Academic journal article Ethical Human Psychology and Psychiatry

Intricacies, Complexities, and Limitations of Research on Autism Treatments: An Examination of Seven Treatment Approaches

Academic journal article Ethical Human Psychology and Psychiatry

Intricacies, Complexities, and Limitations of Research on Autism Treatments: An Examination of Seven Treatment Approaches

Article excerpt

Part 1 of this article, published in Volume 12, Issue 2, probed factors associated with autism. Many of those factors had to do with how toxic substances are polluting our environment. Investigative chicanery involving one neurotoxic agent in particular (thimerosal) was uncovered. The controversy surrounding this neurotoxic agent was examined in some detail, and questions were raised whether information about the degree of toxicity of thimerosal was being minimized, distorted, or covered up by authorities and agencies in positions of influence. Other potentially harmful sources that might differentially contribute to what some might regard as an autism epidemic were listed and described as well.

In this section, science and scientific investigation are described, with particular reference to the complexities, intricacies, and difficulties inherent in conducting research on autistic children, and how these intricacies complicate drawing definitive conclusions about if, how, or why a treatment method did or did not work. In addition, seven treatment approaches to autism are listed, along with concise descriptions of these methods and a general rationale underpinning each method. Considerable attention is paid to applied behavior analysis (ABA) because most behavioral treatments derive from it. Commentary on other treatments is provided, such as psychoanalysis, special diets, and chelation. In particular, aftereffects associated with medication tactics are noted.

Keywords: autism; treatment approaches; behavioral techniques; psychodynamic interventions; medication tactics; "autistic monkeys"

As difficult as it has been to pin down the origin of autism with a high degree of specificity and agreement among researchers, it has been no less of a thorny task to study treatments for autism. One of the problems may be that autism treatments do not lend themselves easily to being examined in the laboratory. Of necessity, treatment must be studied in the natural field, "on the fly," so to speak. However, because of the unpredictable nature of many autistic children, performing reliable in-depth treatment research is tantamount to attempting to study a bullet in flight.

In the aforementioned regard, a lengthy, discursive review by Herbert, Sharp, and Gaudiano (2002) indicated that nearly all treatment approaches to autism, to one degree or another, have not been supported by most empirical investigations. Does this mean that all treatments for autism fail? Alternatively, could it mean that when lumped together statistically, either the methodologies for empirical data gathering and/or statistical analyses of the overall obtained results of studies done thus far are not promising?

It is my position that the studies of treatment outcomes cited by Herbert et al. (2002) that showed poor results did so because research seeks (as it should) to make generalizations from findings that are derived from samples of varying sizes to a whole population. As a result of this noble endeavor to obtain scientific results, individual cases are often overlooked, disregarded, or dismissed out of hand. This has been particularly true with respect to recent studies of autism, where individual cases are rarely considered to be sources worthy of most empirical investigation.

Because children with autism vary from each other in significant ways and degrees, despite certain by now well-known commonalities-autism requires much more investigation of individuals (perhaps more than other disorders) and begs for a much greater emphasis on the use of case studies. Although some are troubled by the use of case studies, Dan Fishman (2005), editor of Pragmatic Case Studies in Psychotherapy, points out that it is a perfectly "legitimate, accepted method in published applied and professional research" (p. 2). His position is consistent with several other investigators who have made the case for the revival and further refinement of the case study method (Edwards, 1998, 1987/1996; Fishman, 1999a, 1999b; Fishman & Peterson, 1987; Sechrest, Stewart, Stickle, & Sidani, 1996), all of whom have put forth related rationales for the use of case studies as a means of systematically evaluating clinical observations. …

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