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Lupron and the Need for Evidence Based Autism Treatments

Posted May 21 2009 10:10pm
The Chicago Tribune has published two articles critiquing the use of Lupron as a a treatment for autism and, in particular, the Lupron treatment efforts of Dr. Mark Geir and his son. Autism drug Lupron: 'Miracle drug' called junk science and Autism drug Lupron: Father-and-son team's crusade shows cracks.

As the titles suggest the focus of the second article is on the Geirs personally and the fact that several tribunals have found them to be lacking in the necessary expertise and credibility to make the claims that they have made in vaccine court cases where they have testified many times in support of plaintiffs claims of vaccine induced autism.

The first article focuses more on the science in support of Lupron as an autism treatment, or more properly put, the lack of scientific or evidential support for Lupron as an autism treatment. The Tribune article seems fair and balanced to me, describing the existence of anecdotal evidence in support of Lupron's efficacy in treating autism but also describing the weaknesses inherent in anecdotal evidence and the dangers of this particular treatment.

Non-evidence based autism treatments may waste parents money and a child's precious development time, resources that might better be used for ABA therapy, a solidly evidence based therapy for helping children overcome some of the deficits associated with autism disorders.

In the case of Lupron the Tribune also points out that direct harm may actually result from the use of Lupron to treat autism:

"Experts in childhood hormones warn that Lupron can disrupt normal development, interfering with natural puberty and potentially putting children's heart and bones at risk. The treatment also means subjecting children to daily injections, including painful shots deep into muscle every other week.

These are serious, very serious dangers, and parents should think once, twice, three times before considering any treatment that exposes their child to such serious risks. They are taking a huge gamble with their child's health, safety and well being. It is not a gamble I would consider for my son Conor.

At age 13 Conor is already 5' 11" and he began the "teen years' development very early and with obvious physical changes. But under no circumstance will my son be receiving Lupron treatment or any other intrusive treatment that is not solidly evidence based and shown to be safe and effective in treatment of autism disorders. Conor receives ABA therapy and ABA based education at school.

One of the problems is that for many parents ABA is not immediate and does not "cure" in a traditional sense. It can result in very impressive and measurable gains in intellect, adaptive skills and social functioning. But ABA is subject to an ideological, and at times irrational, opposition from several quarters, often from people with no real stake in whether an autism treatment works or does not. This intense opposition creates a false impression that there are no significant therapies or treatments available so it is better to gamble with unproven treatments than to do nothing. Even Lisa Jo Rudy, a balanced and respectful commentator, blogger and autism mom routinely lumps ABA in with other non-evidence based therapies contrary to the assessments of autism interventions by several major and credible reviewing agencies. Such commentary blurs the distinction between evidence based and non-evidence based treatment.

Another major encouragement for the use of Lupron and other non-evidence based, and potentially dangerous, treatments is the failure of the medical research community to conduct research focused on understanding environmental causes and developing cures for the various autism disorders. While the Geirs' credibility and expertise have been soundly trounced in numerous proceedings the science which supposedly rejects concluisvely any possible vaccine-autism connection is not as solid as most mainstream media articles state. Even the 2004 IOM report did not state that a vaccine-autism connection had been disproven. It simply stated that the epidemiological studies to date did not support a connection but it also then discouraged, for policy reasons, the type of research that might have shown such connections.

The failure to rigorously investigate vaccine and other possible environmental causes of autism has also been accompanied by a failure to conduct research aimed at possible cures focusing on the causes found. From the days of Teresa Binstock's article in 1999 the medical establishment has preferred to pretend that autism has to be entirely genetic despite evidence to the contrary. Such an approach has helped protect from serous scrutiny the pharmaceutical industry and other industries that produce products containing toxic substances potentially damaging to the proper neurological development of children. Such an approach has also resulted in a failure to develop significant treatments and cures apart from Applied Behavior Analysis.

Most parents will not be foolish enough to believe that autism is anything other than what it is a neurological disorder which pervasively restricts their child's life and well being. Most parents will not be fooled into thinking that autism is a culture, a choice or a way of life. They will seek to treat and cure their autistic child. For many they will want a total cure not just the improvement in life skills and abilities that ABA can bring.

If this intense need continues to be ignored by the medical research establishment some parents will look to non-evidence based, and even potentially dangerous ,treatments. As long as medical research authorities abandon the field as they did with the insistence, for many years, on funding genetic based autism research only, and as they did when the 2004 IOM report expressly discouraged research that might have shown a vaccine-autism connection, some parents, unfortunately, will turn to unproven, potentially dangerous treatments for their child's autism disorder.

Fortunately, the IACC has shown with its new strategic research plan for autism an understanding of the need to broaden the base of autism research to examine possible environmental causes and contributors, including even possible vaccine connections. With such research may come the evidence based treatment that the medical establishment has failed to provide, a failure which has helped create a demand for Lupon and other non-evidence based autism interventions.


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