Denial, by Dan Olmsted and Mark Blaxill

There is no question that the rate of autism has exploded over the last few decades.  Many question this fact, attributing the rate to better diagnostics, expanding the definition of autism, or heightened awareness.  Dan Olmsted and Mark Blaxill take on those who deny that there is an epidemic of autism in Denial: How Refusing to Face the Facts about Our Autism Epidemic Hurts Children, Families, and Our Future.

That lengthy subtitle says much about the theme of the book.  Olmsted and Blaxill argue persuasively that there is an actual epidemic, and that denying it is harmful to those touched by autism.  The numbers are too high to attribute societal factors or awareness: "The autism rate is up one hundred-fold in the three decades with a clear inflection point around 1990, pointing to environmental exposures, not better detection or broader diagnosis."  They address the historical references other researchers make to argue that autistic individuals have always been among us, but we just didn't have the language or diagnostic tools. Even given the historical presence of mental illness among children and eccentric geniuses, there is no way that a population with traits indicating autism would be unnoticed or not remarked on for all those years.  "The Epidemic Denial theory--that autism hasn't really increased at all--requires centuries of observational failure in the medical and educational professionals who cared for children."

In the first decades of the 20th century, doctors began to observe and document what we now know as autism.  "The paucity of cases before 1930, followed by the first clusters, followed by a slow rise, followed by today's catastrophic numbers, means autism is a new, disabling, environmentally triggered disorder--an epidemic disorder."  I freely admit that I had accepted the position that autism was nothing new and that our recognition and diagnosis of it is new.  I have read books like Steve Silverman's NeuroTribes, which Olmsted and Blaxill criticize for his Epidemic Denial.  Contra Silverman, Denial makes a very convincing case that the rate of the incidence of autism is unprecedented.

The further argument is more controversial and not quite as strong, but still should force consideration.  They raise the hackles of the medical community by pinning the cause on vaccines.  Reviewing possible environmental factors, they conclude that "The highest correlation between the rise in autism and any one environmental factor is the increasing number of doses of vaccines."  They go on to paint a picture of the nefarious interrelationships between drug companies, the media, pediatricians, and political pressures that work together to deny a link between vaccines and autism,  actively ostracizing and striving to discredit people like Olmsted and Blaxill.

Denial is surely not the last word about the cause or causes of autism.  But to this reader they made a very convincing case for an autism epidemic.  The case for the link to vaccines is weaker, but is still quite compelling.  When someone on TV, whether a doctor, politician, or celebrity spokesman, denies the autism epidemic and downplays the possibility of vaccines playing a role in autism cases, sit up and take notice.  Ask the question that Olmsted and Blaxill ask, Cui bono?  Who benefits?  In the interest of science, but more importantly in the interest of those suffering from autism, we should heed the message of Denial.


Thanks to Edelweiss and the publisher for the complimentary electronic review copy!