My friend and colleague, Larry Arnold has just produced a DVD about autism. You can read my endorsement at Shining City Visions.
Larry is the first autistic person to serve on the Board of Trustees of the National Autistic Society. His ideas merit wide circulation. I recommend his web site as well.
The DVD is not available on the NAS website yet. So those in a hurry can order direct from
Central Books Ltd
99 Wallis Road
Tel: 0845 458 9911
Fax: 0845 458 9912
or bombard the NAS with emails asking why it is not on the website yet.
NB I have no financial interest in the success of Larry’s venture.
There was an autism seminar at the AAAS Annual meeting yesterday. This is from the AAAS web site. Are there any published reports of what was said or online copies of the presentations. Were any of you there?
ORGANIZERS: Morton Gernsbacher, University of Wisconsin, Madison
Judith Grether (Speaker), California Department of Health Services
Is There an Epidemic of Autism?
Irving Gottesman (Speaker), University of Minnesota, Minneapolis
Do Childhood Vaccines Cause Autism?
Laurent Mottron (Speaker), Hôpital Rivière-des-Prairies, Montreal
What is the Nature of Autistic Intelligence?
Morton Gernsbacher (Speaker), University of Wisconsin, Madison
Do Autistics Lack a Theory of Mind?
No available abstracts.
Scientific and societal interest in autism has burgeoned in the past decade, as documented by nearly 6 million Web sites, almost 10,000 entries in PubMed, and a weekly focus on autism by the national media. But, with this surge of scientists and society turning their attention toward autism, it becomes exceedingly important to distinguish uninformed stereotype from scientific reality, to move beyond myths and misconceptions. In this symposium, presented by epidemiologists, psychiatrists, physicians, and psychologists, four broadly held but possibly incorrect assumptions will be critically evaluated: Is there an epidemic of autism? Do childhood vaccines cause autism? Do autistic individuals really “lack a theory of mind”? Are most autistic individuals cognitively impaired? For each of these fundamental questions, state-of-the-art science will be presented in a format that will be accessible to scientists, laypersons, and the media.
After the fall from grace of Sir Roy Meadow that followed on from serious questions about his role as an expert witness in cases of Sudden Infant Death Syndrome the Attorney General has introduced fresh guidance on expert witnesses.
Lord Goldsmith went on to outline proposals to allay fears that jurors place undue confidence in the testimony of expert witnesses in complex issues during court trials.
He said that he shared the concerns and announced that expert witnesses would now have to reveal all of their evidence, and its source, to investigating police. They must also inform prosecuting lawyers of anything “that might adversely affect their credibility or competence as an expert witness.”
He said: “They are reminded that they must not give expert opinion beyond their area of expertise. This guidance will set standards across the criminal justice system for the use of expert witnesses.
“The new guidance is one of a number of initiatives underway across government which will improve the management of expert evidence in the criminal courts.”
This will raise some interesting questions for m’learned friends when considering the latest case seeking judicial review over the alleged link between MMR and autism.
Part of me shouted, “Hooray!” Ken Aitken will no longer be able to claim expert witness status when he attacks vaccines as a cause of autism. He knows about autism but has no expertise in immunology or epidemiology. And Peter Fletcher, an acknowledged expert on the safety of medicines will have to admit to a lack of expertise when it comes to autism.
But another part of me that thinks, “What if an autism expert and a vaccine expert come together? Can they present combined expertise?” And on a personal note, a while ago one of my pupils was involved in criminal proceedings. I wrote a letter to the court and was prepared to testify that this pupil had severe learning difficulties. So that while her chronological age suggested moral awareness and criminal responsibility, her developmental age placed her below the age of criminal responsibility. The court accepted my written submission.
According to the Attorney General I am not an expert witness. I am not a psychologist. I have no forensic experience. I had a personal interest in this child. If she had put your child in hospital would you accept me as an expert witness?
Then there was the case of the autistic pupil who had been sectioned by a psychiatrist with very little knowledge of Asperger Syndrome. I provided peer reviewed citations and offered my own experience as a teacher of autistic children to support my contention that this young man’s presenting symptoms were explicable in terms of his autistic spectrum disorder and did not necessarily support a diagnosis of schizophrenia. But I was a humble teacher arguing with a Consultant Psychiatrist. I lost. If it had come to a court case the Attorney General’s current guidance would have disqualified me yet again.
For me the real problem is with the whole concept of the ‘expert witness.’ Expert = infallible. Expert = impartial. And it is only when you get expert witnesses contradicting each other that juries are expected to adjudicate on their credibility.
It would be better if juries were to decide on the credibility rather than the expertise of witnesses in all court cases. Arguments from evidence should take priority over arguments from authority. But this is a difficult area. I welcome other people’s thoughts.
I started writing this piece before a judge reversed the BMA decision to remove Sir Roy Meadow from the medical register. I will return to Sir Roy in a later post.
Thankyou Ivor for the correction. It was of course the GMC not the BMA which took disciplinary action against Sir Roy Meadow.
The Daily Mail (6 February)is still pushing the MMR/Autism myth. The Mail’s last attempt to revive its anti-MMR campaign failed miserably when the hapless Melanie Phillips attempted to rubbish the Cochrane Review which concluded that there was no credible evidence for a link between MMR vaccine and autism. IMHO she came off worse in a subsequent exchange with Ben Goldacre whose Bad Science column is the first thing I turn to in the Guardian. Mike Fitzpatrick provides an excellent summary at Spiked Online.
This time round they decided they needed a proper scientist and found Dr Peter Fletcher. According to the Mail, “In the late Seventies, Dr Fletcher served as Chief Scientific Officer at the DoH and Medical Assessor to the Committee on Safety of Medicines, meaning he was responsible for deciding if new vaccines were safe.” In 2001 he was a referee for Andrew Wakefield’s paper “Through A Glass Darkly,” which suggested that the licence for the MMR vaccine had been granted prematurely and serious concerns about its safety had been ignored. Dr Fletcher appeared to concur with this view but still told the BBC that
Dr Wakefield’s research paper did not contain any extra evidence to alarm parents, but that this would be the inevitable effect. He said: “Parents should definitely continue to have their children immunised against these illnesses.”
Dr Fletcher is made of sterner scientific stuff than Melanie Phillips, or myself for that matter. But he is only one scientist. There are many more who have opposed his support for Andrew Wakefield. See for example this article from the Health Protection Agency. The Department of Health was equally adament in its dismissal of Wakefield’s claims.
It is pertinent that Dr Fletcher is an expert witness on behalf of parents of autistic children pursuing claims for compensation against manufacturers of the MMR vaccine. In common with Kenneth Aitken PhD, another expert witness on this subject, he seems to have sacrificed his scientific objectivity in favour of a subjective identification with the concerns of the parents.
While it is easy to dismiss rogue scientists and in some cases point to a financial incentive for their roguery, the fact remains that there are a significant number of scientific and medical experts who are sufficiently persuaded by their contact with disaffected parents of autistic children to become passionate campaigners and abandon their previous commitment to dispassionate research.
Having been through the mill myself, I feel that parents are right to feel disaffected. We are fobbed off with inadequate provision. We are patronised. We are insulted. And, surprise, surprise, this makes us passionate in advocating for our children. So when we find a doctor or a scientist who actually sympathises with us we tend to give them fierce and undying loyalty. Professionals who are seduced by this heady mixture can be forgiven for losing their objectivity.
But when you sacrifice your objectivity you cease to be of any use to the parents you seek to serve. You may find yourself guilty by association with scientific illiterates and no longer a credible supporter or witness for the parents whose cause you have adopted as your own.
So I wonder what Dr. Fletcher makes of previous Mail columns by Ms Philips in which she asserts that evolution is a “flawed theory” while defending faith schools which teach Intelligent (sic) Design or others where she attacks theories of global warming as “global fraud.” Come on, Peter! Are you really happy with the company you are keeping?
My final message is for the government.
Have you ever considered why parents turn to bad science? It is because you do so little for us and our children. Government responses to autism are so bad that bad science like Andy Wakefield’s theories and snake oil remedies from DAN! seem preferable to some parents. You could make this whole MMR debate irrelevant if you spent a lot more time and money on positive autism specific policies and less defending the present indefensible status quo and producing ill thought out legislation that adds to our difficulties.