Tag Archive for 'effective treatment'

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More maltherapy coverage

Trine Tsouderos and Patricia Callahan, the Chicago Tribune reporters who have provided exemplary examinations of unsupported therapies for Autism, continued their series of stories on the topic with a piece entitled “Autism: Kids Put At Risk” in the Los Angeles Times. In this briefer (though still well-researched) article they devote most of the coverage to examining the physicians who prescribe chelation, hyperbaric oxygen therapy, anti-testorsterone drugs, mega-doses of vitamins, and many other unproven regimens and other doctors who have serious doubts about the consequences, including the safety, of such therapies.

Read “Autism: Kids Put At Risk.” See the related articles “On shaky ground with alternative treatments to autism,” “Four autism treatments that worry physicians,” “Chelation based on faulty premise,” and “Autism therapies can get undeserved credit.” Also, see related EBD Blog posts about the investigative journalism of these writers: Dangerous therapy and Baseless, risky therapies for Autism

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ESDM benefits toddlers

File this one in “things that work.”

In a smallish-but-well-done study, Geraldine Dawson and colleagues reported in Pediatrics that the Early Start Denver Model (ESDM)—a variant of the behavioral methods that have often been found to be effective—produced salutary benefits for young children with Autism. The children who received the ESDM intervention had significantly greater gains in IQ than those in a community treatment control and their social behavior kept pace with the standards for their non-disabled peers while the social behavior of the community controls declined relative to the standards.

OBJECTIVE To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD).
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Meds plus behavior management for Autism

Michael Aman and co-authors (and there are at least 25 of them) reported that a combination of medication and parent training in behavior management was more effective than medication alone in reducing behavior problems. They assigned families randomly assigned to receive either risperidone as well as parent management training or risperidone alone. After 24 weeks, they assessed the children’s behavior with parent-report measures. The parents who learned to use behavior management strategies reported lower levels of non-compliant behavior and irritability.
Continue reading ‘Meds plus behavior management for Autism’

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More on alternative treatments for Autism

The second installment of Chicago Tribune reporters Trine Tsouderos’ and Patricia Callahan’s investigation of alternative treatments for Autism is available. Liz Ditz cited it in her comment on my earlier post about the first installment of this exemplary piece of journalism, but I am repeating the link here so that it will be readily apparent to readers. For even more on the coverage of questionable alternative therapies by Ms Tsouderos and Ms. Callahan, see the post entitled “The Unethical Treatments that ‘Autism is Vaccine Injury’ (And Other False Premises) Give Rise To” on Liz Ditz’s blog.

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Baseless, risky therapies for Autism

Writing in the Chicago (IL, US) Tribune under the headline “Autism treatments: Risky alternative therapies have little basis in science” Trine Tsouderos and Patricia Callahan reported about the background and myriad problems with many treatments used as therapy for children with Autism. They expose the lack of evidentiary support for therapies ranging from mega-doses of vitamins to chelation and show the relationships between practitioners of these therapies and a couple of organizations well-known among those who follow Autism.

The Tribune found children undergoing daylong infusions of a blood product that carries the risk of kidney failure and anaphylactic shock. Researchers in the field emphatically warn that the therapy should not be used to treat autism.

Children are repeatedly encased in pressurized oxygen chambers normally used after scuba diving accidents, at a cost of thousands of dollars. This unproven therapy is meant to reduce inflammation that experts say is little understood and may even be beneficial.

Children undergo rounds of chelation therapy to leach heavy metals from the body, though most toxicologists say the test commonly used to measure the metals is meaningless and the treatment potentially harmful.

Reporters Tsouderos and Callahan conducted interviews with an impressive array of advocates for the therapies (including representatives of Autism One, Autism Research Institute, and Defeat Autism Now) and doubters (mostly serious scientists). They combed through the weak and barely related research that many of the advocates use as well as the evidence showing limited or no benefits of the therapies.

All in all, these reporters deserve kudos for the unflinching thoroughness of their reporting. I encourage readers to read, reread, and disseminate the article. Here’s a link to “Autism treatments: Risky alternative therapies have little basis in science.” Flash of the electrons to Liz Ditz, whose Twitter post about this article alerted me to it.

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National Standards Project

The National Autism Center released the report of its National Standards Project. The project was designed to identify interventions that are or are not beneficial for individuals with Autism or Autism Spectrum Disorder and it presents known therapies in three categories: established, emerging, unestablished (including a subsection on “ineffective/harmful treatments”).

In summary, the National Standards Project, a primary initiative of the National Autism Center, seeks to:

  • describe the age, diagnosis, and skills/behaviors targeted for improvement associated with treatment options
  • identify the limitations of the current body of research on autism treatment
  • offer recommendations for engaging in evidence-based practice for ASD

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Secretin reminder

Although I have followed the promotion of secretin as a treatment for Autism pretty much since the first reports about it, I hadn’t checked on it lately. My initial foray into the topic in 1998 resulted in some skepticism with hedges. As the research evolved, it became clear that the skepticism was warranted.

However, I was surprised that Stephen Edelson, writing in a 2008 article entitled The secretin story: Still a promising treatment for autism,” considered “the studies investigating the efficacy of secretin have been very positive.” Coupled with some vaguely remembered notion that fewer than 50% of physicians discouraged use of secretin, the article gave me pause. I thought, “Hmmm. Maybe you’re earlier analysis was hasty, John.”
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Screening teens

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

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A. Duncan promotes PBIS

Arne Duncan, US Secretary of Education, wrote to the chief officers of education for each of the states in the US on 31 July 2009 regarding the use of seclusion and restraint in schools. He expressed concern about the testimony heard recently by the Education and Labor Committee of the US House of Representatives, and recommended that states adopt Positive Behavioral Interventions and Support.

My home State of Illinois has what I believe to be one good approach, including both a strong focus upon Positive Behavior Intervention and Supports (PBIS) as well as State regulations that limit the use of seclusion and restraint under most circumstances….

Several other States have also adopted effective seclusion and/or restraint policies, but there are many jurisdictions that have not, leaving students and teachers vulnerable.
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Citalopram’s non-effects

Citalopram, one of the class of drugs known as selective serotonin reuptake inhibitors (SSRIs) which are usually used to address depression, did not yield beneficial results in a recent study of whether the use of the drug with children and youth with Autism reduced repetitive behaviors. The study, reported by Bryan King and colleagues, included 149 individuals ages 5 through 17 with moderate or severe Autism who were recruited from various parts of the US. Not only did the treated group appear no better than the placebo group, but the children in the Citalopram group were more likely to have adverse outcomes.

Lack of Efficacy of Citalopram in Children With Autism Spectrum Disorders and High Levels of Repetitive Behavior Citalopram Ineffective in Children With Autism
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Following Danny Watt’s story

Tom Jackman’s article about Danny Watt to which I referred a few days ago (see this post) is generating a lot of discussion on the Post’s Web site. The comments on Mr. Jackman’s story are informative. For example, at least a half dozen mention having a family member with mental illness. Link to the comments.

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Evidence-based practices registry

The Substance Abuse and Mental Health Services Administration, which is a part of the US Department of Health and Human Services, maintains a Web site where users can search for and learn more about methods for preventing or treating some Emotional and Behavioral Disorders. It’s called the “National Registry of Evidence-based Programs and Practices” (NREPP) and, for those who are concerned about employing or recommending evidence-based practices, it’s worth reviewing.

The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of mental health and substance abuse interventions that have been reviewed and rated by independent reviewers.

The purpose of this registry is to assist the public in identifying approaches to preventing and treating mental and/or substance use disorders that have been scientifically tested and that can be readily disseminated to the field. NREPP is one way that SAMHSA is working to improve access to information on tested interventions and thereby reduce the lag time between the creation of scientific knowledge and its practical application in the field.

NREPP is a voluntary, self-nominating system in which intervention developers elect to participate. There will always be some interventions that are not submitted to NREPP, and not all that are submitted are reviewed. In addition, new intervention summaries are continually being added. The registry is expected to grow to a large number of interventions over the coming months and years. Please check back regularly to access the latest updates.

Although NREPP originally focused on substance abuse, its coverage is broader now. Look for resources about, for examples, Across Ages; Aggressors, Victims, and Bystanders: Thinking and Acting To Prevent Violence; Al’s Pals: Kids Making Healthy Choices; All Stars; Caring School Community; CASASTART; Children’s Summer Treatment Program (STP); Coping Cat; Creating Lasting Family Connections (CLFC)/Creating Lasting Connections (CLC); Early Risers “Skills for Success”; Families and Schools Together (FAST); Guiding Good Choices; Incredible Years; Keep A Clear Mind (KACM); Keepin’ it REAL; Lions Quest Skills for Adolescence; Multisystemic Therapy (MST) for Juvenile Offenders; Multisystemic Therapy With Psychiatric Supports (MST-Psychiatric); Positive Action; Primary Project; Project Northland; Project Towards No Tobacco Use; Project Venture; Promoting Alternative THinking Strategies (PATHS), PATHS Preschool; Protecting You/Protecting Me; Right Decisions, Right Now: Be Tobacco Free; SAFEChildren; Second Step; SMARTteam; Storytelling for Empowerment; Strengthening Families Program; Strengthening Families Program: For Parents and Youth 10-14; Success in Stages: Build Respect, Stop Bullying; Too Good for Drugs; and Too Good for Violence;

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