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Tuesday, February 15, 2011

Autism and Alternative Treatments

APA Dr. Donald Oswald, a renowned scholar in autism spectrum disorders, reviewed The Horse Boy, a film about a family who takes extensive measures to identify an alternative treatment for their son's autism. Oswald reviews the literature on complementary/alternative treatments for autism, including the use of animals in treatment (e.g., horses, dolphins, dogs), and he explores the issues parents confront as they search for miracles: "Faced with parents' desperate inclination to try any new intervention that is promulgated on TV or the Internet, clinicians are frequently called upon to take some stance."

As a clinician, have you had to take a stand in favor of or against a controversial treatment suggested by one of your clients? How did you approach the situation with your client?

Autism in particular has received significant media attention over the last decade. One of the issues raised and recently debunked has been the idea that vaccinations cause autism. How much of an impact do the media have on important decisions parents will make for their children? How might parents best balance contradictions from what they hear in the media and what health professionals say? What role do you, as a psychologist, have to play in this?

Read the Review
ReviewHorses and Autism
By Donald Oswald
      PsycCRITIQUES, 2011 Vol 56(6)


Townley Peters

Where do we draw the line?

There are many movies, such as Extraordinary Measures, books, and stories about parents who literally risk everything in order to find a cure for a suffering child. The movie the 'Horse Boy' appears to be no different, parents of an autistic boy go as far as Mongolia in search of The alternative treatment that is going to cure their son. A movie such as this, leaves me wondering where one draws the line.

As clinicians do we fault the parent that resorts to controversial therapies and/or treatments in search of a miracle? Or do we take the stance that our job is to protect the child, and thus oppose any treatment or cure that is not founded in scientific proof? Could one not argue that all of our present day treatments, lacked scientific evidence at one time or another?

mikako moriyasu@alliant international university

The problem that I see in this movie as with so many others like this, is that the media do not have any responsibility--or appear not to have any. The media just tell us the story and the story changes depending on what the media thinks we are interested in simply so that they can sell their product (as was made clear to me by the fact that the father was paid a million dollars in advance to go on this journey)! Like Dr. Oswald mentioned, how much of the father's desire was due to the money.

I don't think the father necessarily lied, but we don't know whether it is really effective or not in that population. That's why we use scientific method to prove that things are effective or not--not a media production that is the "hot treatment of the day."

Jeannemarie Leone @ Alliant International University

This review poses many great questions to clinicians and clinicians-in-training. Townley's statement about, "Where do we draw the line?" is a huge issue faced by clinicians, and I'd suffice to say, parents alike. For those of us who have not been diagnosed with autism, where do we draw the line in attempting to alleviate symptoms of our own ailments? I'm sure we've all tried OTC products and some sort of traditional herbal medicine at one time or another with the hope that we would be able to obtain some sense of relief. Sooner or later we begin to realize that these products either do or do not alleviate symptoms, but traveling to foreign countries in the hope of eradicating an illness (based on practices that have no scientific evidence) seems beyond farfetched. And perhaps, the most important question is how do we treat and advocate for clients who are in such strong support of CAM methods despite their lack of proven success?

Meg Stein

Parents traveling as far as Mongolia for an alternative treatment to cure their son's autism? It does not surprise or shock me one bit. When parents are faced with the reality that their child has autism it may feel as though the ground has come out from under them. My older brother has autism and for as long as I can remember I have seen my mother work tirelessly for him. She poured all of her resources, money, time, and energy into making sure my brother was receiving the best care and treatment possible. My mother is not uncommon in her behaviors as I witnessed countless parents like my own pour their everything into their children with autism at the school which I worked after graduating from undergrad. Where to draw the line is the question and I don't pretend to have the answer. I have seen numerous alternative treatments to autism used with poor results, leading to disheartened caregivers losing hope. What is our role, as a clinician, in these scenarios? At what point, for example, do I tell the eager and excited parents of a child with autism that the likelihood of facilitated communication being the answer are slim to none? I have been faced with this dilemma and I remained silent. What would you have done?

julia rosholt

The review of The Horse Boy came across as an example of parents that are desperate for hope will do anything to find a solution. I have not had the opportunity to be a clinician who takes a stand on a controversial treatment; however, I am sure that day will come.

I have a deep concern as to how alternative treatments are portrayed in the media. For the most part, media is biased and presented in a way that will attract ratings and not provide an accurate picture for potential consumers. I have seen countless documentaries where desperate parents will follow anyone's advice because they offer hope. Scientifically supported or not. It is the psychologist’s role to present the facts of treatment and be honest about the potential risks and benefits.

Jacqueline Nguyen

While I worked on a large autism research study, I was daily faced with the question of what my role was in providing recommendations/suggestions to parents of children with autism in regards to treatment/therapy options. This was further complicated by my role as a researcher- my role was solely to collect data. This was extremely difficult for me especially when parents reported enrolling their children in therapies which I was aware had been shown to be ineffective. I was limited in the guidance I was able to provide, but I learned to make referrals to clinicians who would be able to provide recommendations.

Parents are eager to try all types of treatments, even those recommended by less reliable resources... it was difficult to convince parents of the findings supported by studies if they were not in line with what they had heard before. This being said, interventions have been shown to be more effective when people believe they are going to work. Perhaps we should not be too quick to take away the hope parents have in these interventions. After all, there is no way to tell which intervention(s) will be effective for a child.

Yzah Jelle Ruiz

Treatment for autism depends on how it was developed. Some children develop autism when their moms ingested a strong drug during their first trimester. If that's the case, you should hire an autism attorney and sue your doctor for prescribing that drug.

Felix C

Thanks for Dr. Oswald's review that raises my concerns on the impact of media to general parents of Autistic Children. I was a practioner in Hong Kong to work with Autistic children and their families before, parents would always ask for my comments about the "new" treatment methods to cure Autism that were reported by the media. The "new" treatment methods included the use of a mixture of Chinese herbal medicine and "Qiqong". Although there are no empirical research showing that these methods are effective, parents would still go for a try to exchange for a hope of eradicating the illness. However, not all kinds of herbal are good for children, while some might impose negative effects on their health. It seems parents from all culture would act similarly, it's a question on how should the clinicians to educate the public with the knowledge to filter message from the media.

Cherry Lau

Autism is one of the difficult lifelong disorder from infancy till adulthood, and it is not surprising that parents of children with Autism would willing to try every single potential treatment hoping to "cure" the disorder, as it could be a day-long torture for parents in just taking care of them. In Hong Kong, parents are frustrated not only by the diagnosis, but they are also frustrated by the services that they could get from the government. Although the knowledge of Autism is increasing, there are still many people not understanding it, and even teacher, who I've heard one called an Autistic child madness in front of the whole class, which makes the frustration and stress of parents increase.
An Autistic child could receive tongue acupuncture therapy, speech therapy, occupational therapy, music therapy, cognitive training, to name a few, in 1 or 2 days. They all do a part in the progress of the child, and thus the parents could hardly give any up.
However, for me, parents are always the best trainer or educator for the child, who could provide the most effective treatment for the child. Thus, a transdiscipinary and systematic education method from different professions is needed, so that the parents could have a more concrete idea on what to do instead of trying different things that may not only waste money but time.

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Editor of PsycCRITIQUES

Danny Wedding, PhD

Chair of Behavioral Sciences,
College of Medicine,
American University of Antigua

Associate Editors of PsycCRITIQUES

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