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Friday, January 31, 2014

What the Common Core Standards Mean for Special Education Students

From The Science of Learning Blog

By Hallie Smith, MA CCC-SLP
January 21, 2014

"...we know – because we’ve seen it again and again with our own eyes – that the majority of students with learning disabilities are capable of much more than they and others realize."

The Common Core standards are considered challenging for general education learners - and they’re meant to be. But given that challenge, many educators wonder what it means to hold special education students to the same standards.

These are students, after all, who have already been performing well below grade level on standards that in many cases are weaker than the Common Core standards that replace them.

Meeting High Expectations Under the Common Core

How are educators expected to get these underperforming students to proficiency with the Common Core standards? A document on the Common Core State Standards Initiative website, “Application to Students with Disabilities,” outlines the supports and accommodations required for special educations students, including:

Standards-Based IEP

The Standards-Based IEP guides instructional planning for students with learning disabilities. It outlines an individualized learning experience matched to student needs and appropriate accommodations, and sets annual goals aligned with grade-level academic standards.

Instructional Supports & Accommodations

Instructional supports and accommodations that must be provided students include:
  • Additional support in the classroom (e.g., students have access to a special education teacher in the mainstream classroom)
  • Varied instructional approach (e.g., incorporating technology into math instruction, or using writing as a mode of inquiry and learning)
  • Access to assistive technology (e.g., text readers or sign language)

Qualified Teaching & Support Personnel

Students must receive high-quality, evidence-based instruction and support, delivered by qualified teachers and specialized instructional support staff. Some experts predict that the role of special education teachers will grow under the Common Core as they support general education teachers in understanding how to scaffold their teaching to fit the needs of different learners.

Controversy

There are parents and educators who argue that holding students with learning disabilities to the same academic standards as general education students is unrealistic and unfair – for reasons of ability or practicality. Some parents of students with severe cognitive disabilities, for example, prefer that their children focus on life skills over academic skills, reasoning that life skills are more valuable for their children in the long run.

Others are more concerned about accurately measuring the performance of students with learning disabilities than they are about the standards themselves. For one thing, special education students may require 30 to 40 more days of instruction than general education students to learn the same material. If all students have the same number of instructional days, special education students would likely find themselves being tested on material they had never been taught.

Then there’s the added challenge of agreeing on a common set of accommodations, such as assistive technologies that could be built right into the tests. Some experts argue that students need to able to use the equipment they're accustomed to using every day in the classroom rather than encountering unfamiliar technology at test time when the stakes are high.

Computer-adaptive tests are also a concern because they adjust the difficulty of questions based on how a student performs on previous questions. The feature is intended to accommodate the full range of learners taking the test, but special education advocates worry that students with learning disabilities may end up being served questions below their grade level if they have a string of a few incorrect answers.

So, while the new PARCC and Smarter Balanced assessments are being designed up front to accommodate special education students – rather than having accommodations tacked on as an afterthought - many educators remain skeptical.

Raising the Bar for Special Education

Many educators see the implementation of the Common Core standards as a historic opportunity – at last – to give students with learning disabilities access to the same academic rigor and high expectations as mainstream students, as mandated by IDEA.

Only time can tell how special educations students will fare under the Common Core. As with any large-scale shift in K-12 education practices, there are loud and persuasive voices on both sides of the issue and a lot of folks in the middle who are simply moving forward with the adopted standards and aren’t sure how things are going to turn out.

But at Scientific Learning, we know – because we’ve seen it again and again with our own eyes – that the majority of students with learning disabilities are capable of much more than they and others realize. Committed educators, a correct diagnosis, and an appropriately targeted intervention can be all that’s needed for dramatic learning gains.

References

Application to Students with Disabilities, retrieved from: http://www.cde.ca.gov/sp/se/cc/

For Further Reading

Related Reading

Brain Activity May Help Predict Autism Before Age 1: Study

From MedicineNet.com
via HealthDay News Archives

By Robert Preidt
January 26, 2012

Infants younger than a year old at risk of developing autism may already have telltale brain responses when another person looks at or away from them, the results of a new study indicate.

The researchers say that the findings suggest that assessing brain responses in infants as young as 6 months may one day help predict whether they'll develop autism at a later age. Currently, firm diagnoses of autism are made only after a child is 2 years old, according to the study in the January 26th online edition of Current Biology.

"Our findings demonstrate for the first time that direct measures of brain functioning during the first year of life associate with a later diagnosis of autism -- well before the emergence of behavioral symptoms," study author Mark Johnson of Birkbeck College, University of London, said in a journal news release.

The study included infants aged 6 to 10 months who had an increased risk of developing autism because they had an older brother or sister with the disorder. The researchers monitored the infants' brain activity while they viewed faces that switched between looking at them and looking away from them.

Previous research has shown that characteristic patterns of brain activity occur in a normal response to eye contact with other people, a response that's crucial for face-to-face social interaction. Older children with autism have unusual patterns of eye contact and of brain responses to social interactions that involve eye contact.

This study found that the brains of the infants at risk of developing autism already process social information in a different way than typically developing children.

"At this age, no behavioral markers of autism are yet evident, and so measurements of brain function may be a more sensitive indicator of risk," Johnson said.

However, the researchers noted that not all the babies who showed these differences in brain function were later diagnosed with autism, and vice versa. Brain-function measuring would need to be further adjusted and used alongside other methods to serve as an accurate predictor of autism in a clinical setting, the researchers said.

Thursday, January 30, 2014

Why Some Children May ‘Grow Out' of Autism

From MedicineNet.com
via WebMD Health News

By Brenda Goodman, M.A., WebMD Health News
Reviewed by Hansa D. Bhargava, M.D.

January 23, 2012

Some kids with autism will no longer qualify for that diagnosis as they grow older. But kids with several physical, psychological problems may be less likely to improve over time, study shows.

A new study shows that whether or not a child "outgrows" their autism may be related to the number and severity of other physical and psychological problems that are part of their original diagnosis.

The study is published in the journal Pediatrics. It compared more than 1,300 children with a past or current diagnosis of autism. About one-third of the kids in the survey had once been diagnosed with autism but were no longer considered to have the condition.

"The main study objective is to try to see what co-existing conditions, if any, would help us to distinguish people who grow out of the autism diagnosis," says researcher Li-Ching Lee, Ph.D., Sc.M., a research scientist at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Md.

In addition to autism, researchers asked parents if their children had ever been diagnosed with other problems, including attention-deficit hyperactivitydisorder (ADHD), a learning disability, developmental delay, speech or hearing problems, anxiety, depression, behavioral or conduct problems, and seizures or epilepsy.

Researchers adjusted their results to account for the influences of other things that are known to affect autism and development, including race and gender, the family's income and education level, health insurance coverage, or whether the children were enrolled in a personalized education plan at school.


Conditions that Complicate Autism

Among preschoolers, kids who were diagnosed with a current diagnosis of autism were almost five times more likely to have two or more other conditions than those kids who had a previous diagnosis of autism. Learning disabilities and developmental delays were the most significant predictors of having a current autism diagnosis in 3- to 5-year-olds.

Among 6- to 11-year-olds, kids with a current autism diagnosis were significantly more likely than kids with a past diagnosis to have once had a speech problem or to be currently experiencing moderate to severe anxiety.

Among teens, kids with a current autism diagnosis were significantly more likely to also have a speech problem or mild epilepsy than kids with a past autism diagnosis.

Having a past hearing problem, on the other hand, made it significantly more likely that a child or teen would no longer be diagnosed with autism.

The symptoms of hearing impairment in young children can mimic symptoms of autism. In some cases, when the hearing problems are addressed, the behavioral and developmental problems also resolve.

Experts who were not involved in the research say it's important for a couple of reasons.


Treatment May Help Kids with Co-Occurring Conditions

"It illustrates, again, the fact that there are some common co-occurring disorders that do occur in young individuals with autism and they're relatively frequent. And this is another way of getting some insight into how frequent they are," says Joseph Horrigan, M.D., head of medical research for the New York City-based nonprofit Autism Speaks.

He says many of the co-occurring conditions, like ADHD, can be effectively treated with medications or cognitive behavioral therapy. And treatment may relieve some of the distress and dysfunction that many people with autism and their families face.

The second reason the study is noteworthy, Horrigan says, is that it sheds some light on the differences between those kids diagnosed with autism who will see their symptoms improve and those who don't.

He cautions, however, that because the research is just a snapshot in time, it can't say very much about why some people's symptoms become milder over time while others continue to qualify for an autism diagnosis.

"It doesn't really get into that notion of how does the pattern change for an individual, or what sort of things might have happened that may have been associated with a change," like medication, or early, intensive behavioral therapy, he says.

For that, he says, a longer study that follows patients over time will be needed.

BPA Among Toxic Chemicals Driving Up Health Care Costs, Experts Say

From HuffPost Green

By Lynne Peeples
lynne.peeples@huffingtonpost.com

January 22, 2014

Health care spending in the U.S. has surged more than eightfold since the 1960s. Skyrocketing in that same time: rates of chronic disease, use of synthetic chemicals, and evidence that many of these widely used substances may be wreaking havoc on human health.

"We know that these chemicals are reaching people. We know that chemicals can cause disease," said Dr. Philip Landrigan, chairman of the department of preventative medicine at the Mount Sinai School of Medicine in New York.

"Those diseases cost money," Landrigan added.

New research published on Wednesday offers an example of this financial burden, widely overlooked in the health care debate. The use of bisphenol A, or BPA, in food and beverage containers, according to the study, is responsible for an estimated $3 billion a year in costs associated with childhood obesity and adult heart disease.

"One could argue that's absurdly conservative," said Leonardo Trasande, an associate professor in pediatrics, environmental medicine and health policy at New York University's Lagone Medical Center and author of the study.

Trasande's calculations didn't take into account other health issues that studies have begun linking to BPA exposure, such as prostate and breast cancers, asthmamigraine headaches, reproductive disorders and behavioral problems. Trasande added that he was conservative in what he considered a safe level of exposure to the chemical. Scientists have warned that even minute amounts may do significant damage.

Still, Trasande acknowledged, "the science remains uncertain."


The chemical industry continues to underscore this point. "The U.S. Food and Drug Administration, as recently as June, answers the question, 'Is BPA safe?' with one word: 'Yes,'" Steve Hentges, of the Polycarbonate/BPA Global Group of the American Chemistry Society, told HuffPost in an emailed statement.

Hentges criticized Trasande's study for disregarding "the significant economic and public health benefits BPA delivers for a range of things from the safety and integrity of packaged foods to high performance sports equipment and auto parts."

BPA has been banned by the FDA from children's sippy cups and baby bottles, but remains an ingredient in many products, including the lining of metal cans for food. Trasande suggested that his study raises concerns about the refusal of the FDA to ban BPA from such uses.

Trasande pointed to one proposed alternative, oleoresin. Using this mixture of oil and resin to line an aluminum can would cost approximately 2.2 cents more than BPA. With 100 billion aluminum cans produced annually, that amounts to an additional $2.2 billion a year -- a hefty sum, and one that may rise with additional costs, such as premarket testing.

Still, Trasande said, "the benefits of removing BPA could potentially outweigh the costs of a potentially safe alternative."

BPA, which about 93 percent of Americans carry in their bodies, is just one of a growing list of chemicals suspected in America's rising rates of disease. More than 80,000 chemicals are currently in commerce. A small number of those have been fully tested for health effects.

Only a fraction of today's health concerns, meanwhile, were included in a 2011 study by Trasande, in which he tallied $76.6 billion in children's health care costs, lost working hours and reduced IQ points attributable to toxic chemicals and air pollutants. The $1.49 billion in childhood obesity costs that he found in his new study, for example, could be added to this total.

"Most Americans believe the government is protecting them, that chemicals are tested before they go into lipstick or food packaging. But the truth is completely the opposite: They come onto the market with little or no scrutiny," said Landrigan, referring to the Toxic Substances Control Act of 1976.

Two recent moves in California illustrate just how difficult and time-consuming it can be to force something off the market, he added.

In early January, a California Superior Court judge ordered three former lead paint manufacturers to pay $1.15 billion to replace or contain lead paint in millions of homes. The U.S. government banned lead paint for residential use in 1978, after nearly a century of scientific studies linked low levels of lead paint to everything from low IQ and learning disorders to sociopathic behavior.

Also this month, California officially removed a decades-old requirement that flame retardants -- increasingly implicated in neurological and reproductive disorders, and cancers -- be included in the filling of upholstered furniture. (A flame retardant maker has filed suit over the new law.)

Still, Landrigan said, the actions are better late than never.

"Previous efforts to control toxic chemicals have produced massive cost savings," Landrigan and his colleague, Dr. Lynn Goldman, dean of The George Washington University School of Public Health, wrote in a paper on chemical safety and health care costs published this month.

They referenced the Environmental Protection Agency's removal of lead from gasoline, which resulted in an estimated savings since 1980 of more than $3 trillion. While the heavy metal remains a menace in the U.S., mostly due to lingering lead paint, millions of children have been able to dodge lead's notorious effects on the brain, kidney and cardiovascular system.

The price tags associated with chemical exposures may seem significant. Yet mostly missing in heated rhetoric about health care spending, experts say, are these and other factors driving Americans to seek costly care.

"Given current health trends, we will bankrupt the health care system within a generation due to the epidemic rates of chronic disease and escalating costs of treating them -- with or without the new health care laws," Gary Cohen, president of the nonprofit Health Care Without Harm, wrote in a recent blog at HuffPost.

"Prevention is far more cost-effective than treatment," wrote Cohen, noting that only 4 cents of every dollar spent on health care in the U.S. goes toward curbing disease.

Landrigan applied a similar argument to toxic chemical regulation.

"It's more cost-effective to recognize the hazards of lead paint or flame retardants before rather than after they go on the market," he said.

Bisphenol S, now widely used in "BPA-free" products, further illustrates potential problems with the government's innocent-until-proven-guilty regulatory strategy. BPS is chemically similar to BPA and, since its appearance on the market, has been documented to have the same if not more hazardous properties as its cousin compound.

In other words, BPS may be sending just as many Americans to doctors, pharmacies and emergency rooms as BPA.

Landrigan expressed hope Congress will pass the long-awaited update to the Toxic Substances Control Act. The Safe Chemicals Act of 2013, a bipartisan bill, is currently before Congress. Meanwhile, the advent of President Barack Obama's controversial health care reform, he said, could add urgency for addressing toxic chemicals.

Among core components of the Affordable Care Act are measures to incentivize prevention.

"In the past, physicians and the health care system were paid to repair damage," said Landrigan. "Going forward, they will be paid to keep people healthy."

Wednesday, January 29, 2014

Working Memory Training Does Not Live Up to the Hype

From BPS Research Digest
The British Psychological Society Blog



February 14, 2013

According to CogMed, one of the larger providers of computerised working memory training, the benefits of such training is "comprehensive" and includes "being able to stay focused, resist distractions, plan activities, complete tasks, and follow and contribute to complex discussions."

Similar claims are made by other providers such as Jungle Memory and Cognifit, which is endorsed by Neuroscientist Susan Greenfield.

Working memory describes our ability to hold relevant information in mind for use in mental tasks, while ignoring irrelevant information. If it were possible to improve our working memory capacity and discipline through training, it makes sense that this would have widespread benefits. But that's a big if.

A new meta-analysis by
Monica Melby-Lervåg and Charles Hulme has just been published in the February issue of the respected APA journal Developmental Psychology, which combined the results from 23 studies of working memory training completed up to 2011 (PDF is freely available).

To be included, studies had to compare outcomes for a working memory training treatment group against outcomes in a control group. Most of the studies available are on healthy adults or children, with just a few involving children with developmental conditions such as ADHD.

"...there is no evidence that working memory training produces generalisable gains to the other skills that have been investigated (verbal ability, word decoding, arithmetic), even when assessments take place immediately after training."

The results were absolutely clear. Working memory training leads to short-term gains on working memory performance on tests that are the same as, or similar to, those used in the training. "However," Melby-Lervåg and Hulme write, "there is no evidence that working memory training produces generalisable gains to the other skills that have been investigated (verbal ability, word decoding, arithmetic), even when assessments take place immediately after training."

There was a modest, short-term benefit of the training on non-verbal intelligence but this disappeared when only considering the studies with a robust design (i.e. those that randomised participants across conditions and which enrolled control participants in some kind of activity). Similarly, there was a modest benefit of the training on a test of attentional control, but this disappeared at follow-up.

All of this suggests that working memory training isn't increasing people's working memory capacity in such a way that they benefit whenever they engage in any kind of task that leans on working memory. Rather, people who complete the training simply seem to have improved at the specific kinds of exercises used in the training, or possibly even just at computer tasks - effects which, anyway, wear off over time.

Overall, Melby-Lervåg and Hulme note that the studies that have looked at the benefits of working memory training have been poor in design. In particular, they tend not to bother enrolling the control group in any kind of intervention, which means any observed benefits of the working memory training could be related simply to the fun and expectations of being in a training programme, never mind the specifics of what that entails.


Related to that, some dubious studies reported far-reaching benefits of the working memory training, without finding any improvements in working memory, thus supporting the notion that these benefits had to do with participant expectations and motivation.

A problem with all meta-analyses, this one included, is that they tend to rely on published studies, which means any unpublished results stuck in a filing cabinet get neglected. But of course, it's usually negative results that get left in the drawer, so if anything, the current meta-analysis presents an overly rosy view of the benefits of working memory training.

Melby-Lervåg and Hulme's ultimate conclusion was stark: "there is no evidence that these programmes are suitable as methods of treatment for children with developmental cognitive disorders or as ways of effecting general improvements in adults' or children's cognitive skills or scholastic achievements."


Journal Reference

Melby-Lervåg M, and Hulme C (2013). Is working memory training effective? A meta-analytic review. Developmental psychology, 49 (2), 270-91 PMID: 22612437

Free, full PDF of the study.

One Map Sums Up the Damage Caused by the Anti-Vaccination Movement

From I F***ing Love Science

By Lisa Winter
January 24, 2014

Vaccinations are one of the of most incredible aspects of modern medicine. They can make previously lethal diseases disappear from society and save countless lives.

There is, however, a chance that the vaccines work a little too well, and our collective memory is too short, to remember the devastating effects some of these diseases caused just a few short decades ago. Recently, for reasons that are not based on science or logic, many parents have outspokenly rejected vaccinating their children. Unfortunately, this has caused a reemergence of easily managed diseases.

The Council on Foreign Relations has released an interactive map detailing the catastrophic outcome of these poor choices.


The interactive map gives a gut-wrenching tour of global outbreaks of measles, mumps, rubella, polio, and whooping cough from 2008-2014. These diseases -- all of which are easily prevented by vaccines -- can have dire consequences. The CDC estimates that 164,000 people around the world will die from measles each year, and it is experiencing quite a resurgence in the UK.

The United States has recently seen a drastic increase in whooping cough, which causes around 195,000 deaths per year. The majority of these deaths occur in impoverished regions with very little access to vaccines. In the case of developed areas like the U.S. or U.K., they shouldn’t be happening at all.

But how did it all begin?

In 1998, Andrew Wakefield released a paper claiming to have linked the measles, mumps, and rubella (MMR) vaccine to the onset of autism. No other scientist was ever able to match Wakefield’s findings, and in the coming years, it became known that Wakefield had a financial conflict of interest. In 2010, an ethics review board found that he had falsified the data in his report, causing an immediate retraction of his original paper and revocation of his medical license. Despite the fact most scientists opposed Wakefield’s “findings” from the start, some were all too eager to jump on the anti-MMR bandwagon.

Among those leading the charge against vaccines is Jenny McCarthy, the Playboy Bunny-turned-pseudoscience advocate. McCarthy began speaking out against vaccines in 2007, as she believed they caused her son’s autism. Based on her son’s symptoms, some believe the boy actually has Landau-Kleffner Syndrome.

She has written a few books (including one with a foreword by Wakefield himself) continually claiming that vaccines cause autism and that she cured her son’s disorder with alternative treatment, without a shred of credible medical evidence. In the face of a possible misdiagnosis and absolutely no scientific evidence to support the claim that vaccines cause autism, she remains unchanged in her opinion.

Unfortunately, her celebrity status has given her a platform to use anecdotal (not scientific) evidence to urge parents against vaccines.

Of course, absolutely nothing is without risk and there can be side effects from vaccines, but those are incredibly rare. Some people are unable to be vaccinated due to allergies or other medical conditions. This makes it altogether more important for those who can get vaccinated to do so, creating a herd immunity for our most vulnerable members of society.

The full version of the map is

Tuesday, January 28, 2014

9 Food Additives That May Affect ADHD

From MSN Healthy Living

By Amanda Gardner
January 26, 2014

A possible link between ADHD and certain foods has been suspected since the 1970s, but experts can't agree on whether eliminating dye-containing foods can ease symptoms.

If your child has attention deficit hyperactivity disorder (ADHD), it's not because he or she played too many video games, logged multiple hours of TV viewing, or ate the wrong kinds of foods. In fact, researchers think the cause of ADHD is largely genetic. But it is tempting to look for dietary factors that could be making symptoms worse.

In particular, a possible link between ADHD and certain foods—including food dyes and preservatives—has been suspected since the 1970s. Still, despite decades of research, experts can't agree on whether eliminating dye-containing foods from a child's diet can ease ADHD symptoms like hyperactivity and impulsivity—except in perhaps a few special cases.

"Scientific evidence is limited to support the association between food additives and ADHD symptoms," says Maida Galvez, M.D., MPH, director of the pediatric environmental health specialty unit and assistant professor of preventive medicine and pediatrics at Mount Sinai School of Medicine, in New York City.


"Although it is possible that a very small group of children who are allergic to artificial colorings or preservatives may show improvement in symptoms on restriction diets, evidence is insufficient to recommend routine, widespread use of restriction diets to treat a child's ADHD symptoms."

"From the standpoint at least of acute effects produced by food color consumption you really can't deny the evidence any more."

However, Bernard Weiss, Ph.D., professor of environmental medicine at the University of Rochester School of Medicine and Dentistry, in New York, says it's clear that food additives can sometimes affect child behavior, at least in the short term. He has conducted controlled trials on the topic and says: "From the standpoint at least of acute effects produced by food color consumption you really can't deny the evidence any more."

For example, a 2007 study published in The Lancet found that a mixture of four artificial food colors plus the preservative sodium benzoate aggravated hyperactivity in two groups of children without ADHD—3-year-olds and 8/9-year-olds. But a second mix didn't have as great an effect on the 8/9-year-olds, even though it also contained sodium benzoate and two of the same colorings, albeit in lower amounts.

Part of the controversy lies in the fact that most food products contain more than one dye or preservative (some candy products have as many as 10 dyes). And most studies have looked at blends of additives, not single ingredients, making it difficult to sort out the culprits.

"There's no way to know at this point which is the problem dye. Is only one of them a problem? All of them a problem?" says Michael F. Jacobson, Ph.D., executive director of the Center for Science in the Public Interest (CSPI), which has petitioned the U.S. Food and Drug Administration (FDA) to ban all food dyes because of hyperactivity concerns.

The European Union has already acted to place warning labels on foods containing the six artificial colors in the The Lancet study that "may have an adverse effect on activity and attention in children." Those colors are Yellow No. 5 (tartrazine), Yellow No. 10 (quinoline yellow, not approved in the U.S.), Yellow No. 6 (sunset yellow), Red No. 3 (carmoisine, not approved in the U.S.), Red No. 7 (ponceau 4R, not approved in the U.S.), and Red No. 40 (allura red). Britain's Food Standards Agency (the equivalent of our FDA) is also trying to get companies to phase out these additives.

The bottom line for consumers is that the "jury is still out," says Catherine Ulbricht, Pharm.D., co-founder of Natural Standard Research Collaboration, which collects data on complementary and alternative medicine, and chief editor of the Journal of Dietary Supplements. "There's inconclusive evidence that food additives actually cause ADHD, but some research suggests that they may be linked to exacerbated symptoms in people who already have ADHD."

Here's a list of food preservatives and colorings that could aggravate attention problems, although none of them (with the exception of Yellow No. 5) have been studied alone in humans. You can also look up the dyes in a number of products at the Institute for Agriculture and Trade Policy website.

Blue No. 1 (Also known as: Brilliant Blue)

What it is: A food coloring

Where you can find it: Frito-Lay Sun Chips, French Onion and other Frito-Lay products; some Yoplait products; some JELL-O dessert products; Fruity Cheerios; Trix; Froot-Loops; Apple Jacks; Quaker Cap'N Crunch's Crunch Berries; some Pop-Tarts products; some Oscar Mayer Lunchables; Duncan Hines Whipped Frosting Chocolate; Edy's ice cream products; Skittles candies; Jolly Ranchers Screaming Sours Soft; Chew Candy; Eclipse gum; Fanta Grape.

Blue No. 2 (Also known as: Indigotine)

What it is: A food coloring

Where you can find it: Froot-Loops; Post Fruity Pebbles; Pop-Tarts products; Duncan Hines Moist Deluxe Strawberry Supreme Premium Cake Mix; Betty Crocker Frosting Rich; Creamy Cherry; M&M's Milk Chocolate Candies; M&M's Milk Chocolate Peanut Candies; Wonka Nerds Grape/Strawberry; pet foods.

Green No. 3

What it is: A food coloring, though rarely used these days

Where you can find it: Candy, beverages, ice cream, puddings.

Orange B

What it is: A food coloring, but no longer used

Where you can find it: Sausage casings.

Red No. 3 (Also known as: Carmoisine)

What it is: A food coloring found in only a few types of food products

Where you can find it: Candy, cake icing, chewing gum.

Red No. 40 (Also known as: Allura Red)

What it is: A food coloring and the most widely used food dye in the U.S., trumping both Yellow No. 5 and Yellow No. 6

Where you can find it: Some Frito-Lay products; some Yoplait products; JELL-O Gelatin desserts; Quaker Instant Oatmeal; Trix; Froot-Loops; Apple Jacks; some Pop-Tart products; Kid Cuisine Kung Fu Panda products; Oscar Mayer Lunchables products; Hostess Twinkies; some Pillsbury rolls and frostings; some Betty Crocker and Duncan Hines frostings; some Edy's ice creams and candies; Popsicle Sugar-Free Life Savers; some M&M's and Skittles candies; Nestle's Butterfinger; Twizzlers Strawberry Candy; Sunkist Orange Soda; Dr. Pepper sodas; Propel Invigorating Water, Berry Citrus; Gatorade Orange Thirst Quencher; Fanta Orange.

Sodium Benzoate

What it is:
A food preservative

Where you can find it: Fruit juice, carbonated beverages, and pickles. You'll find it in abundance in acidic foods. It is used to stymie the growth of microorganisms, according to the Center for Science in the Public Interest (CSPI).

Yellow No. 5 (Also known as: Tartrazine)

What it is: Yellow No. 5 is the only food dye that has been tested alone and not simply as part of a mix. Those studies did link it to hyperactivity. It is the second most commonly used dye in the U.S.

Where you can find it: Nabisco Cheese Nips Four Cheese; Frito-Lay Sun Chips Harvest Cheddar and other Frito-Lay products; some Hunt's Snack Pack Pudding products; Lucky Charms; Eggo waffles and other waffle products; some Pop-Tarts products; various Kraft macaroni and cheese products; Betty Crocker Hamburger Helper and other products; some Oscar Mayer Lunchables products; Hot Pockets Ham & Cheese; some Hostess cup cakes; some Betty Crocker frostings; some M&M's and Skittles products; some Gatorade products.

Yellow No. 6 (Also known as: Sunset yellow)

What it is: The third most widely used food dye in the U.S.

Where you can find it: Frito-Lay Cheetos Flamin' Hot Crunchy and other Frito-Lay products; Betty Crocker Fruit Roll-ups; some JELL-O gelatin desserts and instant puddings; Fruity Cheerios; Trix; some Eggo waffle products; some Kid Cuisine Kung Fu Panda products; some Kraft macaroni and cheese dinners; some Betty Crocker frostings; some M&M's and Skittles candies; Sunkist Orange Soda; Fanta Orange.

Monday, January 27, 2014

Hot Topic: Behavioral Treatments for Kids with ADHD

From The Child Mind Institute

By Caroline Miller
January 21, 2014

Helping kids get organized and control problem behaviors

There are two kinds of behavioral interventions that can help children with ADHD manage their symptoms of hyperactivity, impulsiveness, and inattention. These therapies don't affect the core symptoms, but they teach children skills they can use to control them.

Some focus on strategies for staying organized and focused. Others aim at cutting down on the disruptive behaviors that can get these children into trouble at school, make it difficult for them to make friends, and turn family life into a combat zone.

Some children, especially those with severe ADHD symptoms, benefit from behavioral therapy along with medication; for others, the training may make enough difference to enable them to succeed in school and function well at home without medication.

One important reason for kids to participate in behavioral therapy (whether or not they also take medication) is that ADHD medications stop working when you stop taking them, while behavioral therapy can teach children skills that will continue to benefit them as they grow up.

For Behavior Problems

For kids whose impulsive behavior is creating conflict at home and getting them into trouble at school, therapy can help them rein in the behavior that's problematic and establish more positive relationships with the adults in their lives. It's called, generally, parent training, because it involves working with parents and children together. It trains parents to interact differently with children, in order to elicit desirable behavior on the part of the child and discourage behavior that's causing him trouble.

Parent training is not just for children with ADHD, but since kids with ADHD are often prone to tantrums, defiance, and tuning out parental instructions, it can substantially improve their lives, and the wellbeing of their whole families. Though it focuses on interaction with parents, it's also been shown to reduce outbursts and other problem behaviors at school, as the skills kids learn in responding to very predictable parental interactions are transferrable to other settings. The training is generally done by clinical psychologists.

One form of parent training, called parent-child interaction therapy, or PCIT, involves 14 to 17 weekly sessions in which parents interact with the child, coached by a clinician behind a one-way mirror who communicates with them via an ear bud. Parents practice positive reinforcement for desired behaviors, and, when a child fails to comply with an instruction, there is a strict series of consequences in the form of escalating time outs.

Parents are assigned homework between sessions to practice skills like giving praise for good behaviors and using time-outs properly. Stimulated by more positive reinforcement, and responding to completely predictable consequences, kids learn, over a number of sessions, to control their behavior and have more rewarding relationships with parents and teachers.

PCIT is for children from 2 to 7 years old, and in general behavioral training works better the younger the child is. Young children with ADHD often find themselves on a collision course with parents—they are scolded or punished much more than they are praised—so a clear way to earn positive attention from the most important people in their lives is a big motivator.

We see kids whose parents and teachers have deemed uncontrollable—given to tantrums and meltdowns, kicked out of preschool, black-listed from play dates—who've been dramatically turned around by parent-child interaction therapy. Children with severe ADHD symptoms often need medication to enable them to complete the behavioral training; others may not.

School Interventions

Young children with ADHD can benefit from systems that encourage positive behavior, like the "Daily Report Card." These approaches pinpoint specific goals for behavior in school, give kids feedback on how they're doing, and reward them for meeting those goals successfully.

Parents and teachers work together on the Daily Report Card. Teachers choose goals for an individual child based on the behaviors that present the biggest challenges for him. Goals might involve academic work (finishing tasks), behavior towards peers (reducing teasing or fighting) and adherence to classroom rules (not interrupting, staying in his seat, following instructions).

The teacher rates the child's performance each day on each goal. He gets a star or a check for each positive behavior, and if he gets enough during the day, there is a prize for him when he gets home—coveted screen time or some other small reward.

This kind of system can be very helpful for children from preschool to as old as 12.

For Attention Problems

The other broad area of behavioral help for kids with ADHD includes skills-based interventions to teach techniques they can use to stay on top of their schoolwork and manage their responsibilities at home. This kind of training, which is done by learning specialists, teaches kids skills to maximize their strengths and compensate for their weaknesses.

Children with ADHD tend to be weak in what we call "executive functioning." Executive functions are the self-regulating skills that we all use to accomplish tasks, from getting dressed to doing homework. They include planning, organizing time and materials, making decisions, shifting from one situation to another, controlling our emotions and learning from past mistakes.

To bolster kids with weak skills in these areas, learning specialists teach a mix of specific strategies and alternative learning styles that complement or enhance a child's particular abilities.

With elementary school children, the learning specialist usually works with parents and kids together, to establish routines and tools to use to get work done successfully and with minimal conflict. For instance, checklists can be useful for anything from getting out of the house on time in the morning to doing homework after school to the bedtime routine. Since the steps necessary for completing a task often aren't obvious to kids with ADHD, defining them clearly ahead of time, and posting them prominently, makes a task less daunting and more achievable.

Educational therapists also recommend assigning a time limit for each step, particularly if it is a bigger, longer-term project. Deadlines can sneak up on all of us, but kids with ADHD are particularly susceptible to underestimating how long it will take to do something. Using a Planner is essential for kids with ADHD who have what's called poor working memory, which means it is hard for them to remember things like homework assignments. A rewards chart at home, as well as at school, can help motivate kids who are easily distracted and struggle to acquire new skills.

For middle and high school aged students, educational therapists work with kids to develop systems for tackling the work, both organizationally and academically. For kids with ADHD, managing their time and school materials can be a huge issue—not leaving enough time to study or complete projects, forgetting to use their planner, losing track of assignments. Materially, their backpacks may be a disaster, notes Dr. Michael Rosenthal, a Child Mind Institute neuropsychologist. Specific skills like studying, memorizing, note-taking, and doing assignments on time can all be addressed.

And executive functions apply to academics, as well as managing homework, explains Dr. Rosenthal. Reading, writing and math all involve skills kids may be weak in. A middle schooler might be a perfectly fluent reader, he explains, but at the same time have difficulty capturing the point of each paragraph or summarizing what she's read.

Writing requires organizing thoughts into a narrative, imagining what the intended audience needs to know, staying on topic, and writing to a chosen length, among other skills. Math requires multi-step operations, and word problems require extracting the information important to solve the problem. These are all skills that educational therapists can focus on with children to strengthen their learning strategies.

Spelling out the Rationale

While a child is learning new skills, he needs to understand how they will help him. . "Kids with attention problems, in particular, are very pragmatic in a way about how much effort to put into things," explains Dr. Matthew Cruger, director of the Child Mind Institute's Learning and Development Center. "We think of it as 'neuroeconomics'-they save their energy for things they are confident will pay off."

"Kids with attention problems, in particular, are very pragmatic in a way about how much effort to put into things. We think of it as 'neuro-economics' - they save their energy for things they are confident will pay off."

A good educational therapist will structure skill building so that kids score successes. "When kids put hard work into something, they expect a return, and if they don't see the return, it's doubly frustrating," says Dr. Cruger. "They'll think, 'You see, it wasn't a good idea to try.'"

The Bottom Line

The frustrating thing about behavioral interventions like parent training and Daily Report Card is that they are labor-intensive for parents and teachers, in addition to the kids themselves. "Parents may have the preconception that when they bring a child for therapy the child is going to be doing the work," notes Dr. Jill Emanuele, a clinical psychologist at the Child Mind Institute. "But this takes a huge investment on the part of parents."

On the other hand, she adds, "the training can be a huge help to parents, too, who often come to us feeling burned out and ineffective in handling these kids. They develop a lot of confidence."

There is evidence that these parent and teacher-based interventions do improve the outcome for children with ADHD, though they don't directly affect symptoms. "Ideally, these environmental adjustments will alter the developmental trajectory of the child or adolescent with ADHD," explains ADHD specialist Dr. Russell Barkley.

"However, such interventions are not expected to produce fundamental changes in the underlying deficits of ADHD, rather they only prevent an accumulation of failures and problems secondary to ADHD."

The strongest gains, Dr. Barkley notes, are in children who are particularly defiant or oppositional. "Thus, researchers and clinicians should anticipate," he notes, "that long-term studies are more likely to find treatment effects on problems secondary to ADHD than on deficits specific to ADHD."

Teenagers

Once children with ADHD reach adolescence, there is less evidence for the effectiveness of behavioral training. Several studies have failed to show results for cognitive behavioral therapy for teens with ADHD, Dr. Barkley explains, but CBT does have a role for kids with ADHD who develop secondary problems like conduct disorder and oppositional defiant disorder.

And Dr. Emanuele notes that since ADHD puts kids at risk for developing an anxiety or mood disorder, many of them are treated with CBT for those disorders. In some cases, she notes, kids have actually outgrown their ADHD symptoms but they're still struggling because the consequences of ADHD persist.

There is no evidence that traditional talk therapy or social skills groups, despite their popularity, are effective for kids with ADHD, according to Dr. Barkley.

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For a detailed look at the evidence for various treatments of ADHD, including both psychosocial and pharmaceutical, see this very thorough online course developed by Dr. Barkley.


Study: Number Of Kids with Autism May Decline Under New Diagnostic Criteria

From LiveScience
via Huff Post Parents

By Rachael Rettner
January 22, 2014

The number of U.S. children estimated to have autism could decline as a result of new criteria to diagnose the condition, a new study suggests.

The findings show that 81 percent of children in the study diagnosed with autism under the old criteria would still be classified as having the condition under the new criteria, which were released last year in the new edition of the psychiatric handbook called the DSM-5.

Before the release of the DSM-5, some people were concerned that the new criteria would exclude some children who previously would have been diagnosed with autism, leaving these children without access to educational services available to children with autism.

The new findings should be reassuring to parents, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, who was not involved in the study.

"The overwhelming majority of children" who met the old criteria will continue to meet the new ones, Adesman told LiveScience.

In addition, it is likely that many children who fall short of a diagnosis of autism under the new DSM-5 criteria will qualify for services under a different psychiatric diagnosis, Adesman said.


According to Autism Speaks, an advocacy organization that funds autism research, no one previously diagnosed with an autism spectrum disorder (including Asperger's Syndrome) will "lose" their diagnosis.

"If you have a diagnosis for ASD, you have a diagnosis of ASD for your life, and should be entitled to appropriate interventions for the rest of your life," the organization says on their website.

More Stringent Criteria?

The new study reviewed information from 8-year-olds living in 14 areas of the United States in 2006 and 2008. The estimated prevalence of autism in 2008 under the old criteria was 11.3 cases per 1,000 people in the population, but under the new criteria, the prevalence dropped to 10 cases per 1,000 people, the study found.

Autism spectrum disorders are developmental disabilities that can cause language delays, impaired social and communication skills, and repetitive behaviors. Over the years, the criteria used to diagnose autism have been revised several times.

In some ways, the new DSM-5 criteria for autism may be more stringent than the previous criteria, said study researcher Matthew Maenner, of the Centers for Disease Control and Prevention. For example, the minimum number of symptoms a person needs to have to be diagnosed with autism using the old criteria was two, but now, the minimum number is five, Maenner said.

However, in other ways, the new criteria are more flexible, Maenner said. For example, they allow doctors to consider past behaviors, rather than just current behaviors.

Still on the Rise

Diagnoses of autism have risen in recent years — a trend not likely to be reversed by the adoption of new criteria, the researchers said.

Maenner noted that most of the children in the study who met the old criteria for autism, but failed to meet DSM-5 criteria, were off by only one symptom. (They had four symptoms instead of the necessary five.)

Many doctors are aware that a diagnosis of autism will qualify children for services, and it's possible that some doctors could be motivated to add more symptoms for children who are very close to meeting the diagnosis, Maenner said.

Because of the change in criteria, it will be challenging to compare newer estimates of autism prevalence to older ones, Maenner said. The new study "is a step we can take to begin to understand how to put those numbers in context," Maenner said.

The study is published today (January 22nd) in the journal JAMA Psychiatry.

Sunday, January 26, 2014

Which Autism Interventions Work Best?

From DisabilityScoop.com

By Michelle Diament
January 21, 2014

A new federally-funded review of thousands of studies finds that there are more than two dozen autism interventions worthy of being called “evidence-based.”

Researchers combed through over 29,000 studies published in peer-reviewed journals between 1990 and 2011 that tested various behavioral, developmental or educational interventions for autism to identify the most meaningful approaches for those with the developmental disorder from birth through age 22.

Ultimately the
review, funded by the U.S. Dept. of Education, identified 27 interventions with substantial research backing, ranging from cognitive behavioral intervention to exercise, modeling, scripting and use of a picture exchange communication system.

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Download and print the 114-page (2.35mb PDF) guide, "Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder, HERE.

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That’s an increase over the 24 interventions considered to be proven in an earlier version of the report that was produced in 2008.

The review, which is often relied on by professionals and parents alike to assess what approaches are worthy of trying is produced by the National Professional Development Center on Autism Spectrum Disorders, a multi-university center housed at the University of North Carolina at Chapel Hill that trains professionals and promotes the use of evidence-based practices with those who have autism.

“Parents often pay for interventions that have no evidence behind them,” Samuel L. Odom of UNC who co-headed the effort. “This report will allow them to make the best choices.”

In order to be deemed an “evidence-based practice,” interventions needed to have backing from at least two group studies conducted by different researchers or at least five studies that collectively included 20 participants or some combination of the two scenarios.

Beyond the 27 interventions that received a stamp of approval, the review also highlighted 24 methods that have some support, but not enough to be considered proven. These included music therapy, theory of mind training and a technique known as sensory diet where various activities are integrated into a child’s routine to meet their sensory needs.

“Some interventions may seem cutting-edge, but we don’t yet know if they have any drawbacks or trade-offs,” said the report’s lead author, Connie Wong of UNC. “Our report only includes what’s tried and true.”

Saturday, January 25, 2014

From ScienceBlogs.com's Respectful Insolence

By Orac
June 11, 2012

A couple of weeks ago, I was horrified to learn of a new “biomed” treatment that has been apparently gaining popularity in autism circles. Actually, it’s not just autism circles in which this treatment is being promoted.

Before the “autism biomed” movement discovered it, this particular variety of “miracle cure” has been touted as a treatment for cancer, AIDS, hepatitis A, B and C, malaria, herpes, TB, and who knows what else.

I’m referring to something called MMS, which stands for “miracle mineral solution.” As I pointed out when I discovered its promotion for various maladies, and then later, when I discovered its promotion at the yearly antivaccine quackfest known as Autism One, MMS is a form of bleach.

It’s industrial strength bleach, actually, 28% sodium chlorite in distilled water. Before use, MMS is frequently diluted in acidic juices, such as orange juice, resulting in the formation of chlorine dioxide (ClO2), which is, as the FDA characterized it in its warning about MMS, “a potent bleach used for stripping textiles and industrial water treatment.”

You might be thinking now: Orac, that’s a really nutty idea! Why on earth would anyone think that bleach would be a cure for anything other than stains? Well, as far as I can figure out, besides being told by God that MMS is a cure-all, a man named
Jim Humble based his decision to bleach people’s diseases away on the use of ClO2 as an antimicrobial in water supplies.

Of course, as I’ve pointed out before in detail, just because something kills bacteria in water or in a dish does not make it a good antibiotic. It’s the same reason that colloidal silver is quackery. Colloidal silver is actually a pretty good topical antibiotic, but taking it internally, it’s impossible to achieve plasma levels adequate to have antimicrobial effects without undue toxicity. The same principle is in effect here.

ClO2 works very well as a water disinfectant, but trying to achieve plasma levels equivalent to those required to disinfect water is a straight line to toxicity, and failing to do so leaves all toxicity and no potential benefit.

More importantly, the hidden assumption behind Humble’s selling of MMS as a miracle cure is that the diseases he’s targeting are all due to microbes. Even if MMS were an effective antimicrobial and antibiotic (leaving aside the claims about how it can be useful for pretty much all bacteria, viruses, and parasites), this rationale is utter nonense when it comes to cancer and autism.


While a few cancers have their origins in infectious diseases (H. pylori leading to stomach cancer or human papilloma virus leading to cervical cancer, for example), by the time the cancer has developed it’s too late. Getting rid of the microbe won’t reverse the cancer.

What really seemed to hit a nerve, though, was a presentation by Kerri Rivera (see for yourself at the Autism One quackfest, in which she advocated MMS as an autism treatment).

When I first wrote about it, the video wasn’t posted yet, but now it is (see part 1, part 2, part 3, part 4) so that you can see for yourself that the talk is no different than what could be expected based on her handouts and her previous talks. That alone was bad enough, but she also advocated giving MMS to autistic children in the form of enemas, in essence claiming that bleach enemas can cure autism.

Even worse (if that were possible), Rivera advocates “fever therapy” and views fevers after bleach enemas to be a good thing, a sign that the treatment is “working,” much as Jim Humble gives MMS to treat adults in increasing doses until they start to feel ill. Indeed, Rivera even exults about how much she loves “fever therapy” and how it “wakes up the immune system.”

In addition to the bleach enemas, she recommends a “72-2″ protocol that involves making children drink dilute bleach every two hours for 72 hours.

In fact, posts by myself and
others (such as Emily Willingham) about forcing autistic children to undergo bleach enemas in a vain attempt to “bleach the autism away,” as I put it, hit such a nerve that there is now a Change.org petition signed by over 1,500 people entitled No bleach enemas to “cure” autism in children!

Well, I guess there’s nothing that quacks won’t defend, because various advocates and quackery apologists are coming out of the woodwork to defend Rivera and her MMS protocol. For instance, Jim Humble himself has placed a counter-petition on Change.org that reads:

"Stop telling people that MMS is bleach because it is not. Because there are some mothers that don’t realize that Emily is wrong and they may never help their child to attain normalcy."

So, there! You evil skeptics! You’re preventing parents from “recovering” their children from autism using bleach enemas! Stop it with your damned skepticism and insistence on science-based medicine! We believe MMS cures autism, and that’s enough!

The petition also has only 31 signatures at this reading.

In any case, when looking for someone to defend the indefensible when it comes to autism quackery, there’s only one place to go; so I went there. Yes, I’m referring to the antivaccine propaganda blog Age of Autism, where the ever-reliable Julie Obradovic wrote a piece about the Autism One quackfest entitled
Autism One: Is there a doctor in the house?

Ms. Obradovic is unhappy, too. She’s unhappy about the blogosphere’s take on Kerri Rivera and her bleach enemas:

"Sometime that night I saw a nasty article already on the Internet about Autism One. To start the conference, there was one slamming it and The Chicago Sun Times. Now to end it, there was one slamming it and the parents who attend.

A blogger, who hadn’t attended the conference, but instead was regurgitating another blogger (who hadn’t attended the conference either), wrote an entire article about the inability to “bleach” the Autism out of a child. She was referring to MMS, a treatment being used for gut problems in some children that hadn’t even been presented yet. It was on schedule for the next morning.

It struck me as really odd that something most people at the conference didn’t even know much about had already been completely scrutinized by people who seem loathe the mere idea of medically treating a child with Autism (with anything but pharmaceuticals, apparently). It seemed obsessive and premature, to say the least, and it was eerily reminiscent of what happened with other interventions in the past."


What other interventions are those? OSR, an
industrial chelator that Boyd Haley tried to sell as a supplement to be used to treat autistic children, at least until the FDA finally stopped it? Chelation therapy itself, which can kill?

"There are certain treatments that one doesn’t have to experience for oneself, and talks that one doesn’t have to attend oneself, to realize that they are fetid, stinking piles of horse droppings."

From what I can tell, Ms. Obradovic is referring to a
post by Kristina Chew, which cited my earlier post about Ms. Rivera’s MMS talk. Whichever posts Ms. Obradovic is referencing, one thing is clear. There are certain treatments that one doesn’t have to experience for oneself, and talks that one doesn’t have to attend oneself, to realize that they are fetid, stinking piles of horse droppings.

It wasn’t hard to glean what Kerri Rivera was going to say from her previous talks, her blurb about her Autism One talk, and her handouts. It was even easier to come to the educated opinion that what Ms. Rivera does to autistic children is pure quackery and quite likely child abuse. No wonder she practices in Mexico, the land where quacks who would be shut down in the U.S. go avoid pesky things like laws and regulations regarding medicine and the standard of care.

Note also Ms. Obradovic’s framing of the issue. To her, it’s not a matter of bloggers like myself being outraged because quacks like Kerri Rivera exist and subject autistic children to bleach enemas until they have diarrhea, calling that diarrhea “good” as long as it’s “detox diarrhea.”


It’s not a matter of us being puzzled and alarmed at how parents could buy into this quackery. Our criticisms, to her, are not a matter of our wanting to protect children who make up an especially vulnerable population, autistic children. Oh, no.

To Ms. Obradovic, supporters of science-based medicine attack quacks like Ms. Rivera because we “loathe the mere idea of treating a child with Autism” with anything other than pharmaceuticals. This is, of course, utter nonsense, but I have no doubt that Ms. Obradovic really believes it.

So, in answer, I will assure her that I personally do not “loathe the mere idea of treating a child with Autism” with anything other than pharmaceuticals.” In fact, I don’t care whether a treatment for autism—or anything else for that matter—is pharmaceutical or otherwise. I only care that the treatment be based on sound science and supported by well-designed clinical trials.


"What I do loathe is the idea of treating a child with autism with a therapy that has not one whit of scientific evidence to support its plausibility, is potentially dangerous, and, at the very minimum, subjects autistic children to what is likely torture for many..."

What I do loathe is the idea of treating a child with autism with a therapy that has not one whit of scientific evidence to support its plausibility, is potentially dangerous, and, at the very minimum, subjects autistic children to what is likely torture for many of them (enemas, even leaving aside the question of bleach) with no prior evidence that they are likely to benefit from the treatment.

In brief, I loathe the idea of subjecting children, be they autistic or neurotypical, to such rank quackery. Come up with a plausible non-pharmaceutical treatment for autism with some real science—not crank rationales—behind it, and I’ll be interested and possibly even support doing clinical trials if the preclinical evidence is compelling enough.

In other words, I go where the evidence leads me, and it sure doesn’t lead me to MMS.

Apparently not Ms. Obradovic, who proceeds to tone troll:


"But mostly, the article irritated me for its tone. The author’s message was clear: parents who try these treatments are gullible, dangerous, and/or don’t love their children, and the people who pass them off are snake oil salesmen."

Some of these are straw men; others are not. The biggest straw man of all is that we claim that parents who try these treatments are gullible and/or don’t love their children. The parents might be gullible, or they might just be insufficently scientifically sophisticated to recognize quackery. No one that I know of claims that these parents don’t love their children.


On the other hand, we do say that the people who pass such treatments off are snake oil salesmen, because they are, although it’s an insult to snake oil to compare MMS to it. And that’s OK. We’re coming to a conclusion we consider reasonable based on the evidence. It doesn’t matter whether someone like Jim Humble or Kerri Rivera actually believe in their snake oil. It’s still snake oil. I’m sorry if Ms. Obradovic is offended to read that, but it’s the truth.

Moreover, the actual purveyor of this snake oil, Ms. Rivera herself, is pretty pathetic when it comes to defending MMS. This can be best seen in
her response to an open letter by Autismum criticizing her use of MMS to treat autistic children. Autismum’s open letter is a blistering attack on MMS quackery that concludes:

"Your “treatment” is abuse. It lacks plausibility. It lacks humanity. You advocate dosing autistic children with your over-priced poison to treat the fantasy symptoms of candida such as, “laughter for no reason.” I love it when my 46 lb., four year old Welsh boy laughs even if I can’t tell what’s tickling him. I won’t do a thing to prevent that."

So how did Ms. Rivera respond?
With a non-response, actually:

"You have your science all wrong. The websites that you site are incorrect. I wish you and your son all the best. Wonderful hearing your opinion. Everyone has one, be it informed or misinformed.
--Kerri"


This is nothing more than argument by assertion. Ms. Rivera seems to think that simply asserting that her critics “have their science all wrong” is enough. She doesn’t explain how we allegedly have our science wrong. She doesn’t provide anything resembling decent scientific or clinical evidence to support her position and show that we are wrong. She doesn’t even make a minimal attempt at a science- or evidence-based counterargument.

I’ll close by noting that there might be some reason for hope. Even if the quackfest known as Autism One has no filters when it comes to allowing dangerous quackery to be presented, apparently Ms. Rivera’s—shall we say?—novel treatment strategy using bleach enemas brought out some actual skepticism, at least about MMS, in the comments after
Ms. Obradovic’s defense of quackery. Some examples follow.

First, someone named
Fielding J. Hurst, who in an earlier comment declared himself a believer in “biomed” treatments:

"Chlorine Dioxide is the important part of this discussion. Your copy/paste is on Sodium Chlorite. Chlorine Dioxide has been shown to cause impaired thyroid and kidney function, as well as cause neurological impairment.

Also, there is a big difference in killing external pathogens and ingesting it. Bleach kills the pathogens by poisoning them, that doesn’t mean it’s a good idea to ingest it."


WHAT ABOUT ALL OF THAT GOOD BACTERIA IN THE GUT PROMOTED BY OTHER BIO-MED TREATMENTS THAT WORK? CAN SOMEONE NAME ME A BLEACH RESISTANT GOOD BACTERIA? I spent a decade healing my daughter’s gut issues that I can easily see undone quickly with this stuff.

If we can’t agree that it’s not a MIRACLE, can we at least agree that IT’S NOT A FRICKIN’ MINERAL. SOLUTION, yes. At least a little truth in the name.

My favorite tidbit from the Archbishop Humble … IT’S NOT REAL DIARRHEA! Thank goodness. Fake Pseudo Diarrhea is very good for you. It’s a sign of a miracle in progress."

OK, there’s no actual evidence that the “other” biomed treatments “work” any better than MMS, but at least most of them aren’t bleach. Oh, wait. They are things like hyperbaric oxygen, chelation therapy, bizarre diets, supplements and other things equally potentially harmful. Never mind.


At least Mr. Hurst realizes that MMS is quackery—unlike all that other quackery. That’s a start. Perhaps that skepticism will blossom and spread to a lot of the other autism “biomed” quackery out there.

Then there’s someone by the name 'tiredmom':
"I believe that autism is a fully-recoverable gut disorder, that the children are suffering and deserve treatment. That being said, I think that there is A LOT of snake oil in the biomed world of autism. Autism is awful and parents are desperate and will try anything. I have also observed that we don’t demand a lot from whoever comes out with a new product. We don’t demand that they prove anything to us because they are one of the few who are telling us that they believe in our kids and are trying to help.

I have had parents admit to me that certain doctors or supplement people asked them to endorse their products or program and gave them free supplies. I think we have to become a lot more skeptical. I don’t believe we can always trust other parents’ opinions.

While there are many biomed treatments that help and even recover children, many children get better in the early years without any intervention, but if the parent is trying a certain biomed protocol at the time or even therapy they will credit that."

I was amazed that there was actually a comment recognizing that some autistic children improve on their own, and that many parents trying biomedical woo mistakenly attribute such improvement to the quackery du jour they’re using. Unfortunately, the vast majority of comments were more supportive, at least tolerating Ms. Rivera’s quackery, like this comment by RisperDON’T:

"Whatever happened to the Mercury apologists, “The dose makes the poison?” Gone?

Naysayers trashed and got OSR removed from the market for its origin as a waste water treatment before revision for human use by one of the nation’s leading University chemists.

Fluoride was suggested as a pesticide early on.

And many FDA approved (and off label use) drugs today have known toxicity including death (e.g. chemo) and those who refuse it are considered the quacks."


This is, of course, a typical fallacy used by defenders of quackery: Because real science-based medicine has side effects and complications, criticizing pseudoscientific treatments for their potential side effects is unfair.


I am impressed, however, that Ms. Obradovic managed to restrain herself from pointing out how some chemotherapies still used (nitrogen mustards like cyclophosphamide and melphalan) had their origins as chemical warfare agents.

Be that as it may, the difference is, of course, that these real medical treatments have scientific evidence and clinical trials showing that they work, how they work, and that the benefits outweigh the risks. MMS has nothing of the sort.

In the end, regardless of what other “biomedical” treatments are beloved at Autism One, I keep holding out hope that the organizers of Autism One would be able to realize that there are some things that are so beyond the pale that they don’t belong even at Autism One.


I agree with Sullivan and Emily on this count that the organizers of Autism One should renounce such quackery, in particular Kerri Rivera. Unfortunately, I also realize that this will never happen because, apparently, offering “hope” to parents of children with autism requires never “judging” and remaining “open-minded.”

Unfortunately, we all know what happens when you are too open-minded. Your brains fall out.