AUTISM QUACKERY REVIEWED

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Persons with autism have slight to substantial impairment in ability to learn, communicate, and interact socially with others. Several recently published articles including two articles in the special double issue of Priorities for Health magazine on “Sorting Out Junk Science” [12(4);2000 and 13(1);2001; published online at http://www.acsh.org/publications/priorities/1301/index.html] provide critiques of dubious claims for interventions to help persons with autism.

In their Priorities for Health article, “Pseudoscientific Treatments for Autism,” James D. Herbert, PhD and Ian Sharp of MCP Hahnemann University note that publicity in 1998 about one child with autism benefiting from the injection of a single dose of secretin — a digestive hormone — led thousands of parents to have their children injected. Herbert and Sharp state that the only FDA-approved medical application of secretin is for the facilitation of diagnosis of gastrointestinal diseases. They cite two studies of secretin given to children with autism. In one study, no effect of secretin was found on standard behavioral measures. In the other study, no effect of secretin was found on standard measures of language skills. No studies have reported positive effects of secretin on children with autism.

Nevertheless in an essay from Autism Research Review International on the Web site of the Autism Research Institute Bernard Rimland, PhD states “The use of secretin appears to be the most promising treatment yet discovered for the treatment of autism.” In another essay Rimland states that “Secretin is widely regarded as being remarkably safe,” but also cites three cases of seizures and one case of breathing cessation requiring resuscitation following administration of secretin to children with autism. Rimland downplays the safety concerns of administering secretin to children by making the deceptive generalization that hormones are much less toxic than synthetic drugs.

Herbert and Sharp also note that some professionals claim that DMG (N,N-dimethylglycine) treatment increases eye contact and speech and reduces frustration among persons with autism. They state that a double-blind placebo crossover pilot study of DMG treatment of eight males with autism did not show effects that significantly differed from placebo treatment.

Rimland, who promotes DMG for people with autism, states in another Autism Research Review International essay: “There aren't any [double-blind placebo-controlled scientific studies showing DMG to be effective in autism] and none are needed.” NCAHF insists, to the contrary, that proponents of treatments need to back up their claims with evidence, not anecdotes.

Herbert and Sharp describe auditory integration training (AIT), which was developed by otolaryngologist Guy Berard in Annecy, France, as involving exposure to sounds of varying volume and pitch to normalize hearing in persons with autism. Proponents claim that AIT improves ability to speak, comprehension, eye contact, memory, and social behavior.

In her Priorities for Health article “Autism and Voodoo Science Treatments,” Gina Green, PhD, BCBA writes on behalf of the Association for Science in Autism Treatment (a nonprofit organization which can be reached at 516-466-4400). Green shows that studies that purportedly demonstrate AIT to be beneficial to people with autism have serious methodological flaws. She notes that in 1998 the American Academy of Pediatrics found no good controlled studies to support its use and raised questions about its safety. She quotes from treatment guidelines developed by a multidisciplinary panel arranged by the New York State Department of Health: “Because of the lack of demonstrated efficacy and the expense of the intervention, it is recommended that auditory integration training not be used.…”

Promoters of the technique of “facilitated communication” (FC) claim that FC is a breakthrough that enables persons with autism and other severe communication difficulties to express themselves on a computer or typewriter keyboard. The “facilitation” is provided by a non-disabled adult, who maintains physical contact with a hand, arm, or shoulder of the disabled person. According to Green, at least 40 controlled studies published in peer-reviewed journals since 1992 have validated the hypothesis that facilitators are the actual sources of the messages entered on keyboards. She writes that the only studies represented as controlled and as validating FC were conducted by proponents of the method and all the papers were published in the journal Mental Retardation. Green lists the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Association on Mental Retardation, the American Psychological Association, the American Speech-Language-Hearing Association, and the Association for Behavior Analysis as having issued position statements “to the effect that FC is not a valid or reliable way of dealing with the communication problems of autism or other disabilities.”

According to Green, thirty years of research has established that intensive intervention with applied behavior analysis can produce large, lasting improvements in the cognitive, social, and communication skills of persons with autism. She writes that widespread uncritical adoption of FC by many professionals who work with persons with autism has led to frequent displacement of validated intervention.

In “Facilitated Communication: A Cruel Farce” [Skeptical Inquirer 25(1): 17–19, 2001], Martin Gardner describes facilitators as totally sincere, but as unconsciously guiding the fingers of the disabled persons they were trying to help. The was demonstrated in a definitive test presented in the October 1993 PBS Frontline program on “Prisoners of Silence.” A tragic aspect of facilitator influence has been the typing of false accusations of child sexual molestation leading to dozens of arrests, in some cases leading to jail time and the need for legal defenses. Gardner cites a case in England reported in 1999 in which “[t]he judge, Dame Elizabeth Butler-Sloss, branded FC a dangerous, unverified technique that should never be used again in any British court to support sexual abuse charges.”

Gardner notes that Douglas Biklen, whose doctorate is in sociology, continues to train facilitators through the Facilitated Communication Institute at Syracuse University, where he is a professor of education. According to Gardner: “Through high-priced seminars, and sales of videotapes and literature, it is estimated that Biklen is bringing millions of dollars annually to his university.”

The Web site for Biklen's Institute is http://soeweb.syr.edu/thefci/index.html. Biklen cautions against facilitators guiding in pointing or typing.

In a previously published article, “The Brutality of Dr. Bettelheim,” [Skeptical Inquirer 24(6): 12–14, 2000], Gardner wrote: “Strong evidence that autism is a dysfunction has been available for half a century, and was taken for granted by neurologists outside the Freudian tradition.” His article focuses on Bruno Bettelheim, a Freudian and the “leading advocate,” of the view that autism was somehow caused by unloving parents. Bettleheim promoted “parentectomy,” a cruel and unwarranted policy that forbade parents from seeing their children for at least nine months.

In its August 2001 article “Vaccines: An Issue of Trust,” Consumer Reports refers to the accusation made by anti-vaccine groups that the that measles-mumps-rubella (MMR) vaccine causes autism as “…groundless, according to the latest research.” The U.S. Institute of Medicine, the American Academy of Pediatrics, the World Health Organization, the Canadian Pediatric Society and the United Kingdom's Medical Research Council have all found that the claim that MMR vaccine causes autism is not supported by the evidence.

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