Epidemiology Bass-Ackwards

Again.

A short news item caught my attention today. Unfortunately, it looks like a fabulous example of bad science, with lousy sampling methods, correllation trying to equal causality, and a heavy dose of confirmation bias. Add in a big dose of well-connected media personalities, and it’s absolute chum-bucket for indiscriminate news sharks.

Dr Lawrence Rosen thinks there is probably some kind of “environmental problem” causing an “autism cluster around St. Anthony’s school in Northvale”, New Jersey. Why is that? “The initial study included interviews with 24 current or former school employees who had children after working at the school. Their 42 offspring included 24 with developmental disorders — and 10 of them have autism.”

Oh, and “The school serves children with autism and other learning disabilities.” Are we not surprised. ( /dry humor )

Saying that something around the school “causes” large numbers of autistics (et cetera) is like saying that swimming pools “cause” large numbers of bikinis. This is a good example of poor incidence / prevalence surveying — the numbers cited were from an informal poll taken from a few staff members’ recollections, not an exhaustive one that looked at the entire population over time. It’s all too easy to get bias from a small, self-selecting sample group especially when using post-hoc data, because of confirmation bias in the memories of people who have reinforced each other’s perceived patterns. (For better or for worse, the human brain is prone to seeing patterns that aren’t there, and we better remember things that reinforce and confirm our biases.)

It is also a good example of aggregation by niche availability. Firstly, there is a great demand for schools that specialise in autism and other disorders, so people who have the means to do so will move to areas that provide such. It’s has been found by demographic analyses that there are areas in the country that have higher ratios of special education (SpEd) students because they offer more services for them. (I would love to see a GIS analysis of this.) On her Autism Vox blog, Kristina Chew PhD points out that Bergen County, where the school is located, is one such area. The biotic and abiotic factors of the area don’t necessarily cause the higher incidence rates, any more than larger numbers of medical-supply companies “cause” higher levels of retirees to be in need of disability aids! When they are able to do so, consumers and suppliers will naturally concentrate in geographic areas; suppliers move to where consumers are, and when suppliers are immobile (such as schools) then those who need them will move. This is a well-understood phenomenon; ecologists refer to these resource areas where populations collect as sinks.

Secondly, a lot of people who get into the work world of special education have particular issues themselves, or have family members with similar issues. (They are often the better sort of SpEd professionals.) So the sampling group here may have a biased gene pool for quirks. Additionally, when it was still open, St Anthony’s school was a specialist school, so likely its staff would have been composed of higher numbers SpEd teachers and SpEd professionals, rather than normal teachers. This also biases the sampling group, weighing it with a particular subset of the education population.

Unfortunately, Rosen appears to be looking for evidence that will fit the hypothesis, rather trying to disprove the hypothesis, as is properly done in research.

Looking up Rosen, we find that he specialises the altie fringe of medicine, giving talks about the “integrative” treatment of autism and decrying the role of toxic autism-causing mercury in vaccines. According to the article, Rosen is “medical adviser at the Deirdre Imus Environmental Center for Pediatric Oncology”. So what is the D.I.E.C.P.O. (more correctly known as the Dienviro)? Why, it’s one of the organisations that flogs the “don’t vaccinate — mercury causes autism” nonsense. If you’re not familiar with her name, Dierdre Imus is married to radio shock-jock Don Imus, she writes articles for the Huffington Post with her company selling media hype about environmental toxins, and the company also sells “green” cleaning products. (Remember, the key to marketing is to create consumer need: convince your buyers that they are using toxic materials and therefore could be contributing to any number of disorders and diseases.) Because of her autism = mercury poisoning views, she is also on the board of directors for the National Autism Association:

“Deirdre Imus is a leading advocate for children affected by autism. Her efforts have been instrumental in broadening public knowledge of the link between toxic exposures and the development of autism spectrum disorders,” said Rita Shreffler, executive director of the National Autism Association (NAA). The mission of the NAA is to educate and empower families affected by autism and other neurological disorders, while advocating on behalf of those who cannot fight for their own rights.

“… on behalf of those who cannot fight for their own rights”? Apparently people are ignoring advocacy efforts, like the recent petition by no less than 22 different disability rights organisations that helped halt the “ransom notes” campaign. If you can convince the public that children-with-autism are the focus, and ignore the fact that they grow up into autistic adults with their own opinions and abilities to communicate them to the world, then no one will bother to look for other opinions.

Meanwhile, this “news” item is actually one of those little press releases meant to set the stage for further media follow-up. The news industry is always on the lookout for heart-string tugging events, and numbers of (relatively dry) research studies in various countries disproving the mercury-autism hypothesis just don’t have the newsy sex-appeal of well-connected personalities who can deliver “shocking” quotes while selling their particular “cures” to the problem.

Sadly, we live in a post-enlightenment era when “truthiness” and exciting sound-bites outweigh good science. It’s all too easy to make money from pathos generated by decrying the “horrible” issues of “afflicted” children, rather than lessening the stigmas of disability, or providing any real improvements in education or social supports.

4 Comments

  1. 3 January 2008 at 3:15

    […] that you are at the epicenter of very serious phenomenon.” “Really?” “Yes. Your waiting room has an incidence of several chronic disease much higher than the surrounding homes,” she said in a concerned voice. “I’m sure I do—this is, after all, a […]

  2. Club 166 said,

    28 December 2007 at 16:42

    This was in the news last year, and I don’t know how they managed to get it back into the spotlight again. I particularly like how they lump all disorders together to get the numbers up into “shocking” range, then just focus on the autism.

    Besides wasting the public’s time and money on a wild goose chase, it’s also sucking money out of the owners of the building (the local archdiocese, if IIRC), who have needed to hire contractors to investigate this ridiculous claim. Not a move that will inspire that archdiocese to start programs for autistic individuals.

    Joe

  3. Marla said,

    27 December 2007 at 22:29

    I read some about this on Autism Vox. I think I would agree with your viewpoint here.

  4. 27 December 2007 at 19:16

    Oh glory, pseudo science, sloppy journalism and aggressive marketing= dangerous ground; funny how these traits seem to attracted to one another.


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