No evidence that most autism treatments work

[Guest guest]

http://today.msnbc.msn.com/id/42385056/ns/health-kids_and_parenting/

No evidence that most autism treatments work

Popular drugs have no hard science behind them; intense behavior therapies may

help a bit

updated 4/4/2011 9:26:30 AM ET 2011-04-04T13:26:30

When it comes to treating autism, there are still more questions than answers.

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...That's the message from a series of reviews published today in the journal

Pediatrics, in which researchers analyzed past studies on the effectiveness of

medication or behavioral and developmental therapies in kids with autism

spectrum disorders.

Parents, doctors, and even entire school systems are " routinely put in the

position of having to make decisions about what the most appropriate services

will be " for kids with autism, said Zachary Warren, one of the researchers, in

an interview with Reuters Health.

" What we would really hope for is an evidence base where you could make those

decisions based on what we know about how particular children respond to

particular interventions, " said Warren, who runs an autism clinic at Vanderbilt

University in Nashville, Tenn.

But for most treatment options, there is not convincing evidence that they

actually help kids get better, Warren said.

Close to 1 percent of children in the United States have an autism spectrum

disorder, which includes both autism and Asperger's syndrome. People with these

conditions have difficulty interacting with and understanding the emotions of

others, and they often engage in repetitive behaviors.

Most children with autism are treated with behavioral therapy starting at a

young age, and many will try multiple kinds of therapy or medications as they

get older.

For their reviews, Warren and his colleagues collected data from all studies

done in the last decade on the effectiveness of a range of medications and

therapies in reducing symptoms of autism.

In their most convincing finding, the authors determined that secretin – a

hormone otherwise used to treat stomach ulcers -- is not an effective treatment

for kids with autism. Excitement about the drug started in the late 1990's, when

very limited evidence suggested it might promote social skills in kids with

autism – but after more thorough research, it's clear that's not the case,

Warren said.

That conclusion was based on 7 past studies that found the drug did not improve

language or reasoning skills or any other autism symptoms.

The researchers found there was not enough evidence to determine whether

anti-depressants such as Prozac and Celexa or the stimulant drug Ritalin might

help kids with autism.

There is some evidence showing that both Risperdal and Abilify might help cut

down on kids' repetitive behaviors. But because both drugs may cause side

effects such as uncontrolled muscle tremors and drowsiness, the authors said

they should only be used in kids who are very impaired because of their autism.

Dr. King, the director of Seattle Children's Autism Center, said that as

many as 70 percent of kids with autism are treated with some kind of medication.

" The real take-home message for me…. is the striking disparity between the

treatments that we use and the number of children that are receiving them, and

the strength of the evidence that we have in support of these practices, " said

King, who was not involved in the current study.

It is " hard to reconcile " the popularity of these drugs with the lack of

information about their effectiveness, he told Reuters Health, but not having

enough evidence isn't the same thing as saying the drugs don't work.

Warren and his colleagues concluded that intensive behavioral therapy or

behavioral treatment started in very young kids has helped some of them improve

reasoning and language skills, as well as their ability to interact with others.

It's hard to know which kids will benefit from those therapies, however.

" Some (behavioral) interventions can show some pretty dramatic changes, " Warren

said. " At the same time, understanding which specific treatments are going to be

best for specific (kids) – we're not quite there. "

King said it was time to " redouble our efforts " to gain more conclusive evidence

on possible treatment options.

The research " just really highlights that we urgently need new treatments and

better treatments, in addition to refining our understanding of how available

treatments work for specific individuals and specific families, " Warren

concluded.

Copyright 2011 Thomson Reuters

[Guest guest]

One problem they are having is that Autism is genetic and not some infection or inflammation that can be done away with with pills. By the same token many behavior modification plans won't work so well either if you can't effectively communicate the intent of what is happening. Whatever others might thing, an autistic child is not an animal that will quickly learn to fear the lash and love the food rewards. Perhaps you could force any person to behave as you please this way, but at what cost? and they would also very likely being plotting their revenge.

On the other hand, if real, honest research is done into methods of teaching coping skills, teaching social skills, etc., that would be a good thing. I suppose that some temporary use of medication wouldn't hurt, particularly for calming anxiety, but it shouldn't be permanent or high doses, more like enough to take the edge off so they can learn to cope with it once the medicine stops. That said, there might be some few cases that will need lifetime medication, but that would likely be for other issues like schizophrenia and the like and not the autism itself.

Lastly, we don't really know what these drugs do to developing minds. We've been shovelling them at our kids for about 2 decades now with little in the way of follow up studies. Such studies should be conducted on a large scale and soon given how students and others are now taking some powerful drugs without prescriptions to try to get an edge in school.

In a message dated 4/4/2011 3:37:18 P.M. Eastern Daylight Time, no_reply writes:

No evidence that most autism treatments work