Quitting the autism blame game

The column I wanted to write – about vaccines, autism and last week’s court ruling that they are unrelated – was going to be triumphant.

It was going to use words like “quacks” and “hysterics,” and phrases involving families devastated by illness looking for someone, something to blame.

It was going to be about how there is absolutely no evidence that shows a connection between vaccines and autism.

I was probably going to write this smug and inflammatory column because the science thus far doesn’t show a direct correlation between vaccines and autism per se, and when emotions and perhaps ideology – even coming from distraught families – quiet such evidence, it irks me.

But to be fair, such a column can’t be written.

Because while the court ruling that thousands of families with autistic children are not entitled to compensation was probably the right one, it sorely simplifies and misrepresents the current evidence surrounding the origin of autism and autistic spectrum disorders.

First things first: Current consensus regards autism as having heterogeneous causes, likely a myriad of them, all of which are still pretty mysterious.

Most interestingly, it’s becoming apparent that the spectrum of autistic diseases, in the words of Dr. Martha Herbert, a pediatric neurologist and expert on autism, may not be disorders of the brain, but disorders affecting the brain.

This is in contrast to previous theories that characterized the condition as congenital and intractable.

Autism may result from a combination of genetic susceptibility – akin to a loaded gun – and environmental exposure to a variety of things – akin to firing the gun.

So while a correlation between vaccinations – specifically, a mercury-based preservative called thiomersal – and autism remains unproven, evidence indicates that certain elements of our environment may contribute to the development of the disease in some individuals.

What those certain elements are made up of remains unclear. A Discovery Magazine article from April 2007 made a comparison between Texas autism rates in the early and late 1990s. It found a suggestive correlation between environmental toxins and autism but could not differentiate between the various chemicals being released. Most of these chemicals have not been studied extensively.

Dr. Herbert has questioned the pervasive assumption in the medical community that our environment is basically safe and has pushed for research that establishes a connection between metabolic intervention, actual brain changes and improvement or recovery in autism.

This debate is having an impact in many areas, from industry-science relations and unregulated industrial disposal practices to genetics, diagnosis criteria, patient autonomy and increased numbers of unvaccinated children.

Such wide-reaching ramifications makes a discourse already rife with emotion that much more intense. And as more evidence comes to light, prudent and rash actions can become indistinguishable.

One thing can be said with certainty: The loud blame game currently taking place between many in the scientific establishment and vaccine-wary families distracts from more substantive conversation about broader environmental influences and autism.