Is Autism a “Public Health Crisis?”. Part 5
The Commission’s report only made passing references to these concerns and, even then, only to point out that there are many honest and sincere differences of opinions between parents, schools, clinicians, and service agencies. The Commission is correct to say that there are many honest differences of opinion among well intended and well-meaning persons. To assume, however, that each opinion has equal weight, veracity, or benefit for children with ASD and their families is, at the least, problematic and, at the most, dangerous. Even honest and sincerely held opinions do not simultaneously infer legitimacy.
Today’s reality is that far too many of the currently available biomedical interventions clearly fit the criteria for pseudoscience, which is defined as treating as a science those variables and components which clearly are not. Pseudoscience includes:
• Demonstrations of benefit based on anecdotal evidence and unsubstantiated testimonials;
• Indifference to baseline abilities and the potential for spontaneous improvement based on maturity, parallel instruction, and environmental impact;
• The disavowal of related or alternative scientific procedures;
• Claims that attribute lack of success to the family (or other caregivers/providers) doing something wrong; and
• Refusal to expose the methods and protocols to a clinical peer review process, thereby allowing replication of the claimed results only by those with a primary investment in the outcomes (Jacobson et al., 1995).
Numerous families, teachers, and other direct providers of children with autism and other special needs can share stories about being handed poorly constructed interventions that did not work. Rather than assuming responsibility for resulting problems, the involved professionals too often claimed the problems were the result of either poor implementation or understanding by others (Albin & Sandler, 1997; Sandler, 2001). Similarly, certain biomedical interventions are often provided in isolation under the mistaken belief that critical behavioral, instructional or other home-based interventions will either interfere or are, simply, not necessary. Many of these biomedical interventions are expensive and inconclusive in their benefit. Furthermore, some of these interventions can be dangerous and children with ASD have been injured, even killed (Offit, 2008). Everything and anything simply cannot be considered as ‘on the table’ with regards to services to persons with ASD. The Commission’s report left families, providers, and service agencies with little guidance or even the most fundamental criteria as to what should (and should not) be considered within an intervention and support model for ASD.
Of course, the current lack of guidance and these stated concerns should not mean treatments which may not be considered viable for children and adults with ASD now would be forever off limits. Instead, there should be clearly stated criteria regarding what is acceptable, and what makes it acceptable; how an intervention that is not now acceptable might become acceptable; and what interventions will remain unacceptable and why.