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Dr. Mark Hyman mangles autism science on–where else?–The Huffington Post

Dr. Mark Hyman is famous as the “founder” of a form of woo known as “functional medicine.” This new form of woo is…well, I’m not sure what it is, and neither are Wally Sampson (1, 2, 3, 4). Suffice it to say that it appears to be a serious grab bag of various forms of woo that, according to Dr. Hyman’s website itself, involve environmental inputs, inflammation, hormones, gut & digestive health, detoxification, energy/mitochondria/oxidative stress, and, of course, “mind-body,” whatever that means. No woo would be complete without mind-body, you know. Actually, no self-respecting woo would leave out “detoxification,” either.

In any case, “functional medicine” is such a–shall we say?–“target-rich” environment that I could do a number of posts about functional medicine in general and Dr. Hyman in particular. Having discovered his “Ultrawellness” website, blog, and podcast, I can see that Dr. Hyman will be the gift that keeps on giving, at least as far as blog material goes. It’s only a wonder that I haven’t really delved into the serious, serious woo that Dr. Hyman lays down on a regular basis before. Learning that, it now depresses me even more that Dr. Hyman is one of the Four Horsemen of the Woo-pocalypse, as I have dubbed the four woo-loving physicians whom Senator Tom Harkin invited to testify in front of his Senate committee as a as a “two-fer” from their concurrent engagement at the Institute of Medicine and Bravewell Collaborative woo-fest being held on the same days. The three physicians in addition to Dr. Hyman physicians included Dr. Andy Weil, Director, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ; Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA; and Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY. Of the four, thanks to “functional medicine,” Dr. Hyman is by far the most quacktastic of the four, and that’s why I’m depressed. That such a woo-meister could be called to testify in front of the Senate as though he were a respectable academic physician boggles my mind, which is why I will be turning my sights on Ultrawellness.

Eventually.

In the meantime, Dr. Hyman has popped up on the one web commentary outlet where he should truly feel at home, namely The Huffington Post.

How do I know this? Easy. A whole bunch of you sent me the link to a truly execrable article that appeared on HuffPo on Saturday entitled Why Current Thinking About Autism Is Completely Wrong. Damn it! I was trying to take the weekend (mostly) off from blogging, with some previously written stuff scheduled to post, and here you all were, trying to tempt me back. Fortunately, my will held strong, and I managed to delay writing anything about this quacktastic woo-fest until last night.

Two days haven’t made me feel any more merciful towards it.

That’s especially true because Dr. Hyman’s HuffPo article is virtually identical to an article he wrote almost two years ago for his Ultrawellness Blog, entitled–surprise! surprise!–Why Current Thinking about Autism is Completely Wrong. Indeed, there’s even a video:

Recycled material on HuffPo? Who’da thunk it? I doubt HuffPo will care much, though. after all, if the editors there don’t give a rodent’s posterior about the medical accuracy of the anti-vaccine line that bloggers there so regularly lay down, I doubt that a little thing like republishing a two year old post would bother them. At least I label my repeats as being repeats.

Be that as it may, Hyman starts out by demonstrating his lack of understanding in no uncertain terms:

“Autism is caused by poor mothering.” That was the belief of the medical community until the late 1960s.

“Autism is a genetic brain disorder.” That is what most people — and most of the medical community — believe today.

I’m here to tell you that neither one of these statements is true.

Think about it. Rates of autism have skyrocketed over the years, from an estimated 1 child in 3,000 to just 1 in 150 kids today. Sure, wider criteria for diagnosis and better detection might explain some of it — but not an increase of this magnitude.

How many times have I been over this issue before? Apparently Dr. Hyman clearly doesn’t understand the confluence of factors, including the marked broadening of the diagnostic criteria for autism in 1994, increased awareness, and, of course, increased screening. Diagnostic substitution has a lot to do with it, of course. Also, although it is controversial whether the incidence of autism has increased over the last couple of decades, it is not controversial that the real rate of autism hasn’t increased by nearly as much as it appears to have increased. True, the apparent rate of autism appears to have increased dramatically over the last 20 years, but careful studies that have been done suggest that we are moving towards a new consensus prevalence of autism and autism spectrum disorders of around 1% and that autism prevalence, if it has changed over the last few decades, has not changed by anything even close to 200-fold. Indeed, the National Autistic Society explains the discrepancy well, pointing out areas of uncertainty and referring to the example of Tourette’s disorder, which is 1,000 times more common than had previously been thought. That’s nothing compared to Hyman’s figures, which, if correct, would suggest that that autism is “only” 20 times more common than previously thought.

It’s also quite clear that Hyman is pulling the old “science was wrong before” gambit. Skeptico, John Jackson, and I have discussed why this is a dubious gambit beloved of advocates of pseudoscience. The CliffsNotes version is that, just because science may have been wrong in the past does not mean that Dr. Hyman is correct now.

Dr. Woo–I mean Dr. Hyman–then goes on to cite a whole lot of, well, woo:

Dramatic scientific discoveries have taken place during the last 10 to 20 years that reveal the true causes of autism — and turn conventional thinking on its head. For example, Martha Herbert, MD, a pediatric neurologist from Harvard Medical School has painted a picture of autism that shows how core abnormalities in body systems like immunity, gut function, and detoxification play a central role in causing the behavioral and mood symptoms of autism.

She’s also given us a new way of looking at mental disease (and disease in general) that is based on systems biology. Coming from the halls of the most conservative medical institution in the world, this is a call so loud and clear that it shatters our normal way of looking at things.

Everything is connected, Dr. Herbert says. The fact that these kids have smelly bowel movements, bloated bellies, frequent colds and ear infections, and dry skin is not just a coincidence that has nothing to do with their brain function. It is central to why they are sick in the first place! Yet conventional medicine often ignores this.

Dr. Herbert’s work shows nothing of the sort. Go ahead. Head over to PubMed and look at Dr. Herbert’s publication record. I’ll wait. She has listed 15 publications about autism, of which:

  • six are review articles
  • two are in alt-med journals, and one of these is an interview
  • one is a paper with dozens of authors reporting the results of mapping autism risk loci using genetic linkage and chromosomal rearrangements. (Dr. Herbert is solidly right in the middle of the huge pack of authors.)

Of the remainder, Dr. Herbert only appears to be first author or senior author on four publications on autism containing original research, and these appear to be all imaging studies of the brains of autistic children. In other words, Dr. Herbert is making claims far beyond what her publication record in the peer-reviewed literature can, even under the most charitable interpretation possible, support. Nothing at all in her publication record appears to support the concepts above of autism being a systemic, rather than brain-based condition. There’s nothing about systems biology there (and I actually rather like systems biology); nothing there to support a link between autism and gut disorders; nothing to support a link between autism and immune dysfunction; and nothing to support a link between “environmental influences” and autism. That’s not to say that there aren’t environmental factors that influence the development of autism; it’s just that there’s nothing in Dr. Herbert’s publication record to support such a hypothesis or to identify what, if anything, those environmental factors might be.

In other words, there is nothing at all to support Dr. Hyman’s claims, which appear to be based on Dr. Herbert’s claims. Certainly, there’s nothing there to support the grandiose claims that Dr. Hyman makes. Not that that stops Dr. Hyman from pulling the Galileo gambit:

My friend and mentor, Sidney Baker, MD — a pioneer in the treatment of autism as a body disorder that affects the brain — often says, “Do you see what you believe or do you believe what you see?”

The problem in medicine is we are so stuck in seeing what we believe that we often ignore what is right in front of us because it doesn’t fit our belief system. Nowhere is this true more than in the treatment of autism.

Such a criticism may be at least partially true of scientific medicine at times, but not in the way that Hyman apparently means, and in this case Dr. Hyman can’t produce one whit of evidence to persuade me that it is true for autism. Perhaps it never occurred to Dr. Hyman that the reason his belief system is not taken seriously by autism scientists is because there’s no credible scientific evidence to support it. But, boy, oh, boy does Dr. Hyman have anecdotes. Actually, strike that. It’s not plural. He has a single anecdote, an “N of 1,” if you will.

Dr. Hyman sets the stage:

He received diphtheria, tetanus, whooping cough, measles, mumps and rubella, chicken pox, hepatitis A and B, influenza, pneumonia, hemophilous, and meningitis vaccines — all before he was 2 years old. Then something changed.

He lost his language abilities and became detached. He was unable to relate in normal ways with his parents and other children. And he became withdrawn, and less interactive. These are all signs of autism.

Sam was taken to the best doctors in New York and “pronounced” as having autism, as if it were a thing you catch like a bug. His parents were told that nothing could be done except arduously painful and barely effective behavioral and occupational therapy techniques. The progress would be slow, and his parents should keep their expectations low, the doctor said. Devastated, the mother began to seek other options and found her way to me. While we have just started working together, the results in only a few weeks have been remarkable.

Note the clever way this story is told. Dr. Hyman doesn’t explicitly blame vaccines, but he makes a very definite point of mentioning that the child received his vaccines…and then “something changed.” No mention of the time course is given. Did this change occur right after vaccination, or did it occur weeks or months later? Who knows? Even if it occurred weeks or months later, the implication is still there: The vaccines done it!

Then there’s the very same structure to the story that we often see in alt-med testimonials. Rejected by conventional medicine. No hope. Then began the search, and, at the end, the savior is found and that savior is Dr. Hyman, who diligently subjected the child to a hole heapin’ helpin’ of woo. None of this “biomedical” woo was based on any clear science. In fact, it’s a hodge-podge–a grab bag, if you will–of remedies based on metabolic tests finding alleged gluten allergies, amino acid abnormalities, methylation abnormalities, various nutritional deficiencies. These remedies included:

Step 1: Fix His Gut and Cool the Inflammation There

This step included a number of different tactics including:

  • Taking away gluten and other food allergens
  • Getting rid of his yeast with anti-fungals
  • Killing off the toxic bacteria in his small intestine with special antibiotics
  • Replenishing healthy bacteria with probiotics
  • Helping him digest his food with enzymes

Step 2: Replace the Missing Nutrients to Help His Genes Work Better

In Sam’s case we:

  • Added back zinc, magnesium, folate, and vitamins A, B6, B12, and D
  • Supported his brain with omega-3 fats

Step 3: Detoxify and Reduce Oxidative Stress

  • Once his biochemistry and nutrition was tuned up, we helped him detoxify and reduce oxidative stress.

Improve nutrition, reduce inflammation, heal the gut, detoxify — this should sound familiar.

Well, actually, yes, this does sound very familiar. Woo-meisters the world over love “detoxification” of unknown and unnamed “toxins” that are supposedly the cause of all disease, all accompanied by a boatload of various supplements.

Dr. Hyman is the protoypical brave maverick doctor who don’t need no steekin’ randomized controlled studies to tell him what works. It matters not one bit to him that autism is a condition of developmental delay, not developmental stasis. Autistic children do develop, regardless of what treatments they are subjected to, but the assumption n is all too often that these children don’t develop, which leads “brave maverick doctors” like Dr. Hyman to attribute any improvement they observe in an autistic child to whatever the woo du jour to which they happen to be subjecting the child at the time. The thought of a randomized clinical trial never enters their mind because they know this stuff works. They’ve seen it. Never mind that without a proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children there’s no way of knowing if any improvement observed in Sam was due to any of the woo to which he was being subjected or just natural aging and development. Indeed, there is evidence that as many as 19% of autistic children move “off the spectrum” by their 7th birthday. Indeed some “recover” spontaneously. With an N of 1, we have no idea if Sam is just such a child. One wonders whether Dr. Hyman will ever publish his “recovery” rate for autism based on a large number of children.

Somehow I doubt it.

How do I know this? Easy. Dr. Hyman concludes with these appeals:

Every child with behavior problems, ADHD, or autism is unique — and each has to find his or her own path with a trained doctor. But the gates are open and the wide road of healing is in front of you. You simply have to take the first step.

Please visit the Defeat Autism Now! website for more information on this subject, including resources and conferences for doctors and parents.

Yes! An appeal to visit the quack site of all autism quack sites, coupled with an appeal to sign up for Dr. Hyman’s newsletter and (eventually, I’d guess) later appeals to buy his stuff. What else would we expect?

The truly depressing part of this whole thing is that Dr. Hyman is actually taken seriously as an “expert” in “wellness” and “alternative” medicine. Not only that, but he’s much sought after as a speaker, and, as I mentioned before, has testified and spoken at the very highest levels of government as though anything he has to say on “wellness” should have any bearing on any health care reform legislation that may be passed this year.

That’s how far woo has infiltrated not only academic medicine, but our government as well.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

136 replies on “Dr. Mark Hyman mangles autism science on–where else?–The Huffington Post”

Senate testimony has a record of pandering to whatever the more powerful senators want to hear. When Delay, Rohrabacher, Inhofe, Doolittle, … and co. were in power, climate science was obtained from fiction writer, economists, and wishful thinking from whoever would give the answers the senate (and house) powers wanted to hear.

In Kansas, when they were having their Kangaroo Court regarding evolution, they imported a Turkish terrorist to testify on their (antiscience) behalf.

“Step 2: Replace the Missing Nutrients to Help His Genes Work Better”

I’m sorry, but I just couldn’t get past this steaming pile of ignorance.

If this were true, and I followed the protocol, I would expect my kid to be EVEN MORE autistic. We have at least 4 family members with AS. Just imagine if my kid’s genes ‘worked better’. Forget Asperger’s, my son would be Rainman.

I now have a headache.

A quick google video search of “dr. mark hyman” yielded several gems.
My favorite is the “Ultra Mind Solution: Key # 1- Optimize Nutrition”. Hyman tells me that “Food is information.” and that “…You put the wrong information [in] your brain won’t work.”

I’m no statistician, but it seems to me an increase from 1/3000 to 1/150 is only 20-fold, not 200.
Otherwise a great post and yet another face and name to watch out for. He’s got a good sincere manner and no doubt a lot of worried parents will swallow the whole story without much question

The crazy, it’s strong with this one. I really enjoyed his evidence free sales pitch right up to the point which he started the ignorant antivaccine mantra. This guy is a quack.

“An appeal to visit the quack site of all autism quack sites”
“The crazy, it’s strong with this one.”
“This guy is a quack.”

The Hypocrisy!!! It burns so bright that it threatens to go supernova!!!!

Sue, what on earth are you on about? What’s hypocritical about calling someone who is a manifest quack exactly that?

Wow, snerd…you really are on top of the mental food chain, aren’t you?

What do you call a bunch of quacks calling someone else a quack? Right….hypocrisy.

And no, I’m not Sue.

The problem in medicine is we are so stuck in seeing what we believe that we often ignore what is right in front of us because it doesn’t fit our belief system. Nowhere is this true more than in the treatment of autism.

Actually, that is true, just not in the way that Dr Hyman meant

Having been on both an antibiotic and an antifungal at the same time (I got a sinus infection while doing a course of Lamisil for fungal toenails), dear god, what a miserable thing to do to a little kid! (And talk about GI upsets.) The side effects of those kinds of drugs are bad enough if you’re an adult and doing it voluntarily, never mind if you’re a little kid with communicative difficulties. The regimen described is, IMO, bordering on child abuse.

I’d say I felt sorry for the parents for having to deal with a miserable kid for that long, but the parents really have only themselves to blame.

To all who would try to argue against the current accepted science on autism:

1) Exclamation points are not good evidence.

2) Constant shrieks of variations of “I know you are, but what am I?” are not good evidence.

3) Articles in pay-to-publish journals are not good evidence.

4) Ignoring existing science is not good science.

5) Lying about existing science is not good science.

6) Being ignorant of existing science in a field where you claim expertise is not good science.

7) Correlation does not imply causation.

Please remember all of this if you want to be taken seriously by actual scientists working in this area of research. Thank you.

What do you call a bunch of quacks calling someone else a quack? Right….hypocrisy.

Ahh, the old I-know-you-are-but-what-am-I defence; cunning. With that out of the way, would you now like to take a shot at defending Hyman’s claims with some (dare to dream) evidence? You know, actually demonstrate that he isn’t the complete and utter quack he appears to be.

Drat! Phoenix Woman undercut me on the “I know you are, but what am I” front.

Must learn to post faster…

He received diphtheria, tetanus, whooping cough, measles, mumps and rubella, chicken pox, hepatitis A and B, influenza, pneumonia, hemophilous, and meningitis vaccines — all before he was 2 years old. Then something changed.

I’m reminded of Peter Griffin…

“Oh no, I knew a guy who bought a used car from the newspaper once. 10 years later? Bam! Herpes.”

He received diphtheria, tetanus, whooping cough, measles, mumps and rubella, chicken pox, hepatitis A and B, influenza, pneumonia, hemophilous, and meningitis vaccines — all before he was 2 years old. Then something changed.

BTW, I knew there was something triggering my Bullshit alarm. A pneumonia vaccination? Seriously?

Second, it is worth mentioning that a lot of the vaccines listed here are given in the first year. DTaP, Hepatitis (hepB, at least, which is given at birth even), influenza is recommended in year 1.

The first DTaP and HIB are given at 2 months. Suddenly, two years later, BAM! Autism.

Pablo said: The first DTaP and HIB are given at 2 months. Suddenly, two years later, BAM! Autism.

I’ve seen moms that claim vaccine injury years after the shots. Some even claim decades. Then they blame the doctor for not giving their theory the time of day. Of course, the same idiots complain about doctors not offering “alternative remedies” like homeopathy.

It must be nice to have a convenient boogeyman on which to blame all that ails you.

Gee, I must remember to remind my son that he should NOT be extremely physically healthy (as he is). He’s autistic, so he should have all these serious health issues that supposedly cause autism. Then I could cure him, right?

How dare he be any different than what the quack says he should be??

I concur Paul, a creepy bio indeed. I love his turgid tale of Mercury poisoning that rivals Jeremy Piven’s. The only thing our hapless Doctor hasn’t presented with is Morgellons . . . yet.

So mumkeepingsane, are you saying that your son does NOT have especially stinky poo?

The fact that these kids have smelly bowel movements, bloated bellies, frequent colds and ear infections, and dry skin is not just a coincidence that has nothing to do with their brain function. It is central to why they are sick in the first place! Yet conventional medicine often ignores this.

Does he seriously think that non-autistic kids’ shit doesn’t stink?

Does he seriously think that non-autistic kids’ shit doesn’t stink?

Dr Hyman probably thinks he is so wonderful that his own shit doesn’t stink.

“Never mind that without a proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children there’s no way of knowing if any improvement observed in Sam was due to any of the woo to which he was being subjected or just natural aging and development.”

Risperdal went through a “proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children,” didn’t stop it from growing milk-producing breasts on boys.

My eyes instantly glaze over whenever I hear or see the word “wellness:” ORAC, is there something metaphysically wrong with me, and how do I cure this problem?

Paul – I read the life story of Dr. Hyman that you linked to: omigod, this is truly shocking! What a weird, creepy story. I wouldn’t see this man for a hangnail. I’d like to have a chat with the two doctor’s wives who “ran him out” of Idaho!

My eyes instantly glaze over whenever I hear or see the word “wellness:” ORAC, is there something metaphysically wrong with me, and how do I cure this problem?

Jake Crosby @ 23: “Never mind that without a proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children there’s no way of knowing if any improvement observed in Sam was due to any of the woo to which he was being subjected or just natural aging and development.”

Risperdal went through a “proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children,” didn’t stop it from growing milk-producing breasts on boys.

I’ll take non-sequitors for $300, Alex.
I’m sorry, what does antipsychotic-induced hyperprolactinemia have to do with the claims of Dr. Hyman?

Hi–

Long time listener, first time caller. You have a typo up high:

which is why I’ve turned my sites on Ultrawellness.

I think a lot of people on all sides of this discussion disagree with Dr. Hyman’s opinions.

Best,

Jay

Dr Jay, you may be right regarding the typo, as a gunman properly sights a target. However, Orac could be warning us all that he is turning his sites (RI and SBM) on Ultrawellness. Certainly this topic would be appropriate at the other blog site also.

Dr. Jay may not be aware of my extreme distaste for pedantry, particularly pedantry in the form of comments that consist of nothing more than a typo or spelling flame and have no substantive commentary associated with them. Indeed, as regular readers may know, I have a tendency, depending on my mood, to delete such comments with extreme prejudice.

“Long time listener, first time caller.”

Uh-oh, that’s a grammatically deficient sentence, desperately in need of a verb. Dr. Jay has to go to the back of the class, mindful of the frequency with which grammar-naggers commit violations in their own attempts at correction.

Dr. Jay and Dr. Hyman actually have a lot in common. They both preen with regards to their “maverick” status and lack a basic understanding of evidence-based medicine, preferring to dwell on anecdotes and subjective experience.

We could use a Hall of Shame website for all of these antivax, self-promoting embarassments to the medical profession.

But, there was substance in my saying that many people, myself included, disagree with Dr. Hyman.

Good for you. Now, what are you going to do about it?

Will you write a rebuttal to the Huff Post? The next time you get to a anti-vax rally (whatever fluff name they are given), will you speak out against such whackery? Or will you sit back and let him go unchecked because you know that were you to speak out against him, you will lose some of your status as the anti-vaxxers favorite doctor? You might even get lumped in with the evil vaccinationists!

Bacon! It’s been a while since you’ve aimed your unpleasant hyperbole at me. The wounds have healed sufficiently for you to resume. I truly enjoy your posts when they’re factual and educational in nature and I’m never quite sure why you resort to being nasty. You don’t need to.

Pablo, good idea. I will work on a rebuttal after work tonight. By the way, I sincerely doubt that I’m the favorite doctor for the anti-vaccine camp because I give shots in my office. Hard to be “anti-vaccine” and give shots, too!

Best to You Both!

Jay

Fine job, there, Dr Orac! My best bud Louise and I did a couple articles over at our blog about functional dumbasses and a dumbass rodeo concerning this woo-doctor thinkin that folks had broken brains. He sure does think they got broken brains and ain’t capable of thinkin straight. Oooh boy, he’s abankin on that so he can take their money.

By the way, I sincerely doubt that I’m the favorite doctor for the anti-vaccine camp because I give shots in my office. Hard to be “anti-vaccine” and give shots, too!

Only if they insist, though, and you admit you discourage it.

Given your profile, you are absolutely a favorite of the anti-vaxxers. I’m sure that makes you proud.

His parents were told that nothing could be done except arduously painful and barely effective behavioral and occupational therapy techniques.

Wow… arduously painful? My son quite enjoyed his behavioral and occupational therapy, what with all the swinging and playing of games – especially as he was rewarded for participation with Skittles. I had no idea the tot was such a masochist.

Barely effective? My son was nearly four and both completely non-verbal and prone to violent/self-injurious outbursts when we began ABA therapy. Just over three months later he spoke his first self-initiated sentence. (“Bye Mom, I love you” – MAJOR tear jerker, that one.) Within 6 months his self-injurious behaviors were a thing of the past.

Now 10, my son is healthy and happy. He has friends and will talk non-stop about a number of fond subjects. He’s behind academically, certainly, but he loves science and is learning to read.

Luckily I understand, more so than Dr. Hyman apparently, that personal experience doesn’t trump sound science so I would never claim that all Autists will respond as well to ABA as my son did – but one good turn of subjective experience deserves another don’t you think?

This doctor claims on his “ultra super duper fabo brain book” site that people ar suffering from “enflamed brains” and that they feel nothing..Nothing that is but “depressed, unfocused-or worse autistic or demented” How does one go about feeling demented?

“Dr. Mark Hyman is famous as the “founder” of a form of woo known as “functional medicine.” This new form of woo is…well, I’m not sure what it is…”

Dr. Hyman is merely a leading proponent of FM, not its founder.

I like John Neustadt’s definition of functional medicine. it is clear and succinct. It strikes me as a sensible way of viewing many diseases (and how to deal with them):

“In many cases, the underlying causes of disease are biochemical in nature. Biochemistry is how the body uses vitamins, minerals, fats and proteins to do its job, and how things like infections, allergies and environmental toxins interfere with proper biochemistry to cause symptoms and disease. In other words, if you weren’t sick last year or last month, and you are now, something has changed in your biochemistry. Determining where a person’s biochemistry has gone haywire and then correcting it through targeted nutritional therapies is called medical biochemistry or functional medicine.”

Tanya –

While it is true that your anecdote about the efficacy of ABA is not all that useful (aside from being a counter-point to the “barely effective” assertion), your insight into how “arduously painful” it isn’t is extremely relevant. I need to calibrate my Bullshit meter a little better, because that should have set it off.

As far as I can deduce, abusive methods are not currently in favor in ABA, are they? I think I have heard claims that there were some places that had used them at one time, but, jeez, no one in their caring mind is going to knowingly allow such to go on (what’s next, shock therapy?) However, an affirmative approach that rewards progress (Skittles!) wouldn’t be a problem. I can’t believe that the case mentioned couldn’t find such an opportunity among all the experts in New York…

Indeed, there is evidence that as many as 19% of autistic children move “off the spectrum” by their 7th birthday.

Orac, that sounds interesting – do you have a citation? It would certainly go some distance to explaining the prevalence statistics.

“Bacon! It’s been a while since you’ve aimed your unpleasant hyperbole at me. The wounds have healed sufficiently for you to resume. I truly enjoy your posts when they’re factual and educational in nature and I’m never quite sure why you resort to being nasty.”

I’ve never quite understood the lack of self-awareness that allows Dr. Jay to substitute nastiness for responsiveness in his own posts (such as insinuating that contributors to this blog are paid off by Big Pharma, as well as the snide comments made in his earlier posts to this thread) while castigating others for being meanies. Perhaps the word I’m looking for is “hypocrisy”.

You could look it up.

“However, an affirmative approach that rewards progress (Skittles!) wouldn’t be a problem.”

I really hate to see ABA’s using skittles, m&m’s, etc. as a reinforcer, since FD&C food colorings have been linked to behavior problems in children. Kinda defeats the purpose of ABA. ::shrug:: Not to mention the effects on dental health.

Keep us posted on that rebuttal, Jay. I’m sure we’re all looking forward to reading it.

Jake Crosby, what Risperdal is or isn’t has nothing to do with the fact that bringing it up is a non sequitur that adds nothing to the conversation. The fact that it has nothing to do with this discussion is what makes it a non sequitur.

Charlotte,
Peter Szatmari, in his book, A Mind Apart: Understanding Children with Autism and Asperger Syndrome, suggests that there have always been reports of improvement and recovery. he cites Kanner from 1972 reporting on the first 96 patients he saw with autism.In adulthood 11 were functioning gainfully in society despite continuing problems with intimate adult relationships. Szatmari suggests that according to his own data 20 per cent of adults with aspergers and 10 per cent with autism progress to the point were they score in the average range for social and communication skills and have few if any clinical symptoms of autism.

There is very little research into adult outcomes. Anecdotally, the autistic adults that I know via the National Autistic Society could all be said to function gainfully but are still recognizably autistic. We also do not know how many “recovered” autistics are, as Liane Holliday Willey put it in the title to her autobiography, Pretending to Be Normal while retaining their autistic neurology. One autistic adult in the USA described himself as an Apple computer running a PC emulator which sometimes crashed.

@”Edumacation”:

Well, Risperdal is “Evidence-Based Medicine,” right?

Riiiight. You bring up a side effect of a specific drug on a thread about the claims of a quackery-pushing doc because…? I still don’t see how it relates. That is, it’s unequivocably a non-sequitor argument.

Oh, we all see what your getting at: Look I found perceived failure of a single product of so-called Evidence-Based Medicine, thus I have disproved the usefulness of Evidence-Based Medicine and simultaneously proved the usefulness of my own favored approach(es)! Except…it doesn’t. It makes you look as stupid a H*ppeh.

You should talk to H*ppeh, though; I think you’d like each other.

A “perceived” failure of a single product? The drug grew breasts on boys, that’s not a “perceived” failure, that IS a failure, and a major one at that.

@Pablo

As far as I can deduce, abusive methods are not currently in favor in ABA, are they?

Absolutely not. There was a time when negative reinforcement was fairly common among ABA practitioners, but it has long since been abandoned by sane therapists – not only out of a sense of decency, but also because negative reinforcement almost always increases stimming behaviors. Unfortunately, there will always be those who resort to abusive tactics but they’re far from the norm.

@Jen

I really hate to see ABA’s using skittles, m&m’s, etc. as a reinforcer, since FD&C food colorings have been linked to behavior problems in children. Kinda defeats the purpose of ABA. ::shrug:: Not to mention the effects on dental health.

First of all, I would like to make it clear that it was my choice to use Skittles as my son’s most common positive reinforcement, not his therapist’s. While some studies have linked food colorings to hyperactivity, the link hasn’t yet been proven conclusively. Regardless, I tested several food rewards before settling on Skittles by documenting both his desire for the reward and any behavioral effects, then narrowing the options and increasing the amount given until I was sure they wouldn’t cause any issues. For my son, Skittles caused no increase in hyperactivity, no decrease in attention span, and had the added side effect of “teaching” him to tolerate chewy foods which had previously been declined.

As to his dental health – we did brush his teeth. Also, food rewards of any kind are usually intended only for short term use – typically being replaced by more complex rewards as part of therapy. We now use a combination of sticker charts at school which are traded for science experiments and pennies at home which are traded for weekly allowance.

Cheers Mike 🙂

I was hoping for something a little more rigorous, but that’s a start. I know that most autistic spectrum adults “function gainfully” (couldn’t think of a better way to put it than yours!) but 7 seems rather young for pretending to be normal and learning to conform with social norms, hence my interest.

Also, 7 is so early that kids who are functioning in the ‘normal’ range by then wouldn’t have made it into the statistics at all until recently (in the UK). I assume they’d also be much less likely to join organisations like the National Autistic Society even if diagnosed, so they may disappear from the conversation a bit.

Jakie still don’t get it…

Maybe a counter-example will work?

A “perceived” failure of a single product? The drug grew breasts on boys, that’s not a “perceived” failure, that IS a failure, and a major one at that.

A certain chiropractic clinic in western Colorado killed six people over the course of two and a half years with colonic-irrigation therapy.

Get my drift?

Quacktastic? Woo-meister?

With that intellectual lead in you shovel the usual drivel that any rise in autism diagnoses can be explained by the change in diagnostic definition dating back to 1993-4, and other social factors?

Not only are you silly but you are also out of date. Even the IACC has acknowledged the need to start funding research of the potential environmental causes of autism. As Professor Simon Baron Cohen has stated publicly on at least 3 occasions given that in some cases where one identical twin has autism the other does not indicates that autism likely a result of an interaction of genetic, environmental and biological factors. Of course he did not explain his position using scientific terminology like woo and quack so what does he know?

If I understood that definition of functional Medicine, it sounds like it denies that bacteria et al cause disease. Is it in the camp of Germ Theory Denial?

As you know Harold, Autism is genetic, but to what degree other factors play a role is unknown. Your small-minded band can cherry pick quotes all you like but it doesn’t make evidence for your pet hypothesis.

Jake bleated, “The drug grew breasts on boys” Wait, are we talking about the Lupron-Autism Quackery? While it doesn’t negate its potential as a tool for psychiatrists, Risperdal has weight gain issues for many, period. Moobs is what happens when someone gets fat.

Jake, you’re spending a good bit of time slinging mud here – a place you hate. Might I suggest you take a good hard look at the lies your parents told you about you being poisoned by the government and really think things through; you’re not damaged goods and you’re not broken. You are different. And that’s ok. What’s not so ok is that you are also a laughably under-educated asshole.

Back to your homework.

Oh, look. Here I am visiting my family in Texas, and as well as being fans of our old friend Wakefield, the even less credible Moulden, and dear Mike Adams, they are also fans of this guy.

And I am apparently obliged not to dismember my blood relatives, for some reason I can’t quite make out at the moment.

Help meeeeeeeeeee……

@”Edumacation”: Let’s stick to treatments used for autism. Do you know of any other than Risperdal which has also been shown to grow milk-producing breasts on boys?

@”Orac”:

“Dr. Herbert is making claims far beyond what her publication record in the peer-reviewed literature can, even under the most charitable interpretation possible, support. Nothing at all in her publication record appears to support the concepts above of autism being a systemic, rather than brain-based condition. There’s nothing about systems biology there.”

-You are wrong:

“This convergence of findings and models suggests that a systems- and chronic disease-based reformulation of function and pathophysiology in autism needs to be considered, and it opens the possibility for new treatment targets.”

From:

Large brains in autism: the challenge of pervasive abnormality.
http://www.ncbi.nlm.nih.gov/pubmed/16151044?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Jake Crosby comments (tangentially):

Risperdal went through a “proper scientific randomized, double-blind, placebo-controlled clinical trial with a large number of children,” didn’t stop it from growing milk-producing breasts on boys.

Since Jake didn’t get the drift of several previous commenters, let me be the one to spell it out in painful detail.

Risperidone (Risperdal) can cause some boys to “grow breasts” (gynecomastia) – this is true. It is called a “side effect”. It also happens to be effective at reducing some of the problematic behaviors of autism – as several placebo-controlled randomized studies have shown.

So, we have a drug that is shown to be effective – not at “curing” or “recovering” autism but at reducing the severity of problematic behaviors (such as aggression). It also has a side effect of mild to moderate gynecomastia in some boys.

This is how real medicines work, Jake. They have a desired effect (or effects) and also may have a number of undesirable side effects. Sometimes, these side effects are troublesome enough to make people stop taking the drug.

In contrast, fantasy medicines (like homeopathy and “energy medicine”) have no side effects – they also have no real effects.

In further contrast, we have “therapies” such as chelation for autism and Lupron “therapy” for autism that – while having no demonstrated real effects – have very real and sometimes serious (e.g. death) side effects.

So, Jake, what would you have us do? Treat with real medicines that have real studies supporting their use – even though they have well-documented side effects?

Or should we resort to fantasy treatments that have neither side effects nor real effects?

Or should we take the third path of using real medicines in ways that have not been shown to work, thus accepting the risk of side effects with little (or no) hope of real effects?

Prometheus

I see Harold is spamming again. We’ve got that Jake Crosby chap saying, well he’s saying something. Perhaps he’ll get round to telling us lot what it is rather than forcing us to guess like he usually does. Don’t hold your breath thou’ because “It’s ‘obvious'” and he’s “Tired of explaining it”.

“Even the IACC has acknowledged the need to start funding research of the potential environmental causes of autism.”

We know. And this relates to the claim that increased diagnosis of autism has been directly caused by an actual increase in what way?

“As Professor Simon Baron Cohen has stated publicly… …autism (is) likely a result of an interaction of genetic, environmental and biological factors”

We know. So tell us where he said “and the diagnostic increase is explained by increase in the environmental trigger”? Direct reference please.

BTW – here’s a quote from SBC, from the article you link to on your wellsphere page.

“This figure represents an increase over earlier ones but this rise is likely to be due to better diagnosis and awareness of the condition.”

So to recap:
Orac postulates that the diagnostic increase in autism is due (in part) to increases in social and clinical factors, perhaps unrelated to any real increase.

Harold disagrees with Orac because:

his first source (which talks about autism genetics and provides multiple references) mentions looking at environmental factors (with zero references), no mention (except in passing) that these environmental factors are involved in the aetiology of autism to the extent that they have caused the diagnostic increase. So, nothing directly related to Orac’s discussion of Dr Hyman there.

his second source has said the same as Orac except he disagrees a bit about the aetiology of autism. Currently no reference supplied that deals with what Orac actually said.

Is Harold even aware of what the opening post was actually about? If so – why didn’t he stay on topic? Why did he name-drop two sources that have nothing to do with Orac’s criticism of Dr Hyman?

As to his dental health – we did brush his teeth. Also, food rewards of any kind are usually intended only for short term use – typically being replaced by more complex rewards as part of therapy.

Not to put words in your mouth, Tanya, but wouldn’t you say that if the choice is between tooth decay and poor development due to autism, that the choice is pretty obvious?

Honestly, Jen, “don’t do a treatment for autism because it might cause cavities”? Your priorities appear a little mis-guided.

@Jake

That’s a review article. Scientists know that review articles are not original research, and when I as a scientist refer to Dr. Herbert’s publication record I am referring only to original scientific contributions, not review articles. I don’t expect you to know that, but this is the convention among scientists. It’s short hand. Original research articles in peer-reviewed scientific journals count. Review articles and editorials don’t.

My comment stands. Dr. Herbert has done nothing in her research/publication record to support her claims.

A good quality systematic review does not support the use of risperidone with autistics (Jesner et al., 2007). A more recent multi-site RCT involving developmentally disabled adults (including autistics) concludes that anti-psychotics, including risperidone, are not an acceptable treatment for this population (Tyrer et al., 2008).

“Honestly, Jen, “don’t do a treatment for autism because it might cause cavities”? Your priorities appear a little mis-guided.”

That’s not what I said, Pablo, and you know it. There are a myriad of ways that good behaviors can be reinforced without the use of sugary, HFCS-containing coal-tar derivatives. ::eye roll::

@Orac:

Well excuse me for being such a lay-person about all this. Finally, you’ve managed to prove to me that you know something about this topic only other “scientists” would know, that when they refer to their publication record they only mean their research. While you’re at it, why don’t you tell me about the scientist’s secret hand-shake?

As for Dr. Herbert, even if there is nothing in her own research to support her claims, she still bases what she says off of original research, that’s what counts.

“There are a myriad of ways that good behaviors can be reinforced without the use of sugary, HFCS-containing coal-tar derivatives. ::eye roll:”

That’s nice. At the end of the day when parents of autistic children get into bed (that’s only if they are *allowed*, of course) and wonder “Could I have done anything more today to contribute to the therapy needs of my child?” there you will be to pass judgment on the sugar content of praise tools.
Way to be, there, you who obviously knows nothing about raising special needs children.

Well, Risperdal is “Evidence-Based Medicine,” right?

It is indeed. And what the evidence shows is that while risperidone can often alleviate some of the more disruptive symptoms of autism that can be an obstacle to educational and behavioral therapies, it also can produce some significant side effects, including hormonal effects, such that its benefits must be weighed against its risks on an individual basis. So did you have some sort of point, or are you simply belaboring the obvious point that genuinely effective treatments almost always carry some risk of adverse effects?

And no, I’m not Sue.

Are you sure you’re not Sue-ish? You seem Sue-ish to me …

You’re also nearing five exclamation marks, the sign positive of insanity.

Not only are you silly but you are also out of date. Even the IACC has acknowledged the need to start funding research of the potential environmental causes of autism. As Professor Simon Baron Cohen has stated publicly on at least 3 occasions given that in some cases where one identical twin has autism the other does not indicates that autism likely a result of an interaction of genetic, environmental and biological factors.

Actually the twin concordance of autism is remarkably high. While autism is almost always shared by identical twins, the severity may vary. This is suggestive of an environmental influence, but that is not necessarily the case. After all, twins have fingerprints that are similar, but not exactly the same. And even identical twins may have genetic differences–epigenetic differences, differences in distribution of mutant mitochondria within the body, and differences in patterns of X-chromosome inactivation in girls. The latter accounts for variations in severity of Rett Syndrome, which is well established to have a genetic cause. Notably, Rett Syndrome commonly includes autistic-like symptoms, as well as apparent “regression.”

Nevertheless, an environmental influence remains a possibility. But it is hard to know where to start. While vaccines have been pretty clearly eliminated, children and pregnant women are exposed to a huge number of chemicals–pretty much every substance ever made or used by man can be found at some level in the human body. And then there is also the possibility that something like a viral infection could play a role. Perhaps once the genetic basis of autism is better elucidated, we will be in a better position to evaluate the impact of possible environmental factors.

A good quality systematic review does not support the use of risperidone with autistics (Jesner et al., 2007).

Actually, Jesner et al. did not come out definitively for or against risperidone. They state, “Some evidence of the benefits of risperidone in irritability, repetition and social withdrawal were apparent. These must however be considered against the adverse effects, the most prominent being weight gain.” They conclude that “Risperidone can be beneficial in some features of autism,” but that “Further research is necessary to determine the efficacy pf risperidone in clinical practice.”

I’d add that the latter statement applies to all drug treatments commonly used in autism. Risperidone actually has better evidence of efficacy than most.

Jesner et al. (2007) note many major limitations with the included RCTs (which were “few and small”), and write that what benefits there may be (which “must be interpreted cautiously”) have to be considered against important adverse effects.

Jesner et al. (2007) conclude that “carers and clinicians should be aware of the paucity of evidence in administering this drug in such a vulnerable group of people.” And: “it is impossible to evaluate the long term side effects and efficacy of risperidone, and this is particularly important.”

I don’t see statements like “paucity of evidence,” and so on, to be in support of administering risperidone to autistics.

The Hypocrisy!! It Burns!!!:

And no, I’m not Sue.

Then stop emulating her. Perhaps you can seperate yourself from the legacy of Sue M. by posting with some intelligence, and here is a novel idea: evidence and facts. Not the usual fact free string of baseless insults which is a Sue M. trademark.

Because you keep changing your ‘nym, it is convenient to just know you as either Sue M., or just a Sue M. clone.

The hilarious thing is that in Arianna’s article on Van Jones, she states doesn’t allow fringe conspiracy theorist like 9/11 truthers on her website

I see the phrase “wellness expert” and instantly think of the word “toothyologist”.

-A “perceived” failure of a single product? The drug grew breasts on boys, that’s not a “perceived” failure, that IS a failure, and a major one at that.-

It’s not a failure. It’s a side-effect. The difference is obviously too subtle for you.

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