Tag Archives: autism resources in Arizona

Autism Q & A: What about alternative treatments?

By Daniel B. Kessler, M.D.

Are alternative treatments harmful? Well, it depends on your definition of harmful. Here I relate the story of Secretin. Secretin is a hormone that helps to regulate digestive functions. It is also considered a neurotransmitter or chemical messenger, based on animal studies that demonstrate effects on the central nervous system. As a hormone, it exists normally in the body. Synthetic secretin is sometimes given intravenously to treat peptic ulcer and in the evaluation of pancreatic function.

A small, uncontrolled case series (reports of the experiences of three children on the autism spectrum who received synthetic intravenous secretin during a routine endoscopy evaluation for gastrointestinal problems) resulted in the funding of the largest controlled trial of an alternative treatment for autism ever conducted. The initial report noted that within five weeks of the secretin infusion the children experienced “a significant amelioration of” their gastrointestinal symptoms but also a “dramatic improvement in their behavior, manifested by improved eye contact, alertness and expansion of expressive language.” The same results were reported after a second infusion given weeks later.

Extensive media coverage caused parents to scramble to obtain this latest miracle cure for autism in the absence of any data to support its safety or benefit. Clinics were popping up in strip malls and corners where desperate parents paid upwards of $1,500 for infusions of secretin. They pleaded with their congressmen to make this treatment available and covered by insurance.

The federal government sponsored multiple well-controlled studies often comparing the results of secretin with an infusion of saline (salt water solution) as the control or “sugar pill.” Despite the suggestion of early benefits, no study showed significantly greater improvements in measures of language, intelligence, or autistic behaviors when compared to study participants who received saline. Both groups showed some improvement. There was simply no evidence that secretin worked as a treatment for autism.

The controversy continues with some individuals recommending oral forms of secretin and transdermal secretin. You simply cannot convince someone of something they don’t want to be convinced about. These parents are in many cases spending time, effort and a great deal of money to provide an unproven treatment for their child. They are not pursuing treatments that are more likely to provide benefit.

You may have guessed that I am not a big fan of alternative (often called biological) treatments for autism. Most have not been studied to the degree that secretin was. Those that have been studied have produced results that are just as disappointing. Most of these biological treatments are based on theories of autism that have yet to be proven. These theories are then used to “develop” treatments without scientific rigor. They deserve to be studied in a rigorous, scientific way and some of that work is being sponsored by the Autism Treatment Network. Until that work is done and results are known, it is unlikely that I will recommend those treatments to any family, but there is no shortage of families and doctors that will.

Next: Is autism really increasing? 

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

The views he expresses in this series are based on his training, his reading of the literature and his more than 30 years of experience taking care of hundreds of kids on the autism spectrum. The series begins here.

Autism Q & A: What are the side effects of medications used to treat autism symptoms?

By Daniel B. Kessler

I tell parents that you can see any side effect from any medication at any time.  Maybe your child has just started to take a new medication, or it has been several weeks since he or she started it. Maybe the dosage has recently increased.

Whatever reaction, response or side effect you are seeing in your child could be from that medication, or not.  If you are concerned, ask the provider who prescribed it and you should have access to someone who can answer that question for you.

Every medication has its own side effects profile and this information should be given to you. If it is not, ask for it. The general categories of side effects may include physical responses (weight gain, rashes, stomach difficulties, changes in blood pressure), behavioral reactions (hyperactivity, irritability, aggression, sleepiness or trouble sleeping), emotional overreactions (meltdowns, crying, agitation), unusual sensations (visual hallucinations) or unusual movements like tics or dystonia, a neurological movement disorder that causes twisting and repetitive movements or abnormal postures.

This can be confusing because some of these side effects  are just like the behaviors that are being treated!

Whenever you suspect a response may be a side effect related to a medication, you should consider whether or not there are other symptoms or behaviors that suggest another underlying cause, like seasonal or contact allergies to something else in the child’s environment. You may need to have your child seen by his or her primary care provider (or in an ER) if the reactions are confusing or potentially dangerous (such as a seizure).  Document what is going on so that when you report the side effect to your medical provider you can  explain when it started in relation to when the medication started, what time of day the reaction started in relation to when the medication was given, how long the reaction lasted (or is it ongoing) and what helped alleviate it.

Next: What about alternative treatments? 

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

The views he expresses in this series are based on his training, his reading of the literature and his more than 30 years of experience taking care of hundreds of kids on the autism spectrum. The series begins here.