It’s been almost a year since I updated a Web page about secretin as a treatment for autism, and it deserves an update. When I originally wrote the page in the late 1990s, there had been a study suggeting that there might be beneficial effects; I was intrigued and wanted to learn about it because I thought I might use single-subject research methods to examine the effects across a range of dependent variables.
What I learned at that time made me skeptical, however. What I learned when I subsequently revised the page has confirmed my reservations about using secretin therapeutically. Professor Peter Sturmey of Queens College (City University of New York) reviewed the research on secretin and found that it has not been shown to have benefits.
1: Res Dev Disabil. 2005 Jan-Feb;26(1):87-97.
Secretin is an ineffective treatment for pervasive developmental disabilities: a review of 15 double-blind randomized controlled trials.
Sturmey P.
Department of Psychology, Queens College and The Graduate Center, The City University of New York, CUNY, Flushing, NY 112367, USA. psturmey@aol.com
In 1998, Horvath et al. [Horvath, K., Stefanatos, G., Sokolski, K. N., Wachtel, R., Nabors, L., & Tildon, J. T. (1998). Improved social and language skills after secretin administration in patients with autism spectrum disorders. Journal of the Association of the Academy of Minority Physicians, 9, 9-15] reported an uncontrolled trial of secretin with three participants with autism, which apparently resulted in significant behavioral improvement. Subsequently, secretin was widely used. Sandler et al. [Sandler, A. D., Sutton, K. A., SeWeese, J., Girardi, M. A., Sheppard, V., & Bodfish, J. W. (1999). Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive and developmental disorder. The New England Journal of Medicine, 341, 1801-1806] reported the first double-blind trial of secretin with negative results. This article is a review of 15 double-blind trials of secretin. Almost none of the studies reported any significant effects and none concluded that secretin was effective. Transient effects of secretin, including both minor benefits and behavioral deterioration were reported, probably due to multiple statistical tests. Four papers reported data on differential responding in sub-groups of participants, including those with gastrointestinal symptoms. These effects were not replicable. At this time there is no robust evidence that secretin is an effective treatment for pervasive developmental disorders.
Evidence such as this does not appear to have detered people from recommending secretin. As a Google search reveals, the Internet is alive with recommendations for it.
Most of the recommendations seem predicated on personal experience rather than science. This is probably the most difficult kind of false evidence to discount. When people have seen something with their own eyes, it’s hard for them to accept contradictory evidence. The problem, of course, is they may not have seen what they saw had they not expected it: “I wouldn’t have seen it if I didn’t believe it.”
This problem revives my interest in conducting research on secretin. I’d like to study whether (a) child behavior and (b) adults’ reports of child behavior change when children with autism are given placebo or secretin. My hunch is that the child behavior will not change, but that some adults will report improvement, even when the child receives placebo.
Link to the Pub Med abstract of Professor Sturmey’s review (same content as quoted here). Link to contact information for Professor Sturmey.
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