The treatment of autism (developmental disabilities and a number of other conditions) is rife with interventions that have no sound supporting evidence and make no sense. In a previous post I discussed a treatment, Facilitated Communication (http://www.psychologytoday.com/blog/radical-behaviorist/201004/fc-is-bs), that has no evidence base and the plausibility of the treatment being effective is exceptionally low. Facilitated Communication, or FC, has fooled many people and not only in the treatment of autism.
Recently, a man in Belgium, Rom Houben, was reportedly found to be communicating after having spent half his life in a minimally conscious state following a tragic car accident. Prominent Yale Neurologist, Steven Novella, has followed the story (http://www.theness.com/neurologicablog/?p=1596) in which Belgian Neurologist, Steven Laureys, was initially duped into believing that FC worked. Mr. Houben was supposedly communicating freely with his family and others with the assistance of a speech therapist using FC. Several videos of the communicative episodes were videotaped and it was apparent that Mr. Houben was often not looking at the keyboard when being facilitated and occasionally appeared to be asleep. Eventually systematic testing was applied and communication was clearly coming from the therapist and not the patient. Just more proof that FC is BS.
FC is not the only highly suspect intervention strategy out there. Treatments based on the notion of treating vaccine injury are implausible given that vaccines don't cause autism (see these posts: http://www.psychologytoday.com/blog/radical-behaviorist/201005/vaccines-and-autism-not-debate-battle; http://www.psychologytoday.com/blog/radical-behaviorist/201003/the-vaccines-cause-autism-hypotheses-lose-in-court; http://www.psychologytoday.com/blog/radical-behaviorist/201001/dishonest-discredited-and-absent-wakefield-is-thoughtless-home; and for a referenced summary of the research, http://sciencebasedmedicine.org/reference/vaccines-and-autism/). These "treatments" include chelation to rid the body of mercury from vaccines (which are no longer present in vaccines while the prevalence of ASDs continue to rise); the use of Lupron (a chemical castration agent); and other forms of "detoxification."
This main purpose of this post is to revist a topic I've covered previously, dietary treatment for ASDs (http://www.psychologytoday.com/blog/radical-behaviorist/201001/is-eliminating-casein-and-gluten-child-s-diet-viable-tx-autism). Since the early 1990s, many have speculated that casein and gluten are not processed by persons with ASDs the same way they are in others. The "theory" goes that casein and gluten act like opiates causing the symptoms that we interpret as autism. Is that bullshit? There's no sound evidence for this theory and no evidence other than anecdotes that diets are an effective treatment for ASDs. Read my previous post for background information on this topic.
Today I was forwarded information about a clinical trial that was recently completed by a well respected research team from the University of Rochester. This study is being presented Saturday at the International Meeting for Autism Research in Philadelphia:
Hyman SL, Stewart PA, Foley JT, Peck R, Morris DD, Cain U, Smith T, Wang H
Department of Pediatrics and Clinical Research Center, Golisano Children's Hospital, University of Rochester Medical Center, Rochester NY (IMFAR, 5/22/2010). Dietary Treatment of Young Children with Autism: Behavioral Effects of the Gluten Free and Casein Free Diet.
Supported by:
National Institutes for Mental Health (Studies to Advance Autism Research in Treatment) NIMH PO1HD35466 and the National Center for Research Resources (NCRR) NIH UL1RR024160
There was no evidence to suggest that the GFCF diet had a positive effect. Fourteen preschool children with a valid diagnosis of an autism spectrum disorder (ASD) were given the gluten-free, casein-free (GFCF) diet for 18 weeks. Strict adherence to the GFCF diet was ensured and each child participated in comparable early intensive behavioral intervention throughout the study. Additionally, following at least 4 weeks on the diet each child was exposed to blinded challenges to the diet. That is, each child was given food containing gluten, casein, both, and a controlled challenge. Behavioral ratings were collected before each of the 4 challenges, and at 2 and 24 hours following the challenges.
The authors found that there was no change in bowel movements, sleep, or behavior after the challenges. Interestingly they found "a slight increase in social approach after the gluten-containing or casein-containing snacks and in social language after the gluten containing snack. The differences were small and did not reach statistical significance." This implies that pro-social behavior increased when they ate the "opiates." Maybe they wanted more? Moreover, these results held for the analysis of each child and across the group. The authors are appropriately cautious in discussing the limitations of their findings but I am ready to declare that the GFCF diet is bullshit.
