Autism ﾠ I'm currently doing research into autistic children for a project, and have a few questions for this group. 1) There seems to be a disturbing rise in autism cases, worldwide. Does anyone have a pet theory about this? 2) Some of you may have autistic people in your family, or circle. I would appreciate any comments or observations about them. Especially things you have noticed that you've never heard discussed in media. 3) What media depictions of autism do you find offensive? ## There's a new martial arts flick called "Chocolate" from the same team that brought Muay Thai phenom Tony Jaa to the screen. Only "Chocolate's" star is a woman, a Tae Kwon Do expert who trained for five years (!) for this film. I've seen coming attractions, and she's pretty incredible. If anyone checks this out, let me know, would you? ## Does anyone but me think that the Republicans are shooting themselves in the foot, complaining about the 500K cap on executive salaries for companies that have taken bailout money? I mean, how in the living hell do they expect the average person to have any sympathy for that position, even if, in some way, it makes sense? It feels like a trap they're stepping into. ## I have NEVER felt Delayed Onset Muscle Soreness to match what kettlebell juggling produces, even at a fairly light weight. Good Lord. I can only assume that if I was twenty years younger it wouldn't hit as hard. I'm upping the amount of yoga I'm doing to see if that helps, but if it doesn't, I'll just have to drastically decrease the weight. # Speaking of that, I ran across another odd mental glitch I have to look at. Fifteen years ago, I knew that I had to do yoga every day, in order for my body to work the way I want it to. But the voices in my head do everything they can to talk me out of it. It is so strong, and so persistent, that it actually frightens me. ﾠ From the perspective of my chosen world view, I think I'm hearing the serpentine whisper of my Death drive. We need both, you know: our drive to life, and our urge to destroy ourselves. An excess of Life and we hide from our fears, cowering in the shadows, afraid to change, because true change means the shattering of the ego shell. An excess of Death and we take terrible risks, push ourselves too hard, sprint when we should amble. In this instance, what I think I see is an odd collaboration. Hell...all of this is trying to put words and labels to things that really have no distinct parts. As long as I remember that, these analogies hold. The instant we start thinking: "gee! There, right there on the sonogram, I see my Death Drive! And there's my Inner Child..." etc. An overdose of literalism and the whole thing devolves to puree of bat shit. ﾠ That said, if I don't do yoga, the exercise tears my body apart. My body starts remembering that I'm almost 57. Frankly, it takes about one minute a day of yoga to turn back the clock one year. So...if I want my body to function as if I'm 30, I need a dead minimum of 27 minutes a day, right? And that's just to break even. I probably also need another minute for every minute of high-intensity exercise (sprinting, weight training, etc.) If I don't, the body starts aching. Joints start hurting. My sleep gets interrupted. And the voices in my head hiss: "you're too old for this shit. Why not just relax, and die, like you were programmed to do..?" ﾠ What it uses is the fact that yoga isn't "exercise" in the traditional sense. So, the voice says: "you're a big bad martial artist. You don't need that sissy stuff. You can just do joint rotations, and other sports-oriented Active Recovery stuff. Other athletes don't need yoga. What kind of wuss are you?" ﾠ Man oh man...it works. It's worked over and over again, even though I KNOW what its up to. I'm promising again to get back to a daily yoga routine (the 30 minute Ashtanga routine on the "Yoga Short Forms" DVD works very nicely). I wonder how long it will be before I con myself out of this again. And if I injure myself, it is my family that will suffer for my lack of aliveness, not just me. I have to stop listening to that voice. I am DEFINITELY too old for that shit.
Friday, February 06, 2009
Too Old For This Shit
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I have a grandson who is on the "autistic spectrum."
This is a wide swath -- the term covers everything from the most mild manifestations to the most severe. I think when most people use the term, they are referring to the worst cases.
Look up Temple Grandin, an autistic veterinarian, who writes books, lectures, and who is famous for having designed slaughterhouses designed to keep the cattle from feeling fear.
My grandson is six. He reads above his grade level, does arithmetic above his grade level, and can remember the license plate of a car he passed on the road yesterday. Judging by IQ test, he is considerably smarter than average. He plays computer games far better than I'd be able to if I lived to be a hundred and did it every day.
His social skills lag. Fortunately, these can be learned in his case, and he is already mainstreaming in school part-time and probably will be able to do it full-time within a year or two.
All the evidence I've seen, which isn't much, points to environmental toxins of some kind, and what it is, or they are, as yet undetermined.
I don't think it is vaccine, nothing concrete has been proven there. I worked at a clinic for years, gave a lot of vaccines, and didn't want to be part of the problem, so I did a lot of research on that. I didn't see it as a cause.
Like Parkinson's Disease, there may be a genetic component in some cases, and maybe, as one researcher said about that, "Genetics loads the gun, and environment pulls the trigger." In Cyrus's case, there is no family history on either side as far back as we can see, and his younger brother shows no signs of it. His mother didn't smoke, drink, or do drugs while she was pregnant.
Given that the incidence is rising -- one in a hundred and fifty or sixty children, last I heard -- it would be great if a cause for autism could be identified.
Republicans...are worried about future government influence upon private sector salaries. Does the government have the right to dictate pay rates to everyone who accepts some form of government funding? I don't have enough information to make an informed answer to that, but from speaking to my extreme right wing friends, that seems to be the issue.
A "trap" seems to imply some motive other than currying political favor on the left. Judging from my past interactions with politicians that seems like a strategy a bit too deep for most of them.
My pet theory, which I have seen mentioned in some alternative health ads is that as the soil gets depleted in our farmland, we are more and more deficient in assorted trace minerals, and one or more of these may play an unknown part in brain development. Vitamin D deficiency and iodine deficiency in early childhood could also play a role.
I am going to send you a private note over on 5MM with something else.
"Given that the incidence is rising -- one in a hundred and fifty or sixty children, last I heard -- it would be great if a cause for autism could be identified."
I have a question: *is* the incidence rising, or are the numbers rising because the percentage of affected people hasn't changed but more people are actually being diagnosed as autistic than used to be? That would indicate the methods of diagnosing it have improved but not an increase in the incidence itself.
I think knowing if it's an actual increase in percentage or just better diagnostics might be a step forward to learn the cause ... is it a case of "what changed?" or "what's the core of this steady percentage?"
~ Jas.
My pet theory also leans in the improved diagnostics camp. My father was clearly autism spectrum. Look at our mathematicians, physicists, engineers, chemists ... My husband calls it the INTJ disease (Myers Briggs reference there.)
Both my kids are autistic and I have a friend with *three*, one of which is profound and lower-functioning (but you would have a hard time telling she's autistic if you got an email from her! You'd misjudge age but not communications skills.) My husband appears to be in the spectrum, whereas I'm not.
If you have any specific questions email me.
Things that chafe my cracks--the idea that it's necessarily a bad thing. My kids have incredible spatial perception. We focus on the advantages around here, while maintaining awareness and working on the social disconnects. My kids are proud to be autistic and think it's kewl. It's hard work sometimes, but overall they wouldn't want to be any other way. Although I haven't asked her, I bet my friend's child would feel the same way.
One of the things I've noticed about the stronger-willed of our set of kids, mainly my daughter and my friend's daughter--they are aware that they don't fit in socially, but they could care less. The human race can take a flying leap for all my daughter cares.
She cracked me up one time in grade school. I asked her about a girl who'd just asked if she wanted to play and my daughter said no to. I asked, "don't you like her?" My daughter said, "she's okay, but I already have a friend." "You can have more than one," I told her. "I don't need more than one," my daughter replied, and went off to play. She still, to this day, has one main friend though, now that she's in high school, she's decided it's okay to have more. She has a second friend that she enjoys spending time with and is nurturing a third friendship!
I've been slowly working on a book about this. Not sure if it'll ever see the light of day, but I have lots of stories and I'm willing to share.
Could be either or both. Last research I saw indicated that the current methods of diagnosing AS have shown an increase in incidence after having been in use for a while. Is that because more people are using the tools, or there are more kids to be found? I dunno.
Probably a lot of kids who had minor variations got back as "bad" students back in my day.
A touch of autism is actually an advantage in some professions, they say. Science, computer programming, music, mathematics. The ability to concentrate is heightened in some ways that are useful.
Oh, I'd like to plug my little cause if you folks don't mind. If you're at all convenient to the Pac NW region and either have autistic spectrum kids or know of any, please consider looking into the University of Washington's genetic study of autism. http://depts.washington.edu/uwautism/
They have some great info for those who want to learn about autism. For fiction projects wanting accuracy, I would highly recommend lining up an interview with someone on that team. For non-fiction projects, I think it's essential to look at what these folks are doing in the field. Work that doesn't consider their research would seem incomplete to me, but that may just be a Pac NWesterner's bias.
Autism, or effects on the autistic spectrum, are most probably inherited, and there's also probably a relationship with high IQ. I have close friends who're parents of autistic children, one who's diagnosed as having Asperger's syndrome (and is on his way to get a doctorate in Sociology) and another friend who's doing graduate work on teens with Asperger's.
email me if you're interested in talking to any of these people, and I'll pass on the request.
As it happens, I myself have been diagnosed with an Autism Spectrum disorder (Asperger's).
Personally, it chafes my ass something awful. I dislike being portrayed in the same group as the stereotypical 'autism kid' who sits around silently, has random violent outburst, and is a burden on his parents (though they'll never say so aloud!) Very TV movie of the week type shit.
Basically, I dislike the perception that something is 'wrong' with me. Ten or twenty years ago, I would have been considered an INTJ personality type and we'd have left it at that. I don't suffer any neuromuscular troubles, I can look people squarely in the eyes, and I've learned social skills.
I think treating it like a 'disease' is coddling, in a way. Never having known anything about this until a couple years ago, I wasn't brought up with the expectation that other people should accommodate me. It isn't like we can send our children into the world as adults with neon signs that read "Autistic--Handle With Care."
Well, really we can and do, but those signs serve nobody's purpose. They set up the other person with a pejorative context to view you in, and they set you up with some vain expectation that anyone gives a damn what your malfunctions are.
My pet theory on the rising incidence, by the by, is increased diagnosis. Not necessarily /improved/, but increased. Notice how it coincides with increased ADD diagnosis and tranquilizing (or technically stimulating) every ten year old boy in America for behaving like (gasp) ten year old boys?
Watch a pharmaceutical company's presentation to doctor's sometime. Note the 'Don't Miss the Diagnosis!' taglines.
And yes. The whole thing has left me bitter and a tic paranoid. I'm aware of this and I've made my peace with it. And I've also learned not to tell people I have anything that even smells slightly like an AS disorder. It buys you two days of slack then a lifetime of being viewed askance. Not to mention the condescending remarks of "Oh, you're doing an Asperger's thing" every time I display a bit of personality or prickliness. What, I can't have a bad day, or be stubborn, or misunderstand someone without there being a disease in my head?
Could you expand on the death wish thing? How sure are you that it's biological rather than a cultural meme?
I'm up against quite a bit of it myself-- I know how good the Tibetans are for me, but I'm having a hard time getting back to them.
In my case, they're starting to look more attractive again, and I'm wondering if I was going through enough emotional changes that I didn't want/need to have the changes shoved along faster for a few weeks.
Perry,
I have a grandson who is on the "autistic spectrum."
I suspect you have a nephew who is, too. Probably not entirely a coincidence -- the ability to think algorithmically appears to be associated with an increase in the tendency toward autism.
I just found out a couple years ago that Steve Perry's nephew was a very bright young man who I worked with at launch.com -- one of the original online radio stations -- back in the late 90s.
A touch of autism is actually an advantage in some professions, they say. Science, computer programming, music, mathematics. The ability to concentrate is heightened in some ways that are useful.
Yep, there's a lot of that in my field. At the extreme ends you get guys who can't carry on a conversation, but code like deranged weasels.
I can do both, which is why they keep trying to stick me in management....
Bennett wrote, among other things:
I think treating it like a 'disease' is coddling, in a way. Never having known anything about this until a couple years ago, I wasn't brought up with the expectation that other people should accommodate me. It isn't like we can send our children into the world as adults with neon signs that read "Autistic--Handle With Care."
I agree with a certain amount of this, but I can't detach from the fact that kids like my friend's daughter, the 'stereotypical autistic kid' is profoundly affected by autism. I think even in her case there are huge advantages, and I know she wouldn't want to be any other way, however, it's very very difficult and clearly a disability in her case. I think that awareness of the spectrum helps her out a lot. A little extra patience goes a long way. And yeah, there's the pity part and condescending dismissal of valid emotional states that's annoying, but you know, for cases like my friend's daughter I'd be willing to put up with some inappropriate bs knowing that she'll benefit on the other end of the scale.
I know little about the subject, but from that little I suspect that the increase is in at least part due to a change in definition/diagnosis. It appears that children both who exhibit a smaller number of symptoms and symptoms to a lesser degree are now being classified as autistic and that doctors are also more alert to the symptoms.
I"m no expert on Autism Spectrum Disorders and feel that Kami may be in the best position to enlighten us on the subject but I have some interest and have done some study and I think there are a lot of things in play here.
I agree with those that say the diagnostic tools have changed so that there is an increased number of diagnosis per 100 children. I also think that our schools and medical profession tend to overdiagnose certain things like ADD or Autism and it goes in cycles. In a year or two it may be something else that hits an all time high. Autism and Autism Spectrum Disorders are the pet diagnosis right now. ADD is down somewhat,as they've been accused of overdiagnosing.
There is increased awareness of these things as well which leads ot more diagnosis, and appropriately so. I think of the 'mountain men' of the last century and presume that many of them lay on the spectrum somewhere.
It does seem to be highly genetic but varies in 'intensity' from person to person, even within a family. I have a friend who I believe is somewhere on the spectrum whose father we believe was also Autistic. Since it was not diagnosed at that time it may have actually lead to his death as he did not have the tools to compensate for it in his work. Her two sons are also Autustic.
To the person that says many are coddled. I agree. I have another friend with a son who is now in his 20's and he has been excused from every thing that would have helped him grow up to be an independent adult due to his diagnosis. He's quite bright but he will always live at home. There are, however, those that require much more work and assistance than you perhaps and they wear their issues like a sign around their necks. they can't help it. Got to cut them some slack.
As to causation...I read an interesting theory many many years ago which has not carried forward to this date but that has always sort of stuck with me. Many severly autistic children exhibit the kinds of behavior that a person in total sensory deprivation exhibits after a long period of time. The theory was that perhaps, these kids were mentally ready to be born long before their actual birth and this is the result of many months of sensory deprivation. Bizarre, I know but I"ve not been able to shake it.
Other research is pointing to genetic and environmental issues. Lord knows what we've done to ourselves over the last century or so.
Does the government have the right to dictate pay rates to everyone who accepts some form of government funding?
Of course it does. The government is like a super investor in this instance. They are buying into a position of control like individuals that own large volume of stocks. Its like a position on a board of directors, they are stipulating that their money can only be used under certain conditions. I'm finding it hard for anyone to reasonably justify offense at government involvement this way. If corporations don't want strings attached, they don't have to take the money. Firms had chances to have the money without conditions and spent it on frivelous trips, exhorbitant bonuses, and many banks refuse to say where the money was funneled to. Accountability is non-negotiable when you're using money that belongs to the people.
Well, I don't think the government should have done *any* bailout, but then I'm a tad radical that way.
And I have a real problem with the government suddenly becoming stockowners of thousands of businesses...having seen what they can do for a business (Amtrak, anyone?) and a health care system (VA hospitals..of which I have far too much personal experience with) I don't have any belief whatsoever that government will be part of the "solution".
I'm not sure how comments on stimulus package/bailout fit into this discussion, but I'll throw in my biggest peeve on the subject right now. This country has gotten so divided that news commentators seem more interested in analyzing who wins the Republicans or Democrats from the battle over this bill then in what's in the bill. Its real simple if what ever bill passes works we all win Republicans and Democrats and if it fails to do the job we all lose.
Well, I don't think the government should have done *any* bailout
I agree wholeheartedly. I wrote to every congress person I could get access to, demanding them to listen to us and not pass the first bailout. Pelosi told me to shove it sideways because I wasn't in her district. Everyone else just ignored me. I only meant to assert that if the government is hell bent on giving away tax dollars they better ensure that its used appropriately or at the very least maintain some accountability on the part of the companies receiving it.
I don't like the government telling corporations how much they can pay their employees. Given the way the feds have abused the federal highway funding (to impose nominally "voluntary" raised drinking age laws, among other things), it's a bad prcedent.
On the other hand, apparently the bill enabling the bailouts including language which permitted them to make this call. The bankers and other executives who signed on to belly up to the federal teat presumably understand the concept of contracts. So...sucks to be them, I guess. But they agreed to the terms.
well, this is my two cents about autism. I live in a city that barely qualifies as such, basically one step above being east cupcake nowhere. the point is there aren't a fantastic amount of people around and yet there are alot of young kids with autism around.its scary. my wife knows five women with kids who have severe autism. unfortunately they all have the same story to tell. they brought their children in for a shot. child has a bad reaction. mother is assured by doctors and nurses its nothing to worry about. follow up shot child has worse reaction and loss of motor/ developmental skills, again doctors/ med staff say its not the vaccine. child recovers somewhat and final vaccine is administered.. child has convulsions or coma. this time the child survives but doesnt recover fully. My kids didnt get vaccinated. we will do a slower less aggressive schedule. Its one thing to look at a website against vaccines. hell you can find anything on the web. It is totally another to hear stories like these in person. Did the vaccines damage these kids? there moms think so. Why then can so many kids have the same shots and have no ill effects? My theory is that evironmental pollutants are finally catching up to us. Even a fleeting look at the news tells that nature is reaching the breaking point. killer whales dying off.. inuit mothers who cant breast feed because their milk is full of pcbs. Its all shades of Warren Zevons "Run Straight Down" scary
Langdon
You might want to check out Dr. Amy Yasko at http://www.holistichealth.com/. Her work in selecting treatments according to genetic testing is alleged to be nothing short of fantastic. There are groups using her basic paradigm for the treatment of various chronic diseases like ME (Myalgic Encephalomyelitis) as well.
I feel that some of the increase in autism is due to expansion of the term: Asperger's for instance, would probably not have been categorized as "autism" years ago. When I took Abnormal Psychology years ago (1980 or so) the only discussion of autism was a step up from "idiot savant" to "autistic savant". Not much of an improvement, frankly.
A speculation and a proposal: If autism generally confers advantages in mathematically and visually intensive activities such as coding, computation and the physical sciences, shouldn't its incidence be apt to increase in response to greater opportunities for those so inclined? That is, if autism generally enhances skills that confer economic (i.e. reproductive) success, its incidence should NATURALLY increase via Darwinian Selection, regardless of potential helpers such as pollutants. Or course, the number of Autistic people possessing "abnormalities" so severe these cripple the bearers cognitively and socially would also markedly increase. The situation would be analogues to populations with high Anti-Malarial Trait incidence, who as a whole thrive amid malaria infestation, while those unfortunate enough to bear double doses of mutant hemoglobin genes aren't long for this world. Greg Cochran's work on Ashkenazim Cognitive traits offers another, closer parallel. If correct, North European Jewry gained hyper-enhanced cognitive (i.e. economic) fitness at the expense of a fraction of its members, who pay for the majority's gain with crippling neuro-muscular impairments. Perhaps we should shift our focus from the institutionalized Rainman-esque extremes to the legions of high-functioning, upwardly mobile autistics whose insights propel scientific and technological progress and support our collective prosperity. In short, let's consider accepting and even possibly embracing Autism as both natural and indeed often desirable, instead of viewing it as an aberration, decrying its increase and stalking industrial scapegoats to combat it.
On the personal level, my sister is severely autistic and requires supervised care. She also possesses heightened spatial skills, as evidenced by her art, pieces of which have been on exhibit.
Langdon --
The plural of anecdote is not evidence.
Some years ago, my family came down with intestinal flu. Eventually, we all had it, but my daughter developed the symptoms first.
We all went out to a Chinese restaurant one evening, and the next day, she fell ill.
While it was possible that she could have gotten food poisoning, and that had to be considered, nobody else had any symptoms and we all shared the same plates. My daughter was convinced it was the Chinese food, and for years, would not eat any such.
Over the course of the next four or five days, each of us developed the same symptoms, as did friends and neighbors who hadn't eaten at the restaurant. It was flu season.
If your belly is rumbling, whatever comes down the chute could be a precipitating event, and not a cause in itself, but a result.
When something happens and we don't know the cause, we start looking. A lot of children who have been diagnosed autistic have had childhood vaccines. But some who haven't had them also have been diagnosed on the spectrum. The syndrome has been around long before childhood vaccines were routinely administered. There wasn't a term for it until the 20th century, but is has been around much longer.
At the very least, that tells you that there must be some other cause in the works. There might be multiple causes, but nobody has found a definitive scientific link that the MMR vaccine does it.
Steve, your point is well taken, no multiple anecdote is not evidence of a direct link between mmr shots and autism. the reaction to the shots might well be caused by environmental factors or something else that we don't know of yet. However, I suspect that it is due to environmental pollutants. we have thousands of man made chemicals in our environment. recently we have been seeing signs of stress in animals, particularly those at the top of their respective food chains. human beings are pretty much the alpha predators no matter how you slice it. is it unreasonable to think that we are being stressed too? Autism was around long before modern vaccines, but i think it was extremely rare, not about 1 in 160 kids. Am i wrong? langdon
On Chocolate - I haven't seen it myself, but I bought it as a gift for a friend who is a martial arts movie fan, and he *loved* it. Another friend who bought it at the same time also gave rave reviews - I'm looking forward to seeing it.
The question of incidence is open. It wasn't diagnosed as frequently, autism spectrum, but there were undoubtedly a whole bunch of kids who were just lumped into the bad-behavior, doesn't-apply-himself, troublemaker categories who would qualify for it today, just as ADD or ADHD kids didn't get noticed.
Ever buy a new car, then suddenly notice there seemed to be a lot of them on the road just like it?
Before, you weren't looking, had no reason to.
I suspect environmental triggers, just as in things like Parkinson's, which really took off after the Industrial Revolution. There is a lot of crap in the air, water, soil, our food, that didn't use to be there. Civilization is a huge stress factor. The aether is full of radio waves, electricity, all kinds of unnatural radiation. The combinations of things are beyond calculation, and nobody knows what might do what to whom.
It is worrisome.
At 57, too much of anything is a foundation principle. If you dissect out the principles of yoga they can be applied to any activity. You touch on that with your comment that decreasing the kettlebell weight is necessary to decrease the muscle soreness. This mindfulness can and should be applied to all that we do. Sport specific training is essential if you want to excel(any definition). A different definition of yoga is all thats required to do everything that is necessary.
OLDDUDE
*"PET"* Theory?
Yes. I think it's the next wave of human evolution. I think the autistics are arriving slightly ahead of the curve, but I think they will prove increasingly useful as we learn to adjust for them.
I think they are "designed" for man\machine interface and come the next-gen personal omni-device they'll fit right in and probably begin to stand out.
I think modern technological pressures are increasing their numbers.
That's my pet theory.
I've seen a lot of articles saying that Aspergers/Autism are much more common in boys. Then I see the descriptions of the behaviors. And I have developed some pet theories:
1. I think it's not new, but just more commonly diagnosed, now because we are looking for it.
2. It's more commonly diagnosed in boys, because autism spectrum disorders are more maladaptive in males. Men who cannot engage with the world are going to have a tough time of it, while women who don't engage will just be seen, and treated, as passive. The patriarchy will provide some large percentage of the autistic women, with fathers and husbands who will manage the parts of their lives, that autistics have such trouble with. And no one will ever notice - these women will just disappear into housewifery.
On autism, it doesn't help that the seminal work (which has inspired many of the activist who fight innoculations) was faked:
http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece
And it may be virtually impossible to directly research the answer (more likely it will be stumbled upon while looking for something else). We're just beginning to learn the cascade effects of gene activation and the interaction with environmental factors. And our current exposure to chemicals via the food chain is staggering. Equally problematic is the impact of plastic slush in the ocean food chain.
If the world could divert even 10% of current military spending into basic research we could revisit science fiction as template rather than fantasy. Not that I want us distracted by staring at Mars when we don't have decent maps of half of the US (the half that is under water given our 200 mile claim on the sea beds)....
I'm going to chime in with my agreement to most people here. The increase in autism is due to the expansion of what is considered autism and better diagnosis.
One thing it is NOT is vaccines. The anti-vac people are a bunch of damned kooks. There was even an incident not too long ago where some anti-vac group was doing a joint study with a medical group and when the study didn't turn out the way they wanted, they disavowed it.
And don't get me started on Jenny McCarthy. "Mommy Instinct", indeed.
Get your kids vaccinated. It not only protects your own kids from diseases that can be deadly, it helps everyone else. Especially infants not old or healthy enough to be vaccinated. Herd immunity needs to be maintained. It's no coincidence that the measles outbreaks are all happening in populations where the anti-vac goon squads have gotten a foothold.
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