Science-Based Medicine now has a great overall listing of their reports on vaccines and autism. This resource is comprehensive and can be found here. While the anti-vac people spread psuedo-science, this resource will help you understand the many many holes in their arguments.
Remember, get you information from a doctor, not a celebrity, activist or politician.
Tuesday, August 25, 2009
Sunday, August 23, 2009
Regimens: Restrictive Diets May Not Be Appropriate for Children With Autism
Today the New York Times reported on research concerning diets for children with autism. Many of my patients come in and ask about diets, hoping that a change at the breakfast table will make a change in their child's life. Regretfully life isn't that simple. And many people are mislead by practitioners of "alternative medicine," and the "Defeat Autism Now" diet plan that they pay good money for alternative medical advice which research simply does not support. The NYT article says, "Many parents of autistic children have put their children on strict gluten-free or dairy-free diets, convinced that gastrointestinal problems are an underlying cause of the disorder. But a new study suggests the complicated food regimens may not be warranted"
Lets understand, by "may not be warranted" they are saying there is no evidence that these diets do anything to help children with autism. As a matter of fact, in many cases they do more harm than good.
"Researchers at the Mayo Clinic reviewed the medical records of over 100 autistic children over an 18-year period and compared them to more than 200 children without the disorder. The scientists found no differences in the overall frequency of gastrointestinal problems reported by the two groups, though the autistic children suffered more frequently from bouts of constipation and were more likely to be picky eaters who had difficulty gaining weight. The study, published on Monday in the journal Pediatrics, is the first to look at the incidence of gastrointestinal problems in an autistic population, according to the paper?s first author, Dr. Samar H. Ibrahim, a pediatric gastroenterologist at the Mayo Clinic. She suggested that autistic children should only be put on restrictive wheat-free or dairy-free diets after having appropriate diagnostic tests done."
To make this clear,"There is actually no trial that has proven so far that a gluten-free and casein-free diet improves autism, she said. The diets are not easy to follow and can sometimes cause nutritional deficiencies."
For more information on the article and to locate the original research you can click here: New York Times
The number and frequency of gastrointestinal problems is basically the same for children with autism and children without. As a parent you may notice the problem more because your child is not as tolerant of these feelings as children who do not have autism, but that does not mean their is a connection, or that you can "cure" autism in any way with restrictive a diet.The evidence is simply not there. Some parents, who start to re-organize their child's life around diet may find behavioural improvements because of the new structure, attention, or perhaps because parents become more tuned in to their child's physical state. But there is simply no connection between the two. It's easy to become confused by reports you hear of success, but you are not hearing from all those who did not find these diets made any change, and interpretation of data becomes cloudy. The new rush to publish "Autism cookbooks" and "Autism Diets" (and their are ADHD diets too, all either unproven or in many cases disproven) is more a reaction of the publishing industries success than any success with the diet during a controlled scientific experiment.
Final advice, talk to our pediatrician.
For those who are trying to figure out who to believe in this confusion I suggest starting by reading a little about Science Based Medicine itself at Steve Novella's web page. Click here for Science-Based Medicine 101
Dr. Roche's web page can be found at socialcognitivetheapy.com
Lets understand, by "may not be warranted" they are saying there is no evidence that these diets do anything to help children with autism. As a matter of fact, in many cases they do more harm than good.
"Researchers at the Mayo Clinic reviewed the medical records of over 100 autistic children over an 18-year period and compared them to more than 200 children without the disorder. The scientists found no differences in the overall frequency of gastrointestinal problems reported by the two groups, though the autistic children suffered more frequently from bouts of constipation and were more likely to be picky eaters who had difficulty gaining weight. The study, published on Monday in the journal Pediatrics, is the first to look at the incidence of gastrointestinal problems in an autistic population, according to the paper?s first author, Dr. Samar H. Ibrahim, a pediatric gastroenterologist at the Mayo Clinic. She suggested that autistic children should only be put on restrictive wheat-free or dairy-free diets after having appropriate diagnostic tests done."
To make this clear,"There is actually no trial that has proven so far that a gluten-free and casein-free diet improves autism, she said. The diets are not easy to follow and can sometimes cause nutritional deficiencies."
For more information on the article and to locate the original research you can click here: New York Times
The number and frequency of gastrointestinal problems is basically the same for children with autism and children without. As a parent you may notice the problem more because your child is not as tolerant of these feelings as children who do not have autism, but that does not mean their is a connection, or that you can "cure" autism in any way with restrictive a diet.The evidence is simply not there. Some parents, who start to re-organize their child's life around diet may find behavioural improvements because of the new structure, attention, or perhaps because parents become more tuned in to their child's physical state. But there is simply no connection between the two. It's easy to become confused by reports you hear of success, but you are not hearing from all those who did not find these diets made any change, and interpretation of data becomes cloudy. The new rush to publish "Autism cookbooks" and "Autism Diets" (and their are ADHD diets too, all either unproven or in many cases disproven) is more a reaction of the publishing industries success than any success with the diet during a controlled scientific experiment.
Final advice, talk to our pediatrician.
For those who are trying to figure out who to believe in this confusion I suggest starting by reading a little about Science Based Medicine itself at Steve Novella's web page. Click here for Science-Based Medicine 101
Dr. Roche's web page can be found at socialcognitivetheapy.com
Sunday, August 16, 2009
Caution Urged for Autism Treatments Researchers Say 'Fad Therapies' for Autism Are on the Rise
Great article on fads in autism treatment at MedicineNet. A good place for beginners!
Several people have mentioned that this article is "down" so for the time being I've copied the catch here:
Caution Urged for Autism Treatments
Researchers Say 'Fad Therapies' for Autism Are on the Rise
By Kathleen Doheny
WebMD Medical News
Reviewed by Louise Chang, MD
Aug. 20, 2007 -- Unproven treatments for autism have increased as the number of children with autism and related disorders has grown dramatically, according to a team of Ohio State University researchers.
"Fad treatments have grown as the numbers have gone up," says James Mulick, PhD, a professor of pediatrics and psychology at Ohio State University, Columbus, who led a symposium on the topic at the 115th annual convention of the American Psychological Association (APA) in San Francisco.
Today, one in 150 children has autism or an autism spectrum disorder (ASD), which encompasses several related disorders, Mulick tells WebMD. In the 1970s, the commonly held belief was that three in every 10,000 children had autism. Autism and related problems, such as Asperger's syndrome or childhood disintegrative disorder, are all complex developmental disabilities that affect the development of social skills, communication skills, and behavior. Genetic vulnerability is suspected, and abnormal brain development during an infant's first months may also contribute.
As more parents hear these diagnoses, they are searching, understandably, for a way to make their children's lives better. "They desperately want their children to have a future," Mulick says.
"The average parent has tried seven different therapies," Mulick says, citing the results of a survey his research team found on the Internet.
Unproven treatments are often marketed aggressively, he tells WebMD, and information often includes testimonials from other parents, making them difficult to resist. As a result, he says, it's sometimes difficult for parents to evaluate the treatment objectively and to avoid totally unproven approaches. The unproven treatments can escape oversight from the FDA, says Mulick, because many are not drugs or devices.
Fad Treatments Abound
Among the autism treatments that Mulick and his colleagues cautioned against at the APA convention:
Facilitated communication. A facilitator holds the hands of those with autism over a keyboard and helps them to communicate. Or a facilitator helps the person with autism communicate by pointing at letters, images, or symbols that represent messages. The goal is independent expression, according to advocates. "In no case was it shown to be a valid communication" for the autistic person, Mulick says.
Chelation therapy. A chemical that binds to heavy metals -- believed by some to cause autism -- is given orally, rectally, or infused intravenously, Mulick says. "The chemical binds to heavy metals and allows the heavy metals to be excreted, and the belief is it will cure autism." But chelation therapy is unproven for autism, Mulick says.
Dolphin therapy. Advocates believe swimming with dolphins can help an autistic child improve interpersonal relationships. Says Mulick: ''There is no evidence it supports any effect except recreation."
Auditory integration therapy. Developed by an ear-nose-throat doctor, this therapy originally was meant to help those with hypersensitive hearing. The theory is that the person is overstimulated and the hearing is overly sensitive at specific frequencies. The therapy involves listening to music at different frequencies to normalize the hearing response across all frequencies within the normal hearing range. "This is based on the theory that kids with autism will often hold their ears," Mulick says, and that they are overly sensitive to sound. "They do hold their ears, but they don't have greater hearing acuity."
Dietary interventions. The gluten-free, casein-free diet, or GFCF diet, is another approach. Casein is a protein found in milk and cheese, and gluten is a protein found in wheat, barley, and rye. The theory, says Mulick, is that in autistic children these proteins result in an overproduction of opiates in the brain, in turn contributing to social awkwardness and thwarting brain maturation. Scientific studies on the effectiveness of the GFCF diet are lacking, he says. "And very few people adhere to the diet."
Autism Treatment: What Works?
An intensive approach using behavior therapy, often called applied behavior analysis, is uniformly recommended by experts, including a recommendation by the U.S. surgeon general. The basic research for this approach was done years ago at the University of California, Los Angeles. This program is intensive -- one-on-one for 40 hours a week. Similar programs are offered in major metropolitan areas around the country, Mulick says.
The goal of these types of programs is to reinforce desirable behavior and decrease undesirable ones. For instance, the child is taught to perform tasks in a series of simple steps and is given a predictable schedule. The treatment is continued at home.
"Occupational therapy is often given in combination," Mulick says.
The downside of the behavior therapy, he says, is its expense. At Columbus Children's Hospital, for instance, he estimates the cost of behavior therapy for autism is about $65,000 a year -- and it's typically not covered by insurance.
For specific symptoms, medication may help, Mulick says. For instance, the FDA approved Risperdal in 2006 for the treatment of irritability in children and teens with autism. Short attention spans can sometimes be improved, he says, with stimulant drugs.
SOURCES: James Mulick, PhD, professor of pediatrics and psychology, Ohio State University, Columbus. 115th annual convention of the American Psychological Association, San Francisco. News release, CDC.
Several people have mentioned that this article is "down" so for the time being I've copied the catch here:
Caution Urged for Autism Treatments
Researchers Say 'Fad Therapies' for Autism Are on the Rise
By Kathleen Doheny
WebMD Medical News
Reviewed by Louise Chang, MD
Aug. 20, 2007 -- Unproven treatments for autism have increased as the number of children with autism and related disorders has grown dramatically, according to a team of Ohio State University researchers.
"Fad treatments have grown as the numbers have gone up," says James Mulick, PhD, a professor of pediatrics and psychology at Ohio State University, Columbus, who led a symposium on the topic at the 115th annual convention of the American Psychological Association (APA) in San Francisco.
Today, one in 150 children has autism or an autism spectrum disorder (ASD), which encompasses several related disorders, Mulick tells WebMD. In the 1970s, the commonly held belief was that three in every 10,000 children had autism. Autism and related problems, such as Asperger's syndrome or childhood disintegrative disorder, are all complex developmental disabilities that affect the development of social skills, communication skills, and behavior. Genetic vulnerability is suspected, and abnormal brain development during an infant's first months may also contribute.
As more parents hear these diagnoses, they are searching, understandably, for a way to make their children's lives better. "They desperately want their children to have a future," Mulick says.
"The average parent has tried seven different therapies," Mulick says, citing the results of a survey his research team found on the Internet.
Unproven treatments are often marketed aggressively, he tells WebMD, and information often includes testimonials from other parents, making them difficult to resist. As a result, he says, it's sometimes difficult for parents to evaluate the treatment objectively and to avoid totally unproven approaches. The unproven treatments can escape oversight from the FDA, says Mulick, because many are not drugs or devices.
Fad Treatments Abound
Among the autism treatments that Mulick and his colleagues cautioned against at the APA convention:
Facilitated communication. A facilitator holds the hands of those with autism over a keyboard and helps them to communicate. Or a facilitator helps the person with autism communicate by pointing at letters, images, or symbols that represent messages. The goal is independent expression, according to advocates. "In no case was it shown to be a valid communication" for the autistic person, Mulick says.
Chelation therapy. A chemical that binds to heavy metals -- believed by some to cause autism -- is given orally, rectally, or infused intravenously, Mulick says. "The chemical binds to heavy metals and allows the heavy metals to be excreted, and the belief is it will cure autism." But chelation therapy is unproven for autism, Mulick says.
Dolphin therapy. Advocates believe swimming with dolphins can help an autistic child improve interpersonal relationships. Says Mulick: ''There is no evidence it supports any effect except recreation."
Auditory integration therapy. Developed by an ear-nose-throat doctor, this therapy originally was meant to help those with hypersensitive hearing. The theory is that the person is overstimulated and the hearing is overly sensitive at specific frequencies. The therapy involves listening to music at different frequencies to normalize the hearing response across all frequencies within the normal hearing range. "This is based on the theory that kids with autism will often hold their ears," Mulick says, and that they are overly sensitive to sound. "They do hold their ears, but they don't have greater hearing acuity."
Dietary interventions. The gluten-free, casein-free diet, or GFCF diet, is another approach. Casein is a protein found in milk and cheese, and gluten is a protein found in wheat, barley, and rye. The theory, says Mulick, is that in autistic children these proteins result in an overproduction of opiates in the brain, in turn contributing to social awkwardness and thwarting brain maturation. Scientific studies on the effectiveness of the GFCF diet are lacking, he says. "And very few people adhere to the diet."
Autism Treatment: What Works?
An intensive approach using behavior therapy, often called applied behavior analysis, is uniformly recommended by experts, including a recommendation by the U.S. surgeon general. The basic research for this approach was done years ago at the University of California, Los Angeles. This program is intensive -- one-on-one for 40 hours a week. Similar programs are offered in major metropolitan areas around the country, Mulick says.
The goal of these types of programs is to reinforce desirable behavior and decrease undesirable ones. For instance, the child is taught to perform tasks in a series of simple steps and is given a predictable schedule. The treatment is continued at home.
"Occupational therapy is often given in combination," Mulick says.
The downside of the behavior therapy, he says, is its expense. At Columbus Children's Hospital, for instance, he estimates the cost of behavior therapy for autism is about $65,000 a year -- and it's typically not covered by insurance.
For specific symptoms, medication may help, Mulick says. For instance, the FDA approved Risperdal in 2006 for the treatment of irritability in children and teens with autism. Short attention spans can sometimes be improved, he says, with stimulant drugs.
SOURCES: James Mulick, PhD, professor of pediatrics and psychology, Ohio State University, Columbus. 115th annual convention of the American Psychological Association, San Francisco. News release, CDC.
Proven Treatments for Autism: Behavioural, Social and Communications Based Interventions
(From Wellsphere): "James Mulick, and several graduate psychology students, presented a symposium on ? Outrageous Developmental Disabilities Treatments ? Aug. 20 in San Francisco at the annual meeting of the American Psychological Association. The focus of the symposium was the multitude of fad treatments, some of them dangerous, which have accompanied the explosive growth in numbers of autism diagnoses. Ineffective or unproven treatments like special diets or nutritional supplements, Megadoses of Vitamins C and B6, and supplements with fatty acids like omega-3s were discussed. Chelation therapy, the medicinal removal of substances such as mercury from the body, was identified as being not only unproven, but also dangerous and potentially deadly. The conference also mentioned the one proven treatment to date - early intensive behavioral intervention:
While other treatments are still being investigated, right now the only therapy that has been shown to have a long-term positive affect on autism is called Early Intensive Behavioral Intervention, Mulick said.
The Wellsphere article this is from can be found here at Wellsphere
Information about the intervention conference can be found by clicking here
Dr. Roche's web page can be located at www.socialcognitivetherapy.com
While other treatments are still being investigated, right now the only therapy that has been shown to have a long-term positive affect on autism is called Early Intensive Behavioral Intervention, Mulick said.
The Wellsphere article this is from can be found here at Wellsphere
Information about the intervention conference can be found by clicking here
Dr. Roche's web page can be located at www.socialcognitivetherapy.com
Evidence Based Medicine FIRST!
Another very good web site on Vaccines. May good links.
"Either it is true that a medicine works or it isn't.
It cannot be false in the ordinary sense but true in some 'alternative' sense."
Prof. Richard Dawkins, Oxford, April 2001
from the foreword to 'SNAKE OIL' by John Diamond
The site is found here: Evidence Based Medicine First.
My recent return to this topic stems from several experiences with parents in the lower mainland who have used all their autism funding for alternative treatments that have no scientific evidence to back them, and have been left with no support for teaching communication, reciprocity, behaviour management for the parents. It's a shame that the medical and psychology colleges of BC, as well as UBC, SFU and other providers don't take a stand against treatments that are ineffective and experimental at best. There are treatments out there that help, no miracles, but there is hope.
"Either it is true that a medicine works or it isn't.
It cannot be false in the ordinary sense but true in some 'alternative' sense."
Prof. Richard Dawkins, Oxford, April 2001
from the foreword to 'SNAKE OIL' by John Diamond
The site is found here: Evidence Based Medicine First.
My recent return to this topic stems from several experiences with parents in the lower mainland who have used all their autism funding for alternative treatments that have no scientific evidence to back them, and have been left with no support for teaching communication, reciprocity, behaviour management for the parents. It's a shame that the medical and psychology colleges of BC, as well as UBC, SFU and other providers don't take a stand against treatments that are ineffective and experimental at best. There are treatments out there that help, no miracles, but there is hope.
Celebrity Medicine and Jenny McCarthy
Here is a great article I missed back in May on the dangers of "Celebrity Medicine." McCarthy, who can't understand even the most basics of science continues to scream down medical doctors.
Reader's Digest Version: Childhood vaccines save lives by preventing killer diseases. They're not risk-free, but an immense amount of evidence says the risks do not include autism.
The article can be found here at Reader's Digest.
More sanity from the mainstream media!
Reader's Digest Version: Childhood vaccines save lives by preventing killer diseases. They're not risk-free, but an immense amount of evidence says the risks do not include autism.
The article can be found here at Reader's Digest.
More sanity from the mainstream media!
Thursday, August 13, 2009
The Problems with "Alternative Medicine."
I sent my daughter a great cartoon the other day. An ambulance was at the scene of an accident, and on it's side it read "Alternative Medical Services." The ambulance attendant was kneeling by an accident victim yelling "clear!" She has two acupuncture needles in her hands. Not the kinds of services that I would hope for. Yet not one block away from my home in Vancouver there is a "holistic medicine" practice. They advertise they provide treatment for ADHD, autism and Asperger's. They provide a long list of their services from blood cleaning to auditory "realignment." None of these are supported by scientific evidence, and many have been clearly proven to be ineffective. Yet families go to these clinics and spend all of their government funding looking for cures and hope. The lack of regulation disappoints me. And watching families waste all their funds on unproven, or worse, disproven therapies is disheartening.
In my assessment reports I have begun to list web sites and resources that I hope guide people to scientifically proven interventions. But we need more of these, and professional organizations like the BC Colleges of Medicine, Psychology and Nursing need to take a firmer stand on the promotion of unproven or disproven treatments.
For ADHD one good source is Dr. Russell Barkley.
Dr. Barkley has written about the various treatments that do not have a sound scientific basis for use in ADHD or that have been disproven in research. These include diet or nutrition treatments or diet supplements for ADHD, health food or homeopathy, sensory integration therapy (usually provided under occupational therapy or physical therapy), chiropractic treatment, EEG biofeedback, neurofeedback, or neurotherapy, cognitive or cognitive-behavioral training, or alternative treatments. One of his recent research reviews on EEG and its use in biofeedback appears on his site. I urge all parents to read it.
Dr. Barkley
Two other good sites are Quack Watch and Science Based Medicine. Check them out for good information on ADHD, Autism and Alternative Medicine you should avoid. You can also seek information at my professional web site, RelatedMinds, on the resource page.
In my assessment reports I have begun to list web sites and resources that I hope guide people to scientifically proven interventions. But we need more of these, and professional organizations like the BC Colleges of Medicine, Psychology and Nursing need to take a firmer stand on the promotion of unproven or disproven treatments.
For ADHD one good source is Dr. Russell Barkley.
Dr. Barkley has written about the various treatments that do not have a sound scientific basis for use in ADHD or that have been disproven in research. These include diet or nutrition treatments or diet supplements for ADHD, health food or homeopathy, sensory integration therapy (usually provided under occupational therapy or physical therapy), chiropractic treatment, EEG biofeedback, neurofeedback, or neurotherapy, cognitive or cognitive-behavioral training, or alternative treatments. One of his recent research reviews on EEG and its use in biofeedback appears on his site. I urge all parents to read it.
Dr. Barkley
Two other good sites are Quack Watch and Science Based Medicine. Check them out for good information on ADHD, Autism and Alternative Medicine you should avoid. You can also seek information at my professional web site, RelatedMinds, on the resource page.
Sunday, August 2, 2009
Asperger Syndrome, Autism, And Empathy: Study Links 27 Genes
Scientists from the University of Cambridge have identified 27 genes that are associated with either Asperger Syndrome (AS) and/or autistic traits and/or empathy. The research will be published July 16 in the journal Autism Research. This is the first candidate gene study of its kind.
Asperger Syndrome, Autism, And Empathy: Study Links 27 Genes
Shared via AddThis
Asperger Syndrome, Autism, And Empathy: Study Links 27 Genes
Shared via AddThis
Subscribe to:
Posts (Atom)