Autism and Abstinence. Get the connection?

Newsflash!  Two surprising medical announcements came out this week and you’re probably wondering why on earth we think they’re related.

First, and oh-boy does this make my head explode, is the retraction by the ultra well-respected medical journal Lancet of their 1998 paper that linked the childhood MMR vaccine to autism.  Dr. Andrew Wakefield, the author of the original paper and the father of the autism-caused-by-vaccine movement, was found to have acted unethically in conducting his research. Oops! Experts in the field now doubt that such a link ever existed.

As many of our loyal MamasOnCall readers know, I’m a big fan of childhood immunizations. And I also believe that parents, armed with all the best up-to-date information available, will make the right decisions about the care of their kids.

So it’s incredibly disappointing when a research source as highly regarded as Lancet has to admit an error that has had this much impact on medical practice.

Not only does it discredit the last 12 years of controversy over childhood vaccines, it makes all those parents who chose to delay them, or forego them altogether, wonder what they were thinking.  Just as important, it’s a huge slap in the face to parents who put their faith in Dr. Wakefield and truly believed he had identified the cause of their child’s autism.  And, oh by the way, it sheds big-time doubt on other “research findings” so many of us hang our hats on.

That brings me to the second revelation of the week.  And this one is truly eye-opening.  A study  published in the current issue of the Archives of Pediatrics & Adolescent Medicine found that abstinence-only education is the most effective way to prevent 6th and 7th graders from having sex during the next two years.  Yes, you read that correctly folks.  If we tell our very youngest teens to “just say no”, we have the greatest chance that they’ll remain chaste … um, at least until they reach the age of 14.

According to the study, about one-third of the pre and young teens who received an eight-hour abstinence-only lesson had sexual intercourse within two years of the class, as compared to more than half of the students who were taught only about safe sex and condom use, and more than 40 percent of students who received a course incorporating both abstinence education and safe sex.

Now, I ask you, does this pass the smell test?

The study looked at 662 African-American sixth and seventh-graders recruited from four public middle schools that serve low income communities in an unidentified city in the northeastern United States.

These were high risk kids with higher-than-average rates of sexual activity at younger-than-average ages. They were studied between September 2001 and March 2002. Hmmm. Is this a representative sample?  Are these current and timely results? Did this study use reliable scientific methods?  I’m not feelin’ it.

Don’t even get me started on all the reasons why abstinence-only education makes no sense, because that’s a topic for another day.  Suffice it to say that yes, 12 to 14 year olds should be counseled that it’s best to wait to have sex until their bodies and their brains are more fully formed.  For lots of reasons.  AND they should also be taught the biology of sex, how to prevent pregnancy, and how to avoid sexually transmitted disease.

I’m a doctor and I’ve been taught to respect science and research.  It’s the most important tool we have to advance medical practice in a responsible, information based way.  We depend on it.

But wrapping “information” in a cloak of academic respectability without real integrity diminishes us all, experts and parents alike.  We can’t possibly make informed decisions if the data we’re depending on is suspect.  If we can’t be assured that the results guiding our decisions have been subjected to scrutiny before they’re accepted, what are we to believe?

I’m ashamed of my colleagues who are responsible for this stuff.  It’s a good reminder to always ask ourselves … does common sense support these results?  Have other studies come to the same conclusions?  Have the conclusions been rigorously examined?  If not, cast a critical eye.  Ask questions until you get answers. Don’t fall for the big headline without doing as much due diligence as you can.

Gee, maybe abstinence causes autism.  Or vice-versa.

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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2 responses to “Autism and Abstinence. Get the connection?”

  1. Jay Bute

    The study has defined limits, the “set”: urban Yankee low income school-attending black kids studied over individual time lines of 11/12-13/14 years of age. The study indicates a marginal deferral of sexual activity, from 1/2 down to 1/3 in the 2 year age range. This study is very tightly constrained and “most effective” is comparative to other modalities, none of which can be labelled “effective at preventing adolescence sexual activity” in the cohort studied. This study is not “eye opening”. It is too constrained by design and too uncertain of result to have any broad usefulness at all in pedagogy or medicine. HOWEVER, it may say something important about preventing unwanted pregnancies among 11-14 year old urban black girls. The inferred reduction of such pregnancies by 33% may well be an important social outcome.

  2. Abbi

    I have to agree with Jay. How do you define “representative sample”? How do you define “current and timely results”? If you said this study was from 1991-92 or 1961-62, I’d have to agree with your questioning the study’s timeliness. But a study from this decade? I’d hardly describe that as ancient.

    As for representative sample, are you suggesting that because the study didn’t include white middle class students from your neighborhood, that makes it invalid? Black girls from the hood don’t count in science? Clearly, the study’s authors chose to focus on a specific population in a specific area. 662 is not a minute sample size. I’ve read about studies published in peer reviewed journals that use 12 as a sample size.

    It basically sounds like you’re questioning the study’s validity because you disagree with the results, because “abstinence-only education makes no sense” to you. Is this your approach to all studies that prove things that make no sense to you?

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