A Doctor on Junk Science and Autism
August 12, 2007 by Kristina Chew, PhD
Filed under Health
Rahul K. Parikh is a fellow of the American Academy of Pediatrics and a pediatrician in Walnut Creek, California. Back in June, his op-ed, The Truth About Autism: Amid cries of an epidemic and parental fears that childhood vaccines may instead be poisoning their kids, doctors try to put a rapid increase in diagnoses of the learning disability in perspective appeared in the San Francisco Chronicle and made the case that a link between vaccines and autism has been “soundly disproved,” yet parents seek out what might be referred to as “their own truth,” in doing their own research and in seeking out treatments other than those offered by mainstream medicine. Another op-ed by Dr. Parikh appears today in New America Media, which again argues that parents have been “duped by junk science” into believing that mercury or vaccines causes autism, and in experimental treatments such as chelation. Dr. Parikh defines “junk science” as “science that is inaccurate, created out of self-interest” and that doesn’t “deserve to be in a courtroom.”
Dr. Parikh offers a succinct explanation of the vaccine court trials in which lawyers argued that 12-year-old Michelle Cedillo became autistic due to a vaccine; the “rise and fall” of Dr. Andrew Wakefield, “father of the vaccine equals autism theory,” who is now facing misconduct charges before the General Medical Council in the UK; and the work of father and son Mark and David Geier, “who publish studies that help sell their homegrown brand of medicine, and then use those same studies as evidence in a court of law to rake in consulting fees.” Writes Dr. Parikh in Parents Duped by Junk Science on Autism, Says Doctor:
Will the omnibus verdict, and its exposure of junk science, be a death knell for the autism equals vaccines myth? Probably not. What’s unfortunate is that too many families have their emotional and financial hopes pinned on theories created by those with a lot to gain by promoting them. Obviously, families have the right to question the safety of what they give their children. The debate about vaccines was settled by well designed and well conducted scientific studies a long time ago. Trials don’t change that.
If you do not think that mercury or a vaccine caused your child to become autistic, and experience “autism treatment fatigue” when hearing about the latest novel treatment (this would be ionic foot detoxification), then Dr. Parikh’s op-ed reads as a straightforwardly, and soundly, worded statement.
If you think the opposite, or have found that some biomedical treatments have helped, or can be thought of as helping, your child, it may be somewhat discomfitting to hear Dr. Parikh’s references to “junk science,” and that some parents appear to be “duped by junk science”—–or maybe it is just plain discomfitting, and eye-opening.
OK, I’ll bite
probably counting myself among the latter of Kristina’s two categories — a parent who has tried some biomedical approaches and has seen (believes he has seen? has been duped into thinking he has seen?) considerable improvements in my child’s pain level, gastric distress, tendency to self-injure, ability to self-regulate and avoid meltdowns, and general mood/stress levels. At least one neurodiversity advocate, Kevin Leitch, opines that biomedical approaches are not inherently problematic — indeed, he has claimed they have benefited his children) — and in the same context, he has observed that “I give supplements to my non-autistic kids too. Because we feel they need them. Not because we’re treating them for something.” And indeed, while there certainly are parents who are looking to ‘cure their child of autism’, others of us are trying to relieve what we believe are symptoms that indicate or create distress in our non-verbal child (though I will cede the point that we may be mis-interpreting some of xir actions as distress, and we are also doing our best to learn how xe communicates and teach xir to communicate with us). Our child has seizures; our neurologist has prescribed medication to limit them. Our child has (had?) severe reflux, which did not know about for a long time, because xe could not tell us about it; the GI specialist who works with us has prescribed medications that make our child much less prone to post-meal discomfort and (at least somewhat) more likely to sleep through the night. Our child has difficulty sleeping; melatonin was suggested, and has been helpful. And so on down the line. For each of the above, we tried some medications or supplements, and one finally worked. Some of them are standard pharmaceutical usages; others are not officially sanctioned by the USDA (melatonin, for example). All of them work, or appear to work, to improve our child’s ability to self-regulate. NOT to cure xir autism, which isn’t something we want to cure, or could even cure if we wanted to, whatever ‘cure’ might mean in this context.
I think the bottom line is that biomedical intervention does not automatically correspond to a wish to “cure” one’s child of autism. Our child is autistic. Xe also exhibits many symptoms of pain/stress/distress (though sometimes xe doesn’t, and is cheerful and delightful, and wonderfully “non-neurotypical”), and we have found biomedical approaches (as well as more “conventional’ ones) to be effective in relieving those symptoms.
I think criticism of biomedical approaches as a “cure” for autism are valid, and I for one have had my eyes opened (and have been fruitfully discomfited) by the arguments of neurodiversity advocates. But it seems to me that Parikh’s criticism goes beyond that, and the idea that all biomedical approaches are “junk science” seems to me to be highly problematic. But maybe I’m over-reading Parikh.
I think it’s in part the term “junk science” that sounds objectionable to parents who’ve tried some things biomedical (melatonin for instance has helped Charlie regulate his sleep these past several months), some things of a more traditional nature (Risperdal and Zoloft) and a lot of things educational. Its the stridence of the tone of some biomedical advocates that troubles me………..and I sense that Parikh’s responses are very much based on his being a pediatrician who has perhaps had to field a high number of parental queries of a DAN! type.
Thanks for jumping in!
Hi Kristina –
“some things of a more traditional nature (Risperdal and Zoloft)”
LOL! LOL! These are ‘traditional’ treatments for autism?!?!? Have you ever looked at the fine print on the labels of these drugs to see what the warnings are?
For Zoloft:
“Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
seizure (convulsions);
tremors, shivering, muscle stiffness or twitching;
problems with balance or coordination; or
agitation, confusion, sweating, fast heartbeat.
Other less serious side effects are more likely to occur, such as:
drowsiness, dizziness, weakness;
nausea, diarrhea, dry mouth, or changes in appetite or weight;”
It is more ofthe same for Risperdal:
“Stop using risperidone and call your doctor at once if you have any of these serious side effects:
fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
restless muscle movements in your eyes, tongue, jaw, or neck;
tremor (uncontrolled shaking);
trouble swallowing; or
feeling light-headed, fainting.
Continue taking risperidone and talk to your doctor if you have any of these less serious side effects:
mild restlessness, drowsiness, or tremor;
sleepiness, dreaming more than usual;
blurred vision;
dizziness or headache;
weight gain;
problems with urination;
nausea, dry mouth, constipation”
Given the challenges you have described in Charlie’s communication, how in the world are you going to know if he has dry mouth, nausea, trouble swallowing, is more agitated, or has blurred vision?
There are plenty of quacks out there, but the notion that giving a child who cannot communicate Risperdal or Zoloft is anything but an expirement along the lines of the most aggressive DAN doctor is a delusion you seem OK with because it isn’t ‘junk science’. That is some serious doublethink.
- pD
M’s Dad, I find it interesting that when you report on biomedical approaches that you’ve tried, and think might have had results you can see, that your language is so – hedging. You’re not sure if the child has/had reflux, the kid’s trouble sleeping has “improved.”There’s a reason that quack remedies are targeted towards some health problems & not others – the pain & stiffness of arthritis, for example, tends to wax & wane. People seek newer/more radical/quacky treatments at the time when they’re most desperate. The chances are good that some symptoms will wane after that point, and this waning [even any slight improvement in a symptom] will be credited to whatever remedy the person last tried. Also, the more different problems the condition is causing creates more opportunities for the consumer of a new/radical/quack remedy to credit the remedy with doing “something.” [e.g. I took it for the pain, which didn't get better, but my hands feel less cold now"]This is one of the main reasons that scientific medicine requires controls like double-blind, and actual results of tests & examinations [rather than the self report "I feel somewhat better"] before accepting that there might be some benefit to a new treatment.Also, people who have invested time, money and “face” by buying/using/promoting a remedy, are going to be predisposed to seek at least “some” improvement to confirm that they’ve been doing the right thing all along. It’s also important, when judging whether a treatment is working [whether in a clinical trial, or "will this FDA approved drug do something helpful for this kid"] that the parameters of success be defined in advance. Otherwise, someone desperate to think that the situation is improveable will grasp at any change as a sign of success ["we gave this child a drug for GI problems & have seem him/her sleep longer uninterrupted periods, be less fussy about food,,," or whatever]. This is called retrofitting, and is unfortunately, not evidence that a treatment is helpful. Especially when dealing with a complex situation like autism, where there are many facets, it’s easy to find changes suitable for retrofitting. It could be that the non-GI behavior/symptom was going to get better on its own anyway, or that normal variations in number of incidents of the behavior/symptom is on a downside at the moment, or even that the person providing the treatment just notices the “positive” changes more than any non-changing or negatively-changing symptoms/behaviors.Look at how impressive the reports about Secretin were, but later, more definitive studies showed that it didn’t help.None of the above is to say that there’s no hope, and that nothing can ever help. Just that it’s more complex than give a child treatment X and accept that any subsequent changes in behavior/symptoms can be attributed to treatment X.There’s reason to hope – autism research is getting more attention & funding. Educational interventions are more available these days.Most important of all, I’m sure that parents who care and are willing to do whatever they can to help is probably the best thing that an autistic child can have.