Leave it to my good buddy Mark Crislip over at the Society for Science-Based Medicine to have my back when I don't have a lot of time for a detailed post. (Basically, I was being a good university and cancer center citizen last night, going out to dinner with a visiting professor, and I ended up staying out later than I thought. Fortunately, it was a bunch of people that I liked, and it was a very nice restaurant, which made being good enjoyable, particularly when we got to talk a lot of science.) He pointed me to an absolutely horrible study. The modality is perhaps not quite as bad as aversive therapy that I described a week ago, but for autistic children it's still plenty bad, man. I'm referring to chiropractic for autism.
Yes, you read that right. Chiropractic for autism.
There's a chiropractor in Fargo, ND named Scott Van Dam who posted an article Hope for Autism on his website, referencing a study on website Chiropractic Research, a site I hadn't encountered before (I know, I know, it's hard to believe) and appears to be—shall we say?—a "target-rich" environment to be bookmarked for the future. In any case, the study referenced is from 2006 appeared in the Journal of Vertebral Subluxation Research (JVSR.com, which now turns up an "domain available" placeholder, suggesting that the journal is as nonexistent as chiropractic subluxations, although there is now an Annals of Vertebral Subluxation Research, which is just as bad). That tells you all you should need to know about the journal right there. Of course, as I've pointed out, antivaccine views and chiropractic are two quacky tastes that taste quacky together; so, given how many antivaccine activists consider vaccines to be a cause or contributor to the "autism epidemic," I suppose it shouldn't be too surprising that chiropractors think they can treat autism by back cracking.
As Mark Crislip points out, the study itself is not exactly what we would call...methodologically sound, if you know what I mean. Of course, you might say, why would we expect it to be methodologically sound? After all, it's chiropractors who think that they can treat autism by cracking autistic children's back or necks. Even so, this study goes off the rails right from the very first paragraph:
Since the primary problem in autistic children is neurological, it is prudent to research the efficacy of chiropractic care in these children. Functional MRI in patients with autism showed significant differences from normal people in the activity of cerebellar mesolimbic and temporal lobe cortical regions of the brain when processing facial expressions. 1 These differences are most likely neurodevelopmental in origin. There are several different approaches for treatment of autistic children beyond the scope of this paper 2; some of these will be mentioned later. Diagnosis of this condition is based upon parent’s observations of specific behaviors, and an experienced team of clinicians. This team may include a neurologist, psychologist, pediatrician, speech/language therapist, learning consultant, and other professionals who are knowledgeable about autism.
Yes, because autism has something to do with the brain, then "adjusting" their spines will help the behavioral problems in autism! Basically, these chiropractors took 14 autistic children, administered the Autism Treatment Evaluation Checklist (ATEC) to them. They started chiropractic manipulation and had the parents do monthly ATEC scores on them. Well, actually, first they randomized the children into a group receiving the full spine treatment versus upper cervical adjustment for reasons every bit as fantastical as the rationale for chiropractic and this study itself because they wanted to find out the "recommended chiropractic technique in these cases of autism." Note how they assume chiropractic will help. So there's no control group, no blinding of any kind, and the treatment must have been at least somewhat traumatic because one parent dropped out because "the parent refused to continue to handle the difficulties of stabilizing her child during x-ray procedures." Translation: Holding the kid down during procedures was too difficult for this parent. Indeed, as Mark noted, these children were stressed for no good reason:
- "A few of the children displayed aggressive behavior such as pushing, falling, flaying arms in the air, and kicking."
- "X-ray examination proved to be the most difficult procedure for autistic children. There had to be another doctor, chiropractic assistant, or parent available to help with the process. In most instances, the presence of the parent was an important component to keep the child from moving. A few circumstances required that the patient’s head be stabilized with another’s hand."
- "Hypersensitivity to light and sound were also observed. Light from the collimator bulb either scared or fascinated the children. Sound from the adjustment instrument had the same effects."
As for that third one, no wonder the autistic children were frightening::
The selected method for upper cervical adjustment used in this study was Atlas Orthogonal (AO). This technique utilizes pre-adjustment /post-adjustment supine comparative leg checks, spinal palpation and a percussion adjusting instrument.
The percussion adjustment instrument is used in AO technique. The patient is placed on his side with head support at four inches below the mastoid. A metal stylus is placed between the mastoid and the ramus of the mandible. An adjustment, an impulse imparted to the stylus by a plunger that excites a compressional wave in the stylus, is then delivered to the patient. At the patient-stylus interface, a portion of the wave energy is transmitted to the patient and a portion is reflected back to the plunger.
That's right. For the cervical group, these chiropractors were taking a plunger, sticking it between the mastoid process right near the ear and the back part of the mandible and hitting it to "impart energy," all accompanied by unnecessary radiation exposure and trauma of being held down in order to obtain completely unnecessary X-rays of the cervical spine.
The results, as you might imagine, are meaningless. Both groups improved after three times a week chiropractic evaluation and adjustments, but because there was no control group and no blinding and the outcomes were so short term as to tell us very little this study is worthless to tell us anything. There are a bunch of cervical spine X-rays that purport to show elimination of “subluxations” but appear to show nothing of the sort.
One thing Mark Crislip wasn’t familiar with Bernard Rimland and the Autism Research Institute (ARI), the organization from which the ATEC sprang. (Hey, if I’m going to do a “me too” post, at least I have to add something different to it not covered by Mark.) According to the paper, one reason the ATEC was used (besides its not having been copyrighted) is because “It was designed by experts in biomedical research for the care of autistic children.” Well, not exactly.
Let’s just put it this way. The ARI is known for being antivaccine to the core and devoted to “autism biomed” quackery. In the past, it used to maintain a list of the quackiest of quack autism doctors, the “Defeat Autism Now!” (DAN!) doctors. Indeed, ARI even lent its signature to a petition supporting Andrew Wakefield. In addition, the ARI was one of the sponsors of Luc Montagnier’s highly dubious study looking at infectious causes of autism in which he proposed to treat autism with antibiotics, probiotics. It was also one of the financial supporters of Laura Hewitson’s horrible and unethical study examining thimerosal as a cause of autism in monkeys. Surprisingly, even though the source of the ATEC is font of quackery, it’s not a horribly unreasonable tool. It has, however, as far as I’ve been able to tell, largely been supplanted by newer, more well-validated tools.
In any case, this is chiropractic research. Mark Crislip was right to characterize it as “frightening autistic children” for no good purpose. It’s a study about as bad and unethical as can be imagined. I suppose I should be relieved that it didn’t combine other forms of “autism biomed” quackery with chiropractic, such as chelation therapy, to the back cracking of chiropractic. It makes me wonder what institutional review board (IRB) approved this study. Oh, wait. There’s nothing about IRB approval mentioned in the article. Never mind.
This is only tangentially related to the subject of the post, but can somebody explain to me why it's called "chiropractic"? Morphologically, that's supposed to be an adjective. What idiot first decided to make it a noun without at the very least adding an s?
the study referenced is from 2006 appeared in the Journal of Vertebral Subluxation Research (JVSR.com, which now turns up an “domain available” placeholder, suggesting that the journal is as nonexistent as chiropractic subluxations…)
So we have a confirmed instance of a fly-by-night journal.
Which is just as well for the alleged authors of that alleged study, because if that first paragraph is representative of the quality of that article, they would be out of their depth in a car park puddle.
@Yerushalmi: Perhaps the inventor/founder of chiropractic knew less about ancient Greek than he did about modern medicine. Which would have been an impressive feat in a supposedly educated person a hundred years ago, as knowledge of Greek was then considered essential for educated English speakers.
In a just world, the inflictors of this sort of trauma on autistic children would be locked up for child abuse.
Why am I reminded on a Dutch quack Maria Sickesz who claims to be able to treat things like schizofrenia, by manipulating the neck.
This is the only article in English I could find.
I wouldn't give him even that much benefit of the doubt, Eric, since you don't have to know any Greek to recognize that "chiropractic" is an adjective construction. Heck, they *use* it as an adjective themselves. "Chiropractic adjustment." This is a mangling of the English language, but not an unusual one; English is relatively tolerant of pushing words into other parts of speech unchanged. "Nounification", if you will, which isn't all that different from "verbing" (the act of making a noun act as a verb). But as an English major myself, it does put my teeth on edge. It's comprehensible, but sloppy.
An off-topic note. An article in the July 30 Wall Street Journal: "Researchers Fret as Social Media Lift Veil on Drug Trials". Here's the link to the paywalled article: http://online.wsj.com/articles/researchers-fret-as-social-media-lift-ve…
So we have a confirmed instance of a fly-by-night journal.
Heck, they *use* it as an adjective themselves. “Chiropractic adjustment.” This is a mangling of the English language....
The modality is perhaps not quite as bad as aversive therapy that I described a week ago, but for autistic children it’s still plenty bad, man.
From the sound of it, the "chiropractic" being practiced on these poor kids is just another form of aversive therapy, which might account for the improvements the study claims. People have pointed out a similar pattern with MMS and other unpleasant forms of autism quackery: kid misbehaves, kid gets bleach enema (or whatever), rinse and repeat. Parents often note that the poor kid is "quieter" (read: exhausted) after one of these "treatments," and presumably over time the behaviors that result in punishment (oops, I mean "treatment") will decrease in frequency, simply due to operant conditioning, so the parents come to believe that the treatment "cured" their kid's autism.
Also - no IRB approval for a study using human subjects? How is that that even legal? I mean, seriously, can't you be arrested for something like that?
*clicks link, confused* Topology?
^ (Alternatively, would "chiropractics" be an improvement?)
*clicks link, confused* Topology?
Schwarzschild metric, Kerr metric, Euclidean metric, etc. W—pedia has a stick up its ass about how the GR versions are "more properly" the "metric tensor," but they don't raise the same complaint about the "Euclidean metric function" or some other aimlessly clumsy Thistlebottomism.
Sarah -- well, well...no IRB approval. The temptation to drop a dime on these people (dime, heckfire, more like a manhole cover) is growing.
Schwarzschild metric, Kerr metric, Euclidean metric, etc. W—pedia has a stick up its ass about how the GR versions are “more properly” the “metric tensor,”
I'd say they are being excessively pedantic: if you know enough physics and/or mathematics to know how to use a non-Euclidean metric, you know that it's a tensor, and so does your audience, so you don't have to spell it out every time. Strictly speaking, the Euclidean metric is a tensor, too, but one with special properties such that you don't have to worry about that fact (such tensors are called "isotropic").
The possible issue with "topology" is it can refer both to how, e.g., a surface is connected, and the branch of mathematics that studies the consequences thereof. It's not the only mathematical term of art to have such a dual use (one can speak of "an algebra", which one studies using algebra, or "a geometry" studied using geometry), but it's the one most likely to be used by people who don't know quite enough about the subject to speak intelligently about it.
"Metric" doesn't have the same fingernails-on-chalkboard quality for me as "chiropractic" even though it also ends in "-ic" and is used as an adjective; I suppose I've just gotten used to it. Which, I suppose in fairness, is how language works -- the grammatical horrors of one century become the bastions of pedantry in another. ;-)
Now what *does* bug me is talk of "meeting our metrics" at work. But that's for a totally different reason. :-D
"For the cervical group, these chiropractors were taking a plunger, sticking it between the mastoid process right near the ear and the back part of the mandible and hitting it to “impart energy,"
Between the jaw and the mastoid process ... "imparting energy" into that hollow right below the ear and behind the jaw?
That's one of the places my self defense instructor pointed out as a good place to attack to inflict pain on an assailant ... ram your thumb, car keys, pencil or whatever into that hollow spot. He demonstrated it. It HURTS!!!!
And this fool is doing it to children?
Functional MRI in patients with autism showed significant differences from normal people in the activity of cerebellar mesolimbic and temporal lobe cortical regions of the brain when processing facial expressions
Copying a sentence almost verbatim from a source is 'plagiarism', even if (as here) one distorts its meaning by omitting the comma between 'cerebellar' and 'mesolimbic'.
Fourteen children under chiropractic care at Kentuckiana Children’s Center in Louisville, Kentucky, participated in this study.
In case you were wondering about the KCC, the first author (who evidently specialises in grifting on autistic children) elsewhere describes it thus:
Since its inception in 1956, Kentuckiana Children’s Center (KCC) has existed to provide chiropractic care for children in exceptional circumstances. ... In the early days of operation, the Center’s staff served children suffering from the ravages of polio, the myriad disabilities associated with cerebral palsy and epilepsy as well as children with a variety of genetic limitations including children with Downs Syndrome.
given how many antivaccine activists consider vaccines to be a cause or contributor to the “autism epidemic,”
The article at issue prefers the euphemism "mineral intoxication".
I can design a study of chiropractic treatment for autism that would be about a million percent more ethical and have prior plausibility. Based on the principle of trying the least invasive treatment first (because isn't that what they usually want from a chiropractor, as opposed to other types of practitioners, in the first place?), have the kid stretch out face down on the funny tablebenchbed thing, plop a heat pack on the supposedly out-of-whack region of their back or neck, let the kid partake of their preferred music to keep them still, and leave them that way for 15 minutes with no one bugging them. It'd probably work wonders compared to anything the curebies are into...where do I sign up for a NCCAM grant to study this?
Yes maybe, but do you have a good control?
Oh btw, there's a resting room at work for which there's a big comfy chair which I listen to music for 30 minutes to an hour to relax between coding sessions. Would that work too?
Controls? I didn't know NCCAM was into that kind of thing. But we could do a pragmatic study of heatpack vs. coldpack if it makes a difference in getting funding.
And quit bragging about your self-prescribing privileges.
Don't know what I'm self-prescribing (except a few beers tonight) but you'd be jealous about my work condition.
it is prudent to research the efficacy of chiropractic care
I'm not sure in English, but in French "prudent" would mean to me "better be very cautious about trying it". Here it seems to mean "we better try it, stat!".
So many assumptions packed in this little sentence...
Both groups improved after three times a week chiropractic evaluation and adjustments
"Mommy, could we not go to the scary man today? His hands are clammy and he hurts."
As Sarah A. already pointed, I betcha kids - and parents - were willing to pretend everything was better after a few days of this ordeal.
That's one of the points of a well-designated control group, for FSM sake - to measure how much the improvements are due to the patients being fed up with the trials and just wishing to go home.
As was stated in previous comments, most uses of the word "metric" come as adjectives with an implied noun that comes afterwards. But even those uses that aren't are still less grating, because "metric" is used as a quantifiable noun. We've slowly gone from talking about "a metric tensor" to "a metric", which is fine.
"Chiropractic" has no such excuses. It's a mass noun. That's just horrifying.
This article is essentially a semi-informed person making a lot of guesses.
Autistic children being difficult to position to x-rays is not surprising, and in fact the use of the term "traumatic" belies the uninformed hyperventilating going on here. It is very easy to "traumatize" an autistic child since they have social and behavioral issues, not that taking a series of x-rays could fairly be described by traumatic by any person but someone with an axe to grind. Grinding an axe is not science.
Furthermore, the lack of a control group does not totally invalidate this. It suggests that follow up research, if indicated, should include tighter methodology. Not all research is perfect, instead the clinician and researchers progress towards more valid and more reliable research as the data allows.
The AO technique is not traumatic, by the way. Next time you want to talk about something as if you are informed about it, first inform yourself about it. I suppose it was chosen because of the specificity and quantifiable nature of the technique with pre and post adjustment protocols and measurements to verify structural change if it should occur.
I have had many parents bring autistic children to my office, and I adjust them. Parents tell me it helps. I do not tell parents it will help because I do not excel in neurological or developmental/behavioral disorders of the child. Still, the adjustment has been shown to have measurable changes in CNS activity which may very well serve to attenuate nervous system dysfunction. Educated, informed, skeptical parents tell me it makes a difference.
But then again you are a smart, smart man who has dinner with smart, smart people are fancy restaurants. I am sure you are incredibly more intelligent and these parents and any DC you disagree with are all wrong, because, well, you did some Google searching and you claim the mantle of science. Good for you, champ. Keep blogging.
Helianthus: beware of false cognates. ;-) Words shift over time and diverge from their common ancestry. "Prudent" in English means it's sensible and wise. So they're saying the sensible thing is to research the efficacy of chiropractic care. Personally, I disagree with them; I think it would be more prudent to spend our limited research capacity on more promising avenues.
Still, the adjustment has been shown to have measurable changes in CNS activity
Do you have citations for that claim?
which may very well serve to attenuate nervous system dysfunction.
Please tell us how autism is a "nervous system dysfunction" -- with you know, peer reviewed research.
I can certainly believe an adjustment, especially one as painful as this might be to a very sensitive individual (as many autistic people are -- seriously, these are people who find shirt tags excruciating), would cause measurable changes in CNS activity. So does somebody stomping on your foot. Just because there's a change doesn't mean it's good, or even meaningful. Hell, if the person isn't actually dead I'd expect *anything* perceptible to have some affect on the CNS. The CNS is where we perceive, after all.
I have had many parents bring autistic children to my office, and I adjust them. Parents tell me it helps. I do not tell parents it will help because I do not excel in neurological or developmental/behavioral disorders of the child.
I'm rather curious, then, what exactly you *do* tell them. You don't tell them it will help? What *do* you tell them when you recommend a particular procedure? Or do you not recommend anything? Are these people who sit silently while a stranger mutely performs procedures on their child, trusting that in your silence you will be accomplishing something helpful? (Talk about paternalistic, then.) That seems very peculiar to me, and so I don't think it's an accurate depiction of your practice. You must be telling them *something*. I mean, you don't seem like a monster to me. So what *do* you tell them, then, if not that you think there is some sort of point to this procedure?
@Rob #26 - what type of adjustment do you use on autistic kids, and why?
I think the adjustment device that is being referred to is the 'Activator', which seems to be beloved of the sublux chiros here in Australia for use on paed patients. It is affectionately known as the 'clicky thing' to those of us who like to challenge the beliefs of these chiros, and for the life of me I cannot see how in any way releasing a plunger to impact on the chosen area can have anything to do with any form of treatment given that the whole premise of subluxation is laughable.
And it would be very scary for kids, especially kids who don't process interactions and conract the way others do.
Autistic children being difficult to position to x-rays is not surprising, and in fact the use of the term “traumatic” belies the uninformed hyperventilating going on here. It is very easy to “traumatize” an autistic child since they have social and behavioral issues, not that taking a series of x-rays could fairly be described by traumatic by any person but someone with an axe to grind. Grinding an axe is not science.
Rob, you are an arrogant insensitive shitheel who obviously doesn't have the slightest clue or regard for what autistics may find traumatic. It's not about your or the parents' perceptions but the perceptions of your patients victims.
not that taking a series of x-rays could fairly be described by traumatic by any person but someone with an axe to grind
How does "idiotic exposure to ionizing radiation" work for you?
I was looking for something else, and found a library of citations of how wonderful chiropractic is for autism. I'll be posting one per comment because of URL restrictions.
Claims cure of autism.
As Published in the Journal Today’s Chiropractic; Vol 27, No 5: 32-47
Autism, Asthma, Irritable Bowel Syndrome, Strabismus, and Illness Susceptibility: A Case Study in Chiropractic Management
To what magnitude the upper cervical spine is involved in the genesis of organic conditions remains to be seen. In an atmosphere where much of the public see our profession as useful for neck and back pain treatment at most, patients with complex disorders are left unaware of the possible benefits of care. The body of literature detailing a possible upper cervical etiology, or at least contribution, to organic disorders is substantial. Further research into this area of the spine, combined with objective monitoring of neurophysiology, may reveal that chiropractic does indeed offer consistent conservative management of complex visceral disorders.
Sure they cured the child's autism.
Darn. Forgot the citation
Amalu WC. Autism, asthma, irritable bowel syndrome, strabismus and illness susceptibility: a case study in chiropractic management. Todays Chiropr 1998;27(5):32-47.
Marini NSC, Marini SC. Improvement in autism in a child coupled with reduction in vertebral subluxations; a case study and selective review of the literature: case report; review. J Pediatr Matern & Fam Health Chiropr 2010; 3:107-115.
Outcome Improvement was noted after the 4th adjustment. The mother mentioned that the child no longer rocked his head and jabbered less..... After his 6 th adjustment, the child began spelling out the words on video cassette covers, which is something he had never done before. The spelling of words in lieu of vocalizing the words continued for 6 weeks. He would either jabber or spell, but he would not vocalize words. The mother reported that after 7 weeks, the child began to vocalize his name, as well as the words that he had been spelling. ...
This case demonstrates that there is a possible link between chiropractic care and the reduction of autistic signs and symptomatology, as seen by the improvements in subjective and objective findings.
This one also includes a review of the "literature" showing effectiveness of chiropractic for autism treatment.
An Epidemiological Approach to the Effects Subluxation-Based Chiropractic Care had in Managing a Three Year Old Girl with Autism, Acid Reflux, Bilateral Head Pain, Seizures, and Vomiting: A Case Study and Review of the Literature
Eric Zielinski, B.A. Bio & Staci Jean Borkhuis, D.C. Bio
Annals of Vertebral Subluxation Research ~ September 12, 2013 ~ Pages 51-65
Interventions and Outcomes: Subluxation-based specific chiropractic care was administered to the patient which resulted in complete resolution of bilateral head pain, acid reflux, vomiting, and sleeplessness. Significant improvements in ASD manifestations were also noted including calm behavior, increased eye contact, happier demeanor, improved attitude, increased focus and attention and an initiation to sound out words. She continues to progress as is evidenced by a significantly increased vocabulary, continued improvement in attention and focus, and complete lack of epileptic episodes.
This one is cute. Eric Zielinski also wrote it up for Natural News.
Couldn't get a functional link for the following
Improvement in Autistic Behaviors Following Chiropractic Care: A Case Series
Jesse Cleave BChiro Bio, Joel Alcantara DC Bio, Kelly Holt BSc(Chiro), PGDipHSc Bio
Journal of Pediatric, Maternal & Family Health - Chiropractic ~ Volume 2011 ~ Issue 4 ~ Pages 125-131
Objective: To describe two cases of individuals diagnosed with autism undergoing chiropractic care.
Clinical features: Case one involves a 20 year old autistic male who displays aggressive behavior towards others. Case two is a 17-year-old autistic female who abuses herself.
Intervention and outcome: Both patients received a trial of chiropractic care for 5 and 4 months respectively with visit frequency of once per week. Both patients responded favorably to chiropractic care with the male patient decreasing in aggressive behavior and the female patient decreasing in self-abuse and improved socialization.
Conclusion: Two cases of individuals who suffered from autism are presented. Each had favorable results after undergoing chiropractic care. This case series provides supporting evidence that individuals with autism may benefit from chiropractic care. More research is warranted in this area.
Control group? Blinding?
Discussed in more detail at another chiropractor's blog
Evidently the patients were in New Zealand.
Are you impressed yet?
OK, penultimate one
Improvement in a 3½-year-old Autistic Child Following Chiropractic Intervention to Reduce Vertebral Subluxation
Nick Hoffman, BS, DC, David Russell, BS, DC
Journal of Vertebral Subluxation Research ~ March 24, 2008 ~ Pages 1-4
Objective: To describe, discuss and track the subjective and objective changes of a 3½ year old autistic girl following chiropractic adjustments over a 10 week period.
Clinical Features: A 3½ year old female child with reduced social interaction and language skills and learning difficulties presented for chiropractic care. The child had been diagnosed with autism 1 year earlier.
Intervention and Outcome: The child received full spine adjustments where indicated to reduce vertebral subluxation, using the Torque Release Technique protocol and Integrator™ instrument. Strong verbal and physical apprehension to initial care was observed, however no signs of this were present after 5 visits, along with further improvements in social interactions, language skills and increased symmetry in surface EMG and thermal scanning over the 10 weeks of care.
Conclusion: The subjective and objective improvements observed by both practitioner and parents following chiropractic care indicate a link between subluxation and autistic behavioral patterns. Comparable studies have been undertaken previously with similar findings, however further study needs to be conducted to determine the exact relationship between chiropractic care and behavioral changes in autistic children.
This is state-of-the-art chiropractic research.
When I first read this article I was stunned. However, it was the overwhelmingly opinionated (supposedly) scientific blog that stopped me in my tracks. To promote your opinion of your interpretation of this research study as if you are a source to be trusted, is a terrible representation of the scientific process. An appropriate critique does not require a respectful attitude, just cold hard facts. There is not a single substantial evidence based point in your article that refutes the results of this study. Note, since I am reviewing this profoundly ignorant and bigoted article, I may feel free to call it just that.
I want to address your statement about where the article has been published. The section stating that JVSR.com is as "nonexistent as chiropractic subluxations" is astounding. Especially because you mention that the Annals of Vertebral Subluxation Research exists, but you fail to mention that the article has been peer reviewed and published in that journal. You also neglected to give the reader a means in which to find the article, which is why your opinion being displayed as "superior" is so harmful to the scientific process and those who are unfortunately influenced by your "respectful insolence." If your readers wish to make up their own mind about the article here is a direct link to the abstract: http://vertebralsubluxation.sharepoint.com/Pages/2006_1135_autism.aspx
The Atlas Orthogonal adjustment, as you describe it, truly sounds terrifying and traumatizing. Unfortunately for you (and the readers that you have done so well to sway) the AO adjustment is completely painless. In fact the patient cannot feel C1 move at all, even though there are measurable changes recorded on the standardized x-ray series. However, one would only know this through true experience, not conjecture. But hey, we already established that you are purposefully ignorant.
Now, I will attempt to do what you failed to do and post the results free from opinion and preconceived judgement. The Autism Treatment Evaluation Checklist (used commonly, along with expert opinion such as those named in the article) showed an improvement of 32% in the upper cervical group and 19% in the full spine group. Two of the children in the upper cervical group "no longer met the criteria to be considered autistic" after the 3-5 month period.
Finally, I would love it if anyone can locate a peer reviewed blinded randomized controlled trial proving that a liver transplant in a patient with acute liver failure is beneficial to that person's health. Since this is apparently the only acceptable scientific design, Orac may need to create one before he opts out of the "quackery" that are liver transplants. Rob is correct in stating that this research study is something of a stepping stone, hence the paragraph at the end of the article stating that further research is necessary. To ignore the results of this study shows that you had already made up your mind before you read it.
A lot of research has been done and some has improvements while others have none. Could it be a case to case basis?
So provide that research, or just go away, spammer!
In reply to Brad #40, re: manipulation of the atlas cervical vertebra for hypertension, read this:
In my 43 years of practice as a chiropractor, I was never able to determine that manipulation of the spine ever permanently changed the position of the atlas or any other vertebra that is freely movable.
One more thing:
Finally, I would love it if anyone can locate a peer reviewed blinded randomized controlled trial proving that a liver transplant in a patient with acute liver failure is beneficial to that person’s health.
That is an extremely foolish demand. We know very well what the functions of a liver are, what happens in liver failure and that replacing a diseased liver with a healthy one will prevent those problems. Some medical interventions are not amenable to double blind RCTs, many surgical techniques are among them. This does not get chiropractic off the hook, as it is perfectly amenable to RCTs. If subluxations really existed, and if chiropractic was really able to do the things its practitioners claim, we would have evidence by now, 119 years after it was developed.
BTW I was tangentially involved in the development of liver transplants, and I know the years of work that went into their development. I analyzed the blood of some of the dogs and pigs that were used to perfect both surgical techniques and the use of cyclosporin as an immunosuppressant. I also did blood work on the first human patients, who were very ill and didn't survive very long (patients with liver failure don't clot very well, which does not mix well with major surgery). It took some time before improvements in survival were seen, and less ill patients were offered transplants.
One-year patient survival is now 80–85%, which is pretty good when you consider that before liver transplants were developed these patients faced a certain and very unpleasant death.
The Atlas Orthogonal technique, as used in the article, is not considered a "manipulation" of the Atlas. Medically, the term "manipulation" means movement by hands. During the Atlas Orthogonal adjustment no audible is present. This is a very low force, vectored adjustment determined by specific x-ray findings on a patient-to-patient basis. Also, to quote one chiropractor does not a case make. I know many (with more years of experience) that would disagree.
Trauma's, whether minor or major, have the ability to move the atlas. However, I have personally seen x-rays of doctors in the orthogonal position 8 years after their last adjustment. Don't worry, I don't expect you to take my word for it. However, I find it substantially more convincing to speak from experience rather than doubt (and most likely anger).
Finally, thank you for recognizing my sarcasm with the RCT comment. The lesson on liver transplants was illuminating. I do disagree with your statement that chiropractic is perfectly amenable to RCTs. There are many people attempting to find avenues in which chiropractic can fit into the established research design. However, not every technique can be blinded, randomized or able to incorporate a placebo.
To say that research does not exist to substantiate the subluxation is to say that you have not attempted to find it.
Peer reviewed journals exist that post articles every single day. Unfortunately, it does not seem "main stream" or "acceptable" because a majority of them are not published in well-known scientific journals. If you do not believe there is an outside influence attempting to keep chiropractic research from public light, you must not understand how powerful pharmaceutical money is.
To say that research does not exist to substantiate the subluxation is to say that you have not attempted to find it.
Excellent! So, as an expert, it should be very easy for you to point to an article or two that you think is the best evidence of subluxation, right?
Due to the fact that I can only put so many links in one post I will just post the titles.
The Existence and Clinical Meaningfulness of Vertebral
Matthew McCoy DC, MPH
Vertebral Subluxation Research: An Agenda to Explore the
Epidemiology of Vertebral Subluxation and the Clinical
Outcomes Related to Management
Matthew McCoy DC, MPH
Christopher Kent DC, JD
Combined Effect of a Biomimetic Oral Appliance and Atlas
Orthogonist Cervical Adjustment on Leg Lengths in Adults
Chris Chapman DC, BCAO
G. Dave Singh DDSc, PhD, BDS
Clinical models of vertebral subluxation
Christopher Kent DC, JD
Also, there is a great book called "Explorations in Chiropractic Theory" written by Mark Amos, BA, DC, DACNB.
Peripheral Nerve Response to Experimental Damage
Marvin W. Luttges PhD
Douglas E. Groswald, M.S.
Richard A. Garren, M.S.
of the Department of Aerospace Engineering Sciences University of Colorado
Finally, experiments performed by C.H. Suh, PhD at the University of Colorado, Department of Mechanical Engineering in August of 2000. Using the most advanced biomechanics computer technology available, Dr. Suh analyzed distortion-free pre and post x-rays and concluded that there is indeed a reduction or elimination of upper cervical subluxations via the use of the Atlas Orthogonal technique.