figures in Press Release from Ray Gallup, President, Autism Autoimmunity Project
- 1992 - 2001 statistics (click to view)
Between the 1992-1993 and 2000-2001 school years, 23 states had an increase of
1000% or more of children between 6 and 21 with autism, some many times
more. Another 15 states had increases of between 500% and 999%.- SM)
to the House Government Reform Committee by Mary Megson, M.D.
segment of children with "regressive autism," the form where children
develop normally for a period of time then lose skills and sink into autism most
commonly at 18-24 months of age, is increasing at a phenomenal rate. I am seeing
multiple children in the same family affected, including in the last week four
cases of "autistic regression" developing in four-year-old children
after their MMR and DPT vaccination. In the past, this was unheard of.
we are staring a disaster in the face that has affected thousands of
to the House Government Reform Committee by Bernard Rimland, Ph.D
supposed experts will tell you that the increase reflects only greater
awareness. That is nonsense. Any pediatrician, teacher or school
official with 20 or more years experience will confirm what the studies tell
us: there is a real increase in autism and the numbers are huge and
growing. The epidemic is serious and world-wide.
figures soar in America
number of children diagnosed with autism in America is continuing to increase at
a rate of more than 20% a year, according to the latest figures published by the
US Department of Health.
show that in the year 1999/2000 the number of schoolchildren in America with
autism was 65,396 compared with 53,576 the previous year.
have risen steeply since the reporting of autism became mandatory in American
schools in 1991. At first the increase was attributed to better reporting of the
condition but after nine years some experts argue that the consistent rise must
demonstrate an actual rise in autism rates.
To Quell the Rising Rate of Autism
are calling it a national emergency as the rate of autism among children in the
US and around the world is rising by as much as 800 percent.
ranks are growing...
the 1970s the rate of autism was about one case in 2500 children.
Today it is one in 250 children. In
California in the 1970s only 100-200 new cases of autism were reported annually.
In 1998, new cases reported to the public-school system were 1425!
In 1999 that figure jumped to 1944! In New Jersey the reported cases of
autism jumped from 241 in 1991 to 1634 in 1997 (an 800% increase)!
There were 4.4 cases of autism per 10,000 live births reported in
California in 1980 and 20.8 cases per 10,000 live births in 1994, a 373 percent
relative increase. [Journal
American Medical Association 285: 1183-85, 2001]
British Medical Journal reports that autism jumped by 700% from 1988 to 1999!
[British Medical Journal 322: 460-63, 2001]
In studies prior to 1988, the estimated prevalence of autism was between
4-6 cases per 10,000 children. Among
15,500 British children between the ages of 2 and 6 years of age the autism rate
has risen to 17 cases per 10,000 children.
When the entire spectrum of autism disorders is considered (which
includes Asperger syndrome and other rare childhood degenerative disorders), the
rate rises to 63 per 10,000 children. [News.telegraph.co.uk
July 8, 2001] In Japan the rate of
autism was 5-16 per 10,000 in the 1980s but rose to 21.1 per 10,000 in 1996, a
31-400% increase. [Japanese Journal
Infectious Diseases 54: 78-79, 2001]
is causing the rise in autism, it is a worldwide factor.
- Why the Increased Rates?
- Congressional Hearings
asked about the increased rates in autism, many will immediately discount that
there even is an increase. Even though the latest statistics from the
Department of Education show increased rates in every state. Others will say the
increase is due to better diagnostic skills. Others will say it is because
the diagnostic category was expanded.
has reported a 273% increase in children with autism since 1988. As for
this increase, twenty-one percent of all autistic children in California live in
the 29th district.
has reported a 571% increase in autism. Maryland has reported a 513%
increase between 1993 and 1998. You can't attribute all of that to better
1999, there are 2,462 children ages 3 to 21 in Indiana diagnosed with autism.
That is one-fourth of one percent of all the school children in Indiana or 1 in
400. Twenty-three percent of these children live in the 6th district.
This increase is not just better counting.
rise in autism backs up fear of MMR vaccine link
say a new study revealing that the number of children diagnosed as autistic is
15 times more common than previously believed is further proof of a link between
the condition and the combined measles, mumps and rubella (MMR) vaccine.
scientific study carried out by the Autism Research Centre at Cambridge
University shows that 57 in every 10,000 children aged between five and 11 have
been diagnosed with the condition. Campaigners have long argued that the rise in
autism can be linked to the introduction of the combined vaccine in 1988.
Fiona Scott, one of the researchers, said: "Most people, including the
health authorities, argue that the the prevalence of autism is four or five in
10,000, and most research up until now has stated that the largest possible
number would be 18 in every 10,000. This is the first scientific study to show
that it is significantly greater."
and lies: Is the astonishing rise in autism a medical mystery or a
I read statistics from the Department of Education that said autism in
school-age children had increased 556 percent in five years, skyrocketing past
any other disability, I was shocked and horrified.
Autism Explosion, the Vaccine Connection, and the Autism Research Institutes
Mercury Detoxification Consensus Conference
maintains what is probably the worlds best and most systematic database on
autism and other developmental disabilities, which includes children who are
formally diagnosed by strict criteria for acceptance into a comprehensive
entitlement program. California
reports an increase in the prevalence of autism of over 1,000% (in autism, not
mental retardation, epilepsy nor cerebral palsy) over a 20-year period.
Similar enormous increases have been reported in New Jersey, and in
several places in the U.K., in the Middle East, and in Asia.
The increase is certainly not the result of greater awareness nor better
to figures recently released by DDS, California has experienced an all time
record number of new cases for a second quarter reporting period in
professionally diagnosed cases of level one autism, which again does not include
any of the other autism spectrum disorders. The addition of the 664 new children
added to the system from April 3 to July 8, 2001 represents the largest number
of new cases of autism added to the system during a second quarter reporting
period in the 32 year history of Californias developmental services system.
The increase represents a 27% increase in the number of new children added to
the system over the previous (April to July, 2000) second quarter reporting
period. The most recent numbers
continue the onslaught of children diagnosed with full blown autism and
qualified for services in California at the incredible rate of seven (7) new
children a day....seven days a week.
more horrifying is the fact that through the first SIX MONTHS of 2001,
California added more children with level one autism to its system then in
any other FULL YEAR from 1969 through 1998 !! If this trend continues for the
remainder of 2001, California will add over 2,700 new children with autism to
its system in 2001 alone.....A number that would equal 13.5 years worth of
new cases of autism, pre-1979-80, or more new cases of autism then entered the
system for all of 1994,1995, and 1996 combined !!
Explosion Persists: 457 New California Children In 91 Days
to figures just released from the California Department of 2 developmental
Services (DDS), during the third quarter of this year (July 7through October 6),
457 new children with fully diagnosed DSM IV autism were added to the roles of
California's Developmental Services System. 457 new children have
qualified for services at a cost to taxpayers, according to DDS, of at least $ 2
million each ($914 million worth of new kids in just three months from just one
state!). Keep in mind as well, that these 457 new children DO NOT include any
children with PDD, Asperger's, NOS, or any other of the autism spectrum
disorders, except full-blown, DSM IV autism.
This most recent third quarter report represents the second highest number of
new cases reported for a third quarter in seven years. An astonishing 35% of all
the new intakes to the system during this three-month period were new cases of
autism; this, compared to the pre-autism epidemic traditional intake rate of 3%.
During the first nine months of 2000, the California Developmental Services
System experienced a 5% increase in total caseload growth, which includes all
new cases of mental retardation, conditions similar to mental retardation,
epilepsy, cerebral palsy, and autism. During this same nine-month period, there
was a 14% increase in caseload growth in autism. California
continues to add an average of 5 new children a day, with full-blown DSM IV
autism, seven day's a week to its system.
would the response be from the public health community if five new children a
day from one state were showing up on their doorsteps with a horrible disease
that leaves its victims brain damaged and terribly disabled? Besides trying to
develop a vaccine for it, I would guess that an immediate public health crisis
would be declared, and a major effort by CDC and NIH would be undertaken to find
the cause, and develop treatments and a cure. We are experiencing such a public
health crisis today...it's called the autism epidemic.
on the most current data report obtained from the California Department of
Developmental Services (DDS), California has just experienced the largest
quarterly increase in the number of new cases of level one autism in its
to DDS, between July 6, 2001, and October 4, 2001, a record number 705 new cases
of DSM IV autism entered Californias developmental services system, bringing
the nine month total for 2001 to 2,069....more new cases in the first nine
months of 2001 then reported in any other FULL YEAR on record. As with all of
DDSs autism case growth reporting, the 705 new cases do not include other
autism spectrum disorders such as PDD, NOS, Aspergers, etc.
2001 Third Quarter report represents: (1) the largest quarterly increase EVER
reported by DDS, (2) constitutes a 54% increase over the year 2000 Third Quarter
report, (3) shows that autism, for the first time, has now increased from, on
average, 7 new children a day entering the system to 8 new children a day, (4)
that 708 ADDITIONAL children with autism entered Californias system during
the first nine months of 2001 then did during the first nine months of 2000, (5)
that in October 2000 level one autism accounted for 28% of the total number of
all new intakes (autism, cerebral palsy, mental retardation, epilepsy, and
conditions similar to mental retardation) now in October 2001 level one autism
accounted for 36% of all new intakes, and (6) that for the third straight
quarter, autism has become the number one disability entering Californias
developmental services system.
Third Quarter Reports
705 new cases
2001: The Silent Epidemic
cruel reality is that the last published incidence of autism in the UK of 1 in
324 (Journal of the American
Academy of Child and Adolescent Psychiatry, volume 39, p 694), was just amended
this week to 1 in 166, according to
a Medical Research Council (MRC) report commissioned by the Department of
Health. A National Autistic Society survey had found that 1 in 110 children
under 11 has autism.
increases in the incidence of autism have been reported on the European
Continent. A Swedish study in
1993 by Ehlers and Gillberg found a rate of 71 per 10,000 (1 in 141) in children
with IQs of 70 or above. A Finnish study looking at the incidence of autism in
the northern provinces, revealed a fourfold increase between 1979 and 1994 with
a present incidence rate of 1 in 483 among 5 to 7-year-olds
(European Child and Adolescent Psychiatry, volume 9, p 162). Also, in
this study, a clear increase in the number of children with IQ of 70+ was
reported. (This finding has often been reported with regressive or late-onset
autism.) Interestingly, this particular Finnish study went almost unnoticed,
while other Finnish studies (of dubious epidemiological relevance) were highly
publicized because they supported the MMR vaccines safety.
the United States, the atrocities of September 11, the Anthrax letters and the
present war in Afghanistan have certainly touched every one. But life goes on.
For the parents of children with autism, each days battle is overwhelming and
their lives have changed forever. There is no final victory they can look
forward to and no end to their war in sight. Each morning brings new problems,
new challenges and more concerns about funding cuts and decreased services.
Every night, the same awful dream recurs What will happen to my child when I
to the Department of Education annual reports to the US Congress, autism cases
in children aged 6-21 in US schools increase yearly by approximately 25%
September 12, it is more than likely that between 600 and 700 new cases of
autism were diagnosed and accepted into the system in California alone. This
projection is based on the last published 3-month rate of between 7 and 8 new
cases a day. If the average incidence of new cases of autism in the remaining 49
states averages only 1/8th of the California ratea very
conservative estimate, indeedwe should expect that approximately 4000 new
cases of autism have been diagnosed nationwide in the last 3 months. In the
United States, the cost per child over a lifetime is soon to surpass 2 million
Autism Update from Rick Rollens
no changes in the diagnostic criteria for many years, and in a system that has
been ascertaining autism since 1970, the California Department of Developmental
Services (DDS) recently released the following data on the number of new cases
of fully diagnosed DSM IV (Level One) AUTISM (NOT including other autism
spectrum disorder such as PDD, NOS, or Asperger's, or other rare "autism
like" genetic diseases):
An all time one year (1970-2001) record
number of cases (2,725) were added to California's system in 2001. This
number represents a 20% increase in one year over the previous record year of
2000. The just completed 4th Quarter of 2001 (Oct. 4, 2001 to Jan. 3, 2002) also
set an all time record for numbers of new cases for any 4th Quarter in the
history of the system. During 2001, each of the four quarters posted all time
record setting increases. THERE WERE
MORE CASES OF LEVEL ONE AUTISM ADDED IN 2001 THEN IN ALL OF 1994, 1995, AND 1996
In 2001, for the first time ever in California's history, level one autism
became the number one disability entering California's system...accounting for
an astonishing 35% of all new intakes in 2001. A percentage that has
exploded from historic levels of 3%. AUTISM HAS SURPASSED MENTAL RETARDATION,
CEREBRAL PALSY, EPILEPSY, AND ALL OTHER CONDITIONS SIMILAR TO MENTAL RETARDATION
AS THE NUMBER ONE DISABILITY ENTERING CALIFORNIA'S DEVELOPMENTAL SERVICES
California now has 16, 802 persons with
level one autism in it's system. IT TOOK 25 YEARS (1970-1995) TO ADD 6,527
CASES. UNBELIEVABLY, IT HAS TAKEN ONLY 3 YEARS (1999-2001) TO ADD AN ADDITIONAL
6,596 NEW CASES. SIMPLY PUT, WHAT USE TO TAKE 25 YEARS NOW TAKES THREE.
According to DDS, of the 16,802 persons
with level one autism in it's system: 82% are male, 56% have NO mental
retardation, and 80% were born after 1980...
the beginning of the autism epidemic. AMAZINGLY, OF THE TOTAL NUMBER OF
PERSONS IN THE SYSTEM (16,802).... 11,104 OR TWO OUT OF EVERY THREE PERSONS
(66%) ARE CHILDREN BETWEEN THE AGE 0 TO 13 YEARS OLD.
& Vaccines: A New Look At An Old Story .1 - National Vaccine Information
Responding to the
concern of a Dad, whose healthy son became autistic following a series of DPT,
Hib and MMR vaccinations, in 1998 the California Legislature decided to analyze
the history of autism in the state. Rick Rollens, father of two, former
Secretary of the California Senate, and co-founder of FEAT (Families for Early
Autism Treatment - (http://www.feat.org) and
the University of California-Davis M.I.N.D.
Institute, persuaded the
legislature to fund an investigation by the California Department of
Developmental Services (DDS) into state autism statistics after he concluded his
son, Russell, now 9, was not the victim of a rare disorder but one that had
become quite common in children.
California Autism Rates Soar
Sure enough, in an
April 1999 report (http://www.dds.ca.gov) DDS
found a 273 percent increase between 1987 and 1998 in the numbers of new
children entering the California developmental services system with a
professional diagnosis of autism. The report concluded that the number of
persons with autism grew markedly faster than the number of persons with other
developmental disabilities (cerebral palsy, epilepsy and mental retardation)
and compared to characteristics of 11 years ago, the present population of
persons with autism are younger (and) have a greater chance of exhibiting no or
milder forms of mental retardation. . . ..
autism has been cited by public health officials and autism researchers to occur
in 2 to 10 in 10,000 children nationwide, the Centers for Disease Control in a
report released in April 2000 found the incidence of autism in Brick Township,
New Jersey in 1998 was 1 in 150 children (the incidence in the Granite Bay,
California public elementary school district is 1 in 132 children), which may be
more reflective of the true rate of autism in the U.S. today. The Autism
Society of America estimates that more than one-half million people in the
U.S. today have autism or some form of pervasive developmental disorder,
making autism one of the most common developmental disabilities. (http://www/autism-society.org).
California report documented the dramatic increases in autism in the past
decade, the California legislature voted to appropriate one million dollars to
the UC-Davis M.I.N.D. Institute to look for environmental and biological
factors, including vaccine use, that could have contributed to this autism
increase. At the same time, parents began to check autism statistics in other
Other States Report Similar Increases
story is the same in other states. The 1998 Maryland Special Education
Census Data revealed that the state experienced a 513 percent increase in autism
between 1993 and 1998, while the general Maryland population from 1990 to 1998
increased just seven percent. A comparative analysis of the 16th and
20th Annual Reports to Congress on the implementation of the
Individuals with Disabilities Education Act (IDEA) conducted by Ray Gallup,
President of Autism Autoimmunity Project (http://www.gti.net/truegrit)
and father of Eric, who has vaccine-associated autism, showed increases of more
than 300 percent in autistic children served under IDEA between 1992 and 1997 in
the states of Alabama, Alaska, Arkansas, Colorado, Delaware, Illinois, Indiana,
Iowa, Kentucky, Maine, Maryland, Michigan, Montana, Nebraska, Nevada, New
Mexico, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South
Carolina, Vermont, and Wisconsin.
to the House Government Reform Committee by Shelley Hendrix Reynolds
are those who will argue that we are better at diagnosing autism today than in
the past and that these children were once considered mentally retarded.
However, according to a recent study, the mentally retarded have followed
normal population increases and remained a steady constant while the autistic
population has exploded. Is
autism just the diagnosis du jour? Hardly.
I would truly
like to know where the parents of these autistic children were that did
not recognize that their children were not talking, were spinning constantly in
circles, doing odd things, abusing themselves, not making eye contact, having
serious gastrointestinal disturbances, eating and sleeping problems,
experiencing a failure to thrive due to malabsorption and suffering from
excessive allergies. You cannot
miss these children.
Among Children - CDC
It is not known how many children in the United States currently have autism
spectrum disorders. Studies done in Europe and Asia since 1985 indicate that
there may be as many as 2 to 6 per 1000 children who have one of the autism
spectrum disorders. (This works out to be from 1out of 500 to around 1
out of 160.)
Autism spectrum disorders (ASD) are a
group of life-long developmental disabilities caused by an abnormality of the
brain. ASD are characterized by problems with social interaction and
communication skills, and by the need for sameness or repetition in behavior.
ASD includes autistic disorder, pervasive developmental disorder - not otherwise
specified (including atypical autism), and Aspergers disorder.
Children with ASD require long-term
intervention and support services. Special education costs for a child with ASD
are over $8,000 per year, with some specially structured programs costing about
$30,000 per year, and care in a residential school costs $80,000 - $100,000 per
Little is known about what causes ASD,
although genetic and environmental factors have been suggested. There is no cure
for ASD, however, early and intensive education can help children develop
skills. Also, although available medicines cannot cure ASD, some may relieve
symptoms associated with the disorders.
many people have autistic spectrum disorders?
The specific pattern of abnormal behaviour
first described by Leo Kanner is also known as early infantile autism. Kanner
made no estimate of the possible numbers of people with this condition but he
thought that it was rare (Kanner 1943).
twenty years later, Victor Lotter published the first results of an
epidemiological study of children with the behaviour pattern described by
Kanner in the former county of Middlesex, which gave an overall prevalence
rate of 4.5 per 10,000 children (Lotter 1966). (This works out to be
about 1 out of 2,000 in 1966.)
Eric Fombonne says, "prevalence of autism is 68 per 10,000 or 1-147.
the recent IMFAR (International Meeting For Autism Research) Conference, noted
autism epidemiologist Dr. Eric Fombonne
stated in his presentation that based on 50 previously published epi studies
of autism, the prevalence rate of autism had been established, by his work and
others, at between 2 to 10 per 10,000...which is to say as low as 1-5000 or as
high as 1-1000 (Fombonne's own past studies reported the lower end of the
prevalence spectrum). In a monumental statement at IMFAR, Fombonne now claims,
as a result of his most recent work, that the prevalence of autism is 68 per
10,000 or 1-147.
latest work shows that the prevalence of autism has increased between 600% and
3400% (1-1000 down to 1-147 = 600% increase) and (1-5000 down to 1-147 = 3400%
the middle ground of 5 per 10,000 or otherwise stated as 1-2000, the most
recent epi study by this most conservative autism epidemiologist would now
suggest a 1300% increase in the prevalence of autism over a 25 year period, or
on average, a doubling of the prevalence of autism every two years between
1976 and 2001.
changes in prevalence of autism must be determined
has argued that despite reported increases in the prevalence of
autism in many countries, the true incidence has remained constant.
The impression of an increase, he argues, arises only because of
increased rates of detection.
is no hard evidence to support this hypothesis. The only studies that have
explored the question have failed to find a "hidden
horde" of autistic children. Burd et al conducted a prevalence
study of autism in North Dakota.3
They found a prevalence of 3.26 per 10 000 among a cohort
of children born between 1967 and 1983. A 12 year
follow up survey of the same cohort showed that the original
prevalence study had found 98% of the autistic children in the
area; only one child had been overlooked.4
scientists and health professionals are uncomfortable about the data regarding
recent increases in rates of autism. A few have developed
extravagant theories as an expression of their discomfort.
Nevertheless, the simplest interpretation of the record supports
the conclusion that the incidence of autism has increased.
the dramatic increase in autism be ascribed to change in diagnostic practice?
Data from the recent California report from the Office of Developmental
Services belie this contention. The figure
juxtaposes the data from California with those from north-west London.
Identical temporal trends are shown, with the rise in autism from a steady
baseline value, coinciding with the introduction of MMR vaccine as the single
strategy in both countries that use the same diagnostic criteria for autism.
and mercury: coincidence or cause and effect?
considered a rare disorder with an incidence of only 1-3 per 10,000 births,
autism is now reaching epidemic proportions with an incidence of 20-40 per
10,000 births and clusters of
1 per 150 have been reported in New Jersey and California. Autism now ranks
third among childhood developmental disorders, making it more common than
Downs syndrome, Multiple Sclerosis and Cystic Fibrosis.
to the House Government Reform Committee by Sallie Bernard
First, autism was first discovered in the early 1940s among children born
in the 1930s; and thimerosal was first introduced into vaccines in the 1930s.
Second, prior to 1970, autism was estimated at 1 in 2000 children, while
studies after 1970 showed a higher prevalence of 1 in 1000; this was a period of
increased immunization of American children.
Then in 1996, the NIH estimated the rate of autism to be 1 in 500, and
just recently the CDC has found 1 in 250 children affected with classic autism;
this dramatic increase in the past decade coincided with the introduction and
spread of two thimerosal-containing vaccines - the HIB and Hepatitis B.
linked to mercury vaccine
in vaccines for babies and infants could be the cause of a steep rise in cases
of autism in children around the world, according to a growing number of
of the prevalence of the syndrome in Britain range from 10 cases per 10,000 of
the population with classic autism, to 9.1 cases per 1,000 showing some
signs of autistic behaviour.
National Autistic Society estimates that there are about 500,000 people with
autism in Britain, 120,000 of them children. According to one recent study,
there has been a tenfold increase among children between 1984 and 1994.
- Ray Gallup
is an epidemic of autism in the US and the UK. We are losing children
daily to this life-long disability and the sad part is that we can
prevent this as well as develop research to look into immuno-therapeutic
treatments that will help those already damaged.
Epidemic Based on Data Misinterpretation
the conclusion that autism has reached epidemic proportions is based on numbers
and not rates. It does not take into account increasing populations, Fombonne
researchers made no attempt to account for changing diagnostic criteria used
over the years. Nor does the data reflect the fact that children are now
diagnosed at a much earlier age than 30 years ago, he writes.
data nevertheless point to the magnitude of the problem, which had clearly been
underestimated in the past. But there is no need to raise false alarms on
putative epidemics nor to practice poor science to draw the attention to the
unmet needs of large numbers of seriously impaired children and adults,
May Be More Common Than Once Thought: Study
there have been conflicting reports on whether autism rates are on the rise, a
new UK study indicates that pervasive developmental disorders (PDDs) like autism
and Asperger syndrome are more common than previously believed.
is not as rare as once thought. Thirty years ago, we had a narrow view of
autism, and we estimated the rate to be four or five children out of every
10,000 children, lead researcher Dr. Eric Frombonne
of Kings College in London told Reuters Health.
vaccine and autistic spectrum disorder: report from the New Challenges in
Childhood Immunizations Conference convened in Oak Brook, Illinois, June 12-13,
data indicate increased recognition and reporting as primary factors,
but the epidemiologic
data are insufficient to determine if there has been a true increase in the
incidence of ASD (autistic spectrum disorder).
rates rising, researchers race to find the cause of autism and better treatment
For reasons not at all clear, the rate
of reported cases of autism is rising. Between the years 1987 and 1998, the
latest figures available, the California Department of Developmental Ser-vices
-- a statewide agency providing services and support to children and adults with
developmental disabilities -- reported a 273 percent increase in diagnosed cases
of autism, one of several diseases in a related spectrum that also includes
Asperger's syndrome and Pervasive Development Disorder.
California isn't unique. Studies in
Illinois, Florida, England, Iceland and Japan have all recorded incidence rates
of autism much higher than previously assumed, some worse than here. A decade
ago, it was estimated that one child in 10,000 would become autistic; now the
number has dropped to 1 in 500, and less. Autism
activists have a word for what's happening: epidemic.
is it? Like almost everything else about autism, indisputable facts about
the disease are scarce. At least some of the increase is likely due to improved
techniques for diagnosing the disease and a greater social willingness to do so.