Wednesday, September 26, 2012

LA Times article uncovers risks of alternative treatments for autism

“Autism: Kids Put at Risk” is the name of an article that appeared in the LA Times Health Section (,0,5807576.story ).  The article is in essence an expose of biomedical treatments for autism being promoted by a select group of physicians.  The piece follows another investigation conducted by the Chicago Tribune and states that “after reviewing thousands of pages of court documents and scientific studies and interviewing top researchers in the field, an investigation by the Chicago Tribune found that many of these treatments amount to uncontrolled experiments on vulnerable children. The therapies often go beyond harmless New Age folly. Many are unproven and risky, based on flawed, preliminary or misconstrued scientific research. Lab tests used to justify therapies are often misleading and misinterpreted. And though some parents fervently believe their children have benefited, the investigation found a trail of disappointing results from the few clinical trials conducted to evaluate the treatments objectively.”

Some of the more questionable approaches include Chelation, a treatment where the patient is given a drug that binds to heavy metals to be excreted in urine. The theory is that it will rid the body of heavy metals but it carries significant risks including death. According to court records, a 5-year old boy with autism died in 2005 after experiencing a heart attack while being intravenously chelated at his doctor’s office.

Hyperbaric oxygen therapy (HBOT) is another highly risky treatment purported to help treat autism by reducing inflammation. Patients are sealed in pressurized chambers which are enriched with extra oxygen. It carries a risk of oxygen toxicity.  Last month, the Center for Autism & Related Disorders (CARD) published the results of a randomized double-blind placebo-controlled trial stating that researchers found no differences between HBOT and placebo groups across any of the outcome measures. The present study demonstrates that HBOT does not result in a clinically significant improvement in the symptoms of Autistic Disorder.

With such high risk and questionable results, why would a parent be willing to expose their child to such dangerous therapies? The article contends that many of the parents are desperate.  Until someone has spent a day in the shoes of a parent dealing with autism, it would be unapprised to pass judgment. But the real reason probably has to do with lack of treatment recommendations by the medical community.  If a desperate parent attends a conference and hears stories of improvement that offer hope from other parents and physicians, that is far more persuasive than a pediatrician who is going to spout off statistical studies.  But parents need to know that the results of these therapies may have more developmental explanations. With early intervention, children with autism often show natural improvement at the age of 3 or 4 and by age 5, many make so much progress they can be indistinguishable from their typical peers. This happens regardless of whether the child is undergoing alternative therapies.

To prevent a parent from agreeing to these risky alternative therapies, the medical community needs to offer a more streamlined response in terms of treatment recommendations, resources, and ongoing support.

To date, Applied Behavior Analysis (ABA) is the only safe and effective method of autism treatment backed by evidence-based scientific research. It is considered the gold standard in autism treatment and has been endorsed by the U.S. Surgeon General. But ABA requires commitment, support and can be quite costly.

Information is paramount for parents. The more you learn, the better you can help your child with special needs. The road ahead is challenging, but it can also be very rewarding.
Daniel Adatto, MA, BCBA 

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