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IMFAR 2012 begins

17 May

The International Meeting for Autism Research (IMFAR) started on Wednesday with a press conference and a pre-conference program focused on stakeholders. I was fortunate to be able to attend last year, but not this year. I did call in to the press conference, though and it brought back some of the excitement for me.

Before going on, note that the press conference is covered at the Thinking Person’s Guide to Autism (by people who actually attended!) as IMFAR 2012 Press Conference

The press conference highlights a number of studies which are about to be presented at the conference. It was stressed that IMFAR is a conference where the abstracts are reviewed before being approved, but the studies are not peer-reviewed as in a journal. It is a conference for very new results.

One study highlighted was Beyond ASD: Developmental Outcomes of High Risk Siblings. This is a follow on study to the well publicized baby siblings study that found about 19% recurrence risk for baby siblings of autistic children. This is the study that looks at the other 81%, the kids who did not get an autism diagnosis. Short answer–even among the children who did not get an autism diagnosis, the baby siblings had more autistic traits than children who were not baby siblings of autistics.

Here’s the conclusion from the abstract:

Conclusions: At three years, HR [high Risk]children without an ASD had higher levels of ADOS symptom severity, and lower levels of developmental functioning than LR [Low Risk]children. They were more likely to occupy clusters characterized by lower levels of developmental functioning, and less likely to occupy a cluster characterized by higher levels of developmental functioning and low levels of symptom severity. Descriptively, two-thirds of HR children occupied Clusters 1 and 2, characterized by normative outcomes, whereas one third occupied Clusters 3, 4, and 5, characterized by elevated ADOS severity, lower developmental quotients, or both. These results suggest an early ‘broader autism phenotype’ in HR siblings characterized by ASD symptoms sub-threshold for diagnosis and/or developmental delays.

and the summary:

A new study presented at the International Meeting for Autism Research examined the development of the younger siblings of children with an Autism Spectrum Disorder (ASD). ASDs are developmental conditions characterized by problems with interaction, communication and repetitive behaviors. Previously, an international consortium of researchers found that almost one in five of the younger siblings of children with an ASD themselves developed an ASD. The researchers’ new findings suggest that of the younger siblings who did not develop an ASD, one in three faces challenges at three years of age.

The challenges faced by these younger siblings of children with ASD include slight delays in verbal and nonverbal functioning and somewhat elevated levels of autism-related characteristics. Examples of a child’s autism-related characteristics—which are not as severe as those of children with an ASD—include lower levels of back-and-forth play with others, and lower levels of pointing to express interest in what is going on around them. Overall, the researchers say, the majority of high-risk siblings are developing typically at three years of age, but a minority face challenges that appear to reflect subtler forms of ASD-related problems. Follow-up of these children through school age is necessary to understand their long-term outcomes.

The second study highlighted was Shared Decision Making (SDM) and the Treatment of Autism Spectrum Disorders (ASDs). My guess is that the themes presented in the summary below will not come as a great surprise to those who have read parent narratives on the internet. I.e. that parents look to pediatricians for treatment options for their autistic kids, but the doctors often don’t see autism treatment to be something they can do.

The goal of this qualitative study was to describe factors influencing shared decision making for treatment decisions by pediatricians and parents of children with autism spectrum disorders (ASD). We conducted in-depth interviews of 20 pediatricians and 20 parents of children with ASD 2-5 years of age. The analysis of the interview transcripts revealed that many pediatricians did not view treatment for autism spectrum disorders to be within their scope of practice or competence. Parents did not view their pediatrician as knowledgeable or invested in making treatment recommendations. We also found that parents often independently pursue treatments, not benefiting from professional guidance regarding safety and effectiveness. Results from this study indicate substantial barriers to shared decision making between pediatricians and families in the care of autism. Research is needed in order to understand how best to help 1) parents have realistic expectations of their pediatrician and 2) improve training of pediatricians to be effective partners in care of children with ASDs and their families

The third highlighted study was Oxytocin’s Impact on Social Cognitive Brain Function in Youth with ASD. The study member who presented this for the study called it “very exciting and very preliminary”. Two features of this study stand out immediately: (1) it is a double-blind, crossover, randomized control study and (2) it includes fMRI (functional magnetic resonance imaging).

Here is the summary:

We are presenting the preliminary data from the first ever double blind, placebo controlled study of changes in brain activity in children with an ASD (ages 7-18) after a single dose of oxytocin. The initial results indicate that oxytocin, administered via nasal spray prior to the scan, increased activity in brain regions known to process social information. Oxytocin is a naturally occurring substance that is produced in the brain and plays a role in regulating social abilities.

These results provide the first, critical steps towards devising more effective treatments for the core social deficits in autism which may involve a combination of validated clinical interventions with an administration of oxytocin. Such a treatment approach will fundamentally alter for the better our understanding of autism and its treatment.

There were two more studies highlighted at the press conference but, I’m sorry to say, I was not able to listen to those presentations.

Measuring Interactive Developmental Pathways in ASD: A Dual-Domain Latent Growth Curve Model Symptoms, Diagnosis & Phenotype – Cognition & Behavior: Early ASD

As children with autism spectrum disorders (ASD) grow up, they embark on quite different developmental pathways. Some individuals learn to live independently, maintain friendships, and find work, many require some support in their daily lives, and still others experience many challenges. Understanding how very young children with ASD develop important early skills can provide vital clues that might help predict these various pathways. For example, researchers have suggested that greater social interest and awareness in children with ASD may have a positive impact on language, which in turn may have a positive influence on other aspects of learning and development. This model of “cascading” effects is intuitively appealing but has not been validated in ASD. The Canadian “Pathways in ASD” Study (funded by CIHR and other provincial governments and foundations) is uniquely able to shed light on this issue as it is the largest prospective follow-up study of very young children with this disorder. As part of this study, we used information about 365 2-to-4-year-olds with ASD to examine whether such cascades occurred across early social competence and language abilities in the year after diagnosis. On average, the children made significant progress in social competence and remarkable gains in language abilities over that year. Within this one-year period, greater change in social competence in the first year was associated with more growth in language skills. However the reverse wasn’t true: early language ability had a much smaller effect on changes in children’s social competence. These findings therefore support the idea of early developmental cascade effects. Early advantages and gains in social competence may lead to advantages in other domains. However, children whose very early social skills lag farther behind at time of diagnosis are also less likely to show language progress. This study highlights the importance of early interventions that focus on emerging social competence (versus only language skills), as these are likely to “spill over” across other developmental pathways.

and

Head Lag in Infants At Risk for Autism

This new prospective study of six-month-old infants at high genetic risk for autism identified weak head and neck control as a red flag for autism spectrum disorder (ASD) and language and/or social developmental delays. Researchers at the Kennedy Krieger Institute concluded that a simple “pull-to-sit” task could be added to existing developmental screenings at pediatric well visits to improve early detection of developmental delays.

While previous studies have shown that head lag indicates developmental delays in children with cerebral palsy and preterm infants, postural control in infants at risk for ASD had not been examined. In this research, Dr. Landa and her team assessed infants in a “pull-to-sit” task, a simple measure of postural control in infants. The findings suggest that motor delays may have an important impact on child development.

Four of the editors from The Thinking Person’s Guide to Autism are at IMFAR this year. Their post on the press conference is already up: IMFAR 2012 Press Conference

Prevalence of autistic spectrum disorders in Tripoli, Libya: the need for more research and planned services.

15 May

Autism prevalence studies are being performed in more and more locations around the globe. It’s somewhat amazing how little is known about autism prevalence outside of Europe and the U.S.. There are data from Japan and data has been coming in from Australia and elsewhere. There is very little data from Africa. Prevalence of autistic spectrum disorders in Tripoli, Libya: the need for more research and planned services.

Data on autism are lacking for Libya. We conducted a hospital-based study in the Neurodevelopment Clinic of AI-Khadra Hospital in Tripoli to estimate the prevalence of autistic spectrum disorders in children attending the clinic. All children referred to the clinic between 2005 and 2009 with a diagnosis of speech and language disorders or behavioural difficulties were assessed. There were 38 508 children in total seen during 2005-09,180 of whom had a history of delayed speech and language and/or behavioural difficulties. Of the 180, 128 children were diagnosed with autistic spectrum disorder: 99 had classical autism, giving the prevalence of about 4 in 1000. The male:female ratio for autistic spectrum disorders was 4:1 and for autism was 4.5:1. The most common age at presentation was 2-5 years (58%) and 56% presented 6-18 months after the onset of symptoms. Physicians should consider autism in the differential diagnosis of any child presenting with a speech and language disorder and/or behavioural difficulties.

The study population is biased, being taken from children referred to a hospital. On top of that, they limit themselves to children with a history of speech and language delay and/or behavior difficulties. A lot of kids could fall through the net on this, but it is still great to see the effort being made to get information on autism prevalence in Libya.

For those who may wonder, 128 out of 38,508 is a prevalence of 0.33%, or about 1 in 300.

On the topic of autism in Africa, there is a recent paper by Richard Grinker (author of Unstrange Minds), “Communities” in Community Engagement: Lessons Learned From Autism Research in South Korea and South Africa, which I hope to review soon.

Postsecondary education and employment among youth with an autism spectrum disorder

14 May

Prof. Paull Shattuck’s group from Washington University in St. Louis has published a study in the journal Pediatrics today entitled Postsecondary education and employment among youth with an autism spectrum disorder. The full study is available free on the Pediatrics website.

Prof. Shattuck’s group presented results on autistic adults and the transition from school to adulthood previously. At IMFAR last year they presented The Role of Parental Expectations In Predicting Post-High School Outcomes for Youth with ASD and a paper in Archives of Pediatric and Adolescent Medicine discussing how autistic young adults miss out on much-needed services. Prof. Shattuck presented to the IACC in September of last year.

This sort of work is extremely important and, yet, little attention has been placed on issues surrounding autistic adults and the transition from the school programs.

The abstract is below for the present study is below.

Objectives: We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD).

Methods: Data were from a nationally representative survey of parents, guardians and young adults with an ASD. Participation in postsecondary employment, college or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in three other eligibility categories – speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome.

Results: For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first six years after high school. Over 50% of youth who had left high school in the past two years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared to youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education.

Conclusions: Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first two years after high school. Those from lower income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning prior to high school exit can facilitate a better connection to productive postsecondary activities.

Here is the press release from Washington University in St. Louis:

Youth with autism face barriers to employment and education after high school
Rate of disconnection from work and school higher for low-income young adults

Compared with youth with other disabilities, young adults with autism spectrum disorders (ASD) face a disproportionately difficult time navigating work and educational opportunities after high school, finds a new study by Paul Shattuck, PhD, assistant professor at the Brown School at Washington University in St. Louis.

“Thirty-five percent of the youth with ASDs had no engagement with employment or education in the first six years after high school,” Shattuck says.

“Rates of involvement in all employment and education were lower for those with lower income.”

The study, published in the current issue of the journal Pediatrics, examined data from the National Longitudinal Transition Study 2 (NLTS2), a nine-year study of adolescents who were enrolled in special education at the outset. The NLTS2 included groups of adolescents with ASDs, learning disabilities, intellectual disabilities and speech and language impairments.

“Compared with youth in the three other disability categories, those with an ASD had significantly lower rates of employment and the highest overall rates of no participation in any work or education whatsoever,” Shattuck says.

“Those with an ASD had a greater than 50-percent chance of being unemployed and disengaged from higher education for the first two years after high school.”

https://www.youtube.com/v/Qyl2ZQRb4ds?version=3&feature=player_embedded

Shattuck notes that approximately 50,000 youth with ASDs will turn 18 this year in the United States.

“Many families with children with autism describe turning 18 as falling off a cliff because of the lack of services for adults with ASDs,” he says.

“The years immediately after high school are key. They are the time when people create an important foundation for the rest of their lives.

“There needs to be further research into services for young adults with ASDs to help them make the transition into adulthood and employment or further education.”

Shattuck says that particular attention should be paid to interventions that will help poorer youth overcome barriers to accessing services and achieving fuller participation in society.

This study was funded by the Organization for Autism Research, Autism Speaks and the National Institute of Mental health.

Shattuck’s study co-authors are Sarah Carter Narendorf, Benjamin Cooper and Paul Sterzing of the Brown School; Mary Wagner, PhD, of SRI International; and Julie Lounds Taylor, PhD, of Vanderbilt University.

Shattuck will give a keynote presentation on his research at the International Meeting for Autism Research in Toronto on May 16, 2012.

Autism Criteria Critics Blasted by DSM-5 Leader

10 May

Remember how some comments in a scientific talk about the DSM 5 in Iceland was picked up by the New York Times, leading to a media and advocate firestorm of activity? The Times article was New Definition of Autism Will Exclude Many, Study Suggests.

Medpagetoday.com has another chapter in this story: Autism Criteria Critics Blasted by DSM-5 Leader. The term “blasted” doesn’t strike this reader as helping to bring some order to the discussion. The new article reports on a talk by Sue Swedo, who is a member of the DSM 5 committee. The New York Times article was focused on a talk by Fred Volkmar, who was a member of the DSM 5 committee but has since left.

PHILADELPHIA — The head of the American Psychiatric Association committee rewriting the diagnostic criteria for autism spectrum disorders took on the panel’s critics here, accusing them of bad science.

Susan Swedo, MD, of the National Institute of Mental Health, said a review released earlier this year by Yale University researchers was seriously flawed. That review triggered a wave of headlines indicating that large numbers of autism spectrum patients could lose their diagnoses and hence access to services.

Prof. Volkmar’s group analyzed data from 1993, when the DSM-IV was in development, and presents results claiming that a large fraction of autistics would not be identified under the DSM 5. Sue Swedo is quoted as responding in her talk:

Swedo said the Yale group misused the 1993 field trial data because it was inappropriate to take clinical evaluations structured a certain way to evaluate the DSM-IV criteria against DSM-III, and use them to determine how the DSM-5 criteria would perform.

“It was not just comparing apples and oranges, it was comparing apples with Apple computers,” she argued. “We [in DSM-5] were using words that hadn’t really been used in DSM-IV.”

In my opinion the main goal of the DSM 5 should be accuracy. Sue Swedo says that the field trials indicate that it is accurate, and suggests that the prevalence will not be dramatically changed with these criteria:

She pointed to the new field trial data from DSM-5 as justifying the work group’s decisions. The criteria showed excellent reliability — that is, different clinicians evaluating the same child usually came to the same diagnoses, with intraclass kappa values of 0.66 and 0.72 at the two academic centers where the criteria were tested.

Moreover, when the clinicians applied DSM-IV and DSM-5 criteria to the nearly 300 children included in the trial, the autism spectrum prevalence was not changed much.

I’m sure this isn’t the end of the discussion. One can hope that the discussion can be more data and fact driven than it has been in the recent past.

Services for adults with an autism spectrum disorder

7 May

Paul Shattuck is one of those people I greatly admire. He and his group ask important questions in areas which are generally given low levels of attention. Regular readers to Left Brain/Right Brain will (I hope) recognize that improving the research base for knowledge about autistic adults is a high priority of mine. I can’t say as I was exactly pleased to see the abstract below, as it points out the lack of knowledge that we have. But I was pleased to see this topic highlighted. The study (which I have not seen in full yet) is Services for adults with an autism spectrum disorder.

The need for useful evidence about services is increasing as larger numbers of children identified with an autism spectrum disorder (ASD) age toward adulthood. The objective of this review was to characterize the topical and methodological aspects of research on services for supporting success in work, education, and social participation among adults with an ASD and to propose recommendations for moving this area of research forward. We reviewed the literature published in English from 2000 to 2010 and found that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Extant research does not reflect the demographic or impairment heterogeneity of the population, the range of services that adults with autism require to function with purposeful lives in the community, and the need for coordination across service systems and sectors. Future studies must examine issues related to cost and efficiency, given the broader sociopolitical and economic context of service provision. Further, future research needs to consider how demographic and impairment heterogeneity have implications for building an evidence base that will have greater external validity.

It is amazing that after a decade of intense focus on autism research, we know so little. I greatly appreciate Prof. Shattuck’s team taking the time to review the literature. It’s time to put some major effort into filling in these knowledge gaps.

Parental socioeconomic status and risk of offspring autism spectrum disorders in a Swedish population-based study.

2 May

In many autism prevalence studies, higher socio-economic status (SES) for the parents is correlated with higher autism rates in the children of those families. While a conclusive reason for this has not been shown, it has been conjectured that the SES variability could be due to social influences such as access to care.

A recent study from Sweden shows the opposite. In this study, lower income families and children of parents with manual occupations show higher autism prevalence:

OBJECTIVE:
Epidemiological studies in the United States consistently find autism spectrum disorders (ASD) to be overrepresented in high socioeconomic status (SES) families. These findings starkly contrast with SES gradients of many health conditions, and may result from SES inequalities in access to services. We hypothesized that prenatal measures of low, not high, parental SES would be associated with an increased risk of offspring ASD, once biases in case ascertainment are minimized.

METHOD:
We tested this hypothesis in a population-based study in Sweden, a country that has free universal healthcare, routine screening for developmental problems, and thorough protocols for diagnoses of ASD. In a case-control study nested in a total population cohort of children aged 0 to 17 years living in Stockholm County between 2001 and 2007 (N = 589,114), we matched ASD cases (n = 4,709) by age and sex to 10 randomly selected controls. We retrieved parental SES measures collected at time of birth by record linkage.

RESULTS:
Children of families with lower income, and of parents with manual occupations (OR = 1.4, 95% CI = 1.3-1.6) were at higher risk of ASD. No important relationships with parental education were observed. These associations were present after accounting for parental ages, migration status, parity, psychiatric service use, maternal smoking during pregnancy, and birth characteristics; and regardless of comorbid intellectual disability.

CONCLUSIONS:
Lower, not higher, socioeconomic status was associated with an increased risk of ASD. Studies finding the opposite may be underestimating the burden of ASD in lower SES groups.

I haven’t been able to view the full study yet, so I am not sure what influences the authors may be implicated. What they do suggest is that the autism prevalence in lower SES groups may be underestimated in many prevalence estimates. I don’t think this will come as a surprise to many who consider the lower prevalence in the lower SES groups to be an indication of social factors at play.

Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias.

27 Apr

I had hoped to read this article and have a good review in place when the embargo lifted. Time is working against me and I just haven’t had the resources to apply to this. But I shouldn’t let that stop me from highlighting this study: Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias. The full paper is available free on the Pediatrics website.

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used most often to treat depression. They are also used off-label for treating anxiety and, also, autism symptoms. A study carried out in 2009 showed that one drug frequently prescribed to autistics, Citalopram, was no different than placebo in reducing repetitive behaviors (Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism.) The study results came as a bit of a surprise to many and was a minor news story for that week.

Publication bias “is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive (i.e. showing a significant finding) differently from results that are negative (i.e. supporting the null hypothesis) or inconclusive, leading to bias in the overall published literature.”

A recent study looked at previous publications (and one unpublished study) and claims that there is publication bias involved in reporting on SSRI’s and repetitive behaviors in autism:

OBJECTIVE:
The goal of this study was to examine the efficacy of serotonin receptor inhibitors (SRIs) for the treatment of repetitive behaviors in autism spectrum disorders (ASD).
METHODS:
Two reviewers searched PubMed and Clinicaltrials.gov for randomized, double-blind, placebo-controlled trials evaluating the efficacy of SRIs for repetitive behaviors in ASD. Our primary outcome was mean improvement in ratings scales of repetitive behavior. Publication bias was assessed by using a funnel plot, the Egger’s test, and a meta-regression of sample size and effect size.
RESULTS:
Our search identified 5 published and 5 unpublished but completed trials eligible for meta-analysis. Meta-analysis of 5 published and 1 unpublished trial (which provided data) demonstrated a small but significant effect of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.22 [95% confidence interval: 0.07-0.37], z score = 2.87, P < .005). There was significant evidence of publication bias in all analyses. When Duval and Tweedie's trim and fill method was used to adjust for the effect of publication bias, there was no longer a significant benefit of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.12 [95% confidence interval: -0.02 to 0.27]). Secondary analyses demonstrated no significant effect of type of medication, patient age, method of analysis, trial design, or trial duration on reported SRI efficacy.
CONCLUSIONS:
Meta-analysis of the published literature suggests a small but significant effect of SRI in the treatment of repetitive behaviors in ASD. This effect may be attributable to selective publication of trial results. Without timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications.

Autism Science Foundation to host online chat with Jill Locke tomorrow (Friday)

26 Apr

Jill Locke is a researcher (a post-doc) at the Center for Autism Research at the U. Pennsylvania. Here is her biography from the CAR website:

Dr. Locke is a post-doctoral research fellow at the Center for Autism Research. She completed her doctorate degree in Educational Psychology at the University of California, Los Angeles. Jill worked with Dr. Connie Kasari at the UCLA Center for Autism Research and Treatment where she contributed to multiple randomized controlled treatment trials that examined the effects of targeted social skills interventions on the peer relationships and social networks of elementary-aged children with autism in the Los Angeles public schools. She created a social skills assessment tool using the Q-Sort methodology for her dissertation that investigated the differences in teachers’ and classroom aides’ perceptions of social competence in children with and without autism spectrum disorders as well as how these perceptions related to teacher-student and peer relationships.

Jill’s research interests are in social skills training and friendship/relationship development in children and adolescents with autism. She is also interested in exploring the ways in which treatment gains in intervention programs are generalized and sustained over time as well as the delivery to and sustainability of evidence-based practices in community settings.

She will be participating in a live chat on the Autism Science Foundation’s Facebook page tomorrow (Friday, April 27) at 12 noon Eastern time.

If you want an idea of what these online chats look like, transcripts are online for last week’s chat with Stephen Shore, Marcus Center Autism Research Dr. Celine Saulnier, and Yale Autism Scientist Dr. Kevin Pelphrey.

Todd W., running for a good cause

26 Apr

Todd W. of Harpocrates Speaks is a frequent author of articles and commenter in online discussions involving questions of vaccines and vaccines and autism.

In his article, Help Me, Interwebz! You’re My Only Hope!, he tells us that he is participating in a run to raise money for medical research. In specific, he’s helping to raise money for a new type of vaccine adjuvant:

The VIC is researching the use of a laser as a vaccine adjuvant. Basically, adjuvants allow vaccines to use fewer antigens by increasing the body’s immune response. In the U.S., we use aluminum salts (e.g., aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate) as adjuvants. Because there are some individuals who question the safety of these adjuvants (largely based on false information), the laser adjuvant may induce a similar boosted immune response without the concerns associated with aluminum. It also has the potential to reduce even the current minor side effects associated with aluminum adjuvants, like local soreness and swelling. The VIC researchers have completed animal studies and are ready to move on to human trials. Although the initial research focuses on influenza and hepatitis B vaccines, there is potential for this technology to be applied to a much wider range of vaccines. In the end, this could hopefully make for more effective and safer vaccines, as well as improve overall immunization rates among those worried about ingredients like aluminum.

Todd W. has details on how to contribute in his article, but if you want the short version:

You can be a part of this innovative research by supporting my flight through the zombie-infested wilderness of Amesbury by going to this page and making a donation. If you would rather make a gift by mail, make your check payable to:

Massachusetts General Hospital
Development Office
165 Cambridge Street, Suite 600
Boston, MA 02114

Make sure to put “Todd’s Zombie Run” in the memo line or in a note with your donation. All gifts will go to support these two projects and are 100% tax deductible.

The Geier story on testosterone shifts again

19 Apr

When Mark and David Geier first proposed using Lupron on autistic children, it was supposedly to help remove mercury from the brain. Their theory was that mercury and testosterone bound together in the brain and that this prevented chelators from being able to remove the mercury. They first approached the Rev. Lisa Sykes, whose son was one of their patients, with the idea. You can hear her discuss that encounter here.

The blurb for that video was:

The Reverend Lisa Sykes is the mother of a recovering autistic boy (Wesley) and an ordained minister, currently serving as Pastor for the Christ United Methodist Church in Richmond, Virginia. In this interview, Rev. Sykes discusses how she came to having her son treated using the Geiers’ “lupron” protocol to more effectively remove heavy metals by first lowering Wesley’s abnormally high testosterone levels.

In the video, Rev. Sykes quotes David Geier (Mark Geier’s non-doctor son and partner in his clinic and research) in the video as saying:

“Do you know, we’ve figured something out!”

“We think we can get rid of the mercury by lowering the testosterone”

As the Geiers and the Rev. Sykes have been major proponents of the failed mercury causation idea, this is not surprising.

The science behind the idea was bad. To the point of laughable, if it weren’t for the danger posed to disabled children.

Mr. Geier has since had his license to practice medicine suspended, in large part due his “Lupron protocol” and the way he misdiagnosed children with “precocious puberty” in order to prescribe Lupron.

The Geiers and Rev. Sykes have a new paper out: “An evaluation of the role and treatment of elevated male hormones in autism spectrum disorders.”

The word “mercury” doesn’t appear in the main body of the paper at all. Just in a citation to one of the Geier team early papers. But they do conclude:

Anti-androgen therapy should be considered as an effective means to significantly help improve clinical features of patients diagnosed with an ASD.

The paper was published in Acta Neurobiol Exp, a journal by the Neuroscience Society. The journal has an editor who is a proponent of the idea that vaccines cause autism and has a history of publishing low quality papers promoting the idea.

Frankly, I see this as an attempt by the Geiers to create a defense for their previous actions, those which resulted in Mark Geier’s license suspension. By distancing themselves from both the purported chelation idea and the precocious puberty idea they can create a justification for why they treated disabled children with a drug for which there was no clinically indicated need.

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