Frightening autistic children

Frightening autistic children

Hope for Autism read the title. From a chiropractor. I thought, I'm skeptical. I can't see how the manipulation of the spine to correct fanciful subluxations could do anything for autism . So I went looking for the original paper, which is in a journal so obscure, J. Vertebral Subluxation Res., it is not on PubMed. But the original, Clinical Efficacy of Upper Cervical Versus Full Spine Chiropractic Care on Children with Autism: A Randomized Clinical Trial, is available for download.

Their introduction is humorous, although I suspect not deliberately:

Since the primary problem in autistic children is neurological, it is prudent to research the efficacy of chiropractic care in these children.

Since at its heart chiropractic has nothing to do with neurology, or reality.

They decide to answer the question as to

which is the recommended chiropractic technique in these cases of autism?

I would wager none.

It is every bit as methodologically horrible as you could predict: 14 patients, no randomization or blinding, no control, short follow-up and outcomes based on subjective parent observations and the Autism Treatment Evaluation Checklist. Any results, given the zero prior plausibility of chiropractic, are going to be due to bias. The study, and its results, are best described as garbage.

If the study was approved by an IRB it is not mentioned in the methods nor is there any mention of informed consent. When I read the study it looked appalling for stressing the children for no good reason.

A few of the children displayed aggressive behavior such as pushing, falling, flaying arms in the air, and kicking. These actions were usually momentary. Chiropractic care was resumed when he child was able to continue... X-ray examination proved to be the most difficult procedure for autistic children...Light from the collimator bulb either scared or fascinated the children.

The kids received a healthy dose of useless radiation:

To attain this, the technique recommends four pre-adjustment cervical x-rays and two post-adjustment x-rays be taken immediately after the first adjustment in the cervical area.

Not a benign diagnostic modality (although the data is from CT scans, ionizing radiation should not be given as part of tooth fairy science without IRB approval and informed consent)

Risk estimates are derived for paediatric head computed tomographies (CTs) as well as for brain tumours in adults. On the basis of estimates for Germany about the number of head scans, the annual rate of radiation-induced diseases is calculated. About 1000 annual paediatric CT investigations of the skull will lead to about three excess neoplasms in the head region, i.e. the probability of an induced late effect must be suspected in the range of some thousands.

The scant literature on the chiropractic for autism is also horrible

Our systematic review of the literature revealed a total of five articles consisting of three case reports, one cohort study and one randomized comparison trial. The literature is lacking on documenting the chiropractic care of children with ASD...However, given the ineffectiveness of pharmaceutical agents, a trial of chiropractic care for sufferers of autism is prudent and warranted.

The 'since airplane design has flaws, flying carpets should be used' argument.

A worthless study that only served to scare autistic children and proved nothing about the efficacy of spinal manipulation for autism. If it had been approved by an IRB, they ought to be ashamed for allowing autistic children to be frightened and irradiated without good reason.  

Points of Interest 7/31/2014
Points of Interest 7/29/2014