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Why Don’t Children Regress Before They Turn One? by F. Edward Yazbak, MD, FAAP


Bernard Rimland PhD was a remarkable researcher and a national & international expert on autism. His interest in the subject started very abruptly, three years after he obtained his Doctorate Degree in Experimental Psychology, when his son Mark was diagnosed with “Early Infantile Autism”, at a time when autism was rare.

 

Bernie’s passion about autism, its causes and its treatment never waned and he remained a fierce campaigner for affected children and their families until his last breath.

 

We had many long and interesting discussions over the years, in person and by phone and I learned a lot from him. One day, I asked him about “Regressive Autism” and its recent relative increase. He beamed, looked at me over his glasses and started searching among the many papers he usually carried in his brief case. He appeared relieved when he found a graph he had hand-drawn and that was based on thousands of records he had personally reviewed and tabulated for the Autism Research Institute huge database.

 

That very simple graph was remarkable. It showed two intersecting lines: A dotted line representing the Regressive Autism cases, with onset of symptoms at 18 months, running for years below the Early Onset Autism solid line and suddenly taking off in the late seventies / early eighties and steadily rising until it intersected the solid line by the mid eighties. By the late nineties, the dotted line was much higher than the other line and Regressive Autism cases represented around 80% of the ARI’s total case-load.  

 

Bernie, clearly very pleased with his graph added: “You are a pediatrician so I don’t need to tell you when the MMR vaccine became widely used in the United States.”

On another occasion, Dr. Rimland [i] discussing his favorite subject again stated:  

“As a full-time professional research scientist for 50 years, and as a researcher in the field of autism for 45 years, I have been shocked and chagrined by the medical establishment’s ongoing efforts to trivialize the solid and compelling evidence that faulty vaccination policies are the root cause of the epidemic. There are many consistent lines of evidence implicating vaccines, and no even marginally plausible alternative hypotheses.”

"As the number of childhood vaccines has increased 700%, from 3 in the 70s to 22 in 2000, the prevalence of autism has also showed a parallel increase of 700%.”

"Late onset autism, (starting in the 2nd year), was almost unheard of in the 50s, 60s, and 70s; today such cases outnumber early onset cases 5 to 1, the increase paralleling the increase in required vaccines.”

"Thousands of parents report and demonstrate with home videos – that their children were normal and responsive until suffering an adverse vaccine reaction.”

On April 6, 2000, I was seated just two rows behind Dr. Rimland when he testified in front of the United States Congress House Committee on Oversight and Government Reform [ii] and stated: “Let me dispel several myths promoted by those who deny the autism-vaccine connection:

1.       They claim the vaccines are safe, but physicians are indoctrinated to disbelieve claims of harm …

2.        They say that the suspected linkage between the MMR vaccination and autism has been disproved by a study conducted by Brent Taylor and his colleagues in London, and published last year in The Lancet. The Taylor study is seriously flawed in many ways…

3.       They say that autism has a large genetic component, and therefore vaccines must play a minimal, if any, role in the causation of autism…However, genes do not begin to account for the huge increase in the incidence of autism, ranging from 250% to 500% in various places…

4.       They claim that autism naturally occurs at about 18 months, when the MMR is routinely given, so the association is merely coincidental and not causal.  But the onset of autism at 18 months is a recent development.  Autism starting at 18 months rose very sharply in the mid-1980s, when the MMR vaccine came into wide use.     A coincidence?  Hardly!  See the graph below…”

 

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Researchers outside the United States also reported that Regressive Autism was being diagnosed in increasing numbers. In a 1998 study from Italy, De Giacomo and Fombonne examined data of 82 consecutive children referred for evaluation and diagnosed with a pervasive developmental disorder and reported that the mean age of children was 19.1 months when the parents first became concerned about their speech and development. [iii]


Two years later, Baird et al published the results of their testing of 16,235 children in London [iv] and reported that four out of five children subsequently diagnosed as having an autistic disorder appeared normal at 18 months, exhibiting good eye contact, fantasy play and pointing.

*****

 

Early on, the first dose of MMR vaccine was administered at the 15-month check-up, usually alone.

Worried about vaccination being blamed for Regressive Autism, the health authorities and vaccine promoters quickly circulated the idea that autism, supposedly a purely “genetic disorder”, manifested itself between 18 and 24 months of age. In time, that somewhat preposterous idea became an accepted scientific fact, even though the syndrome was originally called “Infantile Autism” or “Kanner’s Infantile Autism” and an infant is, by definition, a child under the age of 12 months.

The CDC recommendation was later changed and the first dose of MMR vaccine was administered, most often alone, at age 12 months. As time went by, other vaccines were added. Presently, a 1-year-old boy may receive his first dose of MMR vaccine plus vaccines for Varicella, HIB, PCV, IPV and Hepatitis A. [v]

Not to be outdone, the UK Chief Medical Officer [vi] recently recommended to NHS that Hib/MenC, MMR and the pneumococcal vaccines be administered at the 12-month visit starting January 1, 2011. A DOH spokesman promptly reassured the nation by stating that "Independent scientific research has shown that providing these vaccines at the same time is safe, effective and more convenient for parents."

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Of the many parents I have personally interviewed over the last few years, the majority describe the changes in their children very much the same way: The baby who is normal at birth achieves expected milestones until his first birthday. When prompted to try hard to recall, some parents report minor deviations from the norm in some tasks. Sometime after his 12 or 15-month visit (depending on the vaccination schedule), the busy toddler stops acquiring new words and doing new things, either abruptly or gradually. He (or she) then starts losing words he knew and is unable to do things he did well, just a month or two earlier. The change is particularly noticeable to relatives and friends who do not see him every day. 

Many if not most of the children who regress also have reactions to their vaccination: High fever, febrile seizures, irritability, a rash or diarrhea. A large number of children develop  intercurrent infections such as persistent colds and ear infections, as their immune system is affected.

Parents often also describe the child as being “out of it” a week or so after vaccination.

The acute reaction phase is usually followed by behavioral changes: Constant crying, head banging, rocking and toe-walking. Within two or three or four months, the regression is severe and another family is devastated. 

In a recent Canadian study (2009), Meilleur and Fombonne [vii] compared children with “an apparently normal early development, followed by a loss of verbal and/or non-verbal skills prior to 2 years of age” with other children on the autistic spectrum. They reported that children who regressed “spoke at a significantly earlier age” and had a “more severe autistic symptomatology profile.”

When one hears the same story twice or three times, it is permissible to attribute it to a coincidence; when one hears it 50 or a 100 times, it is less likely to be a coincidence; and when hundreds and thousands of reliable people report the same events time after time, one cannot say they are all wrong and the whole thing is nothing but a coincidence. 

It is both cruel and insulting to insist that hundreds and thousands of parents do not know what they are talking about because they do not have letters behind their names. It is also unacceptable, inhuman and outrageous to maintain, for years and years, that all of them are wrong.

In any case… a huge question remains:

WHY DON’T ALL THOSE MISTAKEN PARENTS EVER REPORT THAT THEIR CHILDREN STARTED REGRESSING AT 11 or 10 ½ MONTHS?
 

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Most babies born in the United States presently receive a hepatitis B vaccine in the nursery (God only knows why). They then receive several vaccines at age 2, 4 and 6 months of age and then … they get a break until they are one.


Babies do not all achieve developmental milestones at the same time. Some are precocious and already walking at ten or eleven months and some only walk at 15 months or later. Some “talk” constantly and some, silently, just look at their moms with bright eyes. In general, many if not all 9 to 12 month-old children listen when spoken to, know their names, understand “no”, recognize the meaning of gestures, react to voice inflections, babble, say few words, use and repeat sounds, “pet” the dog like their parents do and clearly “communicate”. They walk around their playpen or the living room, some get up by themselves and they all keep their parents busy.


So why don’t any of those little ones ever regress - really, really regress - at 11 months of age and why do they all wait and regress all together, just after their first birthday and their “one-year” check-up whether they are in the United States, the United Kingdom, Israel, Egypt or Australia? 

Why don’t we ever, ever hear of babies regressing into autism during the vaccine break period, between 6 and 12 months of age or more specifically between age 9 and 12 months, when they are doing all those wonderful exciting things we need to call the neighbors, friends and family to witness or quickly find the movie camera to record?

 

WHY, WHY, WHY

DON’T BABIES REGRESS BEFORE THEIR ONE-YEAR CHECK-UP?

 

*****

 

It would have been very easy to destroy Andrew Wakefield’s suggestion that more research was required and justified, in order to investigate and rule out an MMR-Autism connection (or in fact, any “vaccine-autism connection.”)

All that Wakefield’s critics and enemies had to do in order to prove him wrong was to document that children profoundly regressed into autism during the “vaccine-break period”, between 6 and 12 months of age and not only in the second year of life.

They would have saved a lot of money and they would have saved a lot of effort.

But they did not, because they could not:

  SEVERE AUTISTIC REGRESSION ONLY HAPPENS

IN THE SECOND YEAR OF LIFE

 

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Dedication:

To Dr. Bernard Rimland who has done so much for so many children with autism!

 

Acknowledgement:

The help offered by a researcher who prefers anonymity is deeply appreciated

 

References:

[iii] De Giacomo A, Fombonne E. Parental recognition of developmental abnormalities in autism. Eur Child Adolesc Psychiatry. 1998 Sep;7(3):131-6. Accessed 01/07/11



[iv] Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A. A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiatry. 2000 Jun;39(6):694-702

[vii] Meilleur AA, Fombonne E. Regression of language and non-language skills in pervasive developmental disorders. J Intellect Disabil Res. 2009 Feb;53(2):115-24. Accessed 01/07/11

 

F. Edward Yazbak, MD, FAAP
Falmouth, Massachusetts