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Tero Toivanen

Common Treatment Ineffective for Autism | Brain Blogger - 0 views

  • The selective serotonin reuptake inhibitors (SSRIs) are among the most widely used drugs for autism treatment, even though the effectiveness to date has been questionable. A new study published in the June issue of Archives of General Psychiatry reports that, not only are SSRIs ineffective, they may actually cause unintended side effects.
  • At the conclusion of the trial, nearly one-third (32.9%) of the patients receiving citalopram showed improvement in symptoms, but this was not significantly different from the 34.2% of patients who showed symptom improvement with placebo. Further, patients receiving citalopram were more likely to experience side effects, including nightmares, increased energy level, impulsiveness, decreased concentration, hyperactivity, diarrhea, insomnia, and dry skin than patients receiving placebo.
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    The selective serotonin reuptake inhibitors (SSRIs) are among the most widely used drugs for autism treatment, even though the effectiveness to date has been questionable. A new study published in the June issue of Archives of General Psychiatry reports that, not only are SSRIs ineffective, they may actually cause unintended side effects.
Tero Toivanen

Why parents swear by ineffective treatments for autism. - By Sydney Spiesel - Slate Mag... - 0 views

  • Since most of the ways we diagnose autism are based on behavior, we can't rely on biological, structural, or chemical findings to determine if a treatment is working. We primarily measure success based on a patient's change, or lack thereof, in behavior.
  • The behavioral changes produced by the few effective treatments make life in social settings (including the home) possible, but we have no idea whether they have any effect on the underlying cause (or causes) of autism or whether they even make severely affected patients feel better.
  • One method intended to help, "facilitated communication," is based on the idea that a sensitive facilitator will hold the hand of a patient over a kind of Ouija board. She will then help the patient respond to questions by sensing his intention and helping guide his hand to spell out answers. Rigorous studies have shown that the spelled-out answers come from the unconscious (or, worse, the conscious) mind of the facilitator. Nonetheless, the practice is still in use, and I know parents who are utterly convinced that it is valid and useful. Frankly, something important did happen when facilitated communication was introduced to my patients: They improved, they brightened, they became more social and more interactive, and they seemed, somehow, happier, even though facilitated communication didn't actually translate their thoughts into words. I'll come back to "why" in a minute.
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  • The techniques of sensory integrative treatment include rubbing or brushing skin (using graded and tactile stimulation), balance exercises, exposure to soft music, and the use of weighted clothes, among other things. Does it work? Most of the research has been of very poor quality, but, in virtually all of the recent studies, sensory integration doesn't seem to be any more beneficial than any other treatment.
  • It looks as if environmental alteration, especially if coupled with increased attention and perhaps expectation, often leads to change in human behavior. It's called the "Hawthorne effect."
  • People respond—mostly favorably—to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
  • Perhaps my patients who became more alive and more interactive after facilitated communication was introduced changed because their families and caretakers were taking them more seriously as people who might have an inner life—people worthy of attention and interaction.
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    People respond-mostly favorably-to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
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