Autism News Beat

A recent article in The Oklahoman by Heather Warlick shows what happens when a credulous reporter lets an “alternative medicine” practitioner pass off speculation as scientific fact.

Dr. Bryan Jepson is a medical doctor, and the father of an autistic boy. He also wrote a book called Changing the Course of Autism: A Scientific Approach for Parents and Physicians. He trained in emergency room medicine, then became a self-proclaimed “autism specialist” after his son’s diagnosis. He currently works at Thoughtful House, an “alternative” autism clinic in Austin, Texas, founded by disgraced UK physician Andrew Wakefield. In 2005, Jepson was licensed by the Texas medical board after paying a $1,000 fine for false advertising. He had claimed, on an internet site, to be licensed to practice medicine in Texas even though he wasn’t.

Warlick says she read Jepson’s book before she heard him speak at an Oklahoma City conference. “He was very earnest, and the people at the conference seemed like they were appreciative to hear what he had to say,” she told Autism News Beat.

She told ANB that Jepson’s claims are backed up by medical studies, but when pressed for details, said she did not know how many of those “studies” are actual peer-reviewed papers from respected science journals.

She says that she found Dr. Jepson “to be credible, caring and concerned about the welfare of autistic children and their families.” But how can we accurately judge a doctor’s credibility? One way is to familiarize oneself with the meaning of peer review, which is an important process by which studies are reviewed by others who usually have equivalent or superior knowledge. Alternative medicine generally avoids evidence-based peer review in favor of its own journals. Too many bio-med claims are based on anecdotes and sales pitches. If, for example, autism was treatable through chelation, then why haven’t the bio-med proponents published peer-reviewed studies to prove their case?
In a follow-up email exchange, Warlick notes the “many differing opinions” about whether autism can be helped with a biomedical approach. “My job as a reporter is to convey information,” she explained. “I am not a scientist, nor am I a medical researcher.”

By scientist, I presume she means she lacks the same training and academic degree as the persons who research and publish on matters scientific. But is that really necessary in order to understand the difference between an evidence-based claim and one that is pure speculation? After all, reporters expose specious claims everyday when they are made by politicians, business leaders, and others. Why should “alternative” medical practitioners get a pass?

A stenographer conveys information. It takes a skilled journalist to assemble, critique, and frame in a meaningful way that enlightens and informs. It’s not enough just to label a questionable, potentially dangerous approach to treating autism as “controversial,” then balance your primary source with a quote from a real scientist. This approach too easily leaves the impression that both sides have equally valid points, whether the evidence points that way or not.

“My goals in writing this article were to shed light on the fact that autism rates are so high and to let people know that there may be some help out there. For so long, people have been told that there is nothing that can be done for their children. I think that is not only sad, but untrue,” says Warlick.

More accurately, parents are told “there is no known cure or treatment for autism”. That’s another distinction worth understanding, if only to make writing about autism easier the next time. Autism is a developmental delay, not developmental stasis. These kids mature, develop skills, and learn to adjust, albeit in their own way. There’s plenty parents can do, and it has nothing to do with exposing kids to unproven and potentially dangerous treatments, or mortgaging their homes for questionable treatments that insurance companies won’t touch.

Anecdotes are powerful tools in the hands of alternative practitioners like Jepson. The very nature of autism makes parents susceptible to unverified success stories and biased observations. Here’s why: because these kids continue to develop, it’s easy for a practitioner to encourage parents to continue with an alternative therapy and to note any improvement. If no improvement if forthcoming, the practitioner can either say “Oh well, the treatment does not work on every child,” or “Give it more time.” In most cases, the child will make some kind of gain, and the practitioner gets to credit the treatment. Developmental gains tend to come in spurts with these kids – one day they’re throwing food at the wall, and the next day they’re using a fork. The only way to test the bio-med approach is with control groups and double blind studies to eliminate observer bias. In the absence of a control, and given enough time, tap water can look like an effective treatment.

Dr. Jepson knows this. Reporters should too.