Autism-Vaccine War Reaches New Height of Stupidity

Can the vaccine-autism wars on the Internet get any more absurd?

Dan Olmsted - "Non-believers are Nazi sympathizers" -

The report goes on to quote the DeStefano/CDC study about how the antigens in vaccines don't correlate with a risk for autism. Even in the self-protective annals of the CDC, this study is a stinker. 

But putting that aside, the fact that Jalen fell off a developmental cliff TWO OR THREE DAYS after vaccination ought to make somebody in the editing room at that TV station, or some mainstream outlet somewhere, sit up and take notice. 

This happens all the damn time, people! These kinds of parental accounts, combined with the $2 billion plus awarded in vaccine court, including to Hannah Poling; the known properties of vaccination, and the concommitant rise of mercury and vaccines with the autism epidemic, are far more than enough to start asking tough questions. 

It's not going to be very PC to say this, but one of the most vivid images from the end of World War II is the Allies making local villagers walk through a newly liberated concentration camp. The message was -- how can you say you did not know?

Orac, aka David Gorksi - "You hate your children" -

It’s very clear that many antivaccinationists hate autistic children. The language they use to describe them makes that very clear. Such children are “damaged” (by vaccines, of course); the parents’ real children were “stolen” from them (by vaccines); they are “toxic” (from vaccines); the “light left their eyes” (due to vaccines). Autism is an “epidemic,” a “tsunami,” even a “holocaust,” with “denial” of that “holocaust” being equivalent to Holocaust denial. All of this likens autism to a horror on par with these calamities, and paints vaccines as the instrument of annihilation of antivaccinationists” “real” children.

Both arguments are full of it.

Any possible connection between vaccines and autism is not straightforward and obvious.  Yes, there have been some high profile cases of vaccines being implicated in autism but no one has been able to document a larger or more widespread relationship.  Just because the average doctor, parent, or journalist follows the lead of the experts in the field - experts who have served them well - does not mean that they are akin to Nazi sympathizers.

And on the flip side, the idea that talking about perceived damage to your children means that you hate them?  I don't think I quite have the words to describe how utterly stupid that argument is.  I'm not quite sure what sort of person hears a parent say that they think their child was injured and turns around and tells them that they must not love their child.

I think this comic from SMBC sums up the current state of the autism-vaccine wars quite well and, if the above exchange is any guide, we might be close to the optimal solution in the final frame-

For Sale : Extra Autism Awareness

Today, April 1st, I am holding a sale on autism awareness.  As you might know, tomorrow, April 2nd, is the sixth annual autism awareness day.  I find myself with some extra autism awareness, having accumulated the equivalent of over 50,000 days of autism awareness in just a few short years, so if anyone finds themselves a little short, I am willing to part with some awareness.

If you are interested in some of my accumulated extra awareness, you will have the chance to experience, by proxy, the purely happy, wonderful little girls that are my children.  You will be in awe of what they can do in spite of facing significant challenges from autism and how hard they are willing to work to get past their limitations.

You will get to experience the joy when they manage to break through one of the limitations that autism has placed on them and be able to get to know them in a whole new way.  You will have the chance to know that they are not defined by their autism and that they are their own individuals, whole and complete, even if they cannot always show it.

You will have to look far and wide to find awareness of sweeter, more lovely, or affectionate little girls.  Everyone who has ever worked with or known any of the three has quite literally fallen in love with them, for good reason, and you will too.

However, there are a few disclaimers that I am obligated to include as well.

You will come to know and love the slogan "sleep is for the weak".  If you enjoy actually getting a solid eight hours of sleep a night or having the opportunity to have uninterrupted sleep more than once a week, this is not the awareness for you.

If you are the sort of person who is unable to put aside your affection and love for your child and do what is in their best interest, then this is not the awareness for you.  You will have to experience the emotional consequences for acting in a way that will best help your child while not wanting to do it at the same time.  Remember, it isn't about you, it is about the children.

You if would like to grow old gradually or gracefully and not start looking old before your time, then this is not the awareness for you.  Seriously, when you get your hair cut the white hair will make it look like it is snowing.

Most importantly, if you have dreams of there ever being a time when you don't have to worry about the future or having a time when the awareness can fade, then this might not be the awareness for you.  I don't have any way of knowing what the future might bring or what the outcome will be, but there is a very real possibility that this awareness and the constant worry for the future will be with you from now until your last day.

But don't let those few disclaimers get in the way of stocking up on extra autism awareness in time for tomorrow's awareness day.  After all, the chance to get to know these wonderful children is well worth the the extra cost.  All of the fashionable people will be sporting extra awareness and you should too.

~~~~

Hmm, you still here reading?  Since this post is going to be up on autism awareness day, I guess there should be a serious point rather being rather flippant about the whole thing.  OK, here is the little bit of the serious that I hinted at above, but I don't think it is going to be a popular point.

There is a lot of talk in the autism community about how autism advocacy should be entirely about the people who have autism.  After all, they are the ones who get to experience the joy of autism first hand.  But the one idea that gets lost in all of the rhetoric of "nothing about us without us" and other feel good slogans such as "I shouldn't have to change" is the cost of autism to entire extended family.

For every one person with autism there are typically going to be at least three, four, or many more other people who are going to be profoundly impacted by that person's autism as well.  So, as unpopular as this idea is going to be, autism advocacy shouldn't be completely about just the people who have autism.

Don't misunderstand, this isn't some woe is me rant from yet another parent.  I am not saying that autism has ruined my life or any other such tale of misery.  I actually like my children and enjoy spending time with them; as I said above, they are truly great little girls and I wouldn't give them up for the world.  I may wish that they didn't struggle with autism but I certainly wouldn't trade them for other "normal" children.

But, at the same time, living with autism - even if you don't experience it first hand - extracts a high professional, social, personal, and health cost and these costs are not limited to the immediate family.  Everybody who is involved feels some of the impact of autism whether it be the parents who bear the brunt of the dealing with the joy of autism on a daily basis to grandparents to other family members and friends who try to help out.

Anyway, that is the serious bit of awareness - the cost of autism to people other than those who have autism.  So, if you happen to know a family whose children have autism (and given how common it is now, you probably do) try to be nice to them.  They are dealing with a lot and can use any help you can provide.

Thanks

Vaccines Exonerated From Being Involved in Autism, Again

Yet another paper has been released that shows that, yet once again, vaccine have nothing do with with autism.  This paper adds to the piles and piles of studies on this topic that are meant to reassure parents that vaccines have no relation whatsoever to autism.

Unfortunately, this paper appears to be yet another paper that purports to dismiss a link between autism and vaccines without actually addressing the core underlying issues.  Or, to be perfectly honest, I should say that it seems to be yet another paper dismissing the link because I only skimmed it and didn't analyze it in any depth.

I only read enough of the paper to realize that it didn't tackle any of the questions that I have about a potential link between vaccines and autism and repeated some rather obnoxious speculations about how an infant could "theoretically could respond to thousands of vaccines at once" before I lost patience and interest.

If you are interested, the full text of the paper is available here and I encourage you to read it and form your own opinion.

I don't think that anybody (rational) would argue that a healthy child *should* be able to easily take a single vaccine or even a few of them at a time, although I would not go anywhere near Dr. Offit's claims a child can handle the equivalent of thousands of shots at once.  I don't think most (again rational) people would argue that vaccines aren't a good thing.

Just to be perfectly clear here in case someone wants to try and misinterpret what I am saying, vaccines = good.  You should vaccinate your children although you should do so in a manner that is consistent with your child's well-being and not simply because some schedule says that it must happen on this date.  I will elaborate on that last bit in a minute.

But getting back to the core issue, one that I don't think I have ever seen tackled directly by mainstream medicine, is whether there is something different about the children who (theoretically) develop autism after vaccinations or whether it is whatever else if going on at the same time or immediately after that causes the problem.

Is it the stress of vaccination or the resulting fever on the body that exacerbates some underlying issue ala Hanna Polling, is it the constant use of acetaminophen to treat resulting fevers that depletes potentially scarce supplies of glutathione leading to other biological disruptions, is it the extra stress on an already disregulated immune system, is it a combination of all of these or something else entirely, or it just figment of parents' imaginations?

I know from my own experiences with my twin daughters that medical practitioners sometimes seem more concerned with giving vaccines on a rather arbitrary and predefined schedule rather than when it is in the child's best interest.  The twins, at one year old, had just both been through a rather nasty cold/flu, rotavirus, an ear infection, and several rounds of antibiotics within a few short weeks when they received the MMRV at a routine visit.

Before this time period they were developing slowly but within normal parameters for twins but afterwards they lost some skills and their development stalled for years.  I certainly don't think the vaccine "caused" their autism as their younger sister also went on to develop a milder form of autism but I certainly think it did add stress when they could least handle it.  It certainly wasn't a medically prudent time to be giving them a vaccine.

But here we have yet another paper suggesting that parents like me are just imagining things without actually taking the time to look at specific children to see what else might be going on that could change a routine, safe, and necessary medical procedure into something else.

I am getting rather sick and tired of papers trying to absolve something of responsibility when we can't even be sure what the thing is.  I completely understand that the existing body of literature shows that there isn't a simple causative relationship between vaccines and autism.  But it is a large jump from that statement to the presumption that vaccines play no role whatsoever in autism.

Before we can completely clear vaccines of any involvement in autism, we have to first understand what autism is and what can cause it.  Only then will we be able to analyze whether there is some involvement or not.

So how about we spend more time doing basic research into the biology of autism and investigating the scores of biological abnormalities seen in people with autism and less time beating a dead horse.  The only way to convince people who have questions is to actually answer those questions, not to keep repeating the same thing over and over again.

Sorry, I will get off the soapbox now.

Autism Rising : By the Numbers

As I talked about last time, a new paper was just released that found the the prevalence of autism in school aged children was about 2%.  This figure is (yet another) sharp upwards revision from last year's surprising 1.1%.  It seems like every year or so we are treated to yet another vastly higher estimate of autism prevalence and every year we are treated to the same reasons for the increase.

Well, the good news is that the increase shown in this years data is being blamed on something slightly different.  The bad news is that this year's explanation doesn't hold up on close examination.

The official line this years seems to be that the roughly 70% jump in the autism rate is mainly attributable to children with a milder form of autism being missed at a younger age and being "discovered" later on in life.  Which is basically a variation on the "better diagnosing" line that has been used to explain away part of the increases for more years than I can count.

The conventional wisdom before this paper is that most - but not all - children with autism will be diagnosed by the time they are eight years old and that children with a diagnosis at that age are more likely than not to keep the diagnosis.  There are a couple of reasons for this belief, not the least of which is by this age most children have been in school for two or three years and that problems that their autism cause will be apparent to their teachers and when they are compared to their typical peers.  It also doesn't hurt that that it has been demonstrated empirically by several studies over the years.

This paper is seeking to amend the conventional wisdom to allow for a large number of "milder" case to be diagnosed at a later age and for this group to account for a substantial portion of the autism population.

So, the question is then whether the data underlying this paper supports that idea or not.  To answer that question I pulled the underlying data from the 2011/2012 National Survey of Children's Health and did some analysis of the data.

For the following analysis I am using the children in the NSCH data set that have a current diagnosis of autism.  I will also be using the 1.1% (1 in 88) prevalence estimate that was published by the CDC last year and will also be making some brief usage of the data from the NSCH 2003 and 2007 survey years.  These different data sets aren't completely compatible but they are good enough for my purposes.

First up, lets consider the idea that a substantial number of children in the 2012 population came a diagnosis later in life.  If the explanation offered by the paper is true and that a large part of the 0.9% increase is due to later diagnosis then that should be apparent by looking at the age when the children in the survey were diagnosed.

The good news is that the 2012 survey has this data so we can directly look at the number of children diagnosed by age.  I am going to used the following age ranges because they (should) be representative of the different times when a child might be diagnosed.

• Ages 0 to 4 are children who are not yet in the school system and represent the group that is picked up by early screening and early intervention efforts.
• Ages 5 to 8 represent the children who are just entered the school system.  Conventional wisdom tells us that most children with autism will be detected by the end of this period.
• Ages 9 to 12 are children who have been in school for a while but have not yet experienced the higher social demands that comes with adolescence
• Ages 13 to 17 are the children who are likely to experiencing the increased social demands of adolescence and where you would expect the children with the mildest forms of autism - forms that are primarily social in nature - to be detected.

Below is a chart that shows the percentage of the autism population that was diagnosed in each age range.

As you can see the majority of children, about 82%, were diagnosed by the time they were eight years old, as is expected.  A simple back of the envelope calculation suggests that 1.6 of the 2% prevalence was diagnosed by age 8 which leaves 0.4% being diagnosed later in life, although that depends on what you mean by later in life.  If later in life means older than 8 that means the 18% of the population but if later in life means the teen-aged years (13 and up) then that means only 4% of the population.

Regardless, the idea that the majority of the 0.9 increase in autism prevalence is being cause by older children being missing simply doesn't hold water even under a generous reading of "older children".

But that is across the entire data set.  Lets do a similar analysis but break down the prevalence not only by the age the child was then they were diagnosed but also by the age that they were when they were included in the survey.  The following chart does exactly that and charts the prevalence per 10,000 using the same age brackets as last time.

Now this chart shows a couple of very interesting things.

Lets start with the most obvious thing - the age of diagnosis in the oldest children shows a different profile than the data set as a whole.  In this group, the number of children diagnosed before the age of 8 roughly corresponds to last year's 1.1% prevalence and the additional increase of prevalence is coming from children who were diagnosed after the age of 8.  Just as a point of reference, the children in this group are older than the children that the CDC's 1.1% estimate was based on.

So in the oldest children, the paper's idea that the increase in prevalence comes from older children being diagnosed does hold up.  The numbers work out pretty well too, you could attribute about 0.7 of the increase in prevalence to older children being diagnosed.

But if you look at the younger age groups you see the bad news.  Both of the other groups of school aged children have a higher prevalence than the oldest age group and both groups are made up almost entirely of children diagnosed by the age of 8.  Or, in other words, the paper's idea falls completely apart and the higher prevalence in the younger children is not being caused by missed diagnosis of milder children when they get older.

Then there is the other little disturbing trend that is visible in the data - the number diagnosed in each age range is climbing as the children get younger.  Look at how the blue section (children diagnosed between 0 and 4) is larger in the 9-12 group than it is in the 13-17 and the 5-8 group is larger than the 9-12.  The same pattern appears in the red section.

Keep in mind when you look at the chart that some of the sections include the current age are going to be incomplete.  So the green section in the 9-12 year olds is going to grow as this age group gets older as will the red section in the 5-8 year olds, as will the blue bar in the 0-4 year olds.

There seem to be two trends in this data - there are children being diagnosed later in life (who are presumably milder) AND the actual prevalence of autism is growing per birth year.

To illustrate this, lets look at the data from the 2003, 2007, and 2012 NSCH survey years.  The earlier years don't have the age of diagnosis available and the 2003 survey didn't ask the exact same questions but it is close enough.

The following is the approximate prevalence per age from all three surveys, the data from the earlier surveys has been shifted to the age that the child would have been in 2012 and I removed the 0-4 age group because, as you can see above, the detection rates are quite low in this group.

The same two trends are visible here as well - the prevalence for the specific age grows each survey year but the prevalence in children born later is higher still.

I think this data makes the overall trend quite clear - the rate of autism is growing by each birth year.

Autism Rising : Here We Go Again

Ah here we are, another year, another autism awareness right around the corner, and yet another new estimate of autism prevalence from the Centers for Disease Control.  But don't worry, the non-real "its all better awareness" increase is only about a 75% increase from the last "its all better awareness" increase.

The new number, which seems to be based on yet to be released survey data from National Survey of Children's Health (NSCH) for 2011/2012, is that 1 in 50 school aged children (aged 6 to 17) have a form of autism.

For comparison -

• The last estimate of autism prevalence from the NSCH in 2009 was 1 in 100.
• The current estimate of autism prevalence of children born in 2000 is 1 in 88

So the current estimate from the NSCH probably contains estimates for children born after 2000, possibly as late as 2005-2006, but the rates in these children are going to be diluted by the (again probably) much lower rates in older children.  If I had to guess, I would guess that this most recent data shows an even higher rate than 1 in 50 in the youngest children.

I have to guess because no official study or data has been released yet.  As is quickly becoming the norm, we first find out about major announcements like this from the mainstream media before we have a chance to look at what the actual data says.

It will be interesting to see what the data actually shows when it finally gets released.

UPDATED : The report from the CDC is available here.

The Autism Community's Response to Planned Violence

I took down my prior entry about the post at Wrong Planet because it appears that the offending post was removed from the site and I don't want that person's words to live on at my site.  But the post, and the way it was mishandled by Wrong Planet, reminded me of the much more worse incident in Newtown and how the autism community responded to that.

I didn't write anything about the tragic incident in Newtown because there wasn't (and still isn't) much known about why Adam Lanza did what he did or whether his mental problems involved autism or not.  I also didn't write about it because the incident hit a little too close to home.  All three of my children are in a single elementary school and their autism would make all three sitting ducks if someone like Lanza showed up at their school.

So I did what any sane parent would do, I stuck my head in the ground and tried to ignore that the incident happened.  I saw the initial tentative link to autism, I saw the response from the ignorant public, and I was (for once) extremely glad that my children are disabled enough by their autism that the incident would pass by unnoticed for them.

But what I saw of the autism community's response to the incident before I started ignoring it bothered me almost as much as the initial incident.  Here you have a community who fights to get their disabled members accepted by society, who fights to break down the stigma associated with autism, and who tries to increase the general awareness of autism is and isn't and the almost universal response from this community was to throw people with other mental disorders under the bus.

The community could have taken this tragedy as an opportunity to talk about the desperate need for more services and supports for all adults with a disability.  The community could have talked about how there is a growing problem of young disabled adults who are utterly dependent on their parents for support and what impact the lack of supports has for these families.  But instead of doing that, the autism community instead tried to distance itself as much as possible from the incident and draw a clear distinction between people with autism and people with other mental conditions.

There were statements about how there is no scientific or systematic link between planned violence and autism which completely ignores the inconvenient fact that there isn't really a large association between most mental disorders and planned violence.  Yes, people who do these horrific things tend to have mental problems (or at least we like to pretend that is the case afterwards) but most (i.e. 99.9%) of people with mental problems don't commit acts like this.

But instead of working to get rid of the stigma associated with mental disorders in general, the autism community instead tried to separate autism from those other conditions.

These statements also ignore the inconvenient fact that the first wave of the autism tsunami is just now reaching adulthood and we really don't know what they are going to be like.  Regardless of why the number of people with autism has grown exponentially over the past twenty years, the fact remains that there are substantially more people with autism today than in the past.  So the people in the past who were diagnosed with autism may be quite different than those who are today and the research into what they are like might not be quite accurate.

Then there was a lot of pontificating about how autism is a developmental disorder and isn't a mental illness and while technically true, the point is rather moot.  I don't think it really matters whether a person never developed a certain mental facility or whether they had it and lost it to a disorder later in life, the important point is that the person doesn't have facility or ability you would expect them to.  So the goal here again was to separate people with autism from people with other mental conditions.

But perhaps the most disturbing statements were from adults who claimed to have autism themselves.  Maybe I am a victim of selective reading but I ran across numerous comments from high functioning adults with autism on all the major media outlets and many of them showed a complete lack of respect for people with mental disorders.

As one kind comment from an aspie on CNN said (I am paraphrasing here), autism is just a difference not some mental illness.  Those people with mental problems are sick and need drugs to help keep them from hurting other people.

The hypocrisy of advocating for acceptance for your own differences and problem while at the same time condemning other people for theirs blows my mind.

Or, in short, I was extremely disappointed that the autism community's almost universal response was to try and draw a line between autism and those other conditions.  The autism community talks a lot about acceptance of differences but, when it was presented a chance to live up to its principals, the community came up short.  Instead of standing up for people with all sorts of differences and working to build acceptance in general, the response instead was a divisive "its not us, its them; we're not like them".

Regardless, the overall point being made by the community is a valid one.  While there might be an association between autism and spontaneous, unintentional aggression, whether it be towards others or the person themselves, there is no known relationship between autism and sitting down and planning to commit a violent act.

But then there was the threat of planned violence posted on Wrong Planet and it made me wonder.  Maybe there isn't a direct link between autism and planned violence but I have to wonder whether there might be a link between social isolation and the willingness to commit horrific acts.

If that is true then that suggests that society as a whole needs to do a far better job at helping people with all sorts of disabilities feel connected and suggests that ideologies that do nothing but divide people rather than bring them together are far more harmful than I thought.

It will be, uhm, interesting (for lack of a better word) when and if we ever get a clearer picture of exactly what happened in Newtown and why Adam Lanza decided to do what he did.  I suspect that we have not heard the last of autism's involvement in the incident and, if little bits and pieces of what I have read are true, well, lets just say that won't be pretty.

At the very least, this incident should force this country to have a serious discussion on how people with mental health issues are treated and, just as importantly, on better gun control.  There is absolutely no reason why someone like Lanza should have had access to the arsenal that he took with him and, without a doubt, the death toll would have been much lower if he weren't so heavily armed.

Well, this has been a little too much reality for me, I think I need to go stick my head in the ground again and pretend that none of this ever happened.  I just hope that if autism gets dragged back into the mess that the community responds better than it did the first time.

A Genetic Epidemic of Down Syndrome?

Over at Left Brian Right Brian, Sullivan (aka Matt Carey) is attempting to make an argument that there can be a genetic epidemic.  He says -

It’s a phrase that is heard a great deal in online discussions about autism: there are no genetic epidemics. Genes don’t change quickly enough for a genetic condition to see an increased prevalence over a single generation, right? Well, yes and no.

Before going on to suggest Down Syndrome might be a model for how a genetic epidemic might work.  But while it is true that Down Syndrome is caused by an underlying genetic mutation and that the number of people with Downs is increasing, it does not classify as a "genetic epidemic".

The main reason is that for the most part¹ Down Syndrome is not an inherited condition.  A child does not have Downs because their parents passed along any sort of mutation.  Downs is caused by a mistake in cell division during the development of the egg, sperm, or embryo.  So while there is a genetic mutation responsible for the condition, the mutation is caused by some non-genetic factor.

Down syndrome (again, for the most part) doesn't run in families.  Having one child with Downs only slightly increases your chance of having a second child with Downs.

And a person with Downs in unlikely to pass the condition along to another generation because most people with Downs have problems with fertility.  Men with Downs are thought to be sterile and women are only fertile about a third of the time.  Although, if a person with Downs has a child, there is a significant chance that their child will inherit their condition.

So while Downs might be caused by genetic mutations (aka is "genetic"), it is not a "genetic epidemic" because the increasing number of people with Downs is not due to the mutations becoming more common in the gene pool.  What is causing the increasing number of people with Downs is due to a few social changes.

First, there is an ongoing trend for women to have children later in life and maternal age is a demonstrated risk factor for Downs (although, as a side note, I have never read a good explanation as to why exactly that is the case).  The risk of having a child with Downs increases with age, going from 1 in 1,600 when a mother is twenty to 1 in 1,000 at thirty and 1 in 90 by forty.

Second, people with Downs are surviving longer.  Down syndrome comes with a variety of related health problems and these problems can shorten a persons life.  About eighty years ago, people with Downs often didn't survive past their tenth birthday.  Over time that age has gradually increased so that today people with Downs can expect to live to 50 and beyond.

Finally, people today seem to be more willing to have a child with Downs.  Abortions of children with Downs is a contentious subject, but as life expectancy and quality of life for a person with Downs has been improving, there seem to be fewer abortions.

These three factors can explain the modest increase in the number of people with Downs that has been seen over the past several decades.

So, back to Sullivan's original argument, there is no "genetic epidemic" of Down Syndrome.  There isn't really even an "epidemic" of Down Syndrome - the growth has been modest and is what would be expected given the social trends listed above.

More importantly, there aren't that many similarities between Downs and autism -

In autism, there is no single mutation that can account for more than a small fraction of cases and yet having one child with autism does significantly increase the risks of having another child with autism.  Down Syndrome centers on a mutation on one chromosome while autism has been tentatively linked to many places across our genes.  So, from the little we know about the genetics of autism, the underlying genetics of autism and Down Syndrome are quite different.

Autism does not automatically come with medical conditions that shorten life expectancy.  And there is no prenatal test for autism² and so there are no widespread abortion trend that is reversing.

Autism is growing much, much faster than Down Syndrome.  Over a twenty four year period (1979 to 2003), the number of people born with Down Syndrome grew by 31.1%.  Over the same time period, the number of case of autism grew from about 2-4 per 10,000 to 66 per 10,000 or about 1500%³.  If you take a more conservative time period (2000 to 2008), autism has grown about 160%.  Anyway you slice it, autism is growing significantly faster than Downs.

The only real link between Downs and autism is parental age, and that is a nebulous one at best.  Some studies of autism involving parental age show a small relationship with maternal age but not paternal age, some show a relationship with paternal age and not maternal, some show a relationship with both, and some show no relationship to either.

At the present time, the best that we can say is that there might be some relationship between maternal or paternal age and risk of autism.  Compare that to Down Syndrome where there is a clear link between maternal age and the risk of having a child with Downs.

So, not only is Sullivan wrong to suggest that there is a "genetic epidemic" of Downs Syndrome, he is wrong to suggest that there is any epidemic of Downs at all or that this tells us anything about what is going on with autism.

1. There are actually three different known types or styles of genetic mutations that can cause Down Syndrome. The most common one, trisomy 21, accounts for more than 90 percent of cases and is almost never inherited.  Another form, which is almost not normally inherited, involves a mutation of chromosome 21 where only some of the cells have the mutation and others don't.  The final form, called translocation Down Syndrome, can be passed from carrier parents to children.  However, only about 4% of Downs cases are these type and only about half of these cases involve inheritance.  Source

2. Well, technically, there are prenatal tests for some known genetic forms of autism, such as Rett Syndrome and Fragile X.

3. A large part of the growth in autism from the 1980 to 2000 is probably due to the condition being added t the DSM III and then its changes in the DSM IV.