ASAT's newsletter has got me thinking ...

01/08/11 12:20

Of course, now ASAT has got me thinking critically about the various studies! Regarding the Citalopram study referenced in the newsletter, I think that this study is highly flawed (and the flaw is subtle). Their sample group is problematic because they took children on the spectrum that displayed "moderate levels of repetitive behaviors" as defined by the Children’s Yale-Brown Obsessive Compulsive Scales modified for PDD and then randomized this group of children. Here's the problem (and I think most of us who are exposed to children with autism in an intensive way know this): repetitive behaviors that are self-stimulatory in nature are different from repetitive behaviors that are obsessive compulsive (OCD). It is difficult to see the difference unless the researcher has been exposed to many children for a considerable period of time. The main difference in my view is that the child who engages in “self stim” looks like s/he is enjoying the experience (rather than is driven to perform the behavior out of compulsion and is relieved when the compulsive behavior is completed). Since some children on the spectrum also experience OCD (which generally goes undiagnosed), their behavior may improve on citralopram; however, if most of the children in the study do not also suffer from OCD, then there will be no effect. My point here is that they need to redo the study with children on the ASD spectrum whose repetitive behaviors are a function of OCD rather than a kind of self-stimulatory behavior. I think that they will be much more likely to find an effect if they redesign their study...