BROOKLYN, N.Y. - Five years after the publication of his book on autism and mercury in vaccines, David Kirby finds much of the ongoing debate on both subjects rather tiresome. Before dismissing the notion that the connection between the two has been debunked, he pauses. He only wishes the public discourse were focused there.

"It's crazy that in this debate, we're still debating whether autism numbers are actually going up or not, which is insanity to me," he said. "It's people desperately clinging to this belief that autism is genetic, that it's always been with us at this rate, that we're just better at counting it, better at diagnosing it."

The two most recent government-backed studies put the rates in children at 1 in 110 and 1 in 91. And since males are four times more likely to be diagnosed with autism than females, that means roughly one in every 60 males of all ages has an Autism Spectrum Disorder (ASD).

"So where are the 1 in 60 men with autism in this country, in this world?" asked the author of Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy. "They don't appear to exist. I've never seen them. I've met a few adults with autism in my life, but very, very few."

BROOKLYN, N.Y. - Two days before the Centers for Disease Control and Prevention (CDC) released its newest data on U.S. autism rates, author David Kirby consented to a two-hour, videotaped interview in his street-level brownstone apartment in the Park Slope section of Brooklyn. The government, the former New York Times reporter said, always drops its worst news late on Fridays, assuming the attention-addled mainstream media will forget it by Monday, when people actually pay some attention.

While the release of new autism data on the Friday before Christmas would normally trigger nervous anticipation in the whirlwind of Washington spin, this year's holiday news dump was anticlimactic. The CDC had revealed the gist of its autism findings in October, after a study in the journal Pediatrics said its incidence had reached 1 in every 91 children.

To inoculate the public against the 65 percent increase the Pediatrics study represented over the CDC's last estimate of 1 autistic child in every 150 born in 1994, Health and Human Services Secretary Kathleen Sebelius herself intervened the day it came out. In a hastily arranged conference call with the autism community, Sebelius announced that preliminary numbers in the third in a series of CDC studies show the ratio was 1 in 100 for kids born in 1996.

Editor's note: This story is the third in a series on autism and the Southwest Indiana environment.

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MOUNT VERNON, IND. - When she discusses her autistic clients, Marcella Piper-Terry almost always speaks in reverential and laudatory tones. "They're just absolutely gorgeous children," she says of kids with Asperger's Disorder, such as her 15-year-old daughter Rachel. "Great big eyes, long eyelashes -- amazing, beautiful children. And very smart, very creative and extremely sensitive. Extremely sensitive."

Only when a two-hour interview in her Posey County, Ind., home turns to the notion that children with Autism Spectrum Disorders (ASDs) cannot be treated does Terry's demeanor assume an edge.

"That is not true," she says. "It's unacceptable to write these kids off because standard medical practice says there is no medical treatment for autism."

BLOOMINGTON, IND. - Data from local school and federal public health officials suggest that children in Monroe County, Ind., are diagnosed with autism at nearly double the epidemic rate that afflicts the nation.

On Dec. 18, 2009, the Centers for Disease Control and Prevention (CDC) released a new report that put the incidence of autism in the United States at 1 in 110 for children born in 1996, or 0.9 percent of the population. A survey, sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration and published in the journal Pediatrics in October, showed 1 in 91 children between the ages of 3 and 17 had autism.

According to figures submitted by the Monroe County Community School Corp. (MCCSC) to state and federal governments last year, one in every 60 students, or 1.7 percent, had an Autism Spectrum Disorder (ASD) diagnosis in December 2008.

MOUNT VERNON, IND. - Listening to Marcella Piper-Terry detail her journey from artist to autism researcher is like any conversation with someone whose life has been touched by the pervasive developmental disorder. It sometimes takes the breath away.

Her family life has been impacted by loved ones diagnosed with multiple disorders and conditions: autism spectrum, bipolar, attention-deficit hyperactive, obsessive compulsive, pediatric autoimmune neuropsychiatric associated with Streptococcus and depression. And through it all, she has become more self-aware.

"The apple doesn't fall far from the tree," she says in her spacious, hardwood-floor dining room a half mile or so north of the Mount Vernon Middle School. "I can definitely see a lot of Asperger's tendencies in myself." Her voice slows. "I don't do clubs. I don't do social events. I would rather be reading and researching than having a dinner party or being part of that kind of stuff."

The dogged pursuit of the unanswerable question, "What causes autism?" could be considered a health hazard. It requires poring over reams of studies, most of whose contents could reasonably be expected to induce paranoia. Mental fatigue from considering the studies' considerable contradictions is a distinct possibility. And the energy with which the proponents of these competing conclusions defend the arguments could lead to high blood pressure for all concerned.

The most emotional dimension of the autism debate, the proposition that mercury in childhood vaccines is linked to the increasing diagnosis rates of Autism Spectrum Disorders (ASDs), is a case in point. Jenny McCarthy and Amanda Peet have offered point-counterpoints all over the Web and on mainstream media, like National Public Radio's Morning Edition.

Editor's note: The Indiana stretch of the Ohio River Valley is one of the most toxic environments on Earth. On Nov. 24, I took a road trip to Evansville and Mount Vernon to interview John Blair, president of the environmental group Valley Watch, and Marcella Piper-Terry, an autism care provider who has collected extensive background data on her clients' environmental exposures. This story is the first in a series on autism and the Southwest Indiana environment. - sh

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EVANSVILLE, IND. - John Blair readily agrees that Southwest Indiana is the perfect laboratory in which to explore the connection between industrial pollution and the increasing incidence of autism and other developmental disabilities. He has witnessed both sides of the equation in his three decades as president of the environmental group Valley Watch.

"We have distinct problems down here with neurological diseases," he says during an interview in his Evansville office on a cloudy, crisp November day. "... And we are under assault from almost every kind of toxic chemical there is."

Indiana citizens with autism are 20 percent more likely to be medicated than their counterparts are nationwide, according to an ongoing survey by the Interactive Autism Network (IAN).

One of every two Hoosiers with autism receives medication, whereas the national average is 41 percent. The disparities hold across the three main diagnoses of Autism Spectrum Disorders (ASDs):

• Autistic Disorder - 22 percent;
• Asperger's Disorder - 20 percent; and
• Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) - 22 percent.

The IAN data also show that Hoosiers spend less out of pocket caring for those on the ASD spectrum than the national average, $3,952 in Indiana versus $6,082 nationwide.

It's been a year since John McCain piqued my reporter's curiosity about the parallel epidemics of autism and environmental pollution that have swept our nation the past couple decades, a journalistically productive and, sadly, intellectually reaffirming 12-month period, to be sure.

Since the Arizona senator announced on the campaign trail last year that he would find the cause of autism if elected, I have pursued the question through interviews with parents, clinicians, advocates, physicians and researchers; stories, articles and books; and more than a few studies and videos. I've also published nearly a dozen-and-a-half stories on the subject in The Bloomington Alternative, CounterPunch online and print editions, NUVO and IU Alumni Magazine.

So far, nothing I've found contradicts my initial premise that toxic pollution is a contributing factor to the meteoric rise we've seen in the incidence of autism. To the contrary, that argument seems more plausible today than it did when I began this time last year. All signs point to "yes," so I am taking this project to the next level.