Eric Fombonne
[back] Experts

[2006 July 1 Pediatrics.] "Pervasive Developmental Disorders in Montreal, Quebec: Prevalence and Links With Immunizations"--- Dr. Fombonne's
[2004 Nov] Smeeth, Fombonne, Hall et al. Rate of First Recorded Diagnosis of Autism and Other Pervasive Developmental Disorders in United Kingdom General Practice, 1988 to 2001
[2004 Lancet] "MMR Vaccination And Pervasive Developmental Disorders: A Case Control Study." By Liam Smeeth, Claire Cook, Eric Fombonne...
[2003 Jan] Fombonne, editorial, Journal of the American Medical Association, January 1st 2003 Vol 289, No.1 49
[2001 Oct Pediatrics] Fombonne & Chakrabarti, No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism, Pediatrics
[2000-2002 Unpublished Study by Fombonne et al, A Case-Control Study of Autism In General Practice, UK, Study Period September 2000-August 2002
[1998] Letter by Dr. Eric Fombonne, Inflammatory Bowel Disease and Autism, Pediatrics, March 28th 1998

When David Ayoub MD critically examined Fombonne’s Thimerosal claims and discovered the above facts (and many more), he reported them in a letter to the editor of PEDIATRICS. In return, he received a “form” e-mail stating that his letter could not be published because of lack of space. Later, a friend who inquired was told that that Dr. Ayoub’s letter was not published because “Dr. Fombonne did not wish to answer it.” [Sept 2008] The Unconvincing Thimerosal Epidemiological Studies: How and Why They Were Produced, Published and Protected by F. Edward Yazbak, MD, FAAP

The AAP has played an important role in perpetuating the misconception that current research refutes the thimerosal-autism link. Three key papers have been published in the AAP trade journal PEDIATRICS-Madsen (Danish epidemiological study); The Verstaraetn study, of Simpsonwood fame, and Fombonne (Quebec epidemiological study)
    The editor-in-chief Dr Jerald Lucey received numerous, substantiated criticisms of each of these studies, but has created an effective roadblock in disallowing any criticisms to be published in the letter-to the editor section of the journal. His response to thoughtful and reasonable criticisms has been unprofessional, illogical and insulting. My own letter to Lucey criticizing the Fombonne study was not even allowed to be published on the less publically visible online forum, even though we had obtained a copy of the Fombonne database and vaccine records from several parents proving Fombonne's work fraudulent. [2008] Dr Ayoub Speech at rally

[From: "Clifford G. Miller"  Dear Professor Leventhal]

[May 2007] The mercury, autism debacle: How stupid do they think we are? by Michael Wagnitz

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004407/pdf_fs.html
Fombonne is a psychiatrist. Here is what the Cochrane Collaboration  said about Fombonne's last paper regarding a review of the safety of  the mmr:  "The number and possible impact of biases in this study is so high  that interpretation of the results is impossible".  (page 21) 

“E. Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers (for a fee), and to several Government committees.” In plainer language, Fombonne had been a paid adviser to the manufacturers of MMR in the then-impending 1,500-strong class action High Court case in the UK that alleged that MMR had precipitated children’s degeneration into autism. The wisdom of using a paid witness to the manufacturers, as defendants, in a central authorship role in a supposedly independent research paper, might be questioned by many. --David Thrower

I was the first to announce the "autism epidemic", in 1995, and I pointed out in that article that excessive vaccines were a plausible cause of the epidemic.  As you know, an enormous amount of clinical laboratory research (as opposed to epidemiological research), has been accumulated since that time, supporting my position. (I did not know then that the vaccines contained mercury, although I had been collecting data since 1967 from the mothers of autistic children, on any dental work they may have had during their pregnancy.)  The evidence is now overwhelming, despite the misinformation from the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the Institute of Medicine.------- The (Pretending to) Combat Autism Act  By Bernard Rimland

Professor Sir Michael Rutter along with a troupe of psychiatrists now or formerly associated with The Maudsley Hospital and The Institute of Psychiatry at Kings have been working hard at telling the public autism is solely genetic and denying there is a world autism pandemic.....Genetics cannot account for the large rise we are seeing in autism since the mid 1980s.  So instead what we see are efforts by Rutter and the King's Institute of Psychiatry other autism denialists to claim there is no real rise in the prevalence of autism.  This claim is unscientific and runs counter to the facts documented in the formal literature.
    The Institute of Psychiatry has or is home to more than its fair share of doctors (psychiatrists mostly) who publish papers claiming autism is genetic and denying there is an autism epidemic (the correct word is pandemic - epidemics have far fewer victims).  These doctors include Rutter, Eric Fombonne, (now expert witness in the US in the thiomersal/autism litigation when he had previously published nothing about it), Simon Baron Cohen.  It is also home to controversial "Gulf War Syndrome" psychiatrist Simon Wessely, director of the Centre for Military Health Research at King's College London and who had been claiming ME/CFS is not a physical condition but a mental one contrary to the definition used around the world...... Rutter was also an expert witness in Malmo, Sweden in an MMR autism case where the key question was whether autism was solely genetic and not environmental.  Rutter's expert evidence was that it was genetic.  Professor Sir Michael Rutter & The Drug Industry Connections

See: Urinary porphyrin profiles  Studies (government)   Studies on vaccine autism link


[2006 July 1] Pediatrics. "Pervasive Developmental Disorders in Montreal, Quebec: Prevalence and Links With Immunizations"--- Dr. Fombonne


[2004 Sept Lancet] "MMR Vaccination And Pervasive Developmental Disorders: A Case Control Study." By Liam Smeeth, Claire Cook, Eric Fombonne, Lisa Heavey, Laura C Rodriques, Peter G Smith, Andrew J Hall. Lancet 2004; 364:963-969.

The study also had to declare one serious conflict of interest, specifically that “E. Fombonne has provided advice on the epidemiology and clinical aspects of autism to scientists advising parents, to vaccine manufacturers (for a fee), and to several Government committees.”
In plainer language, Fombonne had been a paid adviser to the manufacturers of MMR in the then-impending 1,500-strong class action High Court case in the UK that alleged that MMR had precipitated children’s degeneration into autism. The wisdom of using a paid witness to the manufacturers, as defendants, in a central authorship role in a supposedly independent research paper, might be questioned by many.

This study was heavily criticised:

Comment: this study cannot be taken as offering reliable evidence to deny an MMR/autism link, despite the claims made at the time. It is worth reminding readers as to the original “Wakefield hypothesis”, as published in the Israeli Medical Association Journal, 1999, Volume I, pp1-5: “There exists a subset of children who are vulnerable to developing a particular form of regressive autism following previously normal development, in combination with a novel form of inflammatory bowel disease. Onset may occur over weeks or sometimes months, and is triggered by exposure to a measles-containing vaccine, predominantly the measles mumps rubella vaccine (MMR) that is in use in much of the world today. This exposure leads to long term infection with measles virus within key sites, including the intestine where it causes inflammation.”

[pdf March 2006] MMR Vaccine, Thimerosal and Regressive or Late Onset Autism A Review of the Evidence for a Link Between Vaccination and Regressive Autism--David Thrower

[Sept 2004] Dr. Wakefield Responds To British Study Clearing MMR Vaccines


[2004 Nov] Study by Smeeth, Fombonne, Hall et al. Rate of First Recorded Diagnosis of Autism and Other Pervasive Developmental Disorders in United Kingdom General Practice, 1988 to 2001 published in BMC Medicine, 2: 39, November 2004.
This study analysed the rates of first diagnosis of pervasive developmental disorders amongst people registered with GP practices that were part of the UK GP Database during 1988-2001. It included 1,410 cases drawn from over 14 million person-years of observation. The main outcome measures were the rates of diagnosis of PDD, by the year of diagnosis, the year of birth, by gender and by geographical region.
The study found that:
· the rate increased progressively from 0.40/10,000 person years in 1991 to 2.98 per 10,000 person years in 2001
· there was a similar increase in standardized incidence ratios, from 35 in 1991 to 365 in 2001
· the temporal increase was not limited to children born during specific years, nor to children diagnosed in a specific time period
· the rate of diagnosis of PDDs other than autism rose from zero for 1988-92 to 1.06 per 10,000 person-years in 2001
· the rate of diagnosis of autism also increased, but to a lesser extent
· there was marked geographical variation in rates, with standardized incidence ratios varying from 66 in Wales to 141 for SE England
The study concluded that better ascertainment of diagnosis was likely to have contributed to the observed temporal increase in rates of diagnosis of PDD, but the authors could not rule out a real increase. The study claimed to be on of the largest undertaken of trends in the incidence of autism
The study authors had to admit to a considerable number of uncertainties, and make a number of suppositions. Uncertainties included:
· it was “likely” that a proportion of cases in the “autism” diagnostic category had a form of PDD other than autism
· the inaccuracy of diagnosis within the GP research database was “likely” to reflect changes in the definition of PDD
· inflation in the number of cases in later years “could have” occurred as other PDD diagnoses came into widespread use and some previously-undiagnosed children were diagnosed
· greater ascertainment of high functioning autism “may partly explain” the increased incidence of autism
· better detection of less severe cases alone cannot explain all the increases
· geographical variation “may” reflect differences in service provision and parental awareness in different regions
· the accuracy of the data “may” have changed during the study period
· these factors “could explain only a very small part” of the increased rates observed
· the nature of the study precluded the authors from assessing how often children with PDDs were not diagnosed
The study team concluded that the extent to which the increase in incidence that were documented was uncertain.
Comment - there are many criticisms that can be made of this study, many of which are identified by the study team themselves as potential confounding factors.
The study clearly found large increases, and attempted to shrug these off by linking them to factors such as better diagnosis and greater awareness. However, it was unable to accurately weigh these factors and quantify their individual influence. It is therefore the case that the study has very limited value. It is again interesting that the study authors seem anxious to avoid reaching the conclusion that there has been a large real increase in autism. [pdf March 2006] MMR Vaccine, Thimerosal and Regressive or Late Onset Autism A Review of the Evidence for a Link Between Vaccination and Regressive Autism--David Thrower


[2003 Jan] Fombonne, editorial, Journal of the American Medical Association, January 1st 2003 Vol 289, No.1 49

At the start of 2003, Dr. Eric Fombonne wrote an editorial in the Journal of the American Medical association that appeared to acknowledge that there had been some real increase in autism, but which also attempted to explain this away to as great a degree as possible through the usual recourse to references to better awareness, less restrictive criteria and a greater willingness to diagnose.
Fombonne’s key points were that:

Fombonne, seemingly searching for an uncontroversial explanation for any increase, then examined whether this increase implied a broadening of criteria and improved methods of case-finding during studies. He pointed to what he described as the “major” changes in criteria:

He argued that there was strong evidence that differences in methods for case finding could account for a “huge” proportion of the variability of prevalence estimates between surveys. Referral rates were also unreliable, due to confounding factors. This, and other factors, he concluded, combined to offer “good” evidence to support the contention that higher rates of prevalence reflected changes in diagnostic practice, improved identification and availability of services. The hypothesis of an increasing trend in the incidence of autism could not, in his view, be fully tested because of the inadequacy of studies to date. Fombonne dismissed any association with MMR (citing his own study work and studies by Madsen and by Taylor and Miller as proof), and dismissed evidence of any connection with thiomersal as being “weak”.

Fombonne was also quoted in the New York Times of 31st December 2002 as stating: “No strong candidate environmental exposures have been identified.....Claims of an association with MMR have not been borne out by recent studies, and evidence for causal association with other exposures such as mercury-containing vaccines is weak”.

The study being commented on by Fombonne was that by Dr. Marshalyn Yeargin-Allsop et al, detailed earlier. Comment: the editorial by Fombonne offers no hard evidence against a vaccine/autism link, and, whilst offering some arguments in favour of questioning the precise scale of the apparent major rise in autism prevalence, fails to demolish the central assertion of many parents, that autism has grown immensely in a couple of decades. No alternative explanations for the rise are offered by the Fombonne editorial. [pdf March 2006] MMR Vaccine, Thimerosal and Regressive or Late Onset Autism A Review of the Evidence for a Link Between Vaccination and Regressive Autism--David Thrower


[2001 Oct] Fombonne & Chakrabarti, No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism, Pediatrics, Vol. 108 No. 4 October 2001

This paper examined whether there is a new phenotype of autism involving regression and gastrointestinal symptoms.
It is suggested that where this paper is flawed is in the assumptions underpinning the hypotheses that are tested. All else stems from that.
Fombonne & Chakrabarti assume that if autistic enterocolitis existed, then one or more of the following six predictions should be supported by empirical data:

[pdf March 2006] MMR Vaccine, Thimerosal and Regressive or Late Onset Autism A Review of the Evidence for a Link Between Vaccination and Regressive Autism--David Thrower


[2001 Jan] Paper by Fombonne, Medical Research Council Child Psychiatry Unit and Institute of Psychiatry, Is There An Epidemic of Autism?, Pediatrics, January 2001

 At the end of January 2001, a paper, “Is There An Epidemic of Autism?” was published by Dr. Eric Fombonne. The paper sought to deny that autism had really increased, and criticised the “poor research methodology” of Dr. Andrew Wakefield, and said “There is no need to raise false alarms on putative epidemics nor to practice poor science.....”

 ?         Fombonne criticises the California increase on the basis of in-migration, possible changes within the population make-up, the change from DSM-III to DSM-IIIR in 1987, the introduction of diagnostic categories for Asperger, Rett and childhood disintegrative disorder in DSM-IV in 1994, the effects of earlier diagnosis adding to the totals, and other factors.

 ?         His most useful conclusion is that “we simply lack good data”. He raises doubts about the apparent epidemic, but is then unable to refute it either.

 In an excellent FEAT (parents’ group) critique (8th Feb 2001), Mark Blaxill goes carefully through Fombonne’s previous work and argues that Fombonne has become inconsistent. He points out key flaws in Fombonne’s previous work, and criticises his criticisms of the California data and his scientifically-unsupported assertions [July 2004] MMR and Acquired Autism (Autistic Enterocolitis) - A Briefing Note by David Thrower


[2000-2002 Unpublished Study by Fombonne et al, A Case-Control Study of Autism In General Practice, UK, Study Period September 2000-August 2002

 This study, based at the Maudsley Hospital, Denmark Hill, London, is to assess if exposure to MMR immunisation is a risk factor for autism, and to assess the exposure to viral infections, both prenatally and postnatally. Despite the dates, as far as is known the study has yet to report.

 The study will use UK GP data, hospital reports and a parents’ questionnaire. It will use over 400 cases of autism and four times as many controls, selected from a GP database. It is funded by the Medical Research Council (£351,000). No date has been given for publication of the findings.

 (Note: since this study commenced, Professor Fombonne has also agreed to appear at the forthcoming UK High Court cases as an expert witness on behalf of the manufacturers of MMR, against the children. His current role within the study is not known. It is also not known whether the control group will be “unvaccinated with MMR”, “unvaccinated with MR”, “unvaccinated with any measles-containing vaccine”, “unvaccinated with thiomersal-containing vaccines” or “totally unvaccinated”, or what the vaccination status of the control group children’s mothers will be. These may affect any study findings). [July 2004] MMR and Acquired Autism (Autistic Enterocolitis) - A Briefing Note by David Thrower


[1998] Letter by Dr. Eric Fombonne, Inflammatory Bowel Disease and Autism, Pediatrics, March 28th 1998

 This letter set out two studies that attempted to prove that there was no connection between inflammatory bowel disease/Crohn’s disease and autism. The first study looked at UK clinical data collected by the Child & Adolescent Psychiatric Services of the Maudslay Hospital, London.

 ?         For ASD, three diagnostic groups were examined, autism, atypical autism including disintegrative disorder, and pervasive developmental disorder

 ?         Medical disorders were coded for a 25-year period, including Crohn’s and ulcerative colitis, for 8889 patients.

 ?         Of the 8889 patients, 987 were born in 1987 or later, and were therefore most likely to have been exposed to MMR. Of these, 201 had ASD.

 ?         Of the 8889 children, only two had Crohn’s, and both were non-autistic. None had ulcerative colitis.

 For the second study, a similar approach was undertaken. Fombonne surveyed medical, behavioural and intellectual disabilities amongst 6100 French children.

 ?         He found 174 cases with autism.

 ?         One child of the 6100 had Crohn’s, and one had ulcerative colitis. Neither were autistic

 ?         The conclusion that Fombonne drew was that these data provide no support for the hypothesis of an association between IBD and autism. 

 Overall verdict: neither of these studies offer any evidence to disprove an MMR/autism link. [July 2004] MMR and Acquired Autism (Autistic Enterocolitis) - A Briefing Note by David Thrower