Autism Science is a strange little corner of research and medicine. It seems to attract a host of researchers who must have been at the bottom of the class when they learned about the scientific method. Or ethics. Or research methods. Or statistics.
Many research studies on autism are not so much science as “science.”
Today’s exhibit is this article by Arizona State University, titled “Autism Symptoms Reduced Nearly 50% Two Years After Fecal Transplant.”
The article starts off with a scary-sounding quote supposedly from the CDC, predicting a “swelling tide” of autistic adults “for which the country is unprepared.”
They helpfully link to the CDC report… which says no such thing.
A quick google search for the quote reveals that it was not the CDC who said this, but some writer for The Atlantic who obviously didn’t realize that there are already lots of autistic adults walking around.
Anyway, the article describes how fecal transplants can be used to help people with chronic GI issues. This is a real– if young– science and studies have shown some promising results.
So poop transplants are weird, but there’s a lot of evidence to show that they often work. But some people are beginning to find links between your gut “microbiome” and mental ilnesses like depression.
So that makes them wonder if the right gut bacteria can cure autism, even though it isn’t a mental illness.
In this particular experiment, run at Arizona State University, 18 autistic kids were fed donated fecal bacteria in chocolate milk for three months. Kids who didn’t want to drink the poop milk got enema-like doses rectally instead.
By the end of the three months, the GI symptoms had improved by 80%, with far less abdominal pain, diarrhea, etc. Wonderful!
Mind you, they didn’t control for the placebo effect, but this method has been known to be effective in the past so let’s give them the benefit of the doubt and say it really worked.
The researchers discovered that as the GI symptoms improved, so did the autism symptoms– namely “aberrant behaviors” and social communication problems.
Children with ASD saw improvement in their scores in the SRS, which assesses social skill deficits, and the ABC, which evaluates irritability, hyperactivity, lethargy, stereotypy, and aberrant speech. https://doi.org/10.1186/s40168-016‑0225‑7https://doi.org/10.1186/s40168-016‑0225‑7
In other words, they discovered that kids who no longer suffer abdominal pain, diarrhea, or constipation are less irritable, don’t have as many meltdowns, and are more social!
To the scientists, the reason seems obvious — because the new gut bacteria helped their autism. No other possible cause for the change, like, you know, feeling better, is discussed.
These results are promising and provide a crucial step for understanding the connection between the microbiome and ASD.https://doi.org/10.1186/s40168-016‑0225‑7
But according to the article, the really big news is their follow up study two years later.
Two years later, the kids were still seeing a substantial improvement in their GI problems, and they were even more communicative and had fewer “aberrant behaviors” than before.
The fact that the kids had continued to improve over two years of growth and continued therapy is — according to the researchers — obviously because the probiotics they received changed their brains and has nothing to do with the fact that kids grow up.
While the researchers had no control group of autistic kids to compare to (their “control group” consisted of a bunch of NT kids who had no GI symptoms and received no treatment, so… basically weren’t a control group at all), they concluded that this improvement was probably more than could be expected without the fecal transplant.
They based this on some study of 345 kids which showed that 80% of them had “stable” autism symptoms throughout childhood. Except that this isn’t a random population. This is a sample of 18 kids who were relieved of pain and misery.
Maybe the researchers are right — maybe this change is because the donated poop bacteria changed the kids’ brains.
But I think we need to consider the fact that the kids were feeling better and getting older before we jump to the conclusion that changing the gut microbiome heals autism.
As usual with studies involving autistic people, the researchers didn’t think to ask the actual kids what they thought.
I’d be interested to know whether they just felt more able to do things once they felt better, or whether they actually had an improvement in real autism “symptoms” like sensory sensitivity.
But really, the most annoying thing about this article is its messed up priorities.
The study was not presented as a victory in autism research because autistic children had fewer abdominal issues, less pain, and more comfort. The victory was that autistic children acted less autistic.
Stereotypy, or stimming, is a natural behavior for autistic people. It increases when the nervous system is excited– by joy, pain, illness, stress, or hopeful anticipation. Autistic people also find it much harder to cope with challenges like socializing and task-switching when they are already worn down by other troubles.
The reduction of stereotypy or irritability does not mean someone became “less autistic.” It means that autistic children became less overwhelmed.
Maybe they should focus on the truly important issue– that 18 kids were relieved of suffering by this treatment.
Hurray for poo milk!