Monday, October 22, 2007

When the Mainstream is Mistaken: The Case of ABA

As regular readers might have noticed, Natural Variation is, for the most part, what one might call a "skeptic blog." This, however, doesn't mean that I generally bow to scientific authority, and on occasion you will see me question mainstream views, if I feel there are rational arguments that can be advanced to question such views.

This time I will question the view that ABA/EIBI is an evidence-based autism treatment. Let me start by quoting what major mainstream authorities think of it.

Behavioral training, including communication development, has been shown to be effective in reducing problem behaviors and improving adaptation.

There is a growing body of evidence that intensive early intervention services for children in whom autism is diagnosed before 5 years of age may lead to better overall outcomes.
(American Academy of Pediatrics, 2001)

Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning and appropriate social behavior.
(The United States Surgeon General, 1999)

Impressive, right? I will summarize reasons why some of us feel these statements were premature and not entirely supported by the data. Most of this has already been noted by Michelle Dawson and Morton Ann Gernsbacher, who have done a remarkable job of advancing science-based criticisms of ABA.

  • There are no randomized trials of ABA (with or without blinded assessments) demonstrating its broad effectiveness against "eclectic" management approaches.

  • One randomized trial of ABA (Smith, Groen & Wynn, 2000) was conducted to "address criticism of previous research and to increase methodological rigor." It compared a group treated with Lovaas-style ABA against a group receiving parent-instructed treatment. Only 13% of the children in the experimental group achieved "best outcome" (mainstream placement without support). No statistically significant group differences were found in either of two language scales. The paper reports a difference, but there was an error in the data analysis (Smith, 2001). No differences were found in socioemotional functioning or in adaptive functioning. Marginal differences were found in other measures.

  • There are controlled trials, such as Howlin et al. (2007), which have not found EIBI to be effective compared to autism-specific nursery provisions.

  • Adult outcomes of children who had received Lovaas-style ABA have not been reported in the peer-reviewed literature. Children from the experimental group of Lovaas (1987) must now be in their 20s and 30s. What would be the point of short-term gains if, hypothetically, adult outcomes do not differ from those of autistics who did not receive intensive interventions?

Specific Criticism of Lovaas (1987)

It is probably fair to say that the reason ABA gained mainstream acceptance was the widely reported "recovery" rate of 47% resulting from Lovaas (1987). In fact, the Surgeon General of the United States makes reference to it. The methodology of this landmark paper has been widely challenged, however.

  • There was no randomized assignment into groups.

  • Assessments were not blinded.

  • Male-female ratios in the experimental group and control group 1 differed from the ratio normally reported for autism (Boyd, 1998).

  • IQ assessment tools differed between intake and follow-up.

  • It is highly improbable that the reported ranges of intake IQ in Lovaas (1987) match the experimental group average IQ of 63 (source). In fact, the ranges are inconsistently reported.


There is a substantial body of Level-II-1 and lower quality evidence that suggests EIBI is an effective treatment approach. However, since there exists Level-I, Level-II-1 and other evidence that EIBI is not terribly effective, and also considering the lack of adult outcome studies, the statements by the Surgeon General of the United States and the American Academy of Pediatrics seem premature. Indeed, the trial which appears to be the most methodologically rigorous to date (Smith et al., 2000) was largely unsuccessful. The statements are also unfortunate because lowering standards of evidence could allow quackery in the door, and could result in us having to deal with "evidence based" woo.


  1. I agree that this study is not accurate. I believe that none of them are.
    Before you jump down my throat let me ask Joe, and all of you, some questions.
    Joe. You talk about Dawson and Gernsbacher discrediting aba science. You show how they broke this study down. Let me ask you an honest question Joe...Do you put the studies that agree with your beliefs through the same battery of scrutiny?
    Honestly, do any of you?
    Do you see studies that completely agree with everything you think and then say "but lets really scrutinize these studies and see if they hold water" ?
    I do...that's why I don't believe any of them.
    I am not trying to be honestly asking this question. Doesn't it bother you that none of you attack the studies that agree with you in the same manner that you attack the studies that disagree with you?
    Don't you feel as though you're not being fair and not really testing things on an equal basis?
    I couldn't live with that. I couldn't live with knowing I have one set of standards for things that agree with me and another for things that don't agree with me.
    None of you have to answer this outloud...just to yourself. How many of you believe what Dawson and Gernsbacher said about this study without checking their facts?
    How many of you read blogs and believe what the blogger says without checking them or their claims?
    Did any of you study this study yourselves? or are you all believing what Joe wrote that it has been discredited?
    Joe, did you go over the claims that Dawson and Gernsbacher made before you reprinted them?

    All studies (That involve any type of evaluation of children)are flawed and useless for two reasons.
    One is James Watson. The other is something that many claim to believe but when it comes down to it do not practice.

    The findings of these studies are exclusive to those children. If a study of ten or twenty or thirty or more children will yield the same result for all then one size fits all.
    I do not believe that it does.

    Then there is the James Watson factor.
    How can I believe the conclusions that are reached from the studies when it is humans setting them up and humans doing the evaluating and humans interpreting the evaluations and coming to conclusions that have to go through the filter of their view of the world.
    Do you think if James Watson evaluated children that he would have evaluated a black child the same as a white child?
    Do you think that these researches aren't prejudice, chauvinist, men haters, or just have to pee while they are evaluating a child and so they just go through the motions.
    Have each and every one of you given it your all every work day of your life?

    My point is that I don't know how a reasonable and fair person can scrutinize the studies that disagree with them with a more critical eye than they use for studies that do agree with them.
    I personally would feel like I am being hypocritical.

    There are MANY more reasons why these studies dont mean a thing.
    But if you truly believe that One Size Does Not Fit All then i dont know how you can believe that your child will have the same results as any children in a study.
    I like to think that my son is an individual who has no limits as to what he can be and what he can overcome. He is unique and just because someone tried an intervention on their child that worked it doesnt mean it will work for Jake. And vice versa.

  2. one last word about science.
    Many of you claim that "THIS does NOT cause developmental delays and THAT does NOT cause devel delays".
    Then you say you believe in science.
    But then you agree science can not prove a negative.
    So you admit that science CAN'T prove that a specific thing does NOT cause developmental delays. It can only prove what DOES cause developmental delays.

    So if you admit that science cant prove specific things dont cause devel. delays, why do you claim with such certainty that those things do NOT cause devel. delays.
    Then you turn around and speak of your belief in science.
    Science has only proven that those things have not been proven to cause developmental hasn't proven that they DON'T.

    I think thats important.

  3. Do you put the studies that agree with your beliefs through the same battery of scrutiny?
    Honestly, do any of you?
    Do you see studies that completely agree with everything you think and then say "but lets really scrutinize these studies and see if they hold water" ?

    I think I do. I may not write about it if I don't think the scrutiny merits it. But if I don't do that, I trust that someone else will, and the merits of studies will play out in the debate that ensues. That's what science is.

    I do...that's why I don't believe any of them.

    Really? Give me an example of a study you've scrutinized.

    Your argument sounds a lot like this: "Science doesn't have all the answers, therefore all opinions are equally valid."

  4. "THIS does NOT cause developmental delays and THAT does NOT cause devel delays".

    Do you have a specific quote that resembles this?

  5. And Phil, I'd appreciate it if you try to keep your comments on topic, instead of carrying over the debate from the prior thread.

  6. "I personally would feel like I am being hypocritical."

    No - merely presumptuous. Your basic assumption if I'm reading through the fog correctly is that Joseph (and others) are using two sets of standards - one for those articles they agree with and another for those they disagree with. Got any evidence for that? Or is it that you think that Science is a democracy? There are many viewpoints and they all have equal validity?

    For the record, I took a fairly close look at ABA, more its antecedents and supposed empirical basis really and came to the exact same points that Joseph has. No empirical basis, no theories - and less evidence for effectiveness when put against some decent standards.

    Also for the record, two of the latest studies have the same conclusion - when kids make progress, the intervention is immaterial. That's the Sallows and Graupner and the Howlin studies. Interesting eh?

  7. philcommander: "Let me ask you an honest question Joe...Do you put the studies that agree with your beliefs through the same battery of scrutiny?"

    OK Phil,
    Choose a study that you believe agrees with any one inidvidual's beliefs and let's see how many flaws and limitations can be pointed out.

    I'm sure there won't be quite as many as the fine research published by the Geiers or Bradstreet but no study is perfect.

    Shouldn't be too difficult for you, right? Pick a study, any study.

  8. Phil, if you don't find science important to your decision making, what the heck are you doing on this blog?There are plenty of autistic adult bloggers who don't write from this skeptic/scientific perspective.

  9. I'm dying to see phil commander share a study that he has read and critiqued, and then explain exactly what he found wrong with it.

    Hey phil, how about you give us a review of the paper about putting propionic acid in adult rat brains? I'd dearly love to get your take on it. If not that one, then any of them you have actually read would be fine. How about one of the recent paper from the CDC that was published in the NEJM about neurodevelopmental outcomes and thimerosal exposure?

    I'd also like to see where someone claimed, "this doesn't cause developmental problems".

    And Phil, your references to the "James Watson factor" make you look so ridiculous. How about "the Andrew Wakefield factor" if you want to name an utter slimeball in research. How about the "James and Rick Neubrander factor"? They don't turn me off of real research, they just reaffirm to me that the world has plenty of jerks and con-men running around.

    Also, thank you very much for this information assembled so nicely, Joseph.

  10. If Joe wanted to give me a study that he thinks is 100% correct in its science i would break it down and break it apart.
    It would have to include an evaluation of children.
    He would have to feature the outcomes or i wouldnt be interested.
    there ya go Joe, wanna try me?

  11. I can't think of a study that is "100% correct in its science", although I'm not sure what you mean by that. I thought the idea was that you'd scrutinize a study that supported your view.

    But I'll bite. Let's see what you can do to scrutinize this one.

  12. That wasn't my challenge. I was responding to Philip's allegation that certain hub bloggers tend to attack research that is counter to their beliefs while going easy on studies that are viewed as favorable.

    Philip is essentially accusing science minded autism bloggers of cherry picking studies so I'm calling his bluff. He can either point out an example or present a study that goes against his perceptions of hub blogger Philosophy so it can be critically reviewed.

    I'm not asking Philip to break down or break apart something that fits his criteria, that sounds like cherry picking to me, I'm asking Phil to choose a study that has been ignored or treated kindly.

    And Philip, recent racist comments by James Watson do no more to invalidate science than Rick James did to invalidate music.

  13. That study claims this
    "we believe that our study provides the first convincing evidence that advanced paternal age is a risk factor for ASD."

    They give what they feel are possible mechanisms for the increase of risk.

    What did these men do for a living? Do they drink? Smoke? Do drugs?
    They have had more years to be affected by different things in life.
    After 10 years of heavy drinking your liver will probably not nearly as damaged then after 20 years of drinking.
    There could be so many factors as to WHY there was an increased risk of autism and the real problem I have with this study is that is goes on to give opinions as to why there is an increased risk when the study did not test for ANY of those things.
    Lets just say for the sake of argument that they found out that after 25 years of smoking you have an increased risk of having an autistic child. Who would have more incidences of autistic children, 30 year old men or 40 year old men?
    How about long term exposures of low level metals? who would have had more exposure?
    Do you follow?
    The only thing that test did was show that theres more people in their 40s having autistic children than in their 30s and 20s in Isreal.
    Most men in their 40s also have less physically demanding jobs and are more overweight than younger men.
    How about if lack of exercise and being overweight have something to do with having an autistic child.
    Then who would have more autistic children? Older men of course.

    So this study might have established that in Isreal more older men have autistic children but it certainly didnt establish that is has anything to do with their age. There could be a hundred different reasons why they had autistic children and the only way to know would be to do thorough examinations of each adult and see if there is something that they have in common other than be a Jewish male.

    I only glanced over it but that is what jumped out right away at me.
    So in the end I don't feel this study tells us all that much.

  14. Is that it? They have way better potential confounds listed in the paper itself. For example, guys with ASDs might tend to procreate when they are older. The authors obviously understand there are many potential explanations for the findings. That's why they talk about "possible biological mechanisms", and in the conclusion state that even though "further work is necessary to confirm this interpretation, we believe that our study provides the first convincing evidence that advanced paternal age is a risk factor for ASD."

    I think the study establishes that older dads tend to have autistic kids more often. It's very difficult to argue with this, unless you want to say the authors made the data up, or that it was a freak result despite statistical significance.

    The interpretation the authors provide is probably the best one. The same phenomenon has been observed in various genetic disorders.

    Anyway, I'm not impressed Phil.

  15. you're not impressed because you miss the point. This is the conclusion they came to
    "Conclusions Advanced paternal age was associated with increased risk of ASD. Possible biological mechanisms include de novo mutations associated with advancing age or alterations in genetic imprinting."

    They clearly give what they feel are possible causes and yet have not done any studies to see if there is ANY reason to believe either of those two things are possible causes.
    Where did they pull those two possible mechanisms from???

    You copied it yourself so read it again...this is their quote
    " we believe that our study provides the first convincing evidence that advanced paternal age is a risk factor for AS"

    Is AGE a risk factor???
    If a twenty year old was exposed to high levels of GOOBLY GOO and a 40 year old was exposed to the same levels of GOOBLY GOO but it was over a period of years and both had kids that were born with six fingers...would you say that age is a risk factor for having kids with six fingers or that exposure to GOOBLY GOO was?

    This study does not show at all that AGE has anything to do with WHY the children have autism so it HASNT established that age is a risk factor. It may have nothing to do with age.

    Joe, you wrote this
    "I think the study establishes that older dads tend to have autistic kids more often. It's very difficult to argue with this, unless you want to say the authors made the data up, or that it was a freak result despite statistical significance."

    I agree with YOU...but they try to say that it is AGE that increases the if just by living longer you have increased the risk.
    That was not even close to being established by this test.
    say that 5 men out of 200 were in their 30s and had kids with autism compared to 10 men in their 40s.
    Was age a factor? Was age a risk?
    What if they found out that all 15 men drank far more coffee than ANY of the other 385 men who didn't have autistic kids.
    would the study find that age is a risk factor or caffeine?

    so the tests does not show what it claims to show.
    so I say its just a good example of bad logic.

  16. Where did they pull those two possible mechanisms from???

    Because it's well known that genetic mutations are more likely as you age. Are you sure you want to discuss stuff you are not familiar with?

    Is AGE a risk factor???

    Yes, that's the proper scientific way to express it.

    For example, having an autistic sibling is a risk factor. That doesn't mean that autistic siblings cause autism in younger siblings.

    Seriously Phil, you're embarrasing yourself.

  17. LOL! Joe, you are proving you have two standards.
    You say
    "Because it's well known that genetic mutations are more likely as you age."

    So what does that have to do with it being ok to name just those two factors when NOTHING has been shown in this study to indicate that there is reason to believe that they play a factor! NOTHING!
    They might as well say that Erectile dysfunction could be a mechanism because its also known that it occurs in men as they get older.
    You don't mind them using them as examples because the two mechanisms they name have to do with genetics and you believe autism is more genetic than environmental.
    the only reason why you say that I am embarrassing myself is because you don't want to deal with what I say in my posts.

    And I do know what a risk factor is and I don't think that this study sufficiently demonstrated that age meets the criteria.
    If it does then I can claim that living in New Jersey is a risk factor to developing autism.
    Would you be comfortable with that claim?
    You may feel the study did meet the criteria to call age of father a risk factor. I don't.
    But then again, you believe anything that agrees with you and if this study said that one possible mechanism could also be the fact that the longer you live the more you are exposed to mercury and other metals from pollution (which is a fact) you would be the first to SLAM this study.
    Double standard. Typical of the 'science' crowd.

    So Not Mercury got his example of a believer in science and neurodiversity having two standards for studies. His name is Joe.
    YOU should be embarrassed.
    But Suzzanne said it best, she told me that this is a blog for people who believe in science and that if i dont believe in science i should find another blog.
    Knowing that the creator of this blog has a double standard for studies that don't agree with him and for ones that do has left me more convinced that those who believe in science really are only looking for justifications to believe in the things that they do.
    They are not looking for the truth.
    They are running from it.
    I believe in logic.
    Science claims to but doesnt. And i havent found any from any of the people posting here (well, a few maybe).

  18. There's something called plausibility. Obviously, paper authors are going to propose plausible interpretations, and future studies will either confirm them or rule them out and propose other interpretations. That's how science works. I'm not sure how you think it should work. Apparently you think it's all pointless, while at the same time having no problem using the tools produced by science.

    Is living in New Jersey a risk factor for autism? If it were confirmed that the prevalence is higher in New Jersey than anywhere else, using equivalent methodology, yes.

    Now, you acuse people of having a double standard, but you have not been able to provide one example that demonstrates this.

  19. I didnt need to provide any examples Joe, you did that for me.

    You avoid any hard questions I give you.

    Yes, the occurance of autism is higher in New Jersey.
    Calling it a risk factor is using that term in its most general way. Its misleading.
    Science should use logic. It doesnt.
    I think i raised enough questions that should make anyone think about that study and wonder if the conclusions it comes to are correct and appropiate and if they came to a conclusion that the environmental toxins played a role then your community would attack the study in the same way I did, using the same arguments.

    But anyways, I think that I wont change anyones views here and I really never wanted to.
    I don't think I should continue to comment on your blogs simply because it is kinda just being a nuisance.
    So it was interesting debating with you and good luck with your blogs.
    Take care Joe and anyone else.

  20. PC:.. if this study said that one possible mechanism could also be the fact that the longer you live the more you are exposed to mercury and other metals from pollution (which is a fact) you would be the first to SLAM this study.

    They would probably have mentioned the possibility if there were a clear link between mercury exposure/accumulation and autism, which there isn't. There is, however, a strong link between genetic mutations and autism and there are myriad substances that are associated with chromosomal damage.

    Rather than list all known potential mutagens, which may include mercury very far down on the list, isn't it more logical to point out a possible downstream effect.

    Unless you'd like to argue that a father can pass along a toxic payload of mercury to his offspring in that single lucky tadpole, it sounds like you are in favor of prenatal factors. Why then would you use Buttar's transdermal non-chelating cream unless time travel is another one of it's unproven and unlikely properties.

  21. I think i raised enough questions that should make anyone think about that study and wonder if the conclusions it comes to are correct and appropiate and if they came to a conclusion that the environmental toxins played a role then your community would attack the study in the same way I did, using the same arguments.

    That is so false.

    First, you simply provided nonsense, preposterous alternative interpretations, e.g. maybe a lifetime of smoking or mercury intake by the dads causes autism by some means other than genetic mutations or imprinting, or maybe erectile dysfunction in dads is a cause of autism.

    Seriously, come on.

    I have criticized causation papers before. I assure you, if I had found the Israeli paper to have a major issue, I wouldn't keep quiet about it. The only reasonable alternative explanation I can come up with is that ASD dads might procreate when they are older. This is not hard to control for, and I expect future studies could very well do that.

    It just comes to show that some papers are better than others.

    When I have critiqued causation papers, I have proposed reasonable alternative interpretations of the findings, with supporting data. See, for example, my critique of the TV hypothesis or my critique of the environmental pollution hypothesis. In both cases I discussed my critique with the paper authors.

  22. And to elaborate further on that, you might have noticed that I have not critiqued the pesticide connection paper, for example. That's because while I have some ideas on possible confounds there, I don't have anything that's strong enough to warrant writing a critique. I won't write a post that says "maybe people who work in farms smoke a lot." That wouldn't be very good, would it?

  23. Hi Joseph,

    Thank you for this post. Your criticisms were spot on.

    I might quibble a bit that Michelle's criticisms are generally more ethically based than science based, but that is a minor point.

    I would however get on my soapbox to challenge the regulation of single case designs to the lower category of evidence. But that is a fight with the powers that be, not with you.

  24. Phil, time to get some education. Cuz you just got schooled.

    Do you understand what genomic imprinting is and what that has to do with autism?

    The diagnosis of autism is higher in New Jersey. No one knows if the actual rate of autism is higher in New Jersey or to what extent the good services provided there has caused others, like Kristina Chew, to move there.

    The prevalence of really sad little men is said to be higher in NJ. Rick Neubrander, for instance. That guy is surely a mutant of some kind. He probably had a really old father, his mother probably left him before he was born.

  25. Wow hill comando did i just read what you wrote correctly???

    You said that Neubrander is a MUTANT???
    Then you claim he probably had a really old father?
    Didnt this study just say that the rates of autism are higher when the father is older?

    I am in disbelief. On a Neurodiversity Blog you called a man a Mutant?
    And then you suggested he has an old father which has made him a mutant.
    All of this on a blog talking about how older fathers have more autistic kids.

    If that was not the most ignorant statement i have ever read i dont know what is.
    BTW, I know many people who go to neurbrander and they all like him and they all say that it is clear that he is on the spectrum.
    They don't say it meanly, they just say its obvious.
    I have heard it from many sources that did not know anyone else noticed.
    I accept all people no matter what their personality and quirks.
    I do not call people who are different than me "Mutants".

    What a very mean and derisive thing to say about someone who is different than you.

    Three cheers for acceptance of others and Three Cheers for not accepting people calling others who are different "Mutants".

    I did not get schooled, I am on a messageboard where people will not comment against the moderator and let him know that I am right and he is wrong. So the only people commenting are the ones who agree with Joe no matter what. Including you it now equals TWO who have taken his side.
    I am not impressed and obviously neither are his readers.

  26. Just FYI, philcommander, I have been reading this discussion and I agree with Joseph. Why would you imagine that there are lots of people out there who agree with you and are not allowed/unwilling to comment? Not trying to be mean to you, but you aren't making a lot of sense.

  27. I did not get schooled, I am on a messageboard where people will not comment against the moderator and let him know that I am right and he is wrong. So the only people commenting are the ones who agree with Joe no matter what. Including you it now equals TWO who have taken his side.

    As I have stated clearly multiple times, I only remove comments that are in violation of Blogger's content policy. Why else do you think your annoying blathering about the pointlessness of science is still here? Why else would John Best be allowed to say all sorts of nonsensical things here?

    I do this precisely because I believe science-oriented blogs need to have transparency, otherwise censorship of criticism can be alleged as a reason for a lack of rebuttals.

    Face it Phil. You tried to prove a point, i.e. that all papers are equally scrutinizable. I cannot even begin to fathom what in the world led you to believe you'd be successful in this misguided endeavor.

  28. Hi Interverbal.

    Michelle's criticisms are often ethics based, but she's brought forth major science-based criticisms, such as pointing out that Smith et al. was largely unsuccessful. Her post on Lovaas (1987) intake IQ is a major criticism as well. Dr. Gernsbacher also talks about Smith et al. I don't know who was first. Michelle has also discussed the lack of adult outcome studies.

    I think single-clase designs are considered Level-II-3 evidence, behind case-control studies, right? I guess you could argue they might be better than case-control studies, but you'd probably need some empirical confirmation of that.

  29. Joe, please re-read what i wrote and what your response was to it. Please do this and you will see why I just don't think you have the mind to understand me.

    I wrote the following...

    "I did not get schooled, I am on a messageboard where people will not comment against the moderator and let him know that I am right and he is wrong. So the only people commenting are the ones who agree with Joe no matter what. Including you it now equals TWO who have taken his side."

    You responded...

    "As I have stated clearly multiple times, I only remove comments that are in violation of Blogger's content policy. Why else do you think your annoying blathering about the pointlessness of science is still here? Why else would John Best be allowed to say all sorts of nonsensical things here?"

    Joe, where do i even imply that you remove comments?
    I said
    "where people will not comment against the moderator and let him know that I am right and he is wrong."

    I NEVER once said or implied that they wont comment because the comments get removed. Never once.
    You have done this over and over with my arguments...misunderstood them.
    My arguments have been clear and simple and I am sorry that i cant simplify them any more for you to be able to grasp them.
    I write "People wont comment" and you respond "I dont remove comments!"
    Who on earth said you did?
    Face it Joe, you can't grasp my arguments and you believe its because my arguments are wrong.
    That is usually the reaction that foolish people have when they are confronted with sound arguments that are above them.
    Everytime someone on here tries to discredit what I am saying they miss the point so badly that i just shake my head in wonder.

    Just like you now just did. I said people wont comment against the moderator and you come to some kind of odd conclusion that i accused you of removing comments.
    I could explain to you what i meant but after a while it starts to feel like im trying to teach algebra to a box of rocks.

  30. you come to some kind of odd conclusion that i accused you of removing comments.

    Are you sure I'm the one who is misunderstanding statements here?

    Did I say you accused me of removing comments? Where?

    But you did choose the word 'moderator', and the intention of that was obviously to point out a power relationship in this blog.

    I simply stated, for the benefit of anyone reading who might not be sure about commenting because I'm the 'moderator', that I do not delete comments.

    Either way, what's the point of this irrelevant change of subject? Is it another attempt to argue that people are incapable of grasping your brilliant arguments, and that's the only reason they don't agree with you?

    Must be another innovative variation of #20 from the The Woo Handbook:

    "Finally, when you’ve used up all the above tactics, say you’re not going to waste any more time with the skeptics you’ve been debating because they’re too sad, stupid, closed-minded, ______ (insert other flaw the skeptic has) to understand your brilliant arguments. Make a big grandiose statement and exit to start anew somewhere else."

  31. Hi Joseph,

    I recognize Michelle's and Dr. Gernsbacher's science based criticisms.

    I can't remember precisely where single case designs fall.

    The single case vs. groups design, is an old battle in the academic realm. It has gotten pretty rough at times. The criticism goes both ways.

    I my opinion Joseph, we will never be able to test inter-reliability between single case designs and group designs. The questions answered by each research type is fundementally different.

    I plan to do a post on this subject on Sunday comparing and contrasting the benefits of each.

  32. And i would like to just add that i originally made many points about that study that you chose to ignore. This has also been the pattern i have noticed on this blog. People take one thing you say in response and ignore the rest.
    I made multiple points about this blog and you ignored them.
    You can live in your fantasy world that i didnt prove my point and i really should have known that i wouldnt really be able to get through to a group of people who feel that they have all the answers (or that science has it for them).

    So now you can tell me that i am in following some rule of the woo handbook or something.
    That woo handbook reminds me of some dork who cant get a date making a rule book that dumb blondes follow.
    The Dumb Blondes handbook he would call it.
    Everytime I ask a Dumb blonde out on a date she responds with the following...
    and then he has all these rules that the "Dumb Blonde" repeats as if she is just too dumb to notice his brilliance.
    Rule #1 Say politely that the person asking you out on a date is not your type and then go to the prom with a dumb jock.
    Rule #2 Say you dont view person asking you out on a date that way.

    take this rule #14 from woo handbook...
    After the debate has been going for a while you should say you’ve provided studies to support your position, even though you haven’t. You can then periodically refer to these studies as though everyone now agrees you supplied them. Few people will remember you haven’t.

    do you see what i am saying? That the dumb blonde as this dork calls her may really not see him that way and he may really not be her type...and i really have provided you all with enough evidence that the study you showed me is pretty pointless but you guys really dont get it and to try and somehow attempt to write all of my arguments off you will just say "you are just following rule #14" blah blah blah.
    That way you can disregard my comments and not address my arguments.

    So here is my rule that you guys follow...

    Rule #1...ignore 4 out of 5 points the critic makes until he becomes so frustrated he gives up telling you that he has done enough. Then accuse him of following rule #14 of the woo handbook. This way it will make it look like he is following a pattern.

    And he is...and i is the pattern that people must feel when they are teaching algebra to a box of rocks.

  33. LOL!!!! i wrote the above comment before i even read Joes response! HAHAHA...and sure enough...he pulled out his trusty Woo Handbook that allows him to justify dismissing the arguments that he cant hang with...or the blondes he cant date.
    Joe you are priceless.

  34. The only thing the Woo Handbook does is describe why people with intelligent minds get tired of trying to get through the thick heads of others.
    The people with these thick heads never stop to consider that it is saying something when everyone reacts this way to them.
    it should be called "The Book of Reactions That reasonable People Have When Confronted With Ignorance".
    Everyone reacts that way to you guys because you are all so darn arrogantly pigheaded and blind to common sense and sound argument.
    Thats why all of us just throw our hands up and understand that we are wasting our time with you.
    And instead of wondering why people all have this reaction to you, you write a handbook that says they have this reaction because they are the ones who dont understand.
    If everyone tells you that you are (insert anything here) then maybe you should stop believing that its everyone else with the problem and you are fine.
    So many people had these reactions to you all that you should have done some introspection rather than writing a handbook and quoting from it.

  35. Save your breath, Phil, you'll need it to blow up your date tonight.

  36. Any readers agree that Phil proved a point or provided a sound rebuttal of a paper? If so, please elaborate (in a coherent manner preferably.) Maybe I did miss something of interest.

    Phil, you're free to keep blathering on about whatever it is that you like to argue. Tell us how we're going to hell and all that stuff if you'd like.

  37. Joe, asking your readers if i proved a point is like asking a Witches Coven if the Pope is holy.
    (yeah, i compared myself to the pope! lol).
    And it shows just how out of touch you are.
    and Dumb date will be here in one hour and we are going to see a movie together (vampire movie). Her name is CityGirlSeven.

  38. BTW, CityGirlSeven is her youtube name...check out her vids. She has aspergers.

  39. A few of you have commented that I need to understand Neurodiversity and autistic adults. Do any of you know that one year ago I had an unknown channel on youtube that only had five subscribers. We talked about ND and autism and biomed and many other autistic issues.
    The subscribers were Lordalfredhenry, Droopy, Christschool, Aspiegirl, and Amanda Baggs.
    Autismdiva would comment once in a while too.
    We had great discussions and i did learn a lot.
    Amanda was subscribed to only Two youtube channels at this time. Mine was one.
    So theres a whole lot of credit that you guys dont give me.
    I understand a lot more than you know.

  40. Hello Phil,

    To address your points:

    In my experience hub science bloggers will acknowledge criticism when it has merit. Here are two examples:

    And in what was not included here:

    I did check the facts on that Joseph wrote. Sadly for my field of study, he is spot on.

    I have studied all the research cited by Joseph and many more as well concerning autism and ABA.

    James Watson’s bigotry has no validity to disprove research. To claim such is an ad hominem.

    Group based research uses deductive logic. It can only comment on what is generally true of the group. If one recognizes this fact, then we are fine. It is only if one doesn’t understand this point that problems arise.

    It is a logical mistake associate human imperfection with conclusion that therefore research must be mistaken. Part of good research involves controlling for subtle biases and influences. One of the reasons peer review exists is to check for these sorts of shenanigans.

    Neither science, nor logic can prove a negative. However, what we can say is that research shows no association and that the theory seems (a given degree of unlikely).
    The exception to this is when there is an overt contradiction of data. Via logic, contradictions can not truly exist in part or whole.

    The old father study said “association” not “cause”. That is the correct word to use when describing a correlational study.

    You write “The only thing the Woo Handbook does is describe why people with intelligent minds get tired of trying to get through the thick heads of others.”

    Always a pleasure to talk to someone with an intelligent mind Phil. The woo handbook describes common behavior by those who argue with neither logic nor science. What it is really describing is logical fallacies. If it is true that you are using the behavior described in the handbook, indicates that you not using logic to arrive at your points.

    If you feel that we have ignored something pertinent in your argument. Please list it provided that it is on topic.

    You write “Everyone reacts that way to you guys because you are all so darn arrogantly pigheaded and blind to common sense and sound argument.”

    Whose common sense Phil? Common sense is one’s impression of what most people think. As to sound argument, why would those using a sound argument use logical fallacies, such as what are described in the woo handbook?

    Phil, I agree to do some introspection and see if I am deluding myself and failing to use momma’s old standby of common sense. But let me return the favor and suggest that you do the same. I particular you should ask yourself if you are using logic even as you commit well known logical fallacies.

    Thank you for your time.

  41. Thanks Interverbal. It's good to have a teacher around :)

  42. I apologize Phil. It was wrong for me to assume that your female companions would be as overinflated as your ego.

    It appears you are a friend to autistics to the point of providing a list of a few you know.

  43. Dumb blonde, sorry...i could on and on telling you the people who have autism i have talked to.
    I could talk endlessly how i respect and admire ANYONE who has used this label as a launching pad for telling the world that its ok to be different.
    But right now i just spent ten minutes telling my daughter who is eleven why it is ok to be pissed off at jake but not ok to yell and scream at him. I held her in my arms in the front yard while she cried to me to make Jake behave.
    you people dont understand the human element when it comes to intervention.
    I think most of you are damaged so i dont hold it against you.
    Joe, you are a bullshit artist and have conned other suckers into believing you...
    Interverbal, i could debate with you endlessly because you are the first person on this blog to talk to me with respect...
    its odd too because I have had countless people with autism talk to me with respect and i in turn showed them respect...
    but i do disagree that logic cannot prove a negative.
    but thats neither here nor there.
    You have class.
    I have debated with the best of them...and they have all shown me dignity and respect with the exception of Kev Lecht and this blog.
    Its ok though...i will fight for the kids and you guys fight for the label.
    in the end it will all be evaluated by God and who knows what the results will be.
    Its been a real nice time talking to some of you and if nobody comments in a confrontational way to this comment, my autistic tendencies wont compell me to respond.
    Take care one and all.

  44. What I remember about phil commander asking me to view his videos was that he wanted personal instruction as to what the autistic adults were about. I told him to go read what the autistic adults were writing that it's easily found on the web and not to expect some kind of special treatment, like private tutoring.

    I was stunned by his stance that he knew what was what in "biomed" and that he presumed to State for an absolute fact which biomed modalities might work for some kids all based on anecdotes.

    It's the same thing he demonstrated here, he's got his own brand of "common sense" and it trumps ours which is more than common sense it's backed up with logic and science.

    Phil we aren't broken. Your thought processes are defective when it comes to autism and science.

    A lot of us, including Joseph are parents of "low functioning" or "middle functioning" not "high functioning" autistic kids. You don't need to tell us what parenting autistic kids and their typical siblings is like. My kids are in their twenties. I've been at it a lot longer than you, Phil. I sure won't be watching your videos so that I can learn something. And besides my "mommy instinct" trumps your common sense, any day. :-D

  45. That is correct autismdiva, you told me to read what autistic adults wrote on the web. That's actually exactly what you said. But you didn't tell me "not to expect some kind of special treatment, like private tutoring."
    You never said anything like that from what I remember.
    I didn't view it as being that way though...I was getting into email conversations with droopy and lordalfred and me and christschool were communicating via messages on ours and others videos.
    I thought it would be easier to carry on the communication in a video format and I wanted to extend that communication to some others who had disagreed with me in the past.
    I understood if they didn't want to get real involved and always appreciated the times you did put in some input.
    I think you might have just misunderstood my intentions back then.
    I was simply trying to open up communication to some people who had commented on my videos or on whos videos I had commented.

    I feel you have completely mischaracterized me in this post.
    I never claimed to know whats what in biomed and I have said the opposite many times. I only know what worked for Jake and I am not an expert in any of those things either. If you're not watching my videos you wouldn't know either way though.
    It seems that you have made up the Phil Commander you speak of in these comments. You could never know the real me from just watching my videos and certainly cant accurately portray me if you don't even watch my videos like you said you don't.
    I, on the other hand have read your blogs and seen your videos.

    You told me in an email that Jake did not have leaky gut syndrome and that you doubted he had a yeast issue.
    Are you qualified to diagnose either one of those conditions?
    How about if you have never seen the person you are diagnosing?
    Why would you tell someone their child did not have LGS or yeast issues when you have never seen that child and aren't qualified to give out diagnosis?
    But then again you are the one who downplays the harm of Mercury while preaching the dangers of B12.
    Seems to me anyone who praises a neurotoxin and condemns a vitamin has the defective thought process.
    And the fact that you have been at this a long time just means that you are a slow learner if you ask me.
    So if you are not going to watch my videos please don't describe them. You make yourself look foolish.
    Mommy Instinct? has yours been peer reviewed? Most of the moms I know who have seen your videos and read your blogs would say that you dont seem to have good instinct.

  46. I'd like to see a copy of that email where I told you that your son did not have leaky gut. I don't diagnose people over the internet, though I might have said, "If you are going on evidence X, and that's all you have to tell you that your son has a leaky gut, that evidence is meaningless." But I wouldn't contradict a legitimate diagnosis from a legitimate doctor.

    I downplay the way the dangers of mercury have been so extremely over-exaggerated. I you buy into the extreme overexaggeration of the dangers of mercury then my realistic description of the dangers of mercury might seem like downplaying.

    From what I remember you had a ludicrous description of how dangerous thimerosal is on an early video of yours. Just because 48 "brainwashed" parents have been convinced by 10 quacks that all mercury is deadly and you read what they wrote and heard what they said on videos, that doesn't make it true.

    Mercury is all around us all the time. It's everywhere. It's in scary levels in high fructose corn syrup according to Isaac Pessah, the mouse dendritic cell and thimerosal guy.

    You have no idea what high doses of meB12 can do in autistic kids NO ONE DOES. The MIND Institute's description of their B!2 study added a requirement that they wouldn't take kids with a history of seizures. Why is that? Did they learn something about autistics, B12 and how that B12 can kindle seizures or aggravate seizures in some kids? I don't know. But I do know that NO ONE knows if high doses of a powerful methylator can methylate genes that produce inhibitory neurotransmitters, and if that could produce seizures in a kid. Apparently, at least one kid on the East Coast started having seizures after starting on the Neubrander idiotic "protocol."

    Do you know what it means to methylate a gene?

    Do you know that researchers are worried about the addition of powerful methylating vitamins at above normal levels to the American diet, and that they worry what the downstream effects will be, including possibly causing more cancers and more schizophrenia down stream?

    I wouldn't do the idiotic Neubrander protocol on my dog! or on any dog. Much less a child. Neubrander is totally clueless as to what all that b12 will do to kids in the long run. And he doesn't care, would be my guess. He's looks exactly like a sleazy two bit, not board certified, ex-pathologist, for crying out loud. I wouldn't let him give my dog an injection of anything.

    There was no reason for you to be setting up a private discussion area on YouTube to figure out what the autisic adults really think. All you had to do is go read what's out there.

    My blog has 700+ entries, how many would you estimate that you have read? I'm guessing not too many of them. Not that my blog is better than Josephs or any other of the hub blogs, I'm just saying you could learn a lot about medicine and science and things like what "correlation" means, and even things like where "ND" came from, if you read them more and listened to fools like DAN! dox less.

  47. I read a handful of your blogs and found them to be very uninformed and very dated in their thinking.
    They mocked parents who are trying to help their children in ways that you don't approve of. Very mean spirited. It seems your thinking of autism is from the 80s but thank god not too many people who I have spoken to (who believe in neurodiversity) read your blogs or even know your name.
    They usually find it very odd that someone would call themselves AutismDiva.
    You know that diva literally means goddess.
    Sounds a bit arrogant to call yourself that...and it shows in your approach to autism.
    You frankly aren't well informed and you tell others that they don't understand autism.
    As people get older they do tend to get set in their ways. You need to watch out for that.

    You should have participated more in the discussions I had on youtube, you could have learnt a lot from people who have a much better understanding of autism than you do.
    Please don't ever consider yourself above learning need to get onto the biomed chat rooms and talk to parents to understand biomed more.
    Its not unusual that people gain knowledge early on and then spend so much time writing blogs and sharing knowledge that they don't realise that the field has moved on and learnt so much more while they have remained in an intelligence rut.
    Its great though to see someone from your generation involved with computers and still active with the younger just need to catch up in your knowledge of autism now.
    I feel you could help the youth if you would just try and keep an open mind. You could maybe become the Mother Theresa of autism.

  48. Autism Diva doesn't keep up with the latest on autism? I'm sure that made her laugh. That's basically her all-consuming interest.

  49. Hey Phil, as long as you brought it up, why would methylcobalamin help a mercury toxic person?

    I've said it before but positive response to methyl-B12 injections is strong evidence against mercury toxicity. So if we are to believe Neubrander's figure of 90+% responders, that would mean less than 10% of autistics are likely to have problems with mercury.

  50. Phil,

    What you wrote might hurt my feelings if I had the least bit of concern for what you think.

    You have demonstrated a truly uniformed view of autism and total ignorance of what "biomedical" means. You have a cargo cultist's view of the human body and brain.

    Regular visitors to the Autism Diva blog know that the persona of Autism Diva was created to portray people like you, Phil. People who refuse to listen, and refuse to learn about autism and who gladly abuse autistic people who don't agree with them.

    Autism Diva blog comes up very high in search rankings for basic autism biomed searches so your little friends who haven't ever heard of Autism Diva probably have never googled a term like "autism meb12" Right now I am the second in rank on Google for that one. I'm number 5 for "autism chelation". Number 2 for "autism neubrander".

    In other words it's hard for biomed parents to not know about Autism Diva blog if they use internet search engines.

    I'm #14 on "autism biomed" I don't see a "philcommnader" anywhere on the first two pages of Google results for that search.

    Many regular visitors to the Diva blog are from universities. I get visitors from all over the world. many from Canada, Australia and New Zealand, but also from places like Saudi Arabia and countries of the former Soviet Union. Researchers and experts of various kinds have linked to my blog from their websites.

    I get feedback from professors and researchers and people in public health telling me how much they appreciate the information on the blog.

    So I guess they would contradict you, Phil.

    One of the mottos of my blog is "Aut Disce, Aut Discede". It's Latin, it means, "Learn or get out".

    I guess after visiting my blog a few times you realized that you were unequipped to do the former and so did the latter.

    The blog get's plenty of traffic without you. I have had news reporters and science writers contact me through the blog and ask for interviews. I've been quoted in New Scientist magazine, as the blogger from Autism Diva blog. But I bet you never heard of New Scientist.

    Frankly, Phil, you are a little scary. I won't be interacting with you any further for that reason.

  51. Actually I have heard of New Scientist. They interviewed me. Roxanne was honest and told me it was an article just questioning the new trend of non-doctors speaking about medical issues.
    She was honest and polite. it was an article called 'youtube. just what the doctor ordered?'
    She said that personally she thinks its great that im doing the vids but the article wont go like that. I told her do what she needs to do.

    as far as where i am in the would have never even occured to me to look that up.
    Im not trying to be a personality in the autism world.
    I just wanted to do videos showing some exercises i did with jake rather than describing them on message boards.
    It grew from there really.
    I tell parents over and over that im not an expert. I think they just want me to be an expert because the people going around claiming to be experts really don't know what theyre talking about.
    But anyways...i went to your blog and saw 'learn or get out' and read your love of mercury and how you bathe in it and sprinkle it on your cereal and it hasnt done you any harm.
    so i got out because i know that theres nothing to be learnt there.
    Most people agree with me on that.
    I have doctors who love my videos and even have them on there websites. Not dan doctors either. Honestly i dont know why. My videos are not meant to be official videos on any subject really. Im not a part of the autism world really and i dont want to be.
    If you want to stay up calculating how popular you are be my not impressed though.
    but hey, for the sake of argument i will say that you are vastly popular and well loved and make a great meatloaf and are a great mom, friend, patriot, and all around diva.
    as far as me blows me away when someone says that they have heard of me. Just blows me away.
    And if people are trying to learn about autism from me then they arent looking in the right spot. I dont know a whole lot about it really and i really dont know a whole lot about biomed. I really dont and have never claimed to.
    If people have made me into an authority then thats their own doing. when i talk to them on the phone or via email i instantly correct them and tell them that i am not an expert on anything in autism. Im really not. But my videos arent meant for that. They are just some dad telling his story, showing his results, and giving his opinion on some stuff.
    I really do think that you people have made me out to be more than that though.
    Anyways...i really do think ive taken up enough space on Joes blog.
    He's been pretty fair to me overall and i have no ill feelings towards him. I like it when someone lets you speak your mind and sometimes even get rude and gives it right back to you and doesnt cross any lines. I hope i didnt with him either.
    But doing a bunch of videos on RDI and i still like to film and edit my CityGirlSeven videos.
    Check 'em out on youtube when you get the chance!
    NotMercury, Ive never said that mercury is the cause of autism. I have only said that it should never be ruled out as a possible cause of dev. delays. Lots of things fall into that list...mercury is just one thing and heavy metals in general.
    I am just against the approach autismdivagoddess takes and so does much of the neurodiverse community. they are obsessed with defending mercury.
    I just think you guys should take a more level headed approach.
    Thats all...nothing to make me into a demon for. I think you guys are attributing a lot of things to me that ive never said. Ive never promoted chelation or Hbot. Ive openly said they did nothing for me. Ive only ever done RDI so thats all i talk about. I have no idea about any other behavioural interventions.
    I really think you guys give me more credit than i deserve. I dont think my videos influence that many people really. and the whole ND abreviation came while i was writing on this blog a few days back...i just figured you all would know what ND stood for and i got tired of typing out the whole term. I had no idea that someone had used it in a derogative way.
    I wouldnt have used it that way if i would have known. So keep on trucking guys and lets all pray that Autismdivagoddess somewhere down the line gets educated on autism.
    Maybe she should ask Jenny McCarthy to come over her house and help her. Im sure Jenny has heard of autismdivagoddess since anyone who uses google cant help but to find autismdivagoddess.

    ADG (autismdivagoddess) thinks im scary?
    wow...thats pretty cool i guess.

    See, all of this is the tiniest little sliver of my life...just tiny. Youtube is too. It's something i do in my sparetime when i think of it.
    I got about 12 unanswered emails on youtube that i really need to get to. This blog has taken up way too much of my time but its been fun goofing with you guys. But i know its not fair because you all take it way more serious than me and in a way its disrespectful to goof around about it with you guys.
    Im not saying youre all too serious...i just dont take all of this stuff that serious (debating).

    Maybe i intimidate you guys cause deep down inside you know that i am right.
    The Neurodiverse community doth protest too much, methinks.

  52. phil with the messianic photo of himself myspace wrote: "I got about 12 unanswered emails on youtube that i really need to get to."
    you just so popular Phil. hurry, you fans is waiting for you to respond. if you telling people you are not a expert, you is so right.

  53. I hope that this doesn't get lost in the all of the comments; but I have a question for you.

    As a mother of 5, my second child who is now 16 seems quite questionable to me. I have had my mother amoung other family members ask if she could possibly be autistic because of numerous "issues" we have had through her 16 years.

    She was a late talker, she is very quite and prefers to be by herself the majority of the time. Not just intreverted, quite "odd" is how most people describe her. Although beautiful, very sweet (at times)...etc.

    She has learning issues, has difficulty communicating and never seems to understand why she does things or reacts the way she does. Now, most teenagers have "issues", but these are different. The story goes on and on...but what do I there anything I can do? She was diagnose years ago with ADD, but her father won't medicate her, which isn't necessarily bad, but if Autism plays a role; what now?

    Thanks for this site; very informative!


  54. Hi Laura. I can only say it sounds like it, but what you probably want to do is consult a psychiatrist. Just keep in mind that she's the same person she was before the diagnosis, were she to get one. I think it's also important to let her know she's not broken because of a diagnosis (despite what Phil said above). It's her unique way of being. Her self-concept is at stake. Autistic people generally struggle and have to work their way to this worldview.

    A diagnosis can be empowering, if it leads to some level of self-understanding that previously wasn't there.

    As to Ritalin, do check out the latest FDA warnings on it.

    I would not recommend trying to "fix" her. That will probably do more harm than good.

  55. Thank you so much for getting back so quickly.

    Yeah, I don't want to necessarily "fix" her; she is her own unique individual. I guess it would just help to explain so many things her father and I have had to deal with in the past.

    It is difficult having teenagers, much less one that may have Autistic tendencies. So many changes at these ages and I know at times she doesn't quite get why she is the way she is.

    As her Mom, I just want her to be happy and be the best she can. She wants to join the Army and go to college and I think if we can give her some assistance she might be able to handle these life changes better.

    One thing I notice is she can't stand crowds of people; even small ones. She is ok one on one, but get the family together and she runs off and hides; preferrably with a video game..hehe.

    I could go on and on all the things that have happened. Right now she lives with her father and he asks me sometimes what I think is going on with her. I have told him I don't know, but I am hoping to be able to tell him something soon.

    Again thanks! I just want to be able to help her effectviely instead of always guessing. :)

  56. Thank you for doing this blog Joseph. I am a preschool teacher. I have been teaching for six years. These issues of socialization, therapy and medicine, there are so much controversy. It is hard to isolate the factors behind autism and many other neurological issues. I am wanting to know where you stand with the medical communities advancements in research working together with a natural approach.

  57. Hi Christina. I'm entirely in favor of scientific research, but perhaps disagree with the priorities given to certain types of research.

  58. I want to tell you that this site is a great resource. Excellent.
    I am spreading the work for Texas Children's Heal Sick Children campain. They are buidling a Neurological Research Center in an effort to find a cure for autism, asperger's, fragile x, and other specific neurological issues.
    Your site is where many people are looking for answers and the medical community is making gains every day. I know the medical community and the caring families and friend can come together to help in this.