I
have to thank Paul Whitely for a post on his website that I am hijacking
today. Click on Paul’s name to go to his
blog.
National Institute
for Health & Care Excellence (NICE)
Autism, The management and support of children and young people on the autism spectrum. The
guideline is still in the draft stage, but there are two versions:-
DO NOT:-
Consider a social-communication intervention for the management of the core features of autism in children and young people. For pre-school children consider delivering the intervention with parent, carer or teacher mediation. For school-aged children consider delivering the intervention with peer mediation.
Now, I am no medical genius, but nor am I a complete moron. I read the full Stanford research paper as a highly sceptical, but informed, parent. I concluded, as did the Stanford team, that they had found something very important. To get the full report you have to pay $31.50 but I figured it was well worth it. So if this excellent research just gets sliced and diced, and then trashed, in this 790 page review, how much faith do I have in the other 787 pages?
I am with those Quacky Californians on this one. Those NICE Brits can call me a quack too.
NICE
is an organisation in the UK, funded by the Department of Health. They produce excellent guidelines on most medical conditions for both doctors and
patients. They are all available free on
line.
NICE & Autism
NICE
are producing a guideline called:- Full version (790 pages)
Summary (40 pages)
You
may wonder who on earth is going to read a 790 page document. The 40 page document does not say a lot, you
could summarize it as folows:-
- Children should have access to care and therapy, that does not currently exist
- Local autism teams should have the skills to provide, or organize, the interventions and care recommended in this guideline, but they currently do not have these skills.
- No magic cure exists
The NICE list of Dos and Don’ts
(Mainly Don’ts)
DO NOT:-
Do not use the following
interventions for the management of core features of autism in children and
young people:
·
antipsychotics
·
antidepressants
·
anticonvulsants
·
exclusion diets
(such as gluten- or casein-free diets) -
sorry Paul
Do not use omega-3 fatty acids
to manage sleep problems in children and young people with autism.
Do not use auditory integration
training
Do not use the following
interventions for children and young people with autism in any context:
·
secretin
·
chelation
·
hyperbaric oxygen
therapy
DO:-
Consider a social-communication intervention for the management of the core features of autism in children and young people. For pre-school children consider delivering the intervention with parent, carer or teacher mediation. For school-aged children consider delivering the intervention with peer mediation.
Consider the following for
children and young people with autism and anxiety who have the verbal and
cognitive ability to engage in a cognitive behavioural therapy (CBT)
intervention:
·
group CBT
adjusted to the needs of children and young people with autism
·
individual CBT
for children and young people who find group-based activities difficult.
For behavior
that challenges, try antipsychotic medication.
The 790 page version - NICE Brits 281 and
Californian Quacks 305
I
was rather disappointed by the 40 page version of NICE, so I opened up the 790
page version. I recommend you do
too. It is totally different. Some people have spent many 1000’s of hours
analysing all the scientific literature on a wide range of biological, social,
psychological and educational aspects of autism.
The
problem was on page 281. This
is the page where those clever guys over at Stanford 94305, get their research into Glutathione (GSH) mentioned. (94305 is their zip code)
Then
on pages 389/390 NICE give their verdict on the Stanford guys' findings.
They conclude that while NAC does nothing bad, it also did nothing good.
I am with those Quacky Californians on this one. Those NICE Brits can call me a quack too.