The Worse Decade Ever? This Mother Disagrees about the Decade of Disaster

I started off this decade getting knocked up.

Something I almost forgot with columnists and talking heads trying to pick the best name for the past ten years. Or should I say worst name.  The Decade of Misplaced Fear and Anxiety.  The Decade of America's Decline.  The Decade of Arrogant Aggression. The Naughty Aughts. The Double Oh-Ohs. 

At first I joined right in trashing the decade, myself pondering  names for the past decade in the parenting biz.  After all, what a time it's been for the child-rearing set.  Thanks to the internet and 24/7 cable channels, we have an unprecedent, massive, unwieldly amount of information, and by that I mean, misinformation.  Distorted studies.  Outright crappy studies.  Authoritative recommendations. No tv for toddlers!  Breastfeed or Else.  The rise of childhood obesity.  The rise of autism.  The rise of peanut allergies.  The rise of whole-wheat, evaporated cane sugar, and omega-three fatty acids.   The rise (and fall ) of Baby Einstein.  The vaccine debacle.   The circumcision debate.  Mommy Bloggers.  Helicopter Parents.  Free Range Parents.   Attachment Parenting.  Co-sleeping.  Toxic Cold Meds. The Perils of Plastic (hello, our chemical co-conspirators, bisphenol a and phthalates).  Organic milk, organic baby wipes, organic crib mattresses... 

And then I remembered - it's The Decade of Parenting, at least for me and most of you.  The decade many of us became parents for the first time.   True, I disliked plenty about being pregnant and so much of those first few months, okay, years - but I refuse to slap it with the historical equivalent of the Scarlet A.

What a peaceful, promising start.  It was the new millenium after all and my oldest child had the grace and good fortune to arrive during 2000 forever granting her a really cool birthdate.  But her first birthday fell days after the terrorist attacks.  My husband stood in the shadows of the Trade Towers, talking to me on the phone as the second plane hit.  We felt like celebrating not a bit.  My mother and father came to town and like the good and wise parents they are helped me and my husband fashion a "party" out of a few good friends and a cake mix. 

It's dishonest to say I wasn't anxious in those following months.  But I did it again, pregnancy, childbirth, the new baby who doesn't sleep, two more times.  And despite whatever international-political-financial-calamity it's been, despite the ill advice, the botched studies, or exaggerated media coverage it's brought, this decade's not nearly bad enough to discount those three not so tiny people in my life. 

So I'm sorry but I simply cannot call this one crappy decade.

Worse Science Writer of the Year: The Danger of Distinguished Writers Distorting Science

New York Times columnist Nicholas Kristof got slapped with "Worse Science Writer of the Year" by STATS, the non-profit, independent organization that takes scientific inaccuracy seriously. 

Kristof is proof that bad science comes from good, even great journalists.

I wrote about Kristof's "Chemicals in Our Food, Our Bodies" - the column in which he scared parents silly with talk of carcinogenic effects and endocrine-disruption, in other words, our old chemical aquaintance, bisphenol A (BPA).  The award-winning journalist even declared  BPA frightened him more than warlords and tarantulas.  The fear-mongering continued in Is That a Plastic Bottle You're Drinking From on his blog at The New York Times (On the Ground).   The cherry-picked evidence and pseudo science so irritated me I posted a comment on his blog.  His more recent Cancer From the Kitchen? targeted BPA along with other chemical co-conspirators, named (pesticides, P.C.B.s) and unnamed (phthalates).  It contained perhaps even more inaccurate information than the first column.  It's a slippery slope for journalists slipping by with little scientific expertise. 

Read Trevor Butterworth's indictment of Kristof - but beware the extent of Kristof's crappy chemical coverage.  Incredibly, Kristof reports cancer rates among women are climbing despite recent evidence to the contrary courteous of the American Cancer Society, the Centers for Disease Control, the National Cancer Institute, and the North American Association of Central Cancer Registries.


Were the fact-checkers too busy tweeting to check these incontrovertible cancer rates? 

I must have missed the retraction.   

Poor Children Getting More Antipsychotic Drugs: The Power of a Poor Graph

Children on Medicaid are more likely to be prescribed antipsychotic meds than those with private insurance - and for less severe conditions - that's the front-page news in today's New York Times.  

So I read the story by Duff Wilson with interest, expecting something dramatic in the results of a new study out of Rutgers and Columbia to be published in the Health Affairs Journal.  Like we're pushing the powerful drugs on our most vulnerable citizens a lot more than other kids in comfy homes who have parents and psychologists eager to try other therapeutic solutions.  After all, Medicaid shells out a lot less for therapy than drugs and finding a psychiatrist or psychologist who accepts it can be difficult. 

Sure enough, poor children are 4 times more likely to get antipsychotics. 

FOUR TIMES. 

Sounds bad, no wonder the group of health professionals, aka Too Many, Too Much, Too Young, yes, the actual name, want to find a better way to help these kids.

Then I saw the actual numbers.  Remember, four times.  Four hundred percent!  Yikes.  But four times more than what?  Would you believe less than 1%?  Turns out almost 1% of privately-insured kids get the mind-altering meds compared to 4% of the Medicaid kids.  Oh yes, I know, these are young and developing minds and bodies, any overuse and abuse of the drugs with serious side effects is problem for concern.  I get it, but..... 

Is this a meaningful difference?  The sample was in the thousands  But still, we're not sure how reliable these figures are.  We know large samples, let alone gigantic ones, often provide statistically significant results that in reality don't mean as much.   Like when we compare thousands of people.  

And then there are the graphics.  Take a look at the graph on the left courtesy of the New York Times:

Here we have an exercise in tweaking the results.  Or how to present your data in the most dramatic manner.   We got a a vertical axis that runs from 0% all the way to 5%.  Looks impressively bad for the poor kids.  But it's deceptive.  And just a piss poor presentation that wouldn't float in Research Methods 101.  I'd take off points for that on a test.  Imagine what the graph would look like if the vertical axis went up to 100%.  We'd barely notice a difference between the two populations. 

And just why are these kids prescribed the drugs?  We read the poor kids are more likely to get them for less severe conditions.   Are they?  Take a closer look at that circle of kids getting the meds:

27% of Medicaid kids vs. 30% of private-insurance kids take them for serious conditions

73% of Medicaid kids vs. 70% of  private-insurance kids for other less severe conditions

So, the to-do about the poor kids getting put on these meds for less severe conditions doesn't look all that meaningful.

Then there's the matter of how many children are diagnosed with these disorders.  Are children on Medicaid more likely to be diagnosed with mental illness?  Yes, according to the article - twice as likely.  A quick search of recent studies suggest the rate might be even higher, even over three times as high.  The current study shows they're four times more likely to be prescribed the drugs.

So it looks like some bias might exist towards prescribing antipsychotics but it doesn't appear to be large.  Do children from families without economic resources, without health insurance deserve competent doctors and therapists?  Absolutely.  Do we need to rethink services to this population?  Absolutely.  But do we have an epidemic of antipsychotic doping among our poorer children?  Clearly not. 

And yet it made the front page of the Sunday New York Times. 

BTW, what about other less powerful drugs?  Are kids prescribed these at the same rate?  Makes me wonder considering we've not heard a study claiming poor kids are morely to get psych meds in general.  The researchers looked at Medicaid and private-insurance claims, apparently millions of claims, surely they had numbers on the other drugs.  Which leads me to suspect there were no significant differences.  Which makes me question if the antipsychotic result was a freak finding. 
Crystal, S., Olfson, M., Huang, C., Pincus, H., & Gerhard, T. (2009). Broadened Use Of Atypical Antipsychotics: Safety, Effectiveness, And Policy Challenges Health Affairs, 28 (5) DOI: 10.1377/hlthaff.28.5.w770

The Bisphenol A Brouhaha from A Balanced Toxicologist

The safety of  Bisphenol A has divided the public.  I've complained about the bias in the media, their fear-mongering and just plain misinterpretation ("stretching") of research findings. 

But it's not just the media, even researchers can be less than fully objective as we're reminded by Emily Monosson, herself a toxicologist and a blogger (aka The Neighborhood Toxicologist), who's posted  a thoughtful piece on the chemical controversy amongst researchers, even governmental agencies, like the FDA ("we're pretty sure it's safe") and The National Toxicology Program ("it should be banned").  Like many of us, Monosson threw away the suspect plastic bottles but still questions whether BPA is "the evil twin of estrogen." 

This trustworthy toxicologist is keeping an open mind, something I really appreciate on this often confusing and complex chemical, so it's no surprise she's particularly attuned to skewed perceptions on "both sides of the fence" - from scientists working in industrial,  environmental, and yes, academic arenas.  True, the debate within scientific circles is not cut and dry.  Nor is the issue going to be resolved any time soon.  Part of the problem with studying the risks, Monosson  points out, involves the older toxicity testing procedures that often use multi-generational studies.  They take time. 

So what's the bottom line for her?  Well, no surprise, she's reasonably cautious but not dramatic and yes, she has faith in science:

Despite the uncertainties, aren’t all of these studies enough to require that industry remove the chemical from our food and drink? While I am skeptical of studies produced by industries whose bottom line depends upon a particular chemical and in sticking with decades old testing procedures, I also know that a chemical posing an imminent danger is good for academic business, generating more grant money, more publications, and more consulting. It’s not an ideal system, but given time the scientific method prevails – and in the interim we have guidance from the expert panels.

Thanks, Emily.  If only we read this stuff in the national media!

FYI:  The FDA delayed its report on Bisphenol A - it was due to be released at the end of November.  It's unclear when the report will be finished. 

Celebrity Health Advice Sized Up on Slate: Jenny McCarthy Missed Autistic Red Flag?

Jenny McCarthy might have written several best-selling parenting books (Louder Than Words: A Mother's Journey in Healing Autism) but she's no health expert and I highly doubt she's cured her son or anyone else of autism.  But there are plenty of people who do believe her health claims (e.g., vaccines cause autism) despite evidence to the contrary.  Why? She's pretty and famous and a former Playboy Playmate who gets to voice her (uninformed) opinion to national audiences on Oprah and in Cookie Magazine.  There's just no comparison between her and say, Dr. Paul Offit, the real expert who defends vaccines in his book,  Autism's False Prophets.  Honestly, before all the autism talk, I thought she was the type of celebrity that didn't take her celebrity or supposed sex appeal all that seriously.  Maybe that's still true, but she's certainly using both to promote false information.
 
The ex-model is just one of the famous actors and personalities Dr. Rahul Parikh targets in his article on  celebrities who publicize their health conditions or those of family members (Doc Hollywood: If celebrities insist on using their fame to bring awareness to health problems, they should follow these guidelines).  Parikh, a pediatrician, reports that Jenny's son apparently showed signs of autism well before his 18-month vaccinations:

...McCarthy described her infant son as a quiet "Buddha baby" who seemed to stare off into space rather than making eye contact and engaging with his mother. That's a classic early red flag for autism, one that was probably overlooked well before her son received many of his vaccines

McCarthy discusses her son's ordeal at every turn, but she hasn't disclosed his medical records. If McCarthy is going to blame vaccination for autism despite all the medical and legal evidence to the contrary, she needs to be more up-front with her son's story. Celebrities who go public should also refrain from publicizing preliminary findings and be sure to communicate caveats, like the risks of a screening test in addition to its benefits, regularly.

Amen, Dr. Parikh!  Now if we could just find a reasonable yet glamorous spokesperson for children's health.  Wouldn't it be great if we could get someone like Halle Berry for honest public service announcements:

Being a mother is one of the best things I've ever done, but it's hard work.  I breastfed (daughter's name) for (fill in the blank).  Not because I thought it would make her healthier or smarter or better, but because I wanted to and I had the extra time, help, and money to make it possible.   And besides, I'm much more concerned with teaching (daughter's name) how to love, how to be a good friend, to be thankful for and enjoy all the good things in her life.  And if times get tough I want her to feel she can get through it and know I will always love her no matter what.  Those gifts aren't as easy for parents as breastfeeding.  They take a lot of time and patience, and of course, plain old listening.

Plastic Makes Boy's Brains and Play Less Boyish? What Do Phthalates, Phallic Fears, and the Supreme Court All Have In Common?

Phthalates in pregnancy feminize the developing male brain rendering boys less boyish. 

So says University of Rochester researcher Shanna Swan who found women who had high levels of the chemical in their urine during pregnancy later reported their boys showed less masculine play.  

But who cares...

Let's not waste too much time on that study - it's correlational in nature and riddled with methodological pot holes.  And because I've just read  Randy Olsen's Don't Be Such a Scientist, I'm not gonna bore you with the technical details. 

Not when the back story on researcher Shanna Swan is so much juicier, so much more newsworthy, clearly what we science-minded people need to focus on if we're ever gonna patch up the poor science in the media let alone convince parents their children are not endangered by plastic. 

So the dirt comes from Trevor Butterworth, the editor over at STAT.org, in his regular column at Forbes.com (Can Plastic Change Your Sex?: Another weak claim consumes the media).  Butterwoth blames some of the current plastic panic on a 2005 study by Swan. 

Yes, the original fallacious and phallic phthalate study:  

..Swan claimed that levels of certain phthalate metabolites in pregnant women correlated with a lower anogenital index in their male children (the AGI is a measurement of the distance from the anus to the base of the penis, divided by the weight at the time of measurement). 

There wasn't a consensus as to what a normal range for AGI was in baby boys or whether it is significant, but there was evidence that a shorter AGI correlated with a slower rate of testicular descent in animals. When a National Institutes of Health expert panel later evaluated her study, it didn't find her evidence wholly convincing. All the babies in the study had normal genitalia with no sign of defects.

The lack of penile imperfections didn't stop Swan from publicly declaring phthalates in utero cause genital malformations AND birth defects in boys.  Human boys.  Without any evidence!  Well, in fact, with evidence suggesting the contrary.  But of course that didn't stop the media and environmental activists (nor legislators) from proclaiming phthalates a dangerous toxin.  And now said researcher is pushing more bad science and claiming she's got evidence that phthalates feminize the brain. 

But that's not the end of our story.  Swan also has testified as an expert witness in at least two court cases for plaintiffs claiming harm from toxic substance, one, an anti-nausea drug, the other, silicone breast implants.  In both cases the courts actually invalidated her expert testimony.  In fact, her scientific nonsense not only reached the Supreme Court (yes!) but troubled our Supreme Justices so much they decided to redefine what constituted good scientific testimony.   Now that's impressive.  Offending the Supreme Court with your lousy empirical arugments.

So of course that information went missing from the media coverage of Swan's latest phthalate study:

Why You Need to Avoid Phthalates: Baby Boys Are Found to be Affected by Chemicals in Plastic (Babble.com, Dec. 7, 2009)

Common Chemical Making Boys Soft  ABC News (November 17, 2009)

Phthalates Affect Way Young Boys Play: Boys With High Phthalate Exposure in Womb Show Less Masculine Play (WebMD.com, November 16, 2009)

If only the latest pseudo scientific study were Swan's swan song to parents...

Prenatal phthalate exposure and reduced masculine play in boys.  International Journal of Andrology.  Published online November 16, 2009.   DOI: 10.1111/j.1365-2605.2009.01019.x

Talking about Sex with Kids: Sex Talk Putting Kids to Sleep. And Some Parents Too?

Parents are making sex a bore too.

We expect the kids don't listen when we tell them to brush their teeth, fold their laundry, take a shower.  But when we talk about sex???

Come on, people, we gotta sex up the sex talk.

That's my conclusion after reading a new study out of California in this month's journal Pediatrics.  No, the researchers didn't reach that same conclusion.  But, then again academic papers aren't known for their  titillation or their real-world application.  So what did the authors find?  Most parents don't get around to talking about sex until it's too late.  Ho hum.  As one of the researchers told a reporter, he wasn't all that surprised (Time magazine online article: Parents' Sex Talk with Kids: Too Little, Too Late by Alice Park).


More than 40% of teens report having sex before their parents have spoken to them about safe sex, birth control, the consequences of pregnancy and the like.   

The sex researchers surveyed 141 families (with kids aged 13 to 17 years old) who'd already volunteered to participate in the Talking Parents, Healthy Teens program to improve parent-child communication.  The parents and their children filled out surveys at the beginning of the study and at three other times over the next year (i.e. a "longitudinal survey").  The survey asked whether the kids and their parents had discussed 24 different topics ranging from menstruation, how to say "no", and how to put on a condom.  The kids also completed questions about their sexual experiences so the researchers could compare the timing of the sex talks with the actual sexual activity. 

Some interesting results here, beyond the "too little, too late".   Like the disconnect between what kids and parents remember.  Or don't remember.  Especially for the families with teenaged girls.  For the 15 of the 22 sex topics supposedly discussed before the girls actually had sex, parents were more likely to report having "the talk" then their girls.  So, did the girls simply not remember mom's (73% of the parents surveyed were women) lecture?  Or was it actually not a lecture at all but too subtle, the language too indirect, slipped in between "remember to bring your gym clothes home" and "take those muddy shoes off"?  It's not hard to imagine.  The parent nervous, speaking in innuendos about milking cows and such.  But on the flip side, for a few of the topics, the girls actually remembered the talk when the parent didn't.   I wonder what happened there? 

As for the boys, there was less disconnect between the parents and the teens.  There was just less talk for them overall.  For both males and females, when the parents reported more "before sex" talk, often the teens would report more "after" - even though the parents had clearly thought they'd discussed it before.  So, in some sense it seems the information did register. 

It's as if after having sex, the kids started remembering what mom and dad actually said.

That happened more than a third of the time for boys, and a quarter for the girls.  A delayed effect.  Oh yeah, that's what my mom was talking about....
Or maybe the teenagers tried to bring it up after the fact with their stressed out, over-scheduled parents who simply didn't hear them or who cut them short without realizing what they were really asking about.   

And what's up with Time.com gratuitously inserting links in red at the end of paragraphs?  I get the related, useful links in the story and can tolerate the crap on the borders of the screen (don't know the proper terminology).  But when I'm reading an article on teenagers and sex do I really want to see "the top ten teen idols" or "pictures of teens in America" or worse yet "the evolution of the college dorm" -  pretty ridiculous.  It breaks your stream of thought, but maybe that's the purpose?  Does Time not want me to read the entire article?? Does a news publication not want me to read the news? 

Anyhow, read the study for free while you can.  It's easy to read with lots of clear tables.  Click on the link below.  The study is entirely "descriptive" so it's free of any statistical tests or off-putting technical language.

Timing of Parent and Child Communication About Sexuality Relative to Children's Sexual Behaviors.   Pediatrics online (December 7, 2009)

Beckett, M., Elliott, M., Martino, S., Kanouse, D., Corona, R., Klein, D., & Schuster, M. (2009). Timing of Parent and Child Communication About Sexuality Relative to Children's Sexual Behaviors PEDIATRICS DOI: 10.1542/peds.2009-0806