Letter from Mark Blaxill to Frank Marone, in response to letter by Mr. Marone in the Schafer Autism Report (his letter follows):
Dear Dr. Marone,
I'm not quite sure why you felt moved to provide a
science lesson in the SAR newsletter. What you fail to recognize is that,
more than almost any other group, the parents of autistic children are
motivated to weed out spurious arguments about causation and treatment. Our
children's futures depend on the choices we make today. We need to be
ruthless in separating wheat from chaff.
You have also failed to recognize the reality that many of the most
active and vocal parents in the autism community are trained scientists and
professionals who understand issues of correlation, sequence and causality
just as well as you do. Probably better. But we understand some other things
that you appear not to.
1. Facing reality. When a disease incidence increases by an order of
magnitude--tenfold or more, there is no way to dismiss the problem as
"transient", or as a "putative epidemic." We are confronted with the
seriousness of the problem every day. And when we learn that we have more
company than we could ever have imagined, we must confront the simple
puzzle: what has changed? An order of magnitude change requires a strong
cause, which in turn requires an aggressive search for causal hypotheses. We
take any one of these very seriously. Do you suggest we dismiss them?
2. A sense of urgency. We have little patience for those who counsel
us to be patient. We are racing with our children against the tide, trying
our best to reverse this new and terrible pathology that has stolen their
childhood. But we quickly learn that most of those (the doctors) who offer
our children care, or who claim (the scientists) to search for answers have
already written our children off. So we must become active to force change,
because we understand that without our efforts these "experts" will move at
the pace that is comfortable for them. Do you propose we become complacent?
3. A time for outrage. The dirty little secret of this disorder is
that the scientists who are watching over it are far less concerned with
rigorous analysis than with respectable speech. But what is respectable is
often horribly wrong. Dramatic increases in autism are set aside with
comments that autism is "more common than we previously thought." Helpful
interventions that many of those we trust (fellow parents) can qualify for
us are denigrated as "hysterical" quests by "desperate parents" for "miracle
cures." Important clinical evidence (peer reviewed and published) on
biological patterns in our children is pilloried as dangerous and
irresponsible. Important observations about possible toxicity and autoimmune
effects of childhood vaccines are hidden by statistical sleight-of-hand
tricks that fragment samples and dilute their power. Those of us who can
read the science ourselves and critique the analysis, find our jaws dropping
in disbelief at the deceptions we are asked to accept. Do you expect us to
lower our standards?
What you need to realize is this. We have a crisis. It demands
explanations. The search for explanations requires active investigation of a
number of powerful hypotheses, many of which are uncomfortable for those who
control the purse strings.
So please do not patronize this community with high-minded science
talk. Good scientists face the facts and solve problems. They follow the
truth where it leads them. As for wastes of time and energy, there is rarely
much waste in the pursuit of uncomfortable science. Quite the opposite. Far
more wasteful is the distribution of scientific propaganda like your letter.
It's your time, but you're wasting your breath if you think it accomplishes
anything.
- Mark F. Blaxill
From Schafer Autism Report 8-20-02
Interpreting Research 'Researchers identify link ... '
COMMENTARY
By Frank Marone
[Frank Marone is a behavioral physcologist who works
with disable
children in Northern California, including those with autism. He
has
written in concerned that many are parents are being pursuauded
by the
editorial content and commentary in this newsletter and in other
places, to
accept popular conjecture about the possible causes of autism,
like viruses
and mercury in vaccines, as fact. This in turn will make the
lemmings
amongst us make poor decisions related to the health of our
children, like
leaving them unvaccinated and prone to proven health hazards.
Marone here
reviews some basic scientific principles for the socratic pursuit
of the
truth.]
We so often read some headline or other such as
'Researchers identify
link ... '. But, what does it really mean? Often, the situation
is
described as or implies illustrating not merely a link but a
'causal link' -
one thing causes the other.
In science, when one collects information about two things
there are
at least three distinct possibilities: correlation, sequence,
and
causation.
Correlation means that two things occur together in time -
both occur
at the same time, or both change over time. Establishing that
two things
occur together in time or change over time tells us nothing at
all about the
relationship between the two things, if any exists. Does the
first cause
the second? Does the second cause the first? Does something
else cause
both? Is it strictly coincidence?
A good example of correlation is the association (link)
between age
and weight. As one gets older, especially in childhood, one
tends to weigh
more. But one does not weigh more BECAUSE of being older. One
weighs more
because of differences between caloric intake and expenditure, or
because of
growing bigger as in childhood. Similarly, one does not become
older
BECAUSE of weighing more. There is no direct relationship
between age and
weight (i.e., age does not cause weight, nor does weight cause
age), even
though they are strongly correlated.
Establishing a correlation is a good place to start to
develop
hypotheses. But, no causal link is established until one can
manipulate one
of the things being measured and demonstrate that this reliably
causes
changes in the other thing being measured. Research that
measures
occurrence of autism and genetic differences or occurrence of
autism and
presence of abnormal substances or processes is in this realm.
The two
things may be established as occurring together with some
regularity. But,
we cannot know if one causes the other, or vice versa, if they
are related
to a third variable, or if this is merely coincidence, without
introducing
scientific manipulation.
Sequence - This sort of data can be very compelling.
Whenever 'A'
happens, 'B' follows. Whenever I wash my car, it rains. Again,
these data
do not establish causation. The tendency to believe that two
things that
occur in sequence are related, the first causing the second, is
so strong
and long lived that there is a special scientific expression to
describe it.
In Latin, "Post hoc, ergo propter hoc", or "after this, therefore
because of
this".
Establishing a sequence is a good place to start to develop
hypotheses. But, no causal link is established until one can
manipulate one
of the things being measured and demonstrate that this reliably
causes
changes in the other thing being measured. Research that
suggests that
children show signs of autism following administration of
vaccines falls
into this category. The two things may be established as
occurring in
sequence with some regularity. But, we cannot know if one causes
the other
without introducing scientific manipulation. In the car wash
example above,
the number of nonoccurrences (I wash my car and it does not rain)
helps to
establish the lack of a causal relationship. The number of
nonoccurrences
in autism raises similar questions. If vaccines cause some cases
of autism
(a causal relationship not established), what separates the vast
majority of
individuals who do not become autistic after vaccines from others
who do?
Causal Relationship - This is the Gold Standard for
scientific
research. If a correlation or sequence seems to establish a
potential
relationship, manipulating one thing will tell us if there is a
true causal
relationship. This requires at least two groups of individuals
identical
in every way. The manipulation is applied to one group and not
the other,
and measurements are compared. Even under these strict
conditions, mistakes
are made. There are numerous more complicated schemes to more
clearly
insure that the manipulation is the actual cause.
When one reads that "Researchers have identified a link ...
" it is
essential to appreciate exactly what is meant by the summary
statement.
While correlations and sequences can be intriguing, only
manipulations that
establish true causal relationships can inform future actions.
Much time
and energy can be wasted pursuing correlations or sequences as
though they
illustrate causation."
* * *
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.