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The Pediatric Forum
April 2007

The Role of Pediatricians Who Care for Children With Autism—Reply

Author Affiliations

Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Pediatr Adolesc Med. 2007;161(4):416-418. doi:10.1001/archpedi.161.4.417

In reply

We respectfully disagree with many of the points made by Drs Kelly, Kemper, and Rosen in their letter. Perhaps it is most appropriate to begin with a quote from Dr Kemper herself, who wrote the following in a manuscript published in 2005: “Nonjudicious use of CAM [complementary and alternative medicine] therapies may cause either direct harm or, by creating unwarranted financial and emotional burden, indirect harm.”1 Specifically, Kelly et al criticized our recommendation that physicians counsel families to pursue evidence-based behavioral and medical treatment for children affected by autism until other putative therapies are supported by valid scientific research. In fact, we would argue that a failure to recommend evidence-based interventions, in favor of unproven or potentially harmful therapies, would constitute not only “nonjudicious use of CAM,” but also an abandonment of our professional responsibility to do everything we can to maximize the chance for a favorable outcome for our patients. Also, as we wrote in our review, unproven interventions are not only potentially physically dangerous (eg, an excessive dose of vitamin B6), but also consume precious time, energy, money, and hope that could otherwise be invested in evidence-based treatment.2