Facing pseudoscience and autism treatment fads

Facing pseudoscience and autism treatment fads

Some studies have shown that genetic mechanisms contribute to the development of autism; In addition, it is likely that some (unknown) environmental factors also play a role. (Autism speaks).

The standards that determine the diagnosis of autism vary. In addition, the variation in symptoms between patients is so great that it is still not possible to prescribe the “perfect” treatment plan for all children with the autism spectrum. (National Institute of Mental Health). The ambiguous nature of an autism diagnosis offers little help to parents who must learn to cope with behavioral, emotional and cognitive problems. The uncertainty is driving many parents to alternative treatment plans that claim to show results but have little or no scientific support for their claims.

Children with autism have had the most promising results when they participate in intensive behavioral therapy. This therapy can be time-consuming and there is no way to know how well a patient will do. The unpredictability and long-term commitment are of little comfort to families and professionals seeking quick results. This desire for immediate results has led many parents and professionals to seek therapies for which there is no scientific evidence. Some of the popular alternative treatments include dietary restrictions (particularly gluten and casein free), rebirthing, dolphin therapy, nutritional supplements and sensory integration therapy. Due to their lack of scientific evidence, these practices are classified as pseudoscience.

Practices that fall into the category of pseudoscience claim to have scientific evidence to support their practices. However, much of this “evidence” is false or misinterpreted. These treatments can lead to potentially dangerous treatments. Additionally, parents may waste money and time on treatment that doesn't work. Because of the popularity of these new treatments, many behavior analysts devote considerable time to investigating claims or new treatments, reviewing the risks, and discussing their findings with their clients.

Parents often rely on these alternative treatments because they appear safe. Additionally, recommendation from friends or other parents carries a lot of weight as families struggle to figure out how to handle everyday interactions. Parents also understandably seek hope and control over treatment options for their children.

In a perfect world, parents would choose a treatment plan that is thoroughly vetted with peer-reviewed randomized trials. These studies would include large sample groups, adequate control of factors, and validated outcome measures. Unfortunately, most alternative treatments are based on theory and involve superficial studies, if any.

The CAM treatment studies that have received detailed studies are few and have shown that the use of facilitated communication and secretin are not effective treatment options for children on the autism spectrum. In an extensive search for randomized trials of gluten- and/or casein-free diets, only two studies were found. The search was an attempt to examine studies to determine whether these diets could help alleviate the behavior and social functioning symptoms associated with autism. The two studies had conflicting results. The lack of helpful scientific results, coupled with no evidence of negative effects, only increases the uncertainty of these diets as a treatment option. Possible benefits of the diets include improved communication and attention skills as well as reduced hyperactivity. Possible disadvantages included the reluctance of children and wasted money on potentially ineffective treatment.

Lerman and his colleagues studied (2008) three children with autism to determine the effectiveness of hyperbaric oxygen therapy. The study found that the therapy did not affect attention on tasks or improve behavioral problems. The decided conclusion was that the therapy was not worth the time and money to complete the therapy. Other research suggests that behavior, attention, and cognitive behavior may improve after HBOT. Additional research with a larger population and controlled variables is required to make a more precise decision.

To date, there is not enough research into alternative treatments and the lack of scientific evidence refutes their use. Many of the most popular alternative tactics are completely unexplored. Most of these alternative treatments require further investigation.

If a family chooses alternative treatment, their doctor should try to persuade families to do appropriate research and study their options. The need to make an informed decision is particularly true for treatments based on theories that claim to work on multiple, unrelated symptoms. Treatments that suggest children respond dramatically and/or are cured by treatment, or that are based on anecdotal data, should be avoided.

Families and behavioral specialists should be on the lookout for studies that do not have peer-reviewed references and treatments that claim to have no possible side effects. Objective evidence is needed, but people seem to have lowered standards in the social sciences. As scientists, we try to predict and control topics that are familiar to us. This makes it very difficult for many scientists to recognize pseudoscience in unfamiliar disciplines.

If a parent expresses interest in unproven treatments, their doctor has the responsibility to educate the family about the risks associated with these types of treatments. Some alternative treatments, such as chelation therapy and rebirthing, have had fatal side effects. Properly informing a parent about potential risks can protect a child from dangerous practices and/or save a family time, money and frustration

Although it is important to inform families about risks associated with alternative options, medical professionals should be sensitive to parents who need to find a solution. “As parents and professionals continue to try new, unproven treatments for autism, practitioners with experience in behavior analysis can help by providing objective, quantifiable data on outcomes for individual children.” Specialists can show support and interest when a family chooses an alternative that relieves stress and grief and has no side effects.

While parents are free to make decisions for their children, relying on pseudoscientific treatments instead of a proven study can be dangerous as long as their safety is intact. Additionally, parents should not rely on alternative treatment to “get rid” of autism. James Lieder, father of an autistic child, said this about alternative methods of treatment: ““I got up to my neck in ‘alternative’ medicine and came out again, poorer but wiser. I now realize that what the "alternative" practitioners are really selling is hope - usually false hope - and hope is a very seductive thing to those who have lost it. It’s really not surprising that people buy it even when their better judgment tells them not to.”

Inspired by Paul Napier, MA, BCBA