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Presentation on theme: "David Kirby DEBATE WITH ARTHUR ALLEN U.C.S.D. JANUARY 13, 2007."— Presentation transcript:


2 What is AUTISM? AUTISM SPECTRUM DISORDERS (ASD) DSM-IV: Classic or Full Spectrum PDD-NOS: Milder or Higher Functioning ASPERGERS: Savant or High Functioning MORE THAN ONE CAUSE / NAME? Autisms? Autism Type I, II, III? Autism (genetic) vs. Acquired Neuroimmune Disorder (environmental)?

3 KNOW YOUR MERCURY (Hg) TYPE SOURCEEXPOSURE Elemental HgThermometersVapor Amalgams Lights/batteries Inorganic HgCoal power plantsAir pollutants (hydrophylic)Volcanoes Wildfires, etc. Organic Methyl HgFishIngestion Organic Ethyl HgThimerosalInjected vaccines/Rho-GAM Fish(?) OTC topical meds

4 4 7 MAIN ARGUMENTS AGAINST THE THIMEROSAL HYPOTHESIS Autism is genetic, there is no epidemic. Mercury level in vaccines was very low, like a tuna sandwich. Autism is not the same thing as mercury poisoning. CDC study of federal data shows no damage from mercury in vaccines. IOM REPORT: Thimerosal was not linked to autism in five large population studies from the US, Denmark, Sweden and UK Ethyl mercury is less toxic than methyl mercury. Thimerosal was removed from vaccines in 1999 and there has been no decline in autism cases in California and elsewhere.

5 Argument #1 Autism is genetic. There is no epidemic.

6 Evidence of Harm6 AUTISM BY THE NUMBERS: US & EUROPE USA s: 1-2 per 10,000 children Late 1990s: 1 in 500 (20 per 10,000) 2000: 1 in 250 (40 per 10,000) 2004: 1 in 166 (60 per 10,000) DSM IV: (40 per 10,000) OTHER ASD: (20 per 10,000) UK – 2004: 1 in 166 (60 per 10,000) DSM IV: (20 per 10,000) OTHER ASD: (40 per 10,000) Denmark – 2004: 1 in 1,300 (8 per 10,000)

7 Mercury in US childhood vaccines tripled (from 75mcg to 237.5mcg) between

8 Autism cases spiked at same time Effect is greatest for cohorts born between 1987 and Clear differences: the prevalence increases with younger birth cohorts. No concomitant decreases in categories of mental retardation or speech/language impairment were seen. Curves for children with ADHD also showed strong cohort differences. Cohort curves suggest that autism prevalence has been increasing with time. The narrowing of cohort curves in recent years may mark a slowing in the autism prevalence increase.

9 Autism Soars, disabilities steady – US I.D.E.A.

10 BUT – US Dept. Of Education Regs Were Changed in 1992 to Expand Autism Criteria Before change: Many states only recognized and counted DSM IV, classic autism. After change: Many states added PDD-NOS, Aspergers. Reported rates of autism in Illinois schools went from 5 cases in 1992 to 1,101 in 1996 – a jump of 21,920%! In same period, US numbers rose 178.6% BUT - California never expanded inclusion criteria


12 The Hidden Horde? 1-in-104 American boys have some form of ASD. If it is genetic, then the same should be true for American men who are 20, 30, 40, etc. Where are they? Did they outgrow their autism? Why are American schools struggling with ASD students in the last 10 years, and not before?

13 Number of California Children with Full-Spectrum Autism in DDS, Avg. Per Age Group, Oct ,132 2,063 1, SOURCE: California DDS

14 SF: ASD kids more likely born in polluted areas 284 ASD children & 657 controls, born in 1994 in Bay Area. Assigned exposure level by birth tract for 19 chemicals. Risks for autism were elevated by 50% in tracts with the highest chlorinated solvents and heavy metals. Highest risk compounds were mercury, cadmium, nickel, trichloroethylene, and vinyl chloride. Risk from heavy metals was almost twice as high as solvents. Our results suggest a potential association between autism and estimated metal concentrations, and possibly solvents, in ambient air around the birth residence. ENVIRONMENTAL HEALTH PERSPECTIVES – Vol. 114 No. 9, September, 2006

15 Study looked at Texas county levels of emissions, compared to ASD rates and special ed in 1,200 school districts. Autism increased as mercury emissions rose. For every thousand pounds of Hg, there was a 61 percent increase in autism rates. One county with low mercury emissions but significant autism rates was found to harbor one of the nations largest mercury mines. Author: A potentially important connection between environmental exposure to mercury and the development of autism. HEALTH & PLACE: 12 (2006) TEXAS: HIGHER RISK OF AUTISM NEAR COAL-FIRED PLANTS

16 Argument # 2 Mercury levels in vaccines was very low: like a tuna sandwich

17 17 THE "THIMEROSAL GENERATION Maximum Exposure in 1 st year of life - US Schedule ? AGESHOTSHG CONTENT BIRTHHep B12.5mcg 8lb infant (3.6kg)– EPA Hg limit: 0.36mcg = 35 times over 4lb infant (1.8kg) – EPA Hg limit: 0.18mcg = 70 times over 2 MONTHSHep B12.5mcg HIb25.0mcg DTaP25.0mcg (subtotal for visit): 62.5mcg Avg. weight: 10lbs/4.5kg EPA limit: 0.45mcg = 138 times over EPA LIMIT: 0.1mcg per kg per day ADULT MALE: 138 times over EPA limit = 1,300mcg or 1.3 milligrams

18 18 Continued exposures in 1 st year of life AGESHOTSHG CONTENT 4 MONTHSHIb25.0mcg DTaP25.0 mcg (subtotal for visit):50.0 mcg Avg. weight: 14lbs/6.5kg EPA limit: 0.65mcg = 72 times over 6 MONTHS HiB25.0mcg DTaP25.0mcg (subtotal for visit):50.0mcg Avg. weight: 16lbs/7.3kg EPA limit: 0.73mcg = 68 times over 12 MONTHS HiB25.0mcg DTaP25.0mcg (subtotal for visit):50.0mcg Avg. weight: 20lbs/9kg EPA Hg limit: 0.9mcg = 55 times over

19 Typical Tuna Sandwich 20 micrograms, methyl-mercury, ingested, contains selenium

20 TYPICAL FLU SHOT 25 micrograms ethyl-mercury, injected, contains aluminum, etc. 110 lb woman = 5 times over EPA daily mercury limit 1.1 lb fetus = 50 times over EPA daily limit


22 Argument # 3 Autism is not the same as mercury poisoning.

23 23 ACRODYNIA (PINK DISEASE) Cause: Inorganic Hg used in teething powders Afflicted tens of thousands of children in s. Symptoms: weepy rash & peeling skin -AND- withdrawal, poor eye contact, poor coordination and muscle control, lethargy, repetitive behaviors, rocking, spastic movements, emotional outbursts, self- injury, sensitivity to light, visual impairments, drooling, insomnia, general ill health. 1-in-500 exposed children developed the disease. Years passed before mercury poisoning was gradually accepted as the cause, despite stiff resistance by industry. By 1954, most mercury was eliminated from teething powders. Cases fell sharply and then disappeared entirely. Today, Pink disease is virtually unheard of.

24 Acrodynia is not Autism And neither is Minimata Disease Nor Mad Hatters Disease (The Danbury Shakes) Nor Iraqi Grain Disease There is no SINGLE type of Hg poisoning Symptoms depend on age, weight, sex, type of mercury, amount of mercury, route of exposure, genetic sensitivity, etc.

25 Argument # 4 A CDC study of federal data showed no damage from mercury in vaccines.

26 26 VSD - Generation Zero Nov-Dec 1999 Very high relative risks for outcomes. Autism Relative Risk = 7.6 UNPUBLISHED STUDY OBTAINED THROUGH FOIA

27 VSD: Generation Zero


29 VSD Generation 1: Autism (Verstraeten – 2/2000)

30 VSD Generation 2: Autism (Simpsonwood & ACIP 6/2000)

31 VSD Generation 3: Autism (IOM Presentation 7/2001)

32 Generation 4: Autism (Pediatrics Article, 11/2003) Vol. 112 No. 5 November 2003, pp In no analyses were significant increased risks found for autism or attention-deficit disorder.

33 Evidence of Harm Autism Risks Across 5 Generations GEN 0GEN 1GEN 2GEN 3 GEN

34 Argument # 5 IOM REPORT: Thimerosal was not linked to autism in five large population studies from the US, Denmark, Sweden and UK



37 IOM Report: Deference to epidemiology over biology Epidemiology not acceptable to disprove causation: Federal Court System. Epidemiological studies were questioned by lead investigators themselves Danish authors: exponential expansion of patients (inpatient-outpatient) may have spuriously increased the apparent number of autism cases. Verstraeten: We found no evidence against an association, as a negative study would. On the contrary, additional study is recommended, which is the conclusion to which a neutral study must come. IOM final report: Cannot rule out, based on the epidemiology, possibility that vaccines contribute to autism in some small subset.

38 NIH PANEL QUESTIONS CDC METHODS AND DATA - 12/06 Congress requested NIEHS to convene a panel about whether the VSD could be used to compare autism rates before and after Hg was phased out. In December, panel "identified several serious problems" with the database. Several "weaknesses" and "limitations" associated with the database would render a comparative analysis "uninformative and potentially misleading. Panel was concerned about how autism diagnoses were made and recorded by HMO's -- asked if they had adequate services for autism families, who might seek care elsewhere. These and other problems likely led to an "under-ascertainment" of cases. (State rates were 3-4 per 1,000, but VSD reported a rate of 1.1 per 1,000).

39 NIH PANEL QUESTIONS CDC METHODS AND DATA Panel cited many other problems with the study design, particularly that "a large proportion, around 25%, of births were excluded from the analysis." These same children "may represent a susceptible population whose removal from the analysis might unintentionally reduce the ability to detect an effect of thimerosal." Other "serious problems" included no consideration of Rho-GAM or "other vaccinations given during pregnancy, and no accounting for "the cumulative exposure to organic mercurials through diet or other environmental sources. These problems "reduce the usefulness" of the VSD to prove or disprove a link between thimerosal and autism, though suggestions were given to address the problem.

40 Quotes on the NIH report from UPI - Age of Autism, Dan Olmsted Dec. 11, 2006 The results from this study suggest there is not a 'cause and effect' relationship between thimerosal and autism or ADD. --CDC Website The (VSD study) wasn't the last word… things need to be looked at again, perhaps with different methodology," --NIH Panel Chair Irva Hertz- Picciotto, Professor of Public Health, UC-Davis School of Medicine. "Some studies are stronger than others. The Verstraeten study was an improvement on other studies, including the two in Denmark, both of which had serious weaknesses in their designs. --Dr. Hertz-Picciotto "We actually just got the (NIH) report and haven't had a chance to assess it." --CDC spokesman Glen Nowak

41 41 Young Cohort Reduces Signal Over one quarter of the children were under the age of ascertainment for autism - 44 months - causing the signal to disappear. – Mark Blaxill There is certainly an under-ascertainment of cases. Some children are just not old enough to be diagnosed. Crude incidence rates are much lower because the cohort is still very young. – Thomas Verstraeten A CDC official accepted the critics charge that it contained many children too young to be diagnosed as autistic. This is true, said scientist Frank DeStefano, Neil Munro, National Journal


43 SOURCE: VSD Analysis, February 2000 – Obtained through FOIA

44 Biological Studies that Support the Mercury Hypothesis

45 MEET THE MERCURY CAPTURERS Thiol – A class of SULFUR-BASED proteins that bind with heavy metals and eliminate them from the system. Thiols include – Glutathione, cysteine and metallothioneine. Synonym for thiol = mercaptan from the Latin mercurium captans: or literally,mercury capturer.

46 Dr. Jill James and team: Discovered that ASD kids have low or depleted levels of thiols, including glutathione – a powerful antioxidant. Low thiols levels are thought to be based on genes - and possible mercury exposure (See: R. Deth). Methionine metabolites (methionine, cysteine, glutathione) in 20 children with autism compared vs. controls revealed severely abnormal profiles. Targeted nutritional intervention for three weeks with Folinic acid, and Betaine (1000 mg. BID) resulted in significant improvement in methylation capacity in children with autism. Addition of methyl B-12 to cocktail brought all autistic children within normal levels of methionine, cysteine and glutathione

47 Chelation results from autistic child

48 Holmes, Haley and Blaxill Baby Haircut Study 2003

49 Urine samples from 100s of French children yielded evidence for a link between autism and heavy metals. Samples from ASD children had high levels of porphyrins – used to produce of haem, the oxygen-carrying component in haemoglobin. Heavy metals block haem, causing porphyrins to accumulate in urine. Coproporphyrin was 2.6 times higher in autism cases than controls. One author said it was Highly likely heavy metals are responsible for childhood autism in a majority of cases. TOXICOLOGY AND APPLIED PHARMACOLOGY (March, 2006)

50 Asperger coprophyrin profiles matched control cases, not autism TOXICOLOGY AND APPLIED PHARMACOLOGY (March, 2006)

51 Researchers restored porphyrin concentrations to normal in 12 children through chelation.

52 THIMEROSAL CAN CAUSE IMMUNE IMBALANCES Thimerosal and Immune Cells M.I.N.D. Institute – March 26/06 Miniscule amounts (nanomolars) of thimerosal can: 1) Kill immune (dendritic) cells 2) Cause cytokine imbalances 3) Induce inflammation.

53 Autism and Immune Dysfunction Presentation of MIND Institute 2005 International Meeting for Autism Research AUTISM IS ASSOCIATED WITH IMMUNE IMBALANCES Compared to typical children, those with ASD were found to have: Increased autoimmunity Extremely elevated levels of certain immune cells and cytokines Imbalances in the TH1/TH2 immune response

54 Argument # 6 Ethyl mercury is less toxic than methyl mercury.

55 The scientific evidence that PMA & thimerosal causes reproductive toxicity is clear and voluminous. Evidence for its reproductive toxicity includes severe mental retardation or malformations in human offspring who were poisoned when their mothers were exposed to ethyl mercury or thimerosal while pregnant. Studies in animals demonstrate developmental toxicity after exposure to thimerosal. Data showing interconversion to other forms of mercury that also clearly cause reproductive toxicity.

56 Thomas Bubacher and team at Univ. of Washington Primate Center compared ethylmercury from thimerosal and methylmercury from fish. Methyl Hg stayed in blood longer and crossed blood-brain barrier more. Govt press release and media reported: Ethylmercury is less hazardous. BUT - Ethyl in brain converts to inorganic mercury much faster than methyl. 2-4 times as much inorganic Hg found in brains of ethyl vs methyl group. Over half the methyl-exposed brains had no detectable inorganic Hg. Half-life in brain of organic Hg: 30 days; Half-life of inorganic Hg: 20 years

57 Changes in the number of astrocytes and microglia in the thalamus of the monkey Macaca Fascicularis following long-term subclinical methylmercury exposure. Burbacher et al gave methyl mercury (MeHg) orally to primates and found that MeHg concentrations plateaued at around 12 months exposure, whereas inorganic levels, presumably derived from demethylation of MeHg, continued to increase throughout all exposure durations. Both the astrocytes and microglia contain substantially elevated inorganic Hg deposits relative to all other cell types. Inorganic mercury in the brains, accumulating after long-term exposure, may be a proximate toxic form of mercury responsible for the changes within the astrocyte and microglial populations. (Changes in these cells were not noted for six months or more in some cases.) Neurotoxicology. 1996;17:

58 HARVARD & JOHNS HOPKINS STUDIES ON AUTISTIC BRAINS HARVARD: Neuro-inflammation found in autistic brain tissue from childhood through adulthood. Study suggests that chronic disease or an external environmental source (ie, heavy metals) may be cause. JOHNS HOPKINS: Inflammation found in autistic brains - apparently associated with activation of brain s immune system. Compared with controls, autistic tissue showed ongoing inflammation in various sections of brain. Inflammation was produced by activation of brain cells known as microglia and astroglia.

59 Argument # 7 Thimerosal was removed from vaccines in 1999 and there has been no decline in autism cases in California and elsewhere.

60 Net gain in cases drops between

61 Rate of increase fell sharply

62 year olds - quarterly numbers QUARTERTotal # children Net gain Change 3-5 years old (avg.143) net gain 1Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q

63 Yearly trends for 3-5 year olds: Rate of increase YearNet Gain % Change ages n/a % % %

64 Total autism cases among 3-5 year olds rises: ,348 5,680 5,156 4,611 3,732

65 All ages: Rate of increase takes off in 2006


67 PREVALENCE RATES INDEXED TO U.S. AVERAGE, BASED ON IDEA DATA BY YEAR OF BIRTH: CA prevalence rate relative to US average Year of birth California United States average

68 US (green) CA (blue) and PA (red) Autism Prevalence by birth cohort

69 Possible reasons why autism rates have not fallen among California children born (3-5 year old cohort) 1.Mercury was in some childhood vaccines at least through 2003, at an unknown rate (no controlled experiment). Undetermined number of 3-5 year olds received thimerosal in their routine shots. 2.Mercury was in Rho-GAM at least through 2003, at an unknown rate. 3.Flu shot was gradually increased in use for pregnant women and infants from Today there is a 50% compliance rate. 4.Population and immigration grew in California after 2002: including thimerosal vaccinated children – how many were immunized twice? 5.There was a documented rise in environmental mercury exposures in California, from sources such as Asian coal, wildfires, cremation, etc. 6.Early intervention – Average age of diagnosis coming down. 7.Aluminum content – On the rise? Adjuvants are trade secrets

70 1) Mercury remained in some vaccines until 2003 The latest vaccines that contained any thimerosal as a preservative, with the exception of some flu vaccines, were completed in 2001 and outdated in Dr. Harvey Fineberg, IOM President Meet the Press, August 7, 2005

71 HMO Market Penetration 2005 (US Average: 23%) Source: Competitive Edge Reports

72 Merck Misled on Vaccines, Some Say Firm supplied shots containing a mercury compound after saying it had halted its use. Mar 7, 2005 | Myron Levin | Los Angeles Times Drug maker Merck & Co. continued to supply infant vaccine containing a mercury-based preservative for two years after declaring that it had eliminated the chemical. In September 1999, Merck announced FDA approved a preservative-free version of its hepatitis B vaccine. "Now, Merck's infant vaccine line," the company's press release said, "is free of all preservatives." But Merck continued to distribute vaccine containing the chemical known as thimerosal, along with the new product, until October Merck continued to supply the preservative-containing version "during the transition period to ensure an adequate supply," said spokeswoman Mary Elizabeth Blake.

73 2) Mercury Remained in Some Rho-GAM Shots Until 2003 On April 16, 2001, Ortho Clinical Diagnostics was approved by FDA to produce RhoGAM without thimerosal… The product has a 2-year dating period. FDA Statement

74 3) The flu shot may matter A pregnant woman receives 25mcg, fetus is also exposed. Much is absorbed by fetal brain stem. Approximately 15% of fetal body burden was in the brain vs. 1.7% in moms in rat study, (Feng et al Toxicol Lett 152:223) Human maternal/cord blood ratio is ~1:2). 1lb fetus (0.5kg) exposed to 25mcg is 500 times over EPA limit. An 8oz fetus (0.25kg) is 1000 times over EPA limit. (WILD ASSUMPTION: Mercury is 4 times more toxic to a fetus than to an adult, thus toxic equivalency is 4,000 times over EPA) At 6 months, a 16lb baby receives 12.5mcg – or 17 times over limit. At 7 months, baby receives 12.5 mcg. Other shots contain 5-7mcg in residual Hg. Total possible exposure by 7 mos: 57mcg. Max exposure in UK: 75mcg

75 TRENDS IN WEIGHT ADJUSTED THIMEROSAL EXPOSURES FROM CHILDHOOD VACCINES AND INFLUENZA VACCINES DURING PREGNANCY AND EARLY INFANCY Cumulative bolus mercury dose from vaccines through 24 months (mcg/kg) Year of birth From the childhood immunization schedule From the influenza vaccine in utero/infancy Exposure from continued TCV production and related inventory SOURCE: Mark Blaxill, SAFEMINDS

76 Can Prenatal Exposures Make a Difference? Is it possible that toxic or environmental influences can cause autism? The answer is yes. But if it happens, it has to happen early in pregnancy.

77 Can Prenatal Exposures Make a Difference? Is it possible that toxic or environmental influences can cause autism? The answer is yes. But if it happens, it has to happen early in pregnancy. -- Dr. Paul Offit, Childrens Hospital of Philadelphia


79 Coal use goes way up in China : 1996: 1,500 million short tons 2010: 2,666 million short tons Source: DOE/EIA, 1998, reference case

80 And Coal Carbon Emissions Double in China: Source: DOE/EIA, 1998, reference case 682 Metric Tons 1212 Metric Tons

81 : Annual global Hg emissions doubled from 1.1 to 2.2 metric tons Asian emissions increased 58%, from 705 to 1204 tons a year SOURCE: EPA


83 Asia, and China in particular, is NOW the single largest source of mercury from human activity (Pacyna et al., 2002). China contributes 500 Mg (1 Mg = 106 g = 1 metric ton) from small industrial furnaces and village-level coal burning, ALONE. Urbanization, Energy & Air Pollution in China

84 THE PACIFIC MERCURY PLUMES Measurements by aircraft in 2001 and 2002 tracked mercury from industrialized southeast China, near Shanghai, and later detected the same mix of mercury and co-pollutants penetrating the west coast of the United States. These measurements were able to discriminate between urban anthropogenic sources of mercury and background natural sources.

85 THE SHANGHAI PLUME (Moves up and down Pacific Coast) Lower urban mercury plume. 10-day traverse from South China Sea, ending May 5, Trajectory calculations by N.O.A.A.

86 THE MONGOLIAN PLUME Upper Central Asia mercury plume, five-day traverse of eastern China and North Pacific from Mongolian plateau origin region, ending May 5, Trajectory calculations by N.O.A.A.




90 The information on this map represents modeled exposure estimates rather than measured exposures


92 Jacob Buck Pond, Maine

93 Mercury accumulation rates in northeast US lakes during the 20 th Century: mcg per square meter per year Peak values after Actual accumulation rates from fallout alone: 10.4–66.3 mcg/m2/year.

94 Mercury and Wildfires A smoking gun? Mercury emissions from this boreal forest fire near Hearst, Ontario, Canada, last July were measured with instruments aboard a Twin Otter aircraft.

95 The National Center for Atmospheric Research and the University of Washington – Forest Fire Tests 2001 Mercury is picked up by surfaces --leaves or needles and it stays there until those trees burn. Friedli and Radke conducted lab tests by burning forest samples from across the US -- Sensors immediately detected mercury. All samples released nearly all the mercury, ranging from 14 to 71 nanograms per gram of fuel -- a nanogram is one trillionth of a gram. Average acre of forest contains about 22 tons (10,000 kg) of fuel. Each acre of a fire can emit up to 71 grams of mercury, which is 71 MILLION mcg, or about 2.5 ounces. Fires are estimated to contribute 800 tons of mercury each year, or 25% of all anthropogenic sources. The EPA estimates that U.S. coal-fired plants emit 41 tons Hg.

96 11 of top 20 CA fires happened in the last 10 years SOURCE: Calif. Dept. of Forestry

97 YEARSNo. FIRES ACRES MERCURY STRUCTURES BURNED RELEASED* DESTROYED ,038740, tons2, ,110860, tons 7,228 % Increase+6%+16% +16% +353% *Estimate based on 22 tons of fuel burned per acre

98 Cremation costs to rise as tooth fillings poison the living 8th January 2007 Cremations now cause nearly 1/6 th of all UK mercury emissions. This would likely rise by 2/3rds by 2020, making crematoria the biggest cause of mercury pollution. Cremations now account for 3/4ths of UK funerals. The rise in mercury pollution from crematoria is caused by what dentists call the "heavy metal generation" - those 40 and above who are now dying with more teeth because of better dental care. Millions of Britons have two to four grams of mercury in their mouths. One gram can pollute a 25-acre lake. Austria, Belgium, Germany, Holland, Norway, Sweden and Switzerland now regulate mercury emissions from crematoria

99 California Cremations on the Rise National Funeral Directors Assoc.

100 And California Leads the Nation

101 California Cadaver Emissions: One-Half Ton of Mercury in 05? 118,700 cremations in 2005 UK = 4 grams amalgam mercury/person US = = kilos = 1,044lbs

102 Other Environmental Hg Sources Auto switches / junkyards. Fungicides (ethyl merucry) used on golf courses, parks, cemeteries, playgrounds, tree farms, orchards, vineyards, etc. Paper / pulp processors & heavy industry. PMA Thimerosal in OTC products like lens solution, eye drops and nasal sprays. Fish, especially sushi. Dental amalgams. RATIO OF MATERNAL TO CORD BLOOD MERCURY LEVELS IS 1:2

103 Early Intervention Producing More Diagnoses Among 3-5 Year Olds? Average Age of Diagnosis 1990: 5.3 years Average Age 2000:4.4 years Average Age 2006:3.1 years

104 CA Population Rebounds Post 9/ year olds (In millions)

105 California Legal Immigration Rebounds - Post 9/11

106 Proportion of Asian and Hispanic children with autism rises 18% in DDS system from Ethnicity Asian/Hispanic6,518 12,426 33% of total 39% of total White8,44813,242 43% of total41% of total SOURCE: DDS

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