Myths and Misconceptions in ASD
OTARC Response to Four Corners The Autism Enigma
The Olga Tennison Autism Research Centre (OTARC) was established to advance knowledge of the nature and causes of Autism Spectrum Disorders, as well as to develop and study evidence-based strategies for supporting individuals and families affected by an ASD.
When information, such as that disseminated last night on Four Corners (The Autism Enigma, aired on ABC 1 Monday 27 August) we are keen to evaluate its scientific credibility, and respond candidly to ensure a balanced view is put forward to inform the general public. With an abundance of information now available to parents and clinicians, it is important to ensure the public understand what research and interventions have a genuine scientific basis.
Researchers and clinicians in the area of ASDs will be familiar with the ‘gut theory’ put forward in The Autism Enigma. This theory is not new.
In speaking with the Four Corners researcher, on behalf of the Australasian Society for Autism Research, my first note of caution was that this is but one theory among many others put forward to explain the enigma that is autism. Indeed the impact of coverage of one theory, in isolation, is not helpful in informing the public who are indeed concerned about the increased prevalence of ASDs. To their credit, at our behest, the program removed some of the more wildly controversial and unsubstantiated claims. Despite these changes, The Autism Enigma’s main research findings, while of genuine interest, are sorely in need of independent replication. Some children with an ASD appear susceptible to gastrointestinal (GI) conditions. Indeed, Autism Speaks, the US based organization, funded the development of evidence-based guidelines for physicians to use to screen, assess, and treat GI conditions in children with ASD, recognising that their treatment can improve the quality of life for these children and their families.
However, it is important to recognise that the research presented on the PBS program is in the early stages, with the findings to date providing no evidence thus far that gut bacteria and their by products cause ASDs, even a subgroup of them, or that treating the gut can alleviate the specific symptoms of ASD.
I thus expressed disappointment that research in the early phases of discovery is receiving recognition (from a credible program like Four Corners) prior to the much needed replication from other laboratories.
Like the discredited MMR vaccine theory, the gut theory presented in this program targets those cases of ‘regressive’ autism, whereby young children develop symptoms after a period of seemingly typical development. Regression most commonly occurs between 15- to 20-months of age, and these children tend to have more severe symptoms. Whether these are the children who are most vulnerable to GI problems remains to be determined. One would assume, on the basis of the claims made in the program, that this would be one of the first questions addressed by those promoting the ‘gut theory’ Certainly, the argument made in the program that it is the gut microflora that causes the brain changes associated with ASDs cannot be addressed without ascertaining this connection, such that this relationship and the theory remain largely unsubstantiated.
Thus caution needs to be exercised in implementing treatments based on a theory with an insufficient evidence base. Unproven treatments can incur high costs to vulnerable families, often at the expense of securing effective behaviourally based intervention for which there is a solid evidence base.
It is the strong view at the Olga Tennison Autism Research Centre that in the absence of known causes and cures for ASDs, the available evidence to date informs us that the best chance of preventing the effects of ASDs on the developing child is very early identification and behaviourally based early intervention.
