I see that the NIMH hasfunded a new study on the use of transmagnetic stimulation in conjunction with ABA. TMS as it is called is the use of a tool that generates a magnetic field around a given brain area that will either knock it out or enhance it. It can be used to assess function in the area depending on what affects it has. It also has interest as a possible therapeutic tool for conditions such as depression and autism. I do not think I have to explain what ABA is to most of my readers. The grant from the NIMH is $900,000 given to researcher Manual Casanova. Casanova has done research on minicolumns which are groups of brain cells that are abnormally small in autism. The small minicolumns are believed to result in lack of inhibition of certain actions. Using TMS Casanova believes that he can artificially stimulate these inhibitory activities that the small minicolumns are not able to produce. Apparently some believe that this technique used in conjunction with ABA will produce some sort of results in autism.
One of the problems that I have with this is that Lovaas(the most celebrated of ABA practitioners and researchers) has already received quite a bit of money from the NIMH to study the adult outcomes of the participants of his subjects in his renowned 1987 study where he alleges a coin-flip probability of normal functioning in nearly half of the autistic children who as research subjects received 40 hours a week of ABA. I don't know how much money the NIMH awarded him to study these as yet still unpublished adult outcomes; however, this current study is running a tab of approximately $900,000. I don't feel that the taxpayers should foot the bill for more research into ABA therapy until we get the true story of what happened to those supposedly recovered autistic adults who are now in their late 30's, early 40's. Did they graduate college, did they become physicians, lawyers, dentists or engineers? Did they marry? Did their improved IQ scores remain stable? According to what little I have been able to gauge from my correspondence with Lovaas heir-apparent Tristram Smith, there were other psychologic tests administered to these subjects as adults as well.
Another problem is apparently only a pilot study has been done with TMS in which Casanova has gotten some results in a small group of autistic children. We still don't know what its effects are or lack of them is in autistic with just the TMS alone and no ABA other than these very preliminary findings. Of course, in a well-designed study we might be able to get an idea of which treatment affected what change.
Confounding variables were also dealt with in Lovaas(1987). What was found, however, is of chagrin to most behaviorists. Lovaas' work found that the active ingredient in ABA was the contingent use of aversives, such as hitting, slaps, water in the face and even in some cases electric shock. Without the aversives Lovaas (1987) would not have its marketing points and ABA never would have been able to achieve its current status as a cottage industry. This is in spite of the fact that the Hughes act outlawed aversives on developmentally disabled children in 1991. Therefore in jurisdictions such as my home state of California where aversives are a no-no, ABA is dishonestly marketed. Lovaas claimed in a rebuttal to his detractors written about 8 years ago or so that he had found new methods that made the use of aversives obsolete. If this is the case, to the best of my knowledge, he has never presented any evidence of this in a peer reviewed journal-the same fate that has become of his apparently NIMH funded aborted study of the adult outcomes of these children.
Transcranial magnetic stimulation may or may not be a state of the art treatment that will produce pie-in-the-sky rather than shit-from-the-sewer results in persons with autism. Interestingly enough, John Elder Robison, who wrote the bestseller Look Me in the Eye has gotten into the act This is in spite of the fact that on page 5 of his book he states that Asperger's is not a disease but a different way of being. He went on to state there was no cure and no need for one. Yet now he seems to feel the need to be a guinea pig in TMS research stating:
"I knew how much I had struggled as a young person - not knowing, being called 'retard' or 'freak.' This might help young people."
A possible complication from TMS is that it can induce seizure disorders. But supposedly, technology has improved and people have learned how to use this effectively enough to avoid giving someone a seizure.
Though this might be a good line of research at some point in time, one problem I have is that not enough is known about the etiology of the brain dysfunction responsible for ASD's. I suppose if Dr. Casanova were available to me he could explain the rationale to me based on what is known of the neurophysiology of autism aside from the work he has done on minicolumns. It may be that the autistic brain has various things wrong with it in various regions spread out diffusely within the brain. There may be an elaborate mirror neuron system with a variety of connections and it might be hard to find anything that is wrong. I guess Dr. Casanova being the recipient of the grant may have to show some evidence that this is a promising line of research and possible treatment of autism. Of course the same cannot be said of Dr. Lovaas and his cronies. If the work is replicated by a researcher besides Dr. Casanova perhaps studies could be made of TMS in lieu of ABA rather than as an adjunct with ABA. As regular gadfly readers (of which I know there are not very many)I am a cynic when it comes to anything in autism research or the new autism treatments that come up not infrequently as variable flavors of the month. This work may or may not yield some promise for autistic people, but it may not generate anything other than a bitter harvest for years or decades to come. Also work in neurofeedback such as what Jaime Pineda and Lindsay Oberman and their ilk are doing may also be promising avenues. This work may generate figurative diamonds in the rough at some point in time. Much work needs to be done though.