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Some Benefits for Autistic Children From Medications & ABA, None From Secretin

Some Benefits for Autistic Children From Medications & ABA, None From Secretin

The results of three new studies about treatments for autistic children—one about an ‘alternative medicine’ treatment, one about medications and one about educational-behavioral therapies—cohere closely with my husband and my experience of using such treatments for our son Charlie. In the three separate studies, the authors made an extensive review of published research about all three treatments; more than a few studies had to be discarded due to a lack of high-quality research.

The studies are published in the April 4th edition of Pediatrics, the journal of the American Academy of Pediatrics. The analyses were funded by the Agency for Healthcare Research and Quality and the full report can be read as a PDF file.

Charlie’s a teenager now, but when he was much younger we tried quite a few biomedical treatments. We did purchase some secretin, the gastrointestinal hormone used to treat stomach ulcers that, in 1998, was reported to have produced significant improvements in some autistic children. After listening to reports from other families about using secretin and reviewing the evidence, we decided not to use the pig secretin (which was what families were using) for Charlie. An article about the Pediatric studies in Business Week notes that, after analyzing seven randomized controlled trials about secretin, the authors “found no benefit in treating autism symptoms and that it wasn’t even worth further study.”

Findings were more encouraging about the use of medications and behavioral treatments. Regarding the former, the authors noted that some antipsychotic medications, including risperidone and aripiprazole, have benefits in helping autistic children better manage such ‘challenging’ behaviors as self-injurious and aggressive behaviors. However, a randomized, controlled trial on SSRIs showed that these had no benefit in controlling repetitive behaviors, while one about using stimulants to counter hyperactivity was positive, but more research is needed.

Charlie takes a number of different medications including aripiprazole (Abilify) and an SSRI. A brief trial of stimulants a few years ago was disastrous for him. He took risperidone for a few years and it initially helped (we did see the common side effects of weight gain), and then it did not seem to be helping. A difficult period followed in which we took Charlie off of risperidone and started him on other medications (a very challenging process as Charlie has little language to tell us about the effects of all this). He now takes some other medications besides the two mentioned above for anxiety. He has done well with all this, though a key aspect of figuring out the right medications and dosages has been finding a very good neurologist with an excellent office staff.

The third study in Pediatrics looked at behavioral therapy and found it, as many previous studies and reports have, beneficial for some children (especially in regard to ‘challenging’ behaviors) and not so much for others. As the Wall Street Journal says, this third study looked at 34 studies of these treatments, 23 of which the reviewers rated as ‘poor quality’:

Early intensive behavioral treatments can involve multiple hours of practicing skills with a therapist each week for years. Experts have long advocated their use for improving cognitive and social symptoms, but research to assess their value has been difficult to conduct.

…there was enough evidence to suggest that these therapies improved IQ, language skills and day-to-day skills in some children with autism-spectrum disorders, the researchers said. Overall, however, more and better-quality research was needed, Dr. [Zachary Warren, a study author and director of Vanderbilt's Treatment and Research Institute for Autism Spectrum Disorders] said. “Our ability to say this one specific approach should be utilized for the child in front of me — we’re not quite there yet,” he said.

Behavioral therapy in the form of Applied Behavior Analysis (ABA) has been the basis of my son’s education since he was two years old. There are limitations to ABA, which can be an overly highly structured teaching methodology. Charlie is on the moderate to severe end of the autism spectrum and has had the full range of ‘challenging’ behaviors (such as head-banging) and I have found (anecdotally) that families whose children have fewer of these, or whose children have more verbal and academic abilities, have not always found ABA so effective.

I do have to say that, thanks to the years of education and the right combination of medications, Charlie has been doing well, especially after some extremely difficult years when he entered puberty and grew about nine inches. Over the years, we’ve read research study upon research study and heard tell of too many ‘amazing autism treatments.’ Have we become hardened? weary? or rather wary? Parents who can only nod when someone tells them about some ‘new thing they’ve heard of.’ Our goal is to help steer Charlie into a happy, productive, adulthood and life in the community: It was not too long ago that Charlie would have been sent to an institution as a child. Current research is limited, current treatments don’t work for everybody, but the options for Charlie today are better than in the past, and we are glad for each day he lives with us.

 

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Photo of a child using the Picture Exchange Communication System (PECS) by jennratonmort.

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13 comments

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8:30AM PDT on Jun 15, 2011

thanks.

9:04AM PDT on May 3, 2011

Schizophrenia drugs like Olanzapine are risky and are frequently give *off label* I was prescribed Eli Lilly Zyprexa for PTSD and suffered permanent health damage.


Eli Lilly's #1 cash cow Zyprexa drug sale $38 billion dollars to date has a greater risk of causing type 2 diabetes over the non-user of Zyprexa. So,here we have a conflict of interest that this same company also is a big profiteer of diabetes treatment.
--
Daniel Haszard Zyprexa victim activist http://www.zyprexa-victims.com

5:27PM PDT on Apr 7, 2011

While I do realize that there are some deeply-affected Autistics who may benefit from (limited and well-researched) medication, as an autistic woman, I must admit to a deep concern about the current view that sees all autistics as a "diseased state of normal".

The majority of us are healthy, earning our own living and contributing to the community. All we ask is to be left alone to get on with it.

4:40PM PDT on Apr 7, 2011

ty

9:56AM PDT on Apr 7, 2011

I have a 14 year old son with Autism who has little speech, I have found that a gulten and dairy diet has helped and found a big difference when I gave him IQ ( thats a fish oil) and a probiotic ( acidhophillus). I use only natural products for his personal care and for cleaning the home.
He has improved so much from waking every hour during the night to saying at least for words together and is on no medication. Thank you (hope this might be helpful)

9:05AM PDT on Apr 7, 2011

I found out that I have Asperger's a little over two years ago just before I turned Medicare age. A diagnosis in childhood would not have helped. Back then autism was blamed on mothers having a cold personality. My mother was more of a yahoo than a refrigerator.

6:47AM PDT on Apr 7, 2011

Dear Kristina, thanks for this lovely, balanced article. I'm a parent of a 16 yo with Asperger's, who was diagnosed at age 3 and got services immediately. I agree it's hard NOT to be weary and skeptical after multiple years of parenting an autistic child. I'm sick and tired of hearing about things like secretin and vaccines. So much money and time has been wasted on such things that could have been used for other research directed towards effective treatments and support for families. Finally, I find it heartbreaking that SO MANY families are getting ripped off by peddlers of questionable substances that don't cure anything and may actually be unhealthy overall. I have ideas about how to prevent this kind of fraud, but that's another story for another day. Thanks again, Mary

6:30AM PDT on Apr 7, 2011

Balanced article. Well done.
Just a couple of things about Risperidone, however............
Apart from some very nasty side effects (like Tardive Dyskinesia and it is 50% more likely to cause diabetes than other antipsychotic drugs and increases the risk of stroke/blood clots significantly) it can CAUSE anxiety!

http://www.kerrysteigerwalt.com/public/defectivedrugs/risperdal.html

http://www.canadiannetmall.com/blog/risperidone-and-stroke-risk/

As always with BigPharma (offlabel especially) "user beware".

5:27AM PDT on Apr 7, 2011

Sadly, the conventional medical establishment seems oblivious to the role that many commonly used household and personal care chemicals can have for quite a few autistic kids.

I personally have talked with several whose children have shown dramatic improvement when removed from a chemically toxic environment. For example, when the classroom was cleared of cleaning chemicals, pesticides, permanent markers and fragrance, one child went from getting 3 or 4 right on a test to 100 per cent - in two weeks! (The change was sustained, over time). Another was able to get off Ritalin after a similar removal from chemical exposures. This Mom described her son as "a wild man" in school, but quite normal at home and on vacation.

Although this may not apply to all autism spectrum situations, it is something that should be tried for all, because it has no down side whatsoever. In fact, there are some indications that not being exposed to chemicals can help even non-autistic learners.

For more on the environmental chemicals & autism connection, see:
http://toxicsinfo.org/kids/Autism%20Endocrine%20Disrupters.htm
http://toxicsinfo.org/healthconnections/treatmenttips.htm
www.toxicsinfo.org/kids/autism/DiscoverArticle.htm
www.toxicsinfo.org/kids/autism/AutismLinked.htm

5:20AM PDT on Apr 7, 2011

Sadly, the conventional medical establishment seems oblivious to the role that many commonly used household and personal care chemicals can have for quite a few autistic kids.

I personally have talked with several whose children have shown dramatic improvement when removed from a chemically toxic environment. For example, when the classroom was cleared of cleaning chemicals, pesticides, permanent markers and fragrance, one child went from getting 3 or 4 right on a test to 100 per cent - in two weeks! (The change was sustained, over time). Another was able to get off Ritalin after a similar removal from chemical exposures. This Mom described her son as "a wild man" in school, but quite normal at home and on vacation.

Although this may not apply to all autism spectrum situations, it is something that should be tried for all, because it has no down side whatsoever. In fact, there are some indications that not being exposed to chemicals can help even non-autistic learners.

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