BBC News: 'autism caused by sodium valproate'

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JamesW
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06 Feb 2024, 5:38 pm

Just on BBC News was a feature on a young man who has 'severe learning difficulties and autism caused by the drug sodium valproate which his mother took while pregnant'.

Drugs taken in pregnancy may cause severe learning difficulties in children. They do not cause autism.

I expected better from the BBC. Lazy journalism like this only serves as a sop for the likes of the antivax nutters and the 'cure' brigade.



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06 Feb 2024, 6:51 pm

Autism isn't only caused by Sodium valproate, but:

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A 2005 study found rates of autism among children exposed to sodium valproate before birth in the cohort studied were 8.9%. The normal incidence for autism in the general population in 2018 was estimated at 1 in 44 (2.3%). An updated March 2023 report estimates the number increased to 1 in 36 in 2020 (approximately 4% of boys and 1% of girls).


Autism can be lumped into two major categories, syndromic autism and non-syndromic autism. Non-syndromic is where the cause isn't known. Syndromic is where autism is a feature of another condition.

Sodium valproate is 100% known to impact a developing fetus' brain. Among the potential impacts seems to be at least a doubled rate of autism.

If fetuses exposed to sodium valproate have a higher rate of autism than the general population, what other mechanism do you propose for that elevated rate within that population? :chin:


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DanielW
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06 Feb 2024, 7:03 pm

Sodium Valproate is used to treat Epilepsy and Bipolar disorders, both of which can stem from neurodiversity as well, so it would make sense with there already being and increased risk factors present for autism from the mother - even without it.



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06 Feb 2024, 7:09 pm

DanielW wrote:
Sodium Valproate is used to treat Epilepsy and Bipolar disorders, both of which can stem from neurodiversity as well, so it would make sense with there already being and increased risk factors present for autism from the mother - even without it.


That's also a pretty good hypothesis. Further statistical analysis could probably make it easier to control for inherent predisposition, but one would think the makers of Valproate would be publicizing studies indicating that's the real cause if they existed.


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DanielW
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06 Feb 2024, 7:12 pm

The drug also has black box warnings against taking it if you are or may become pregnant, so someone "dropped the ball" somewhere.



JamesW
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07 Feb 2024, 3:30 am

1. Autism is not brain damage.

2. Autism is not the parents' fault.

Anything that feeds either of these narratives is harmful to autistic people.

Your opinion may differ. I've said my piece and I'm out.



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07 Feb 2024, 5:26 am

JamesW wrote:
1. Autism is not brain damage.
Brain damage may produce autism-like symptoms.
JamesW wrote:
2. Autism is not the parents' fault.
Not directly, and certainly no deliberately -- no parent decides to make their next child autistic.  However, there are indications that tendencies toward autism may run in families.
JamesW wrote:
Anything that feeds either of these narratives is harmful to autistic people.
Does this mean you reject any hypothesis, theory, or medical fact that may support the "brain damage" narrative?
JamesW wrote:
Your opinion may differ. I've said my piece and I'm out.
Then it is pointless to ask you to support your claims.


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07 Feb 2024, 5:34 am

Autism is a developmental disorder, meaning the brain / nervous system has not developed in the usual way. This could be hereditary or it could be caused by a gene mutation.

Sodium valproate is a known teratogen - that is, it can affect embryo development. So it is not surprising that some cases of autism can be linked to maternal use of sodium valproate during pregnancy.

It may not be brain damage in the sense of having a physical knock to the head, but it seems like splitting hairs in this kind of case in which autism is triggered by a toxic substance that affects the way the brain develops.

Whether it is the parents fault depends on whether they knew the risks, I guess. It's a bit like drinking alcohol during pregnancy - which risks fetal alcohol spectrum disorder, which shares many similarities with autism. Some people ignore the risks and drink anyway, but some get caught out through, for example, not realising they are pregnant at the time. So I agree it's best not to be judgmental about it.



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07 Feb 2024, 6:07 am

It is a bit 'black and white' to think that various substances can or cannot cause autism, particularly exposure to various substances during an embryo's embryonic development, or sometimes even foetal development.

Whilst it is true that autism is a developmental disorder and is not necessarily associated with damage of any sort, it can be caused by damage in certain cases.

Encephalitis of the brain in the early years can cause the onset of autism.

Autism after all is something that isn't measurable biologically at the current date and is diagnosed by a specific set of symptoms, in a subjective manner that usually requires parental co-operation and reporting of the affected person at their time of diagnosis.

How different people arrive at the same diagnosis/set of symptoms can vary biologically.



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07 Feb 2024, 7:50 am

According to the DSM Autism is defined as a collection of behaviors. Anything that results in these behaviors and therefore a diagnosis of Autism can “cause Autism”. Statistically no single cause of Autism is known to explain every and any case of Autism. Scientific studies of groups of individuals with a DSM Autism diagnosis (by the behavioral definition) have found statistically significant patterns suggesting a number of genetic and neurological patterns that are statistically related to the behavioral diagnoses. Drugs taken by the mother can certainly affect both the genetic and neurological makeup of the child.
But drugs taken by the mother are not the only thing that can affect the neurological and genetic makeup of the child. Currently there is no neurological imaging that can diagnose Autism, or that seems to have a perfect correlation to the DSM diagnosis. Similarly there is no genetic test that can diagnose Autism. There is no genetic test that has a perfect correlation to the DSM diagnosis.

There is a gap between what the neurologists know and what the psychologists (behaviorists) know.

Frankly, there may be more than one type of Autism.


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JamesW
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08 Feb 2024, 6:26 am

OK, I'm back in, because I've calmed down slightly and I can concede that my blanket statements were wrong. I'm glad that there's healthy debate going on, and I'm happy that I've inadvertently been able to provoke it.

It may be the case that valproate (or other drugs taken in pregnancy) causes autism. It is the case that valproate (or other drugs taken in pregnancy) causes autism-like symptoms.

A comparable case: a bunch of drug addicts, all of whom had taken heroin from the same bad batch, started to display Parkinson's-like symptoms. Clinicians studying the addicts found that their brains had suffered damage in the same areas associated with Parkinson's. The research has been invaluable in the ongoing quest for a cure.

First: Parkinson's is a degenerative disease. The quest for a cure is admirable. Autistic people (speaking only for myself) are born with autism. There is no cure, only mitigation. The quest for a 'cure' can lead us into bad places, potentially ending in eugenics.

Second: the addicts had Parkinson's-like symptoms. They did not have Parkinson's. That is beyond dispute. But here we have journalists conflating autism and autism-like symptoms. I also find that UK government advisors are doing the same (at least where valproate is concerned). We just can't do that. We simply don't know enough yet.

I very much hope that research into these symptoms will not only help the people brain-damaged by valproate etc., but also help us understand more about autism. But the pat statement '<Drug X> causes autism' just gets in the way, and doesn't help anyone, including autistic people like myself who were born with autism for no currently identifiable reason at all. NTs have a hard enough job understanding autism already as it is. At the minimum level, all this does is expose us to extra NT microaggressions, like 'But... your mother never took anything when she was pregnant. You can't be autistic. You're just weird.'

I continue to insist that the BBC and the UK government - both responsible agencies, with no agenda to push - should know better. As an autistic person I think I'm entitled to be angry about that. Also as an autistic person (and very much thanks to my evaluation and diagnosis), I know I get angrier than NTs at much less than NTs get angry at. Thanks to jimmy m in another thread for the advice 'sleep on it', and I'm also grateful that I do sleep well, as I know autistic people who suffer from chronic insomnia.

Thanks for listening. I'm off to complain to the right people now.



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08 Feb 2024, 10:48 am

Since there is known cause only things that are linked to autism so a lot of environmental causation theories cannot be 100 percent ruled out.

If toxin(s) are a cause then cures are possible. Antidotes exist for poisons, it does not make sense that an antidote for whatever substances may be proven to cause Autism will not be found.

True or not the belief that chemicals cause Autism increases negative stereotypes and lessons tolerance and acceptance.


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08 Feb 2024, 1:27 pm

JamesW wrote:
OK, I'm back in, because I've calmed down slightly and I can concede that my blanket statements were wrong. I'm glad that there's healthy debate going on, and I'm happy that I've inadvertently been able to provoke it.

It may be the case that valproate (or other drugs taken in pregnancy) causes autism. It is the case that valproate (or other drugs taken in pregnancy) causes autism-like symptoms.

A comparable case: a bunch of drug addicts, all of whom had taken heroin from the same bad batch, started to display Parkinson's-like symptoms. Clinicians studying the addicts found that their brains had suffered damage in the same areas associated with Parkinson's. The research has been invaluable in the ongoing quest for a cure.

First: Parkinson's is a degenerative disease. The quest for a cure is admirable. Autistic people (speaking only for myself) are born with autism. There is no cure, only mitigation. The quest for a 'cure' can lead us into bad places, potentially ending in eugenics.

Second: the addicts had Parkinson's-like symptoms. They did not have Parkinson's. That is beyond dispute. But here we have journalists conflating autism and autism-like symptoms. I also find that UK government advisors are doing the same (at least where valproate is concerned). We just can't do that. We simply don't know enough yet.

I very much hope that research into these symptoms will not only help the people brain-damaged by valproate etc., but also help us understand more about autism. But the pat statement '<Drug X> causes autism' just gets in the way, and doesn't help anyone, including autistic people like myself who were born with autism for no currently identifiable reason at all. NTs have a hard enough job understanding autism already as it is. At the minimum level, all this does is expose us to extra NT microaggressions, like 'But... your mother never took anything when she was pregnant. You can't be autistic. You're just weird.'

I continue to insist that the BBC and the UK government - both responsible agencies, with no agenda to push - should know better. As an autistic person I think I'm entitled to be angry about that. Also as an autistic person (and very much thanks to my evaluation and diagnosis), I know I get angrier than NTs at much less than NTs get angry at. Thanks to jimmy m in another thread for the advice 'sleep on it', and I'm also grateful that I do sleep well, as I know autistic people who suffer from chronic insomnia.

Thanks for listening. I'm off to complain to the right people now.


My father was diagnosed by a MD, a neurologist, as having Parkinson’s. He was later diagnosed by a second Neurologist as not having Parkinson’s. The second Neurologist was at a well known teaching hospital at the Parkinson’s Center and used a new kind of brain scan called a DAT scan. The first did not.

The difference between Autumn and Parkinson’s is that with there is a second, accepted diagnosis that you can get called Parkinsonism and “Parkinsonism” is not always the same as “Parkinson’s disease”. With “Parkinson’s disease” the current understanding is that it is caused by misfolded proteins that cause other similar proteins to also become misfolded. And so it is progressive. The same hospital that did the DAT scan (which measures dopamine receptors in the brain by giving the patient a radioactive dye which attaches to the dopamine receptors) has developed a new test for the proteins of interest by taking a sample of spinal fluid and looking for Alpha-synuclein proteins and clumps called Lewy bodies. But it is laboratory only and was not available to us as a “bio-marker”. So we got the DAT scan. But frankly I think the DAT scan was inconclusive - the doc said it wasn’t normal but it also didn’t look like Parkinson’s disease so it might have been normal aging.

With Autism we just aren’t there yet. There isn’t one thing called “Autism disease” and another called “Autism-ionism”. There is no DAT scan or tell tale Lewy body that can be seen under the microscope.

The closest thing to a bio-marker is EEG scans, but they are laboratory only. They are not used to diagnose Autism. In the USA the DSM is used to diagnose Autism. And that is exactly about observable behavior. No more, no less. In Europe they have different rules and I live in the USA so I don’t happen to know about them. Twin Studies show a 98 percent correlation when one identical twin is Autistic then the other twin is as well. Strong evidence for a genetic component. But still not a 100 percent correlation in every case. Still room for environmental factors. Still room for chemicals that might mess with a baby’s genes with life long affects. And still a twin study is not a genetic test.

Beyond that is only identity-politics and a feeling of a right to be offended. Making up facts because you are angry that someone past or present has mistreated you isn’t going to change the fact that with Autism the behavior IS the diagnosis. With Parkinson’s not so.

So while everyone has a right to be angry, being angry doesn’t always mean being right.


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Fenn
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09 Feb 2024, 7:39 am

Fyi:

Neuroanatomical correlates of autism spectrum disorders: A meta-analysis of structural magnetic resonance imaging (MRI) studies

https://www.sciencedirect.com/science/a ... 2722000774



Heritability of autism spectrum disorders: a meta-analysis of twin studies

https://pubmed.ncbi.nlm.nih.gov/26709141/



EEG Features in Autism Spectrum Disorder: A Retrospective Analysis in a Cohort of Preschool Children

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954463/



Resting-state EEG power differences in autism spectrum disorder: a systematic review and meta-analysis

https://pubmed.ncbi.nlm.nih.gov/38097538/


Biomarkers for Autism Spectrum Disorders (ASD): A Meta-analysis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824829/


The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) provides standardized criteria to help diagnose ASD.

https://www.cdc.gov/ncbddd/autism/hcp-dsm.html


New global diagnostic manual mirrors U.S. autism criteria

https://www.spectrumnews.org/news/new-g ... -criteria/



Innovations of the ICD-11 in the Field of Autism Spectrum Disorder: A Psychological Approach

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881114/


autism.org.uk - The National Autistic Society - Diagnostic criteria

https://www.autism.org.uk/advice-and-gu ... -audiences


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Fenn
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09 Feb 2024, 9:37 am

Sorry, still info-dumping

This may be the article OP was talking about:

Disabilities caused in babies by epilepsy drug a 'scandal'

https://www.bbc.com/news/uk-england-london-42717083.amp

“[ . . . ] It carries a risk of causing physical abnormalities, autism, low IQ and learning disabilities if babies are exposed to the drug while in the womb. [ . . . ]”

If this not the article in question please correct me.

I apologize if my previous posts were lacking in empathy and/or perspective taking.


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JamesW
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09 Feb 2024, 10:50 am

Fenn wrote:
I apologize if my previous posts were lacking in empathy and/or perspective taking.


No need to apologize Fenn. I started it.

Thank you for the infodump. It is excellent, and exactly what we (speaking for myself) need to see.