Olmsted on Autism: 1 in 10,000 Amish
Managing Editor's Note: Dr. Max Wiznitzer of University Hospitals in Cleveland is an expert witness for the government against the families who file in the National Vaccine Injury Compensation Program.
By Dan Olmsted
It is unanimous, apparently -- the rate of autism among the Amish is low. Really, really low. So low that if it were the same in the rest of the population, we wouldn't even be talking about the subject. Shockingly low.
But not so shocking that anyone feels compelled to follow up on the information or its logical implications -- not four years ago when I first pointed it out, not today when the clues it contains are more intriguing than ever -- in fact, never, never, never.
In April 2005 I wrote a UPI column called The Amish Anomaly that began this way: "Where are the autistic Amish? Here in Lancaster County, heart of Pennsylvania Dutch country, there should be well over 100 with some form of the disorder. I have come here to find them, but so far my mission has failed ..."
In case anyone had any lingering doubts about the virtual absence of autism among the Amish, they were effectively put to rest on Friday night's Larry King segment when Dr. Max Wiznitzer -- defending the vaccine program, arguing autism has not increased and insisting it is a genetic disorder preset from birth, said the rate of autism in northeastern Ohio, the nation's largest Amish community, was 1 in 10,000. He should know, he said: "I'm their neurologist."
So in a nation with an autism rate of 66 per 10,000 -- cut that in half if you want, to focus just on full-syndrome, classic, Kanner autism -- we're looking at a population with one-sixty-sixth, or one thirty-third, or one-whatever, the going rate. Heck, let's just say the autism rate in the USA were only 10 per 10,000; for some reason, the Amish autism rate would still be an order of magnitude lower. That, as they say in the medical journals, is statistically significantly. Massively so, I would say.
That leaves, it seems to me, two questions: Why is the rate so much lower, and why doesn't anyone in mainstream medicine seem to care, other than to fling it out as a debating point to demonstrate -- what, exactly?
Dr. Wiznitzer said those Amish were vaccinated. Well, OK, interesting. That's half right, according to what I reported about that same area back in June of 2005:
"The autism rate for U.S. children is 1 in 166, according to the federal government. The autism rate for the Amish around Middlefield, Ohio, is 1 in 15,000, according to Dr. Heng Wang.
"He means that literally: Of 15,000 Amish who live near Middlefield, Wang is aware of just one who has autism. If that figure is anywhere near correct, the autism rate in that community is astonishingly low.
"Wang is the medical director, and a physician and researcher, at the DDC Clinic for Special Needs Children, created three years ago to treat the Amish in northeastern Ohio.
"I take care of all the children with special needs," he said, putting him in a unique position to observe autism. "The one case Wang has identified is a 12-year-old boy."
He said half the children in the area were vaccinated, half weren't. That child, he said, was vaccinated, but let's not split hairs here. Either vaccinated or unvaccinated, that's a low rate -- 1 in 5000. The question I didn't think to ask at the time but will soon, is, exactly how were those half vaccinated? Flu shots for pregnant moms? Hep B at birth? Chickenpox and MMR on the same day at one year? Rotavirus, Hep B, Hep A, and on and on? Or did it look more like the less intense, less front-loaded schedule in place in the rest of the country back before the autism epidemic began? The kind Jenny and Jim and J.B. and Jerry (hey, the four J's!) keep harking back to when the autism rate was, like, 1 in 10,000 and we still managed to stave off wholesale plagues.
Let's even stipulate that the vaccine schedule for every single Amish child is now fully loaded and follows the CDC to a T. What is Wiznitzer's point? That the Amish genes protect them? Well, good for them, then, let's find out why. Or, that some kind of other environmental risk is absent? In that case, autism is a genetic vulnerability with an environmental trigger, and something about the Amish world is not triggering it, which puts us back about where I started four years ago. There would have been plenty of time to have the answer right now if Julie Gerberding weren't still filibustering the question by talking about numerators, denominators and getting more research into the pipeline as fast as bureaucratically possible (meaning never, never, never).
Critics of the Amish Anomaly -- like critics of the idea that vaccines might be implicated in autism -- want to have it every which way. First, they want to say I just plain missed all the autism cases -- droning on about the Clinic For Special Children, which refused to speak with me over a period of many months. When one of their doctors did finally talk to a blogger whose stated purpose was to tear my reporting apart (a "fraud," he called me), that doctor said, oh yes, they do see Amish kids with autism -- but then went on to say those were ONLY kids with other identifiable genetic disorders. In other words, risk factors. He specifically said they DO NOT see "idiopathic autism," a basically nonsense phrase that he used to mean autism without any other accompanying disorders. In other words, they don't see the kind of autism now running at a rate of 1 in 100 or so in the rest of the country. The kind no one can figure out. The kind that is destroying a generation and their families and our future along with it. ("You don't have an affected child," people tell me. Yes, but I have an affected world.)
By asserting the Amish have an autism rate of 1 in 10,000 Wiznitzer is in fact scoring a point -- they call it an "own goal," an "oops, I didn't mean to tap the other team's shot in." The point he's accidentally but effectively reinforcing is the one made by the unfailingly intelligent Bernadine Healy -- that there are so many, many obvious studies being left undone by those afraid to do them, even as they sneer and snarl at the rest of us. The Amish are just one study left undone among -- well, one among ten thousand or so.
Dan Olmsted in Editor of Age of Autism.