Childhood vaccinations and autism
There has been much recent news coverage of a case in which the parents of a child with autism believed vaccinations the child received contributed to the child’s problem. The parents, one of whom is a physician, even appeared on Larry King. There is also much discussion in the medical blogosphere, for example here and here. Amid all the controversy, it is important to understand that the circumstances of this case cannot be generalized to other children. The child had a previously undiagnosed genetic problem that may well have predisposed the child to develop reactions to many stresses, one of which could have been the battery of vaccines she received.
What can we learn from this? The particular case was settled without anybody proving or disproving the truth of any link between vaccines and autism. There is an enormously contentious debate about the validity of this link — books, websites, and thousands of pending cases claim there is one. For its part, the medical scientific community has produced a long list of studies showing no association.
What do I think about it? Parents today forget how many children commonly died in the past from things like whooping cough and diphtheria. In the PICU I still care for the occasional child who becomes deathly ill from whooping cough. My own family tradition in medicine goes back over a century, and both my father and grandfather would attest to how many children once died from these diseases. Parents today who choose not to vaccinate their children are, in effect, taking advantage of the vaccine-induced rarity of these infections in the population; if vaccine rates fall, the diseases come back quickly.
What should a parent who is concerned about vaccinations do? First, of course, discuss your concerns with your child’s physician. But also read about the controversy yourself, and don’t confine your reading to one viewpoint or the other. Recognize that some claims are just silly. For example, I have heard the argument that physicians have a financial interest in promoting vaccines; of course a few dollars for a shot of whooping cough vaccine can prevent a PICU bill of many thousands of dollars. Also recognize that some physicians are going to be plain unwilling to discuss the issue at all. That is also silly — those of us who believe that, on balance, vaccines are a positive good should be able to explain why we think so.
An interesting footnote to this case is that the child’s parents are not anti-vaccine; they advise other parents to vaccinate their children.
Autism is one of what I believe are a number of what are called passive developmental disorders- and autism is the most common. Autism is a disability caused by a brain development disorder of unknown cause, yet some suspect the cause is some sort of neurological dysfunction. Usually, symptoms of the disease present themselves before the toddler reaches the age of three. Before Autism was more understood, others labeled them as childhood schizophrenia or as having a psychosis or mental retardation.
Out of 16 related characteristics, eight must be present to be considered autistic, according to others. As with all passive developmental disorders, the person expresses language, social, and behavioral difficulties. Treatment includes what are called psychotropic medications that delay the progression of the disorder, as well as relieve some of the symptoms of one who is autistic. Behavioral therapy is common as a treatment regimen as well. Boys get Autism much more than girls.
Then there is the controversy between many who claim that thimerosal- a preservative containing mercury, which is a neurotoxin that was used in vaccines until 2001, was the catalyst for autism in children. Over 5000 lawsuits have been filed because of this belief, and some have been successful for the plaintiff. Yet most agree the correlation between thimersal and autism is void of scientific merit. Furthermore, the cases of autism have not decreased since the preservative was discontinued in 2001.
Aside from Autism, the other four passive developmental disorders are known as autism spectrum disorders.
Asperger’s Syndrome is more common than autism, and the symptoms are milder, as there is minimal delay in language abilities, if at all. What is expressed with Asperger’s syndrome is mild autistic symptoms. In time, the patient may express atypical personality disorders, though. While intelligence is within normal limits with the Asperger’s patient, social interactions and abilities preset difficulty for such a patient. As with Autism, medications and behavioral therapy are treatment regimens with one with this syndrome
Rett’s Syndrome or disorder presents with not only atypical behavior, but also suffers from restricted physical growth and movement. There is cognitive and social impairment as well. The disorder affects mostly girls, and the cause is due to a gene mutation.
Chldhood Disintegrative disorder is rare, and is 10 times less common than autism. The disorder has a late onset with mild autistic symptoms. The disorder affects mostly boys, and regression is sudden and possible with this disorder. Skills lost with this disorder may be language, social, self-care, as well as play or motor skills. Decreased function or impairment with this disorder may include social skills and behavioral flaws. Central Nervous System pathology is a suspected cause of this disorder.
Finally, there are passive development disorders that are not otherwise specified. This may include atypical autism, for example. Yet as with the rest of types of these disorders, the symptoms vary in their intensity, and the range of abilities of these developmental disorders vary widely as well. Medicinal treatment along with cognitive and behavioral therapy prove to be most beneficial for all the different types of Passive Development Disorders that unfortunately exist for unknown reasons,