Bad, bad, bad autism advice in the Washington Post

I must admit that I’ve never heard of Margerite Kelly. Apparently she’s some sort of advice columnist for the Washington Post. Apparently she’s also fairly clueless, if her column from last Friday is any indication. At least, she’s clueless about autism. In her column Diagnosing Autism Is Never an Easy Process, she betrays a whole lot of ignorance about autism, autism treatments, and the quackery that is being sold to parents as a “cure” for autism.

A parent writes to Ms. Kelly about her two-year-old nephew, who is throwing tantrums and showing signs that concern her that he may be autistic. Ms. Kelly responds with advice that is initially reasonable but then descends into a truly irresponsible advocacy of quackery that does not belong in the pages of a major newspaper. First the semi-reasonable:

It would be both foolish and unkind to tell your sister that her son might be autistic, however, because the possibility is frightening and because you might well be wrong. Instead, tell your sister that you think her son has a physical problem; that it’s not her fault; and that the sooner it is diagnosed, the more successful the treatment will be.

It will take a doctor, not an auntie, to figure out why your nephew speaks poorly and has tantrums every day. He could be autistic but he could also be — like many little boys — a slow talker, and his tantrums may last a long time simply because he has allergies or a sensory processing disorder. Autistic children usually have these problems, but so do many children who aren’t autistic.

While it’s reasonable for this woman to urge her sister to take her son to see a pediatrician about these problems and it may even be reasonable to use the diversion of a physical problem (which could be true) to distract her from the possibility of autism, it is disturbing that she views autism as so frightening. The main reason it’s frightening is because that’s the message in the media and the anti-vaccine movement: that autism is terrifying, that it “steals the child’s soul” (that’s what Jenny McCarthy’s co-author has said); that it is beyond hope. While there’s no doubt that raising a child with severe autism is an incredible challenge, the image of autism many parents have is that it is all like the most severe cases, when it is not. As the term “autism spectrum disorders” implies, it’s a spectrum, from the very mild to the very severe.

Here’s where Ms. Kelly goes straight off the cliff:

No one knows why one child in 150 is autistic today when only one out of 2,500 was autistic 50 years ago, but there are a lot of theories. Some cutting-edge doctors think the disorder is caused by oxidative stress or by certain proteins in the body. Others blame autism on mercury, the preservative that was used in vaccines — and in some cases, still is — or they think autism occurs if a child gets too much aluminum in his body or not enough vitamin D. And those are just some of the theories.

First, the pedant in me can’t help but express my irritation that Ms. Kelly doesn’t know that the word “theory” in science does not mean what she apparently thinks it does. She means hypotheses, not theories. In actuality, they’re not even hypotheses; they’re more like wild guesses, and these “cutting edge” doctors to whom she refers are, for the most part, quacks who subject children to dubious therapies such as hyperbaric oxygen, chelation therapy, and others. True, there are real scientists studying oxidative pathways in autism, but they are not the ones to whom she is referring, and they are not the ones pushing all sorts of supplements. How do I know this? Because this is what Ms. Kelly writes next:

Your sister can probably learn about most of them if she goes to the Autism Research Institute’s next semiannual DAN (Defeat Autism Now) conference in Dallas from Oct. 8 to 12 and if you give her some books on autism, such as “Healing and Preventing Autism” by Jenny McCarthy and Jerry Kartzinel (Dutton, $27) or “Overcoming Autism” by Lynn Kern Koegel and Claire LaZebnik (Penguin, $15). “Could It Be Autism?” by Nancy D. Wiseman (Broadway, $13) is another good book, and so is “Eating for Autism” by Elizabeth Strickland, written with Suzanne McCloskey (DaCapo, $18). Strickland, a registered dietitian, gives some excellent recipes for the GF/CF diet and a lot of good advice.

Yep. She’s actually recommending books by Jenny McCarthy and, even worse, that this mother attend the DAN! conference. Just look at the list of speakers. It includes luminaries of the anti-vaccine/autism quackery movement as Jeff Bradstreet, Dan Rossignol, Anju Usman, and Lisa Ackerman. If you peruse the list, the usual “biomedical” topics are all there: vaccines as a cause of autism, supplements, “biomedical” treatments, “detoxification,” it’s all there.

Ms. Kelly’s also parroting a key myth of the anti-vaccine movement, namely that there has been a huge increase in autism in the last 20 years and therefore “something” must have caused it. Of course, that “something” isn’t what Ms. Kelly or other “biomeddlers” think it is. That something is a combination of the broadening of the diagnostic criteria for autism spectrum disorders that occurred in 1994, increased awareness, increased screening, and diagnostic substitution. She also falls for the myth of “toxins” in vaccines, in particular the now discredited idea that mercury in vaccines somehow causes autism. Apparently, Ms. Kelly is unaware that there hasn’t been mercury in childhood vaccines other than the flu vaccine (which most children still don’t receive) since early 2002 and that autism rates have not declined.

It’s always depressing to see such ignorance proudly displayed by a columnist with a national reach and such truly bad recommendations being given to a woman who is facing the possibility of autism in her nephew, recommendations that show a shocking lack of understanding, an embrace of quackery, and a belief in the lies of the anti-vaccine movement. That’s why I think some polite e-mails to Ms. Kelly are in order setting this woman straight. It may be a waste of time, but perhaps she is educable.