Author Archives: Mike

Yet Another Baseless Labour Party Scare Story

jeremy_corbyn-1Labour Officials warned to be on the alert for violent behaviour at Labour Party Conference.

This is a headline in today’s i paper. Apparently there is a memo, we are not told who wrote it, that warned Labour Party officials to be on the lookout for “aggressive and potentially violent behaviour” at the conference this weekend.

I am sure the Labour Party will be able to handle anything that comes their way. After all they had no problems 11 years ago when a Stop the War Coalition member was forcibly ejected for heckling the then Foreign Secretary, Jack Straw during a speech supporting UK military intervention in Iraq. According to the Daily Telegraph

The Foreign Secretary was telling the conference that Britain was in Iraq “for one reason only” – to help the elected Iraqi government – when Walter Wolfgang shouted: “That’s a lie and you know it.” Mr Wolfgang, was immediately surrounded by security staff in full view of the television cameras and ejected from the hall in Brighton as officials revoked his pass.

When he tried to re-enter the secure zone, he was stopped by a police officer citing the Terrorism Act. At first Sussex police denied that Mr Wolfgang had been detained or searched but a spokesman later admitted that he had been issued with a section 44 stop and search form under the Terrorism Act.

Mr Wolfgang said: “We have reached a situation where freedom of expression has been threatened. I am not surprised, because the Labour Party has been taken over by a gang of adventurers who are on their way out.”

Mr Wolfgang was just as left wing as Jeremy Corbyn. He was a founder of CND who wanted to nationalize the land, ban nuclear weapons and leave NATO. And for that he was ejected from the Labour Party conference and arrested under the Terrorism Act. But the next day he was back in the conference and Prime Minister Tony Blair publicly apologised on national radio and television.

So when politicians like Chuka Umunna claim that levels of abuse, intimidation and vitriol in the Labour Party are worse than he can remember in the last 20 years, perhaps someone should remind him of the time the Blairites had to apologize when their “thugs” (with thanks to my MP, the Blairite John Woodcock for legitimizing this term of political analysis in a recent article in the Daily Mail) picked on an 82 year old Jewish socialist who escaped to Britain from Nazi Germany before the Second World War and joined the Labour Party in 1948.

Speaking of John Woodcock, his article ended with an invocation of the name of Clement Attlee. This showed an unfortunate sense of timing given that Atlee’s great nephew and great niece recently came out in support of Jeremy Corbyn. And then one of them, John MacDonald, was suspended from the Labour Party for activity on social media that does not exist. 160912-john-macdonald



 This is old style Blairite spin in action. Feed the press with a scare story about potential bullying and intimidation that has not happened yet, while conveniently ignoring what did happen when you were in charge. Raise up the spectre of a hit list of MPs facing potential deselection while ignoring the fact that thousands of members have already been deselected by the Labour Party’s Compliance Committee removing longstanding members’ right to vote. Complain about abuse while subjecting Corbyn and his supporters to unremitting abuse, questioning their capability, their honesty and their political and moral fibre while studiously avoiding any reference to their policies. Unless your name is Owen Smith. In which case you lay claim to the policies while launching personal attacks on a leader whose policies you claim to support.

Never mind. Jeremy Corbyn is going to win the leadership election AGAIN. Will his opponents in the Labour Party remember their democratic credentials and get behind him. What would Clem Attlee think of it all?  160912-clement-attlee


A Tale of Two Headlines

 

Frontpage1On Tuesday 19th July the Northwest Evening Mail was dominated by the news that the renewal of Trident guaranteed the future prosperity of Barrow-in-Furness, where BAe Systems will build the Successor programme of Trident submarines.

The project, which is estimated to cost £31 billion, will bring new buildings and roads to Barrow. 5,000 extra jobs are expected on top of the 7,000 people who already work in the shipyard and the knock on effect for property prices and other businesses in the town will make life better for many people.

But the day after the announcement anFrontpage2other front page headline in the Northwest Evening Mail suggested that not everybody  benefits from the Trident programme. The Borough Council are facing another round of cuts in the service of the government’s austerity programme. These cuts will inevitably fall upon the poor, the sick, the disabled; all those people who depend upon council services. As well as a food bank we also have a soup kitchen for those who cannot always afford the energy to cook a hot meal.

When I first moved to Barrow, thirty-three years ago the shipyard dominated the town even more so than today. 14,000 people worked in the yard, including thousands of white collar workers who drew up the plans and drawings for the vessels the yard built. There was a thriving apprenticeship scheme. It was hard to find a household without at least one family member employed by Vickers Shipbuilding & Engineering Ltd, the company that ran the yard in those days. When the whistle sounded for “Vickers Out” thousands of workers would stream out on foot and on bikes filling the entire road.

Since then computer aided design has devastated the prospects for white collar employment. High tech production techniques and new employment practices such as subcontracting rather than direct employment have affected the blue collar workforce. The closure and demolition of the apprentice school may have been more symbolic than real in its consequences but the message to young Barrovians was clear. You could no longer rely upon the shipyard for your future.

House prices tumbled as Boom Town Barrow went into decline. My wife and I were trapped by negative equity for years as skilled workers were selling up and moving on in search of employment. Young people who could get to university did not return to bring their skills and enterprise to the town.  The 2011 census revealed a 4 per cent decline in population at a time when the overall population of England and Wales was rising at record rates.

Throughout this time the shipyard has survived and prospered thanks to the government funded Trident programme. It is now a profitable part of aerospace giant, BAe Systems. And those Barrovians who were able to keep their jobs or acquire the skills required for the new jobs have benefited from the Trident programme. But I am left with the feeling that, where once the shipyard was a unifying influence that brought prosperity to the whole town, now it seems to divide the town. The shipyard is booming again thanks to massive government expenditure. Meanwhile government cuts are devastating the lives of those least able to benefit from this boom. The high street is dominated by charity shops, Poundsavers and Poundstretchers, and other discount stores. And it could be argued that the people who use them are in effect subsidizing the jobs of their more fortunate neighbours via cuts to social care budget.

This divide was succinctly illustrated by the front page of the Evening Mail on Wednesday 7th September. This issue celebrates 30 years of submarine production at the Devonshire Dock Hall, the largest structure in Barrow and soon to be dwarfed by the buildings that will house the Successor programme. But the main headline tells a more shocking story.frontpage3

Crimes of violence against the person are as bad as Manchester and worse than Liverpool at 20.5 per thousand people. Self-harm is also way above the national average at 358 hospital admissions per 100,000 people. Problems with alcohol and smoking related deaths are also above the national average. There is a well-established link between figures like this and poverty. Barrow, despite thirty years of prosperity based on the Trident Programme and looking forward to a similar period of prosperity during the Successor Programme is one of the poorest, most deprived boroughs in England.

Personally I am opposed to Trident. Weapons of Mass Destruction are immoral whoever wields them. And there are plenty of other infrastructure projects around transport, renewable energy and carbon capture that would benefit from similar levels of investment and guarantee jobs for years to come. There is also an argument that being obsessed with great power status and possessing a so-called independent deterrent detracts from a proper debate about the role of Britain in the world and the sort of armed forces we need to carry out that role. For now that debate is over. Parliament has approved the Successor Programme. Even if we get a Labour government committed to abolishing our deterrent, it will be well nigh impossible for them to extract us from all the contracts, deals and agreements, never mind the horrendous penalty charges that would entail.

We can still learn from the past thirty years. How could such massive expenditure in Barrow lead to increasing poverty and a growing divide between the haves and the have-nots? We may not be in as position to stop the renewal of our nuclear deterrent. But we should strive to ensure that this new tranche of government investment serves to narrow that divide rather than exacerbate it. That is a discussion that ought to find favour with all wings of the Labour movement.

Corbyn’s critics plumb new depths

On Sunday Nick Cohen wrote a column in the Observer: Extremism thrives because of cowardly collaborators.  It was fairly run of the mill. Republican politicians who pride themselves on their desire to emulate Churchill and compare Obama’s rapprochement with Cuba to Chamberlain’s appeasement of Hitler are showing cowardice and hypocrisy by refusing to condemn Donald Trump whom Cohen describes in these terms:

I don’t throw the word “fascism” around, but can we at least accept that Trump follows the Führerprinzip? He has no colleagues, only followers. He is a racist. Not a closet racist, or a dog-whistle racist, but a racist so unabashed that the Klan endorses him. Above all, he has the swaggering dictator’s determination to bawl opponents into silence with screams of “loser”, “dummy”, “fraud”, “puppet,” “biased”, “disgusting”, “liar” and “kook”.

Cohen believes that Trump is unfit to hold office and that any Republican worth his or her salt should come out and say so. But most are staying silent or openly endorsing him, either out of fear or self-interest. This is unremarkable stuff. Many American commentators are making similar points, going so far as to say that Trump is destroying the GOP. This might be expected from The Washington Post but a former speechwriter for President George W. Bush is saying the same thing.

Now, I imagine the last person most people would compare to Trump is Jeremy Corbyn. Yet Cohen does just that in his final paragraphs.

Compare them to the British Labour MPs fighting Jeremy Corbyn. They are everything that conservatives despise: hand-wringingly PC, eco-conscious, emotionally literate, bleeding-heart do-gooders every last one of them. Christ, some of them may even read the Observer. But after the killing of Jo Cox by an alleged rightwing extremist, Angela Eagle, Jess Phillips and all the other anti-Corbyn MPs who are speaking out know that the death and rape threats from left-wing extremists may not just be bluster.

They are showing true courage. Not just moral courage but physical courage. A courage that those American conservatives, who are so loud in the determination to fight the threats of the past, and so silent before the dangers of the present, entirely lack.

By extolling the courage of Labour MPs who stand up to Corbyn and denigrating the cowardice in the GOP is Cohen implying that Corbyn is no better than Trump? And having already compared Trump to Hitler is he suggesting a similar parallel with Corbyn? Perhaps he is harking back to the furore about alleged anti-Semitism in Labour’s ranks and laying that at Corbyn’s door.

And note the not so subtle reference to the “alleged” right wing extremist who murdered Jo Cox that is set against the unequivocal “left-wing extremists” who are blamed for the anonymous online abuse being aimed at Corbyn’s opponents. You can almost hear the subtext.

“They say he was rightwing but just you wait until the left-wing extremists start making good their threats of violence. He may turn out to be not so rightwing after all.”

I happen to agree with Cohen about the craven hypocrisy of Republican politicians. But conflating that with the death of Jo Cox to imply that Labour MPs are more at risk of violence than their American counterparts in the GOP is taking the campaign against Corbyn to new depths. And it is not true. Apart from the IRA bombing campaign against Britain very few UK politicians have been the subject of political violence. By comparison, thirty-four US politicians and senior officials have been assassinated since 1825, including four Presidents of the United States. The most recent was a federal judge, John Rolls in 2011. Sixteen have been killed since the assassination of JFK in 1963. Following his assassination seven US presidents have been the subject of assassination attempts including Barack Obama. The plot to kill him was thwarted at the planning stage in 2008. You can read the full list here.

But in Cohen’s book the Left are all potential murderers and rapists unless proven otherwise. When allegations are raised about conduct within our ranks we are expected to condemn them out of hand whether they are true or not. Remember Angela eagle’s constituency office window that was never broken?

Perhaps he should reread his column, particularly the part where he says,

Latinos have to explain why they are not rapists and murderers or shut up and give up. Muslims have to explain that they are not terrorists or they lose the right to a hearing. At every stage, the argument is shifted on to the troll’s terrain of ethnic and religious loyalty tests. Except here the troll could become the world’s most powerful man.

We know how they feel. Except that here the troll writes a weekly column for the Observer.

Will Theresa May keep her promise to deliver “A Better Britain?”

ThTheresa Mayere has been a lot of talk about Theresa May occupying the centre ground and even threatening to undercut Labour with a speech that would not have sounded out of place at a Jeremy Corbyn rally. But before we get carried away, we would do well to compare her words with those of previous Conservative Prime Ministers on first coming to power. Then compare and contrast those words with their record in office.

Theresa May July 15th 2016

‘That means fighting against the burning injustice that if you’re born poor you will die on average nine years earlier than others. ‘If you’re black you are treated more harshly by the criminal justice system than if you’re white. If you’re a white working class boy you’re less likely than anybody else in Britain to go to university. ‘If you’re at a state school you’re less likely to reach the top professions than if you’re educated privately. If you’re a woman you will earn less than a man. ‘If you suffer from mental health problems, there’s not enough help to hand. If you’re young you will find it harder than ever before to own your own home.’ She added: ‘But the mission to make Britain a country that works for everyone means more than fighting these injustices. ‘If you’re from an ordinary working class family, life is much harder than many people in Westminster realise.’

Margaret Thatcher May 4th 1979

“And I would just like to remember some words of St. Francis of Assisi which I think are really just particularly apt at the moment. ‘Where there is discord, may we bring harmony. Where there is error, may we bring truth. Where there is doubt, may we bring faith. And where there is despair, may we bring hope.’”

John Major December 4th 1990

“Amidst the inevitable competitive thrust of life, it should be a compassionate society. Genuinely compassionate – because some people do need a special helping hand to help them enjoy a full life of choice and independence. And we should never forget that small changes in the lives of private people are every bit as important to them as dramatic changes in the lives of public people. And a classless society: not in the grey sense of drab uniformity – but in the sense that we remove the artificial barriers to choice and achievement.”

David Cameron May 11th 2010

One of the tasks that we clearly have is to rebuild trust in our political system. Yes that’s about cleaning up expenses, yes that is about reforming parliament, and yes it is about making sure people are in control – and that the politicians are always their servant and never their masters.

But I believe it is also something else. It is about being honest about what government can achieve. Real change is not what government can do on its own – real change is when everyone pulls together, comes together, works together, where we all exercise our responsibilities to ourselves, to our families, to our communities and to others.

And I want to help try and build a more responsible society here in Britain. One where we don’t just ask what are my entitlements, but what are my responsibilities. One where we don’t ask what am I just owed, but more what can I give. And a guide for that society – that those that can should, and those who can’t we will always help. I want to make sure that my government always looks after the elderly, the frail the poorest in our country. We must take everyone through with us on some of the difficult decisions we have ahead. Above all it will be a government that is built on some clear values. Values of freedom, values of fairness, and values of responsibility.

I want us to build an economy that rewards work. I want us to build a society with stronger families and stronger communities. And I want a political system that people can trust and look up to once again.

 

 

 

Cameron Blew it Over Brexit. So Lets Blame Corbyn

One narrative that is emerging to explain the outcome of the EU Referendum hinges on the claim that the Labour Party did not deliver the vote in its traditional northern heartlands. Or rather, Corbyn did not deliver because his brand of metropolitan socialism did not resonate with the concerns of traditional, socially conservative labour voters, in particular around the impact of largescale immigration from the EU on their communities.

And younger city dwellers who are fast becoming the natural demographic for Corbyn supporters are alleged to have failed to vote in sufficient numbers. According to a tweet by Sky Data that quickly gained acceptance on social media only 36% of 18 – 24 year olds voted.  Writing in The New Statesman, Barbara Speed was not convinced.

Sky isn’t claiming this is collected data – it’s projected, and a subsequent tweet said it was based on “9+/10 certainty to vote, usually/always votes, voted/ineligible at GE2015”. I’ve asked for more information on what this means, but for now it’s enough to say it’s nothing more than a guess.

On Sunday the Observer provided some more reliable data from Opinium, the polling agency that came closest to predicting the outcome of the EU Referendum.

OPINIUM Poll published on June 22nd

graphgraph 1

According to the Observer, Opinium pollsters, working for the LSE after the referendum

found turnout among young people to be far higher than data has so far suggested. “Young people cared and voted in very large numbers. We found turnout was very close to the national average, and much higher than in general and local elections.

“After correcting for over-reporting [people always say they vote more than they do], we found that the likely turnout of 18- to 24-year-olds was 70% – just 2.5% below the national average – and 67% for 25- to 29-year-olds.

The original Opinium poll published on the eve of the referendum also demonstrated the extent of the split in the Labour and Conservative parties. And the split was more pronounced for the Tories.

graph 2

The figures suggest that the Labour vote for Remain held even in the North, where their core vote was already under pressure from UKIP. This is borne out by post a Referendum poll by Lord Ashcroft.

Remain % Leave %
Conservative 42 58
Labour 63 37
Lib Dem 70 30
UKIP 4 96
Green 75 25
SNP 64 36

Source: Ashcroft polls Get the data

TO SUM UP

The Tories, not Labour promised a referendum on Europe.

The Tories, not Labour negotiated the new terms to keep Britain the EU.

The majority of Tory voters voted to leave.

The majority of Labour voters voted to remain.

But it is Labour, not the Tories who are to blame because they did not deliver a big enough vote for Remain. The Parliamentary Labour Party have accepted this and decided that they are going to blame Jeremy Corbyn. That is the justification for their leadership coup. There may be good political reasons to question Jeremy Corbyn’s leadership. But the Referendum Campaign is not one of them.

Brexit? Blame it on Corbyn!

_89974521_mps_declare_eu_stance_14_06_16_624gr

I am very angry with David Cameron. If the Remain camp is right and Brexit would be an unmitigated disaster for the UK why is he risking all our futures with this referendum? The only reason I can find is that he has put his party first and his country second. Last year with a general election approaching, the euro-sceptic wing of the Conservative Party was threatening to defect to UKIP in large numbers. Cameron did not believe he could win the election and so  made a manifesto pledge to renegotiate the terms of UK membership of the EU and hold a referendum if the Conservatives formed the next government. He never expected he would have to deliver on this promise but he calculated that it would serve to keep the Conservative Party together. So when he won the election what was he supposed to do?

  1. Break the election pledge on the grounds that he would not lead this country into the abyss, and carry on as Prime Minister?
  2. Break the election pledge on the grounds that he would not lead this country into the abyss, and resign as Prime Minister?
  3. Engage in a cosmetic “renegotiation” with our EU partners (Help me out here, guys!) and proclaim a great victory that fools nobody?

Cameron chose the third option and the result has been a Blue on Blue campaign within a divided Conservative Party. Remain is using the politics of fear: economic disaster if we leave. Brexit reciprocates with the bogey of unlimited immigration if we stay. Whether right or wrong both these arguments are about narrow self interest. The Labour campaign to remain has not received the same level of publicity but, as far as I can make out, they are saying that the EU is a flawed institution in need of further reform. Nevertheless it remains a positive force and Britain should remain and lead the campaign to improve the EU.

There has been a constant, nagging element to media coverage that Labour leader, Jeremy Corbyn is lukewarm in his support for the EU and if Brexit wins it will be his fault for not delivering the Labour vote on Referendum Day. Never mind that he has been touring the country delivering a pro EU message throughout the campaign with very little media coverage. What media coverage there is focuses on confusion among Labour voters about where their party stands in relation to the EU. Of course they are confused. Unless you live in one of the towns where Corbyn and his team visits and delivers the pro EU message you have to rely on the national media for your news. And, with rare exceptions, they are not reporting his contribution to the debate, preferring the drama of the “blue on blue action” in the Conservative Party. “Politician says something sensible and people support him,” is not a newsworthy headline.

But if we do leave the EU it will be down to Cameron, not Corbyn. Consider the evidence.

  1. Tory MPs are split 4 to 3 in favour of the EU. Labour split is 20 to 1 in favour of the EU.
  2. The Cabinet is divided. The Shadow Cabinet is united.
  3. Conservative voters divide equally between Remain and Exit. Labour are between 60% and 70% for Remain.

Whatever the outcome  of the Referendum, Cameron should resign. Any notion that a victory for Brexit is down to Labour equivocation has no justification in fact. If not for Cameron’s cowardly retreat in the face of his euro-sceptic opponents in the Conservative Party we would not even be in this plight.

 

 

ADHD – An Independent Position

There was an interesting article in the Independent on Sunday (20/09/15) entitled “Thousands of children are being medicated for ADHD – when the condition may not even exist,”

The author, William Sutcliffe has just published a novel, “Concentr8” described by Sutcliffe as,

“Concentr8, a novel set in a seemingly fantastical London where a mayor has instituted a programme to push out a behaviour-modifying drug on increasing numbers of misbehaving children and teenagers. Non-fiction extracts open each chapter, slowly revealing this world to be far closer to reality than one would like to believe.”

Sutcliffe argues that the real life use of Ritalin to control the symptoms of ADHD has a lot in common with the themes of his book. I have yet to read Concentr8 but I am interested in what Sutcliffe has to say about ADHD.

HOW REAL IS ADHD?

He starts by questioning the validity of ADHD. The use of drugs to treat it has more than doubled in the last ten years. These drugs are a multi-billion pound industry. Yet there is no clinical proof that ADHD is a genuine illness. People diagnosed with ADHD do have real problems but there are no biological markers that can be used to diagnose ADHD. Sutcliffe’s source is a Sami Timimi, consultant child psychiatrist at Lincolnshire NHS Trust. According to Timimi he,

“is ‘not saying those who have the diagnosis don’t have any problem’, he is adamant that ‘there is no robust evidence to demonstrate that what we call ADHD correlates with any known biological or neurological abnormality’.

“Sami Timimi’s clinic in Lincolnshire advocates a group therapy approach that focuses on ‘relationship building’ rather than ‘behavioural control’, using some of the techniques of NHA (Nurtured Heart Approach) therapy, which involves teachers and parents in a process of developing strategies to transform negative behaviours into positive behaviours. Timimi hasn’t prescribed Ritalin to a single child for five years, and claims a 76 per cent ‘clinically significant improvement’ rate among those patients he discharges.”

Timimi argues that changing cultural attitudes to childhood has privileged narrow measures of ability like exam results and conformity at the expense of creativity. Schools are under pressure to deliver. They pass this pressure onto the children and children are rebelling. This is driving the upward trend in diagnosis of ADHD and the resultant use of drugs to manage behaviour in schools.

As well as medicalizing troubled behaviour Sutcliffe examines the notion that the ADHD bandwagon is expanding to take in normal childhood behaviour.

“Matthew Smith, senior lecturer in history at the University of Strathclyde, and author of Hyperactive: The Controversial History of ADHD, goes even further in his criticism of the medical orthodoxy. He believes the diagnostic threshold is now so low that it has led us to a place where we have pathologised naughtiness as a mental disorder requiring medication. ‘And not just naughtiness,’ he adds. ‘All sorts of children, simply those that daydream and don’t pay attention, could now be diagnosed with ADHD and placed on medication.’

“Timimi sees it specifically as a pathologisation of maleness (boys tend to find it harder to sit still in a confined classroom), while a report in Time magazine cited a psychologist describing the symptoms of ADHD as ‘everything that adults don’t like about children’.”

RESPONSE

I do not agree that only conditions with clear biological markers can be reliably diagnosed or even said to exist. Timimi, in his book, The Myth of Autism, proposes a similar argument to that cited by Sutcliffe in relation to ADHD; namely that autism is the medicalising of men’s and boys’ social and emotional competence. In the absence of any drug treatments for autism, Timimi raises the ogre of the Autism Industry as a substitute villain for Big Pharma in his autism narrative. I dealt with this in my review of his book, “The Myth of Autism.

The lack of biological markers is common in many conditions. But clinicians continue to recognize and diagnose them based on behavioural manifestations. Timimi himself must have diagnostic criteria which he uses to identify suitable cases for his NHA therapy. Like ADHD autism has no biological markers. Like ADHD brain scans have found differences in brain development and function, but not consistently across populations. Like ADHD autism often runs in families but genetic studies have failed to isolate an “autism gene.” Autism and ADHD are both spectrum conditions in which a variety of genes have been identified. Autism and ADHD are often found together. Recent research suggests that if ADHD is diagnosed first an autism diagnosis is often delayed or missed altogether.

My son is autistic. He was diagnosed based on a clinical assessment of him and a developmental history taken from his parents by a trained clinician. Comparable assessments are in place for ADHD. As a teacher I regularly used to complete ratings scales for pupils suspected of having ADHD. Clinicians used these alongside parental interviews and direct observations of the pupil in order to make their decisions.

Timimi’s critique of the medicalization of behaviour is not without merit. People are driven to the edge by the pressures they face. Rather than deal with those pressures, the institutions of state, be they medical, judicial or political will medicalize, criminalize or demonize society’s victims rather than address their grievances. But we also have to address their grief. Children with ADHD are often in genuine distress. Their disorder has been validated by clinical research. We have to address their individual needs for care and treatment as well as addressing the political, social and economic background to their situation.

MEDICATION

If ADHD is a diagnosis that is open to question then we ought to be concerned that the treatment of choice is not Timimi’s group therapy. Instead, the treatment of choice is methylphenidate, usually prescribed under the brand names Ritalin and Concerta. Because it is an appetite suppressant it can have a negative impact on growth in children. It is related to amphetamines and there are concerns about dependency and the possibility that it might exacerbate suicidal tendencies and self-harm in subjects with additional psychiatric problems.

“Professor Tim Kendall, consultant psychiatrist and member of the group that developed NICE’s clinical guidelines on ADHD, has said: ‘If you take Ritalin for a year, it’s likely to reduce your growth by about three-quarters of an inch… I think there’s also increasing evidence that it precipitates self-harming behaviour in children, and we have absolutely no evidence that the use of Ritalin reduces the long-term problems associated with ADHD.’

“So why, if the evidence for the disorder is so shaky, and if the medication has significant drawbacks, with NICE explicitly not recommending drugs as a first-line treatment for school-age children, is Ritalin prescription on an ever-increasing curve? Scepticism towards ADHD as a phenomenon tends to be silenced with a simple retort: ‘Ritalin works.’

“And it does. A child who is inattentive, impulsive, and struggling at school, given Ritalin or another similar stimulant, will often demonstrate a marked improvement in behaviour and academic attainment within days.”

All drugs have side effects. Doctors have to exercise clinical judgement when deciding whether the benefits outweigh the drawbacks. Timimi acknowledges that the short term benefits are genuine but argues that long term use yields no better results than non-pharmaceutical interventions that do not have the same side effects. So why are prescriptions on the rise? The reason given in the article is the power of Big Pharma. The drug companies pay vast sums to market their products and hire experts, who sometimes conceal their conflict of interest, to attest to their safety and efficacy.

RESPONSE

I hold no brief for Big Pharma. But unless governments are prepared to take on the cost of medical research and development and fund our public research institutions accordingly the drug companies will continue to shoulder the commercial risk and seek to maximize returns on the successful drugs that do make it to market. And they will cross ethical lines when doing so. It is unfortunate that the two high profile beneficiaries of Pharma Gold quoted in the article earned their money promoting drugs for Bi-Polar disorder and not ADHD. I do not doubt that similar shenanigans will emerge in relation to Ritalin, Concerta etc. But it would have strengthened Sutcliffe’s argument if he had been able to cite specific examples rather than these two undeniably egregious but well known examples.

The NICE guidelines for treatment of ADHD are plain. No drug treatment for children under six. No drug treatment for mild to moderate cases of ADHD until after alternative treatment options have been tried. Regular clinical assessments and pauses in medication to see if drugs are still necessary. Where children are prescribed drug treatments they and their parents should also be offered psychological support. It is not unethical practice from the drug companies that is behind the breaches to the NICE guidelines. There is a crisis of funding in Child and Adolescent Mental Health Services (CAMHS) which means that the sort of treatments offered by Timimi, while recommended by NICE, are simply not available in many areas. We may debate the reasons why it is so hard to be a child in Britain today but children are suffering and the services they need are being cut under the government’s austerity programme. Even at the outrageous prices charged by the drug companies, and cheaper, generic versions are available, medication often comes cheaper than employing mental health professionals. In these cash strapped times health authorities may feel they have no choice.

DLA

Overall Sutcliffe has offered a well-argued if sometimes provocative position. However he descends into sensationalism with this statement.

Children from poorer backgrounds are more likely to develop, says scientists Yet none of these doubts about the ADHD juggernaut come close to the greatest scandal of all. I was originally drawn to this topic as a novelist following a single conversation with a consultant child psychiatrist who related to me a professional worry of hers. She was concerned that some families might be pushing for a Ritalin prescription for their child not because of genuine medical worries, but because an ADHD diagnosis makes a family eligible for Disability Living Allowance.

RESPONSE

In thirty two years as a teacher in special education I can only recall one family that remotely resembles this picture. All their children did have special needs. The family decided to exploit their status to extract the maximum from the welfare state in a manner similar to those who exploit the anomalies in the tax system to minimize their tax burden.

As the parent of a son with Asperger Syndrome I can also testify to immense difficulty in claiming DLA, even with a bona fide diagnosis. You have to fill in a detailed questionnaire describing the impact that the condition has upon your lives. This has to be endorsed by a professional who fills in their own section of the form. The severity of the difficulties you face determines the size of the payment. If Ritalin is as good as is claimed in the article at mitigating the effects of ADHD, surely that would militate against eligibility for DLA because the condition was being managed with medication and did not make excessive demands on parents and carers? I am well aware that the plural of anecdote is not data. Sutcliffe provides a single anecdote for his argument. I see your anecdote and raise you one.

If poverty is indeed driving some parents to exploit their children in order to game the system I see that as an indictment of our present socio-economic system as much as it is an indictment of the parents. And it is true that poverty has long lasting effects on the mental development of children. Research has found that children growing up in poverty are more prone to mental disorders including ADHD. While internal disorders like anxiety and depression improve when a person’s life chances improve and they move out of their bad situation, get a decent job etc., externally directed disorders like ADHD persist even when life circumstances improve. Was the ADHD caused by poverty and became permanent or was it always there and poverty provided the trigger? I do not know. I do know that our son’s DLA kept us out of poverty when we eventually got it, four years after his diagnosis and helped him make a success of his adult life.

CONCLUSION

The voices of those with ADHD were noticeable by their absence from this article. This is a weakness. As with movements for autism rights and autism self-advocacy, ADDers embrace their diagnosis as a badge of identity while recognizing that it is a neurodevelopmental condition that requires greater public understanding and awareness. They are not the passive victims of an unequal struggle between brave maverick doctors and the weight of the medical and educational establishment. ADHD is now recognized as a condition that continues into adulthood. Celebrity ADDults are coming forward to demonstrate both the positives and the negatives of ADHD. Some of their voices would have added weight to Sutcliffe’s conclusion that,

“children should be reminded that ‘failing’ at school is not failing as a human being. Many of the most creative and successful people only find their path through life in adulthood. Being different is not an illness.”

Dr Lorna Wing, OBE 1928 – 2014

I learned today that Dr Lorna Wing died on Friday. Her contribution to our understanding of autism is unsurpassed. I think it was Dr Ekkehart Staufenberg, speaking at a National Autistic Society conference on Extreme Behaviours within ASD in June 2004 who remarked that if we examined every original and productive idea in the field of autism we would find that Lorna Wing mentioned it first. Or perhaps I heard it the following year at the inaugural NAS International Conference, which was introduced by Lorna Wing. Her opening address is available online. It ended with this prescient nod in the direction of the new diagnostic criteria for autism in DSM-V. I hope that ICD-11 will not be far behind.

The present sections in ICD-10 and DSM-IV on pervasive developmental disorders with their illogical mix of criteria should be thrown out of the window. They should be replaced by a sensible system based on a dimensional rather than a categorical view of autism and other developmental disorders. Each person’s profile of skills and disabilities is far more informative than saying they have Asperger’s syndrome, PDD NOS or any other subgroup in DSM-IV or ICD-10.

I never met Lorna Wing. But like many parents I felt I knew her via her book, originally published in 1971, The Autistic Spectrum. Her academic rigour and accessible style combine to make this one of the few books that can justify its subtitle as “A Guide for Parents and Professionals.” This is probably down to the fact that Dr Wing was herself, both a parent and a professional. Her daughter, Susie (1956 – 2005) was diagnosed with autism when she was three at a time when the cruel notion that bad parenting caused autism was the height of orthodoxy. Adam Feinstein, in an excellent chapter in his History of Autism, “The 1960’s; the parents fight back” describes the role of Lorna and her husband, John, both trained psychiatrists, in helping to establish autism as a neurological condition and not a psychiatric disorder. From the very start rigorous research was allied to parent advocacy for their children. Feinstein quotes from Lorna Wing’s personal memoir of the time.

Up to the end of the 1950s, the general public was profoundly ignorant concerning autism and the same was true of most professionals, even psychiatrists and psychologists. Among the few who were interested and aware, many agreed with the theory that the children were potentially normal but had been made to withdraw by cold, distant and overintellectual parents. Diagnosis was difficult or impossible to obtain and there was no help or support for the parents. Children could be excluded from education in school if they had severe learning difficulties or disruptive behaviour and there were virtually no special schools for children with autism.

According to Lorna Wing two things combined to overturn this state of affairs.

One was the development of objective, scientific investigation into autistic disorders, which showed that children had real disabilities underlying their unusual pattern of behaviour. The approach of the pioneers in research was very different from the armchair theorizing that had gone before. The other was the creation of the National Autistic Society [in the UK].

Lorna Wing played a central role in autism research and in setting up the NAS. At that time it was all about parents and children. And following from Kanner’s pioneering work, the children were seen to have a very rare and disabling condition. But Lorna Wing, in partnership with Dr Judith Gould pioneered the concept of an autistic spectrum in which varying degrees of impairment rather an absolute absence of social recipricocity was key to understanding autism. Their finding were published in the landmark Camberwell Study in 1979, which suggested a fourfold increase in prevalence for autistic spectrum disorders of 20 in 10000 when compared to the 5 in 10000 figure for the narrow definition of Kanner’s autism.

Even under this broad definition most children with autism were still severely impaired and most were found within the special education system. But if, as Wing and Gould have consistently argued, autism is fundamentally a disorder of social cognition what about children of normal or above average intelligence with a similar impairment? Do they have a place on the autistic spectrum. Clinicians in continental Europe  who were familiar with the work of Hans Asperger would answer yes. But Asperger’s work was largely unknown in the English speaking world until Lorna Wing published Asperger syndrome: a clinical account in 1981. She also contributed a chapter to Uta Frith’s book, Autism and Asperger Syndrome (1991) which contained the first published English translation of Asperger’s original paper.

So, over the course of thirty years, Lorna Wing was instrumental in countering the “refrigerator mother” theory of autism. She brought it into the mainstream as a developmental disorder which encompassed the full range of intellectual ability and brought the work of Hans Asperger to the attention of the Anglophone scientific community.

Lorna Wing has also been connected to the other great change in our thinking about autism, that for some people its positive aspects may outweigh the disability. A profile published in 2011 in the Guardian quotes her thus.

Another change has been a focus on the positive elements of autism; a kind of autism pride. “I do believe you need autistic traits for real success in science and the arts, and I am fascinated by the behaviours and personalities of musicians and scientists,” says Wing. She also believes that most of us have some autistic traits. “One of my favourite sayings is that nature never draws a line without smudging it. You cannot separate into those ‘with’ and ‘without’ traits as they are so scattered.”

Lorna Wing was never “either/or.” For her autism remained a complex and fascinating area of study in which the needs of the more able and the less able were acknowledged. This has particular poignancy in relation to her daughter Susie, who was one of those more disabled. The same Guardian profile ends with an account of Susie’s death.

“We were devastated. We were so close to her,” says Wing. “She couldn’t express her emotions but when you came home, her face would light up. That was absolutely wonderful.”

Lorna Wing leaves us a massive legacy embodied in her writings and in the Lorna Wing Centre for Autism. This is a diagnostic centre which pioneered the taking of developmental histories from parents alongside the clinical assessment of children and adults with autism. My son was diagnosed there. Most important for me, considering the horrors that have been inflicted on autistic people and their families in the name of science, is that Lorna Wing showed us how to combine academic rigour and fidelity to the scientific method with a deep humanity. She will be missed.

Autism, serial killers and mass murderers

A recent literature review by Doctor Clare Allely, at the University of Glasgow has been attracting a lot media attention. According to Google News there are press reports in Britain, Europe, America and China, with more to come no doubt.

The Washington Post proclaims a  “Significant’ statistical link between mass murder and autism, brain injury” in its headline. The Daily Mail has “Recipe for a serial killer? Childhood abuse, autism and head injuries are more common in murderers, study claims.”

In contrast, the paper itself, Neurodevelopmental and psychosocial risk factors in serial killers and mass murderers and the accompanying press release from Glasgow University are a model of academic restraint. Dr Allely is quoted as saying

“It is crucial to note that we are not trying to suggest that individuals with ASD or previous head trauma are more likely to be serial killers or commit serious crime. Rather we are suggesting that there may be a subgroup of individuals within these groups who may be more likely to commit serious crimes when exposed to certain psychosocial stressors.

“Research on mass and serial killing is still very much in its infancy. New research is urgently required to understand the mechanisms underlying these extreme forms of violence so that preventative strategies can be developed. We would recommend that in future, all serial or mass killers who are apprehended should be thoroughly assessed using standardised tools for investigating neurodevelopmental disorders including ASD and head injury.”

From the paper’s abstract:

“Our findings tentatively indicate that these extreme forms of violence may be a result of a highly complex interaction of biological, psychological and sociological factors and that, potentially, a significant proportion of mass or serial killers may have had neurodevelopmental disorders such as autism spectrum disorder or head injury. Research into multiple and serial murders is in its infancy: there is a lack of rigorous studies and most of the literature is anecdotal and speculative.”

Unfortunately, however nuanced the language, it cannot hide the fact that this paper is seriously flawed.

Others have commented on the flawed methodology, the over reliance on the internet, books and news reports as sources of data because there are so few peer reviewed studies to call on. (See for example John Elder Robison) Then there is the conflation of serial killers and spree killers, two distinct categories with different psychological profiles. Most striking is that the serial killer takes care to select their victims and tries to evade detection. The spree killer ‘selects’ victims at random and their killing spree is usually the prelude to suicide. They make no plans to avoid detection. These two categories appear to have been chosen because the perpetrators are mass murderers who have each killed at least three people. Other murderers were excluded from the analysis. If we assume for the moment that data was reliably collected this was a missed opportunity to ascertain whether autistic people are over represented in all murder statistics and not just mass murders.

But was the data reliably collected? The headline figure is that 67 out of 239 mass murderers were autistic (28.03%). But only six of these had “a definite diagnosis of ASD.” Twenty one were “highly suspected” of being autistic and thirty three were “possible/probable” autistics. Hang on. Do the math. 6+21+33=60. So what about the other seven? This is a really basic error. It should have been corrected during editing but it was not. The authors also state that all foreign language (non English) documents were excluded from their search and then go on to quote a Norwegian language website as the primary evidence for three of their ”definite” autistics, when, in fact, it only reports that Anders Breivik, the Norwegian mass murderer, might be autistic.

So what about these six definite diagnoses of autism?

Martin Bryant went on a killing spree in Australia in 1996. He had learning difficulties and may have had autistic traits. But a diagnosis of Asperger Syndrome was ruled out by a forensic psychiatrist hired by his defence lawyers. My thanks to Paula C. Durbin-Westby  for the link to the full psychiatric assessment. Having read it I think that he may have met modern criteria for ASD. But we will never know and I do not understand the basis on which Allely et al. assign Bryant a “definite diagnosis.”

Robert Napper is a serial killer and rapist who was detained indefinitely at Broadmoor, a UK facility for the criminally insane, in 2008. Napper is a paranoid schizophrenic who witnessed his father physically abusing his mother until their divorce when he was ten. He was sexually assaulted when he was thirteen by a family friend and underwent a personality change. He was diagnosed with Asperger Syndrome after his arrest. Allely et al. rely on Murderpedia.org for this information.

Wolfgang  Zaugg is referenced to the Norwegian language website, dagbladett.no which does not refer to him at all. A Google search found an entry on Murderpedia which reveals him as an immigrant to Sweden who experienced racism as a child. As an adult he became a Swedish citizen and an accomplished businessman. When his business collapsed and he could not pay his gambling debts he financed his lifestyle through  bank robberies.  He was involved with far right terrorists and embarked on a killing campaign against other immigrants, perhaps to prove his Swedishness. There is no mention of autism.

Nicky Reilly is also referenced to the Norwegian language website, dagbladett.no which does not refer to him at all. He is autistic. He has a diagnosis of Asperger’s Syndrome.  But he never killed anybody. He converted to Islam and was recruited as a suicide bomber by extremists who exploited his autism. The only person hurt in his suicide bomb attempt was himself. Nicky survived and is serving an eighteen year sentence for terrorism. Even if he had been successful he is not your typical serial killer or spree killer.

Ragnar Nilsson is also referenced to the Norwegian language website, dagbladett.no which does not refer to him at all. There is no English reference to him in Google searches. My limited Swedish leads me to suspect that he is the triple murderer in this story.

Cary Stayner claims he was sexually abused by an uncle when was eleven. This was when his brother was abducted by a paedophile and kept a prisoner for seven years. Cary was diagnosed with OCD, psychotic disorder and schizophrenia following his arrest for the murder of four women. According to Murderpedia there was a history of mental illness and sexual abuse in the family. But no mention of autism.

These are the six “definite diagnoses of autism.” We can rely on two, maybe three of the diagnoses. What about the cases where “ASD was highly suspected?” Top of the list is Seung-Hui Cho, who carried out the Virginia Tech massacre in 2007. Lee, Lee, and Ng (2007), the best resource listed for Cho regards any diagnosis as “speculative.”

“So we ask if he met criteria for a diagnosis based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) or International Classification of Disease-10 (ICD-10)? Or was he of a criminal antisocial or psychopathic mind? Unfortunately without having interviewed him or having access to his records, we cannot say for sure. We could speculate that he was depressed with delusional thoughts, and perhaps had undiagnosed Asperger's disorder (a mild variant of autism), or was taking illicit substances. But we do not have enough evidence to be certain of a definitive psychiatric condition that could account for his extremely violent behaviour.”

Jeffrey Dahmer is also included. He even gets his own case study. Yet Dahmer was subject to rigorous forensic psychiatric assessment that failed entirely to mention any putative autistic diagnosis. As Emily Willingham points out.

“According to mental health professionals who personally diagnosed serial killer Jeffrey Dahmer, he had a personality disorder. That didn’t stop the authors of a recent paper attempting to link autism and mass murderers, serial killers, and other homicidal maniacs from listing Dahmer as “highly suspected” of having an autism spectrum disorder, along with 61 other people who were never diagnosed with one, including Timothy McVeigh, Terry Nichols, and Dylan Klebold.”

Let us call a halt. If only two out of six ”definite diagnoses” can be confirmed what chance is there that any of the probable or possible diagnoses will stand up to scrutiny? There are compelling factors to do with family histories of abuse and mental illness that are sufficient to explain why these people became mass murderers without recourse to a retrospective diagnosis of autism.

I am also curious as to why the authors examined head injury in tandem with autism. Autism is neurodevelopmental. It is a result of atypical brain development in utero caused by an, as yet unknown, complex set of interactions between genes and environment. These create a predisposition to certain kinds of behaviour in which some of the determining parameters are intelligence and language development. The ameliorating factors include early identification and the quality of early intervention. Brain injury usually results from brute force trauma later in life. It can undo or delay development. But its relation to autism is never explained by the authors.

In conclusion, the authors found two definite cases of autism in 239 cases of mass murder. This is consistent with the rate of autism in the general population. For some reason they included another fifty eight possible cases that do not stand up to scrutiny. Then they get the maths wrong and proclaim their sixty as sixty seven. And from this we are led to the conclusion that there is a possible subset of autistic people who, given the right amount of psycho-social stressors might turn out to become mass murderers, So we should test all future mass murderers for autism, as the authors suggest, in the hope of identifying this subset and curing them? And should we be curing them of autism or of the propensity to become mass murderers? If so, how?

Having read more than I ever wanted to about serial killers and mass murderers in preparing this blog post I would suggest a simpler solution. Let us work together to reduce the number of children who are bullied and abused, especially those who suffer because their neurological difference is misunderstood. In this way we will increase the sum of human happiness and decrease the likelihood of future serial killers and mass murderers, whatever their neurology.

Is Andrew Wakefield a fraud and a bully?

I had hoped that, after he disappeared into obscurity in the United States, I could safely ignore Andrew Wakefield, the disgraced former surgeon, who lost his licence to practise medicine in the UK for his dishonest and unethical role in the MMR Hoax. He did surface last year alongside Polly Tommey, who followed her hero into exile in the USA, when they tried to sell an autism reality show. The premise was simple. Film autistic children in distress. Take them to Arthur Krigsman to be given a colonoscopy and diagnosed with autistic enterocolitis. Then cure them with special diets and supplements and film the happy outcome.

This project never came to fruition. But Wakefield and Tommey did intervene in the case of Alex Spourdalakis. They filmed this young man in distressing circumstances in hospital. They made allegations about the treatment he received, relying on the patient confidentiality enshrined in US law to prevent health authorities from responding to their claims. They had a willing accomplice in Alex’s mother and arranged for Alex to be treated by Arthur Krigsman. But refusing conventional treatment and opting for quack remedies did not have the desired effect. Alex was subsequently murdered poisoned and stabbed to death by his mother. We await the outcome of her trial. Both Wakefield and Tommey were complicit in attempts to use their film to justify her crime.

Wakefield’s most recent exploit pales in comparison to that example of sleaze. It seems that he has taken exception to being called a fraud. Actually he has been called a fraud many times, most noticeably by Brian Deer and Fiona Godlee in the British Medical Journal. He tried to sue them but a Texas court rejected his claim and the appeal has yet to be settled. Time Magazine reported that Wakefield was a fraud. So did CNN, The Daily Telegraph. David Whelan, writing for Forbes Magazine even suggested that the US authorities should deport Wakefield to face fraud charges in the UK. With the exception of his outstanding appeal with regard to the BMJ Wakefield has not responded to any of these reports until now when Emily Willingham, also writing for Forbes Magazine called him a fraud.

Actually Ms Willingham did not make a big deal about the fraud. Her main point was to highlight a recent review of gut issues and autism in Pediatrics which suggests that

It is clear that greater clinical and research scrutiny is needed to increase awareness on this topic and thus support development of the best standards of care. Previous controversy surrounding the MMR vaccine and proposed causal link between ASD and infection of the GI tract probably deterred investigators from dedicating resources to examine GI functioning in this population while fostering uncertainty in the ASD community regarding the validity of this line of inquiry.

This seems perfectly clear to me. Wakefield’s fraudulent research has tainted the investigation of potential links between autism and GI functioning. He has discouraged other investigators into this link and made it difficult for them to obtain funding. He has performed a great disservice to science. More importantly, autistic people with genuine GI dysfunction have struggled to have their symptoms taken seriously. They or their parents have had their concerns dismissed by health professional who are chary of any association with Wakefield’s ideas. It is a bitter irony that some are then welcomed by Wakefield’s acolytes into the alt-med world of untested and unproven biomedical remedies for autism.

Wakefield has written a  letter to Ms Willingham threatening her and Forbes Magazine with prosecution, “pending legal advice.”  He concludes

You are also advised that I live and work in Austin, Texas where my business is headquartered, and that my work is conducted throughout the US. Your defamatory statements about me will undoubtedly cause me to suffer significant personal and financial damage.

My lawyers are currently dealing with Deer and his co-defendants. They will be turning their attention to you well within the statute of limitations for filing a case against you and Forbes.

Three things strike me. One, this is Wakefield acting off his own bat. He has not taken legal advice. That is pending. He has written a threatening letter to a blogger to bully her into silence “pending legal advice.“  Two, he is not going to do anything unless he gets a successful outcome in Texas regarding his action against the BMJ (Deer and his co-defendants ). Three, talk of prosecution and defendants in relation to civil law is a total nonsense. There is only one criminal in this case and he can count himself lucky that nobody has seen fit to prosecute him yet.

So why is he doing it? My best guess is that he has issued this threat and published it on Age of Autism to rally the troops and revitalize his flagging support. And why is he doing it to Ms Willingham? Perhaps he thinks she is more vulnerable than CNN or Time Magazine. Maybe he hoped that Forbes would take the corporate view and silence her to fend off a potential troublesome lawsuit. Not for the first time he has been proven wrong. Ms Willingham is an eminent scientist, an educator and an accomplished journalist. Forbes recognize her talent and show no signs of surrendering to Wakefield’s bluster.