EBD Blog

Nope, not an experiment about how to get kids to clean their rooms, but a proposal to study the effects of a hypoallergenic environment on the behavior of children with Autism. According to an article by Timothy McNulty entitled “Doctor plans novel treatment for autism,” that’s the idea. Writing in the 11 May 2008 issue of the Pittsburgh (PA, US) Post-Gazette, Mr. McNulty reported that a physician named Scott Faber in the Pittsburgh area plans to create an environment that will be free of toxins and examine the effects of living in such an environment on children with Autism.

With childhood autism cases skyrocketing and no cure in sight, doctors at the Children’s Institute in Squirrel Hill are planning on a Hail Mary pass approach to the mysterious disorder — housing young patients for weeks at a time in a pollutant-free “clean room,” in an attempt to detoxify their bodies.

No cause for autism has been found, and debates rage as to whether the brain development disorder is purely genetic or caused in part by environmental factors, including air and food-borne chemicals.

With roots in autism treatment theories that until now have lived mostly on the Internet, the pediatric clean room plan would be the first of its kind in a mainstream American hospital environment.

As Mr. McNulty reported, the idea of Autism as a allergic reaction to foods and other factors in children’s environments is one that has gained most of its support from Internet sources that have presented, at best, anecdotal evidence. Thus, in some ways, it make sense to assess the hypothesis. If there are clear effects, one can say that there is something to the hypothesis.

But, there are a host of problems, too. First, consider what happens if there are positive results. If kids’ behavior changes after they begin living in the clean room, was it actually the cleanliness of the room that caused the change? What is the active ingredient? Will other differences between the clean-room environment and the dirty-world environment be held constant? For example, with the days be structured the same?

Second, consider the comparison condition in another way. What if there actually is a relatively well-defined therapy that produces benefits that is not included in the clean room or to which the clean room is not compared? For example, suppose that systematic and intensive behavior instruction were a comparison condition. Now, think about the possibility that the clean room has an effect of ES=.1 and the instructional condition has an effect of ES=.3. Which one would you want your child to get? Both, you say (i.e., Condition A in the diagram)? Well, sure, then any study of the clean room would need to be crossed with the instructional condition, as shown in the chart accompanying this paragraph. Will that happen?

Third, consider the possibility that there are no effects for the clean room. Bummer. How much time and funding have been lost? What could that time and funding have meant were they invested in relatively well-documented treatments? And what about the costs in human capital?

Fourth, what are the outcomes we can expect to see? How will the children benefit? I hope that the researchers will employ measures with high degrees of psychometric trustworthiness. I hope the outcomes won’t be focused solely or even mostly on subjective rating scales. Low-inference observations of actual behaviors would be far better, for example.

Now, I’m in favor of healthy environments, good eating habits and good food, etc. I’d like to cut pollutants. I’d like to have healthy kids. There are no things wrong with those goals. Shucks, I’d even be happy to be proved wrong about it, I’m a bit skeptical about this project. At the least, I’d like to see any study of the proposed clean room designed to be scientifically strong.

Link to Mr. McNulty’s report. Flash of the electrons to Lenny Shafer’s SARnet mailing list for alerting me to this.