 Many, if not the majority of families with a child suffering from autism, pursue dietary and nutritional approaches as components of treatment. Estimates of the use of alternative therapies range from 28 to 95% with special diets or dietary supplements the most frequently cited approach. Why so common? Perhaps parents are acting on suspicion or distrust of standard medical practices or desire not to have their children drugged, considering alternative approaches more safe, natural, holistic, but could also simply be because the drugs don't work. Pharmacological interventions in autism are mainly aimed at reducing associated symptoms. Calm them down, help them sleep, but have no effect on the core symptoms of ASD, Autism Spectrum Disorders, like the social withdrawal, abnormal behaviors. Only two drugs have been approved for the treatment of autism and both just target an associated symptom irritability rather than the core deficits of the disorder. Both drugs also have significant side effects, including weight gain and sedation. It's no surprise then that parents seek alternative therapies. Okay, but do the alternatives work any better? In the alternative medicine literature, you'll see a lot of this kind of attitude. Evidence shm-evidence, as long as the treatment isn't harmful, why not give it a try? Or even going further to suggest trying a treatment, even if the evidence is stacked against it, because hey, maybe your kid's the exception. I'm sympathetic to that thinking. Unfortunately, there are many unscrupulous charlatans out there, eager to take advantage of parents desperate to try anything that sounds like it might help. These researchers report receiving several emails a week from practitioners offering the cure for autism, often for the low-low price of $299 reporting to their horror at how these emails use guilt and guile to manipulate families. I mean, if you really loved your child, wouldn't you want to leave no stone unturned? When challenged, many such practitioners of these supposed cures will say things like, I know it works, I've seen it work, or I don't want to spend time and money testing it when I could be helping children right away. The researchers urge parents to run, not walk away from any treatment that claims to be too good for science. All treatments should be subjected to the rigor of well-designed, double-blind, placebo-controlled clinical trials our children deserve no less. Parents try them anyway, often without even telling their physicians, noting a perceived unwillingness among doctors to even consider potential benefits of alternatives, which I think arises because we've been burned so many times before. High-profile examples of ineffective or even dangerous complementary and alternative therapies have led to a general mistrust of and distaste for anything believed to be outside the box. Take the secretan story. Improved social and language skills, improved core autism symptoms after secretan administration. Secretan is a gut hormone involved in digestion. It's used in a diagnostic test for pancreatic function, so they're just doing this test on some children who just happen to have autism, and to their surprise, within weeks of administering the test, there was a dramatic improvement in the children's behavior, improved eye contact, alertness, and language. Understandably, this sparked a media frenzy. Parents scrambled to find the stuff leading to a black market for the drug. What makes an interesting television program may not, of course, be the same as what makes for good science. You've got to put it to the test. A randomized control trial on the effect of secretan on children with autism and no significant effects were found. Though the study used porcine secretan pig hormones, maybe human secretan would work better. And the answer is, no, apparently not. Lack of benefit from human secretan, too. But no, look at the data, secretan totally worked. One shot of secretan in autism behaviors dropped within days. But the same thing happened, injecting nothing, injecting saline, injecting water. That's why we do placebo-controlled studies. The widespread circulation of those anecdotal reports of the miraculous benefits of secretan may have raised expectations so much that it biased parents into perceiving improvement, explaining the effects of the placebo injection. In this way, ineffective treatments can become widely accepted, even if there's no evidence to back them up. Exemplified by the fact that most parents in the study still remained interested in secretan, even after being told that it didn't work. They just couldn't give up hope. So the autism community continued to press. I mean, it's just gotta work. In the end, 16 randomized placebo-controlled trials were performed, evolving more than 900 children, and no evidence of benefit was found. None of the studies revealed significantly greater improvements in measures of language, cognition, or autistic symptoms when compared to pretending to give the kids drugs, but actually giving them nothing at all. In the absence of effective and affordable treatments for autism, parents of children with the disorder are extremely vulnerable to extravagant claims of potential cures. In the case of secretan, it was like a perfect storm of factors that propagated the myth, prompting a frenzy of secretan purchases by thousands of parents, often at hundreds or even thousands of dollars per dose. The secretan story shows why it's so important to subject proposed treatments to scientific scrutiny instead of just accepting anecdotal reports as proof.