FAD TREATMENTS WITHOUT CLINICAL EVIDENCE OF AUTISM BENEFITS ARE PROLIFERATING
Marlene Busko Medscape Medical News 2007. August 27, 2007
More children are being diagnosed with autism, and more are receiving "fad" treatments, or treatments that are being marketed and rapidly adopted without scientific evidence to support their use, researchers said in a symposium entitled "Outrageous Developmental Disabilities Treatments," at the 115th Annual Convention of the American Psychological Association, in San Francisco.
Developmental disabilities like autism, for which there is no cure, are "a magnet for all kinds of unsupported or disproved therapies, and it has gotten worse as more children have been diagnosed with autism," symposium chair James Mulick, MD, from Ohio State University, in Columbus, said in a press release issued by the university. Symposium presenter Tracy Kettering, from Ohio State University, told Medscape: "We aren't saying that none of these treatments work or that all of them are harmful, but a review of the literature suggests that there is currently not enough available research to suggest that many of these treatments work."
She said that studies suggest that the prevalence of autism has increased by over 200% from 1987 to 1998, and meanwhile the number of treatments for autism has increased dramatically. A Google search of the term "autism treatments" yields hundreds of different types of therapies, many with associated claims from parents that a particular therapy "cured" their child, Ms. Kettering said. "It's no wonder that parents want to believe," she added, noting that very few of these treatments have any evidence to support them.
Families try multiple treatments, she reported. A survey of 552 members of the Autism Society of America found that, on average, families tried 7 autism treatments for their autistic children. Dr. Mulick explained that the number of cases of autism has mushroomed because of better diagnoses and a changing definition of autism that includes a broader spectrum of disorders.
He added that research evidence shows that early intensive behavior intervention treatments have a positive long-term effect on autism. This highly structured approach to learning involves one-on-one behavioral treatment with a child for up to 40 hours a week for several years. Since this is expensive and difficult for many parents, this might be a reason why families are searching for other treatments, he speculates.
In her presentation, Ms Kettering discussed some of the more popular fad treatments. She noted that 3 small, well-designed studies of combined vitamin B6 and magnesium found this treatment was ineffective but might warrant further study, and 2 studies of a gluten-free/casein-free diet did not find improvement of autism with this diet. She reported that, in addition, several large, well-designed studies of secretin in autism spectrum disorders have shown that it is ineffective; flawed analyses of auditory integration therapy reported mixed results; and no scientific studies have been done to evaluate holding therapy, animal therapy, or hyperbaric oxygen therapy for autistic children.
Some fads can be dangerous, Dr. Mulick cautioned. Chelation therapy, which involves taking medicine to remove the level of mercury in the body, was reported to lead to the death of 1 autistic boy, he noted.
He added that fad treatments might be popular because parents tend to search for treatments when their child's symptoms get worse, and when the child gets better, which happens in the normal course of the disease, parents credit the new therapy. "It's natural that parents have this bias," he said. "They want to believe.
"Autism studies are a long, time-consuming, and expensive process, and some of the fad treatments being used today would never be approved for testing, as they are just too dangerous," he observed.
American Psychological Association 115th Annual Convention. August 17-20, 2007.