Changes in DSM-5 Autism Definition Could Negatively Impact Millions

Salem-News

"The autism community strongly recommends that the proposed DSM-5 autism spectrum disorder diagnostic criteria be revisited with these concerns in mind," - Sallie Bernard, President of SafeMinds

(WASHINGTON, D.C.) - Proposed changes to the diagnostic criteria for autism spectrum disorders in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – 5 (DSM-5) will potentially disrupt appropriate and necessary services to hundreds of thousands of individuals in the US, hamper the ability to track the numbers of people with autism, and interfere with efforts to establish biological causes of autism.

“The proposed criteria make it significantly more difficult to qualify for an autism spectrum diagnosis and they completely eliminate the categories of PDD-NOS and Asperger’s Disorder,” stated Wendy Fournier, National Autism Association President. “In a well-intentioned desire to improve the specificity of an ASD diagnosis, the new criteria may, in fact, go too far and create unintended consequences. It is critically important that any diagnosis address all the symptoms of an individual and allow them the supports they need.”

The new criteria, rationale and previous criteria are available at: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=94

Currently, the federal government is spending millions of dollars to track prevalence of ASDs in 11 states; the 2000 birth cohort is due out this year. The Individuals with Disabilities Education Act (IDEA) requires schools to report the number of students with autism annually. Both sets of data have shown dramatic increases in autism spectrum disorders. One in 110 children in the US is now affected by autism compared to one in 10,000 in the early 1980’s. By significantly changing the criteria for diagnosis, the new DSM-5 will impair the ability of public health officials to compare future rates of autism spectrum disorders to past rates, since the definition will have changed. Accurate projections of trends in autism rates are critical to planning educational interventions, Medicaid and adult services. 

"By analogy, if the medical community chose to only count melanoma in the future instead of all types of skin cancer, it would look like skin cancer rates had gone down, even though other types were still present and needed treatment,” said Ginger Taylor, Canary Party Executive Director.

In addition, incidence and prevalence are critically important to investigating environmental causes of autism. “Toxic exposures to the general population change over time and having good consistent epidemiology allows researchers to judge the likelihood of a toxin being involved in autism,” stated Eric Uram, SafeMinds Executive Director. “The APA’s new criteria should add a specific mechanism to map the old diagnoses onto the new ones in order to allow researchers to compare new and old datasets. We also would like to see the APA address the issue of regressive autism by including age of onset as part of the criteria. The etiologies of infantile vs. regressive autism may be entirely different, but the new criteria do not distinguish them in any way.”

A primary concern for parents is the likelihood that many children on the autism spectrum may not be diagnosed under the new criteria, thereby depriving them of appropriate early intervention and treatment. 

Autism and Vaccines Researcher for CDC, Indicted for Fraud and Money-Laundering

PR-USA.NET

Poul Thorsen, the principal coordinator of multiple studies funded by the Centers for Disease Control and Prevention (CDC) used to deny a vaccine/autism link was indicted on April 13th on 13 counts of fraud and 9 counts of money-laundering.  The charges relate to funding for work he conducted for the CDC, which claimed to disprove associations between the mercury-based vaccine preservative, thimerosal, and increased rates of autism.

SafeMinds first voiced concerns in 2003 regarding a series of epidemiology studies out of Denmark and under the jurisdiction of Thorsen that provided the basis for the Institute of Medicine's claim that there was no association between thimerosal and autism.  That claim has been responsible for the continued unsafe use of mercury in influenza vaccines in the United States and infant vaccines around the world.

"The quality of this epidemiological research has always been questionable," states Sallie Bernard, SafeMinds president.  "Many biological studies support a link between mercury and autism, but these Danish studies have been used to suppress further research into thimerosal.  With clear evidence of Dr. Thorsen's lack of ethics, it is imperative to reopen this investigation."

From August to October of 2003, three articles on the autism-mercury controversy were published in close succession, all of which used data from a Danish registry for psychiatric research to assess the relationship between autism trends and the use of thimerosal. SafeMinds accessed the registry at the time and reported that a large percentage of diagnosed autism cases are lost from the Danish registry each year and that most of those lost cases were older children. Since the studies were  based on finding fewer older thimerosal-exposed children than younger unexposed children, the validity of their conclusion exonerating thimerosal in autism was questionable and likely a result of missing records rather than true lower incidence rates among the exposed group.

In addition, internal emails obtained via FOIA document discussion between the Danish researchers and Thornsen which acknowledge that the studies did not include the latest data from 2001 where the incidence and prevalence of autism was declining which would be supportive of a vaccine connection.
The emails also include requests from Thornsen to CDC asking that the agency write letters to the journal Pediatrics encouraging them to publish the research after it had been rejected by other journals.
A top CDC official complied with the request sending a letter to the editor of the journal supporting the publication of the study which they called a "strong piece of evidence that thimerosal is not linked to autism."

As fraud charges regarding Thorsen surface, and as we believe the registry was unreliable, SafeMinds is calling for an independent federal investigation of these studies for data manipulation and scientific misconduct.