April 2nd, 2011
12:01 AM ET
Four years after the first United-Nation-declared World Autism Awareness Day, the cause of the developmental disorder is still unknown and there is no cure.
Autism affects an average of 1 in 110 children in the United States, according to the latest estimates from the Centers for Disease Control and Prevention. Children with autism spectrum disorders have disabilities that can cause significant social, communication and behavioral challenges. Symptoms can vary from mild to severe and can surface when babies are as young as 12 months, but often become obvious at around age 2. Diagnosing children as early as possible can lead to early intensive therapy which can sometimes lead to significant improvements in a child’s life.
Perhaps highest profile event related to autism since the last Autism Day was the British Medical Journal’s January publication of a three-part study deconstructing and declaring “fraudulent” the controversial 1998 research of Dr. Andrew Wakefield. Wakefield’s study had linked the measles, mumps and rubella vaccine to autism. For more than a decade Wakefield’s work contributed to many parents not getting their children vaccinated for fear of the vaccines causing autism.
The BMJ’s deep dive on the Wakefield study found that the doctor misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the study - and that there was "no doubt" Wakefield was responsible, the journal said.
This report was widely reported in the U.S. but not so much in the United Kingdom, Wakefield's home country. That may be because it was reminiscent of news from 2010, the General Medical Council, which oversees doctors in Britain, said that Wakefield's conduct in researching his study was “dishonest and irresponsible." This was followed by the Lancet's retraction of Wakefield's study just days later.
Wakefield's critics quickly rose to his defense; those who believe vaccines do not cause autism thought the BMJ report would finally end the vaccine-link debate. Judging by the conversation generated on the BMJ's comment board, 59 pages of reponses so far, including those of numerous academics and professionals and parents, this report didn't change too many minds.
Supporters of Wakefield liken him to a misunderstood Galileo. They recounted their children’s autism diagnoses following immunization and some, including editors from the website "Age of Autism" questioned – in detail – the BMJ report. Those who disagree with Wakefield's original findings tended to focus on the fact that Wakefield's claims have never been independently duplicated.
You don't have to turn to a medical journal for passionate exchanges on the subject.
Initial responses on Parenting.com don't suggest minds were changed. One nanny said, "I have simply observed too many times that regression comes shortly after vaccinations." Another states flatly: "MMR and vaccines DO cause autism!" Those who believe the vaccine benefits outweigh the risks chimed in as well. "You would think that the retraction of the Wakefield study WOULD end the debate over any link between vaccines and autism. Unfortunately, the damage has been done," one comment reads.
Of course sampling two websites does not show with certainty whether the debate has changed. But it provides a glimpse. A small sampling of experts in the field who treat children with autism and meet with their parents don't think this report changed much in either.
"I don't know that I've seen powerful shifts because of what we heard [about Wakefield]," says Zachery Warren, director of Vanderbilt University's Kennedy Center Treatment and Research Institute for Autism Spectrum Disorders.
Dr. Eric Hollander, director of the Compulsive, Impulsive and Autism Spectrum Disorders Program at New York’s Albert Einstein College of Medicine, says he's seen fewer parents coming in with the firm belief that vaccines caused their child's autism.
Dr. Geraldine Dawson, who is the chief science officer for the research and advocacy group Autism Speaks, say her organization’s position hasn't changed since Wakefield was pronounced a fraud. "We still strongly encourage parents to have their children vaccinated," she says, adding that vaccines are safe for most children. But she notes that there may still be subgroups of children that are more vulnerable to vaccines and more research needs to be done to find out who these children are as well as finding out what causes autism and how it can be treated better.
Irva Hertz-Picciotto, a researcher at the University of California-Davis M.I.N.D. Institute in Sacramento says that while the vaccine question may not be completely resolved, she believes too much energy is spent talking about vaccine. She along with the other experts believes that more, larger studies are needed to fill in more pieces of the autism puzzle. Some of that research is expected in the next few years.
One big study being conducted in many centers around the country is called the National Children’s Study, which will examine the effects of the environment, “as broadly defined to include factors such as air, water, diet, sound, family dynamics, community and cultural influences, and genetics on the growth, development, and health of children across the United States.” Researchers will follow children while they're still in the womb until they are 21 years old. Results from this study may not provide answers right away, but the goals is to provide data gathered that will help researchers for many years to come.
Is someone in your life effected by autism? Share your story with us.
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.