About the “latest treatments” for autism

“For families struggling with autism finding the latest treatments is a top priority,” begins an October 14th WCBStv story about “a controversial approach” that “is making headlines” (which, of course, has nothing to do with the actual efficacy of said approach). The approach is hyperbaric oxygen therapy and the doctor is Dr. James Neubrander, whose website refers to autism as the “treatable untreatable disorder!.” A hyperbaric chamber will set you back $21,000, WCBStv notes. Dr. Neubrander says that HBOT treats “decreases inflammation” and somehow altars the brain chemistry of autistic children and, while there’s no studies to back it up, he says:

“No, the studies are not there, but it doesn’t invalidate what we see. The studies are coming.”

It’s a familiar refrain about how “studies” and especially studies “in the future” will provide proof that some alternative treatment or other does what it it claimed that it does. Dr. Mark Geier and David Geier are also members of what some call the “autism treatment subculture” and continue to publish studies seeking to offer evidence for claims of a vaccine-autism link. At yesterday’s Pathophilia, the metabolite values used by the Geiers are under question—and this is important, as the Geiers seek to show that “levels of these metabolites—as markers of oxidative stress and “decreased detoxification capacity”—in children with ASD are significantly different from those in children without ASD.”

Pathophilia examines the figures by the Geiers and supplied by their cited references or other relevant sources. Details are here; here’s the conclusions:

Geier et al present metabolite values in children with or without ASD that are questionable. In particular, some values measured by Geier et al—for example, cysteine (whether total or free), oxidized glutathione, and total sulfate—are considerably different from those published elsewhere, including those values obtained or calculated from references cited by the authors. Other values from ASD or neurotypical subjects—for example, reduced glutathione and taurine—are within the reference ranges published in the literature.*** Only in the case of plasma free sulfate was the mean level in ASD subjects outside of the normal range provided by the substantiating literature.

Before any diagnostic or treatment recommendations can be made on the basis of this study (or any study, for that matter), results must be shown to be reliably reproducible by a different set of authors using more than one experienced, reputable laboratory, and any discrepancies between control values and those in the literature must be noted and explained. It should also be determined whether tighter controls, particularly in the form of age matching between autistic and neurotypical subjects, should be performed when comparing these metabolite levels. Last, the significance of any mean values in autistic children that lie within the published reference ranges, although they may be statistically different from a given study’s control values, must be considered cautiously.

In other words, of the metabolite values that the Geiers say are in autistic children, most do not match up with those found in other studies, including the studies cited by the Geiers. Does this study, then, have any application beyond itself—-or, what can do you with a $21,000 HBOT chamber, if you’re not able to cure autism with it?

My main priority as the mother of an autistic son is not to find those “latest” treatments, but to ensure he has the appropriate, and the best possible, school, services and supports that he needs to help him move forward into the future.