the brain and a condition that can be caused by abnormalities in the brain that there just might be a connection?

It isn't like you would say that one condition is "accompanied by" a second condition to mean that the second condition just appeared out of the blue and has no relation to the first.

Yet LBRB insists that that the "can cause" and "may be accompanied by" are quite different -
Well, no, no its not. Lets look closley at the ‘offending’ paragraph:
We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.
Quite clearly Bowman is saying that Encephalopathy may be accompanied by etc. A fact he goes on to clarify further in his next paragraph. How much clearer does it need to be?
Ginger Taylor and David Kirby really have got to stop misrepresenting people in this way. It does their beliefs no justice.
So remember, the next time that you have the flu "accompanied by" nausea, there is no relation between the flu and the nausea.  The flu appeared and then out of the blue the nausea appeared.

Yeah, right.

As for misrepresenting people, I couldn't have said it better. LBRB's continued instance on playing word games does their cause no good.  It is hard to take anyone seriously who tries to redefine the English language to make their case.

Although, former President Clinton would be proud.


  1. It appears the apologists over at a "science" blog are making the same mistake.

  2. Hi Schwartz,

    I saw that article on Ars but I didn't read it too carefully. By the time I read one of the opening lines -

    "Searches for putative environmental influences, however, have generally come up empty, even as researchers have identified very strong genetic influence on the disorders"

    I was laughing so hard that I only skimmed the rest. When most of the mainstream research is switching away from a genetic-only model of autism and starting to actively look for environment triggers, it is an absurd thing to write. Either the guy doesn't follow autism research carefully at all or he purposely misrepresents it.

  3. I looked at the comments on the Ars article. Many are anecdotes from adults who received belated diagnoses. Odd that anecdotes are taken seriously in that context but denied in the context of environmental injury.

  4. Hi Minority,

    That particular quark of "science" sites never ceases to amaze me. On one hand they demand "proof" and dismiss all parental anecdotes. But on the other, they take everything that every random person with autism (self diagnosed or not) says that he thinks about autism.

  5. MJ, it's definitely the latter. They are purposefully misrepresenting it. I can't figure out why though.