Sunday, August 10, 2014

The miraculous 9 percent--and the autism "miracle cures" they inspire

In an article in last week's New York Times Magazine entitled The Kids who Beat Autism, Ruth Padawer reports on research suggesting that a significant subset of kids diagnosed with autism eventually no longer meet the diagnostic criteria.

To those who buy into the various autism miracle cure stories--with cures ranging from psychotherapeutic (Bettelheim's fortress rescue, Greenspan's Floor Time) to behaviorist (Applied Behavioral Analysis; "rapid prompting") to culinary (gluten-free diets) to chemical (chelation) to auditory (auditory integration therapy) to tactile (hugging therapy) to mammalian (riding on horses; swimming with dolphins)--this may be no surprise.

But I once asked a clinician at our local autism center whether they'd ever seen a child lose his or her diagnosis, and she replied that, out of the 98 children they'd seen thus far, only two had possibly outgrown the diagnosis, and, in one of the cases, it wasn't clear whether the child had truly met the criteria in the first place.

The article cites two studies cited, one of which was a retrospective study that examined the early medical files of 34 kids who don't currently meet the criteria for autism to verify that they did, in fact, once do so. But retrospective studies aren't random, and rely on past records that can no longer be independently verified. More compelling is the second study, a prospective one

that tracked 85 children from their autism diagnosis (at age 2) for nearly two decades and found that about 9 percent of them no longer met the criteria for the disorder.
This is the extent of the article's interesting revelations. What causes this recovery--or exactly which children will recover--remains unknown. What is known is that the recovered kids, along with those who stay autistic but make the most overall progress, tend to have higher IQs and to engage in more socially imitative behaviors to begin with. But this is neither news nor surprising.

I've long suspected that, to the extent that there were kids who fully recovered from autism, these were kids who would probably have recovered regardless of what specific therapy they underwent. Just as autism involves a neuro-developmental program that unfolds in the course of brain development, so, too, may be the case with autism recovery. In certain kids, it may be preprogrammed, at least to some extent, in their brain development.

Of course, rigorous therapies may also play key role. But it's hard to know just how much we should credit the particular therapy that a recovered child happened to be undergoing while he or she was simultaneously undergoing recovery.

Indeed, the existence of this mysterious 9 percent may explain the persistence of autism miracle cures. Every once in a while, someone in this group happens to have parents who happen upon one of the latest untested therapies, and, as a result, whatever this therapy happens to be--whether it's oxytocin inhalers or eye saccade training or barefoot heel walking or interactive labyrinths--will inspire screaming headlines, best-selling memoirs, and tons of airtime on daytime talk shows.

1 comment:

TerriW said...

This sounds like the old saw that it's always the fifth phonics program you try with your son that works wonders.