Are there tests that are not recommended for the diagnosis or management of autism?
The following tests are not recommended for the diagnosis or treatment of autism on a routine basis:
Heavy metal testing. Tests for serum levels of mercury, cadmium, or arsenic are not appropriate for the routine evaluation of autism. Although exposure to heavy metals is known to be toxic to humans and may even result in some neurologic disabilities, the cause of autism has not been linked by scientific evidence to exposure to heavy metals. Similarly, tests for such proteins and antibodies as fibrillarin or metallothionein, which may indicate heavy metal exposure, are not appropriate.
Hair analysis. Drug and chemical residues, toxins, and heavy metals in the body embed in hair fiber protein a sit grows. Testing hair rather than blood or urine has the advantage of capturing evidence of toxic exposures that may have occurred in recent weeks or months. Hair analysis is used commonly by pathologists and forensic experts to identify such exposures and to identify issues important to occupational health, public health, and the prosecution of crime. The use of hair analysis in the diagnosis of autism is inappropriate for several reasons.
These include:
– It presumes that autism is caused by exposures to toxic substances.
– Minute and clinically insignificant amounts of toxic substances may appear in typical and atypical children; finding trace amounts of them in hair does not make a diagnosis.
– The use of hair analysis for ASD diagnosis is not supported by any rigorous scientific study.
Celiac antibodies. Celiac disease (CD) is a lifelong digestive disorder, found in individuals who are genetically susceptible to it. This susceptibility results in damage to the small intestine that ultimately results in interference with the absorption of nutrients. Celiac disease is unique in that a specific food component, gluten, has been identified as the culprit.
Gluten is the common name for the offending proteins in specific cereal grains that are harmful to persons with CD. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains: rye, barley, and triticale. Damage to the mucosal surface of the small intestine is caused by an immune reaction to the ingestion of gluten.
Physicians have described the neurological and emotional aspects of patients suffering from celiac disease, which include irritability, anxiety, and withdrawal. Although there are similarities between these manifestations of celiac disease and autism, the association ends there.
Autism is not caused by celiac disease or an allergy to gluten. Testing for antibodies to gluten or intestinal proteins is not appropriate for the diagnosis of autism.
Food allergy testing. A review of Internet sites concentrating on the diagnosis of autism reveals that some practitioners offer an array of tests that supposedly measure antibodies to certain foods or components of foods that these practitioners believe are a cause of autism. These tests may include tests for antibodies to milk proteins, gluten, gliadin, soy proteins, dipeptidylpeptidase IV, and antitransglutaminase.
The benefits of this testing are not supported by scientific evidence.
Testing for infectious diseases. Although an infectious agent has long been suspected as a cause of autism, despite exhaustive scientific inquiry, no agent has been identified. Therefore, practitioners who subject children to tests for infectious agents in order to diagnose or treat autism should be viewed with skepticism.
Routine testing of children for infectious agents in order to diagnose autism is not recommended. Tests in this category are antibody tests for the following agents: human herpes virus-6, streptococcus M protein, chlamydia species, mycoplasma species, and clostridia neurotoxins as well as yeast and fungal species.
Immune system function testing. Some practitioners recommend tests of immune function for the diagnosis and treatment of autistic children. These tests may include a measure of serum immunoglobulins such as IgG, IgM, IgA, and IgE; the activity and effectiveness of the blood’s natural killer cells; and its T4 and T8 lymphocytes or even a measure of a cytokine calledtumor necrosis factor. There is no scientific evidence linking the cause of autism to immune function in general or these measures in particular. There is no evidence demonstrating that treating these immunologic measures is an effective therapy for autism.
Vitamin and mineral testing. A deficiency in vitamins and/or minerals has been suggested as the cause of diseases that range from the common cold to cancer. Indeed, there are few diseases whose cause has not been attributed to vitamin deficiency at one time or another.
These attributions have rarely, if ever, been supported by scientific evidence. Additionally, while there are a few diseases that are known to result from a vitamin deficiency (e.g., beriberi, pellagra, goiter, and scurvy), they are exceedingly rare in Western countries like the
In contrast, malnourishment and vitamin deficiency are common in the third world, yet autism is not more frequently diagnosed there. Further, scientific evidence does not support ideas that autism either is caused by vitamin deficiencies or can be cured by supplementing the diet with vitamins and minerals.
Vitamin and mineral testing is inappropriate for making the diagnosis of autism or for managing the behavior of children with autism. Tests for vitamin deficiency are not recommended by any accepted medical authorities on autism, nor is there a solid scientific foundation for their use.
William’s comment:
Several families we’ve met at Liam’s school report that they’ve had success with alternative therapies, such as allergy testing and that heavy metal business. When asked them for some published medical studies that support these treatments, they didn’t have any. We haven’t seen data to substantiate these claims either, though we’ve looked.
Terms:
Celiac disease (CD) – A disease in which the intestinal lining becomes inflamed after ingestion of foods containing gluten (a protein found in oats, wheat, rye, barley, and triticale). The symptoms in infants and children include diarrhea, slow growth, bloody stools, weight loss, and vomiting. Thought erroneously to be a cause of autism.
Beriberi – A specific nutritional deficiency syndrome that occurs from a deficiency of thiamine. It results in painful nerve damage in the hands and feet and heart failure.
Pellagra – A specific nutritional deficiency syndrome that occurs from a deficiency of niacin. It results in gastrointestinal disturbances, skin rashes, and mental disorders. Sometimes called St. Ignatius Itch or alpine scurvy.
Goiter – A chronic enlargement of the thyroid gland, occurring in areas where food is produced in soil that is low in iodine. Sometimes called
Scurvy – A specific nutritional deficiency syndrome characterized by weakness, anemia, swelling of the hands and feet, and ulceration of the gums and loss of the teeth. It is caused by a diet lacking in vitamin C. Also called scorbutus and sea scurvy. Vitamin and Mineral testing is inappropriate for making the diagnosis of autism or for managing the behavior of children with autism.
