Cristopher Caez Leslie Wolcott ENC 1102-0038 March 24, 2014 Autism: A Misunderstood Condition Autism spectrum disorder

(ASD) and autism are general terms for various disorder that affect the brains development. These disorders are characterized by difficulty in social interaction, verbal and nonverbal communication, and repetitive behaviors in varying degrees of severity. 1 out of 88 children are identified as having some sort of ASD (CDC) and signs of ASD appear between years 2 and 3 of development. The cause of ASD is largely unknown but is more due to the presence of genetic and environmental factors that influence early brain development and lead to the symptoms associated with ASD. In 1998 a study was conducted that claimed to find a link between the measles, mumps, rubella (MMR) vaccine and a new form of autism. The study was conducted with 12 children and the MMR vaccine was administered the to all of them followed by various tests to determine if there were any changes after the study was administered (Wakefield et al.). Endoscopies showed a strange form of inflammation in 9 of the 12 childrens intestines, a biopsy was taken and was determined that the inflammation was directly linked to a new form of autism termed autistic enterocolitis (W akefield et al.). The inflammation was promptly followed by other autism symptoms such as regression in speech, bowel symptoms such as diarrhea, and other forms of developmental regression.

Reactions: The Scientific Community Immediately after Wakefields study was published the scientific community took immediate interest, attracting mostly opposition in Wakefields findings. Scientists tried to recreate Wakefields experiment in larger samples and found no conclusive evidence that the MMR vaccine lead to autism. The biggest concern with Wakefields research within the scientific community was the fact that Wakefield claimed to have found a new form of autism from observing an inflammation in the intestines of the children who had received the MMR vaccine (Wakefield et al.). The reason this statement was such a big deal was because 70% of autistic children (diagnosed or not) show signs of gastrointestinal problems such as inflammation, diarrhea, and bloating throughout development (Valicenti-McDermott et al.). Another study observed autistic children and compared them to children with other disabilities as well as children with normal development and found that gastrointestinal problems were more common in children with autism (DEufemia et al.). Other scientists were more concerned with how Wakefields study was carried off, many analyzing the methods of the study and finding major flaws that skewed the results of the study. The first flaw is that Wakefields study only used 12 children, a sample size so small that it would not properly represent the general population and no controls to compare the results of the children to. The second flaw was that many of the children had already been diagnosed with autism before the study was conducted. The last flaw in Wakefields research was who reviewed it; when biopsies are taken in studies histopathologists are the

ones who examine and provide a definitive diagnosis of what is found in them. Wakefields biopsies were examined and diagnosed directly by him, not by a histopathologist (Deer). In fact, Wakefield complained when he was told a histopathologist would have to review the biopsies and he did everything he could so that no one but him got their hands on the biopsies. Alongside these flaws there are 9 other papers that support Wakefields research. What could be wrong with this? 7 of these papers were either authored or co-written by Wakefield himself (MacDonald et al.), its quite easy to support yourself this way without many people catching on to it. Reactions: The Public Once the media got a hold of the information that the scientific community was researching they immediately took action in spreading the news to the world. At that time there was much more confusion than certainty on the subject, and people started spreading the news and citing Wakefield without necessarily understanding his research or how he went about it. The literacy that the people were being exposed to was something they were not used to or understood, therefore adding to the confusion. Parents in turn started to refuse the measles, mumps, rubella (MMR) vaccine for their children, so much so that the acceptance rate dropped from 92% (before 1998) to an 86.5% acceptance rate (2009) (Bedford & Elliman). Since the time the study was published the vaccine debate has taken a toll in the general public and the debate seems to rise and fall periodically. In 1998 it came up due to the study and the controversy surrounding it. It yet again arose in 2004

with more parents discussing whether to get their children vaccinated for MMR because of its autistic causing properties, and most recently in the 2012 -2013 year parents were yet again debating whether they would get their children vaccinated, only this time the discussion was the possibility that all vaccines cause autism. This has not only led parents to not allow their children to receive the MMR vaccine, but to refuse vaccinating their children altogether. Research: Project Proposal Since the argument seems to continue on in the general population, a closer observation is needed to determine the source of the pattern. In 1998 the argument revolved around the MMR vaccine itself, but since then the argument seems to have spread to generalize Wakefields research and apply it to all vaccines. The point of this research project is to backtrack all published writing on the subject in relation to vaccines and autism and determine which international publication(s) first generalized the autism-vaccination issue.