Painful home videos in the autism/vaccines trial
The government began its defense against the vaccines-cause-autism theory on Monday with expert testimony that Michelle Cedillo was showing symptoms of autism well before she got a measles vaccine. Using some of the same videos that the court had viewed during the testimony of Cedillo’s mom, Dr. Eric Fombonne pointed out behaviors in baby Michelle that he said were evidence of developmental delays.
Teresa Cedillo had presented the videos to show that the girl was normal before she got the MMR shot in December 1995, when she was 16 months old. But Fombonne, director of child psychiaty at McGill University in Montreal, asserted that her failure to respond to parental promptings, and her hand flapping, mouthing, and single-minded obsession with a Sesame Street video—all of these occurring when she was as young as 8 months old--were early warning signs of autism.
During her testimony, Mrs. Cedillo had testified that the video became a singular object of fascination to her daughter only after she got the MMR shot, suffered ten days of intermittent high fever, and went into decline.
As odd as it seemed for the court to be arguing about Sesame Street, Michelle’s response to the video was striking. As it was being put on, she would tense and flap her hands and legs, growl and stare fixedly at the screen.
“I have no doubt in my mind when I see that child that she is very abnormal and shows clear signs of global developmental delay and clear autistic type behavior,” Fombonne testified. “It’s common that parents, especially first-time parents don’t pick up such abnormalities. And they should not blame themselves for that. But with hindsight you do see these very clear patterns.”
Cedillo’s lawyers pointed out in cross-examination that not all autistic children show precisely the same symptoms as infants. As a parent of neurotypical children, I was able to detect some of the abnormalities that Fombonne pointed out. Other behaviors seemed like the kind of weird things that any baby might do.
But Fombonne also demonstrated that Cedillo had an abnormally large head circumference during her first year of life, a warning sign of autism. Her pediatrician’s chart showed delayed speech and motor control, which might be indicative of autism or mental retardation. He disputed that Cedillo had lost language after the shot, saying there was little evidence of much language before she received it. Fombonne acknowledged that Cedillo’s pediatrician had not noted any concerns about communication or behavioral issues until three months after the MMR shot.
Asked what she thought of Fombonne’s testimony, Teresa Cedillo shrugged and said that he was doing his job.
Introducing Fombonne and 11 other witnesses, the Department of Justice lawyer leading the government’s case dismissed last week’s testimony on the grounds that it lacked a plausible theory of harm. The lawyer, Vince Matanoski, noted that Marcel Kinsbourne, the final Cedillo witness and the one who was supposed to wrap up her case, scarcely mentioned thimerosal at all, and stated that if there was no measles virus present in her gut, he would have to withdraw his theory of MMR-induced autism.
Biological plausibility, Matanoski argued, “is not a daisy chain of 50 percent possibilities.” In a snipe at the credentials of some of Cedillo’s witnesses, Matanoski noted that his panel would include scientists who were “based in hospitals, not courtrooms.”
Earlier in his testimony, Fombonne described the varieties of autism, the first time the court had heard a careful explanation of the disorder. He noted that autism had probably existed for centuries despite the fact that it was only Leo Kanner, in 1943, who gave it a name. Then too, Fombonne said, “onset” of autism is not when a parent first notices it. He compared it to cancer—a process that may be going on for weeks or months before it is detected.
Citing the literature with considerable mastery that was reflected in the paltry cross-examination (which focused on his paid legal consultation with the pharmaceutical industry since 2004), Fombonne stressed the clear genetic contribution to autism and the fact that in 90 percent of all cases, no clear cause is known. The few known environmental contributors have occurred in the first trimester of the mother’s pregnancy, he noted—for example rubella infection or thalidomide.
By 16 months of age a normal child would comfortably use 40 words, Fombonne stated, yet Michelle used only 10, and mostly in imitation, according to the records from a later neurological examination of the girl. She was also unable to sit without support until 11 months. Six months is the usual milestone.
Most poignant, perhaps, was video shown of the girl’s one-year birthday. Presented with a large wrapped box, Michelle leans on it with little interest, and does not respond to her mother and grandmother when they tell her to open it. The box slides away, and Michelle falls. She is straightened up and placed in front of the box again, facing the camera. But though she touches it, her grandmother eventually opens the present.