Intended for healthcare professionals

Rapid response to:

Observations Medicine and the media

MMR: the scare stories are back

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39280.447419.59 (Published 19 July 2007) Cite this as: BMJ 2007;335:126

Rapid Response:

We are owed an explanation Prof Baron-Cohen and Dr Goldacre [1]

It is remarkable to note that after the extensive denials surrounding
this matter and particularly the 1 in 58 incidence of autism that Baron-
Cohen delivered a paper amid little publicity which acknowleged an
incidence of 1 in 60 (which sounds like a rounded version of 1 in 58) [2].
The conclusion of the still unpublished paper at International Meeting for
Autism Resesearch was:

"The prevalence estimate of known cases of ASC, using different
methods of ascertainment converges around 1%. The ratio of known to
unknown cases means that for every three known cases there are another two
unknown cases. This has implications for planning diagnostic, social and
health services." [2]

This is equivalent to one child in every second class and
approximately 1 in 38 boys.

Prof Baron-Cohen wrote to the Observer after the publication of the
story:

"The research is based on a study of Cambridgeshire children, which
ran for five years. It has not yet come out with a definitive figure on
the prevalence of autism and it is therefore irresponsible to single out
one figure.

"The best estimate of the prevalence of autism is the 1 per cent
figure published in the Lancet in 2006." [3]

So, it looks as if there are figures which can be discussed by
academics in private and figures which are for public consumption, but
which have now seen the light of day in a Daily Mail article [4].

An interesting question is why Baron-Cohen et al think they can
project figures taken from a school population onto the entire population
as if there was no concern about time trends? This would seem to be based
more on ideology than on science.

Meanwhile, the arrogant indifference of everyone in authority to
parents who report adverse reactions to vaccines followed by the
occurrence of ASDs speaks for itself. How bad does it have to get before
the autism figures start to matter?

[1] Ben Goldacre, 'MMR: the scare stories are back,
http://www.bmj.com/cgi/content/full/bmj.39280.447419.59

[2] Baron-Cohen et al, 'Estimating Autism Spectrum Prevalence in the
Population: A School Based Study from the UK', International Meeting for
Autism Research, 19 May 2008,
http://imfar.confex.com/imfar/2008/webprogram/Paper2245.html

[4] Simon Baron-Cohen, 'Reasons why autism could be on the rise',
Observer Letters 15 July 2007,
http://www.guardian.co.uk/news/2007/jul/15/letters.health

[4] Sue Reid, 'One Child in 60 Suffers from a Form of Autism', Daily
Mail 21 March 2009,
http://www.guardian.co.uk/news/2007/jul/15/letters.health

Competing interests:
Parent of an autistic son

Competing interests: No competing interests

23 March 2009
John Stone
Contributing editor: Age of Autism
London N22