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 brain’s 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 children’s intestines, a biopsy was taken and

was determined that the inflammation was directly linked to a new form of autism

termed ‘autistic enterocolitis’ (Wakefield 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 Wakefield’s study was published the scientific

community took immediate interest, attracting mostly opposition in Wakefield’s

findings. Scientists tried to recreate Wakefield’s experiment in larger samples

and found no conclusive evidence that the MMR vaccine lead to autism. The

biggest concern with Wakefield’s 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 (D’Eufemia et al.).

Other scientists were more concerned with how Wakefield’s 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 Wakefield’s 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 Wakefield’s 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.

Wakefield’s 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 Wakefield’s

research. What could be wrong with this? 7 of these papers were either authored

or co-written by Wakefield himself (MacDonald et al.), it’s 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 Wakefield’s 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.