By
Kelley L. Harrison, MA, BCBA, LBA-KS
and
Thomas Zane, PhD, BCBA-D
Department of Applied Behavioral Science, University of Kansas
What Does Research Have to Say About HBOT and ASD?
Throughout human history, the helping professions – medicine, psychology, education – have operated under many ethical guidelines and codes of conduct. But one singular, defining, and unwavering principle has been, do no harm. Providers of services understand that, fundamentally, we cannot behave in ways that will harm – physically, psychologically, or otherwise – the people whom we serve. This is part of the “DNA” of medical and social services.
This core value is lacking in the proponents of drinking bleach for a cure of or treatment for autism spectrum disorder (ASD). This treatment comes in different names: Miracle Mineral Supplement (MMS Healthy for Life, 2016), Master Mineral Solution (MMS Products International, 2016), or the Chlorine Dioxide Solution protocol (MMS Products United Kingdom, 2016). Different websites all market the exact same product. The promoters of this treatment prescribe that individuals with ASD (or individuals with a variety of other ailments as listed below) drink, spray on the skin, or administer as an enema, a mixture of water, chlorine dioxide (CI02), and citric acid (MMS Products International, 2016). The sellers assert that chlorine dioxide is different and safer than chlorine itself, and thus can be ingested or absorbed safely. They claim that although chlorine kills any germ or organism with which it comes into contact,“…Chlorine dioxide…has the amazing ability to remove electrons from diseased tissue and pathogenic stressors” (MMS Products International, 2016). They insist that this product is safe if used according to their directions.
A Review of its History of Development
Jim Humble, the originator of Miracle Mineral Supplements (MMS, 2016) and the Genesis II Church of Health and Healing, advocates for the use of bleach as a miracle cure (Genesis II, 2016). In fact, the primary activity of the Genesis II Church of Health and Healing is the promotion of bleach therapy (Genesis II, 2016). According to the MMS website, Humble is an aerospace engineer who worked on the lunar module and the atomic bomb. In 2008, however, Humble admits that he does not have an engineering degree (Project Camelot, 2016) and claims to be a billion-year-old god from the Andromeda Galaxy who was sent to protect and monitor Earth. According to Humble, he discovered the miracle of bleach therapy while traveling in South America. Members of his party became ill with Malaria and were allegedly cured within hours when Humble gave them a mixture of water and chlorine. The current formula has changed over the years to the concoction marketed today.
Its Purported Use – In Other Words, What is it Designed to Help Cure or Fix?
Miracle Mineral Supplements’ (2016) website lists the maladies that can be helped by bleach therapy, in addition to autism. According to the website, MMS can treat and cure cancer, the flu, HIV/AIDS, herpes, malaria, problems of the mouth, gum and teeth, sinuses, constipation, burns, fungus infections, Ebola, staph infections, eczema, and cold sores. If reading is believing, bleach therapy can cure almost anything – a true miracle treatment, as the website name clearly states.
Is There Any Research to Support This Therapy?
No. Besides reliance on testimonials (which are often used by promoters of fad treatments 1 ), there are no controlled research studies on this treatment due to significant risk of harm to the participants. Chlorine is toxic and dangerous, potentially causing a host of physical ailments and potential death. For one of dozens of articles on the dangers of chlorine, see Hattersley, 2000. Chlorine is used as an industrial cleaner and disinfectant. Indeed, it is doubtful that any Institutional Review Board (i.e., an organizational board that evaluates the ethics of research involving human participants and carefully assesses the risks involved) would be inclined to approve any study due to the toxicity of chlorine and the potential danger to human participants.
Position Statements Against the Use of Bleach Therapy
For more than a decade, organizations around the world have raised concerns about MMS:
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- The Agency for Toxic Substances and Disease Registry (2004) warned about dangers to health when drinking bleach.
- The Food and Drug Administration (FDA; 2010) of the United States has clearly labeled this substance as dangerous to human health. The FDA emphasized that it has received several reports concerning serious side effects and warned consumers to stop using MMS immediately. It stated, “…This product becomes a potent chemical that’s used as bleach when mixed according to package directions.”
- Canada (Healthy Canadians, 2014) considers this concoction so dangerous that the government has seized these products from an online retailer, warned of its dangers, and pleaded with citizens to stop using it immediately.
- The Food Standards Agency of the United Kingdom (2015) has warned consumers to not use this product and to throw it away if owned.
- The National Autism Society of the United Kingdom (2016) rejects its use.
No autism treatment, with the exception of Facilitated Communication, has been so universally criticized. There is no reason for anyone to consider using this therapy. It is potentially lethal. The larger question to address here is, what is it about this therapy – and other fad treatments – that compel consumers to try it? Consider the following questions that may motivate consumers seeking treatment:
The Cause of Autism is Unclear. Why not Try Everything? What is There to Lose?
When a child is diagnosed with autism, the family likely feels a sense of urgency to find a treatment, and understandably so. The variety of therapies has continued to increase over the past 50 years, since autism was first labeled (Jacobson, Foxx, & Mulick, 2015). Because we do not know the cause of autism, many families take the approach of trying anything and everything, regardless of how implausible or outlandish it may seem. After all, what have they got to lose? Unfortunately, the “everything but the kitchen sink” method has the potential to actually cause harm or, at the very least, perpetuate the current situation for which consumers are seeking treatment. In fact, research has demonstrated that “eclectic treatment” (i.e., a combination of treatment methods used with one individual) actually results in less improvement over time on key behaviors associated with autism when compared to using one scientifically validated treatment – specifically, intensive behavior analytic intervention (Howard, Stanislaw, Green, Sparkman, & Cohen, 2005). As described above with bleach therapy, the majority of the quick fixes, miracle cures, and breakthrough treatments available for autism have little to no sound evidence of effectiveness. Several have potential or known harmful side effects. Therefore, when deciding on treatment for an individual with autism, consumers must avoid pseudoscientific treatments and invest in treatments validated scientifically (Green, 1996). Silvestri and Heward (2016) state, “An extraordinary claim with extraordinary supporting evidence is a basis for best practice; an extraordinary claim based on anything but proportionally strong evidence should bring skepticism” (p. 150). Parents and consumers should seek out and demand extraordinary evidence that a treatment is successful before they invest valuable time and resources.
So, what is there to lose? The answer is time, resources, and potentially the individual’s health and well being (Zane, Davis, & Rosswurm, 2008). Time spent implementing a pseudo-scientific treatment is time that could have been spent implementing a scientifically validated treatment. Additionally, pseudoscientific treatments could actually interfere with the effectiveness of another treatment, thus further delaying improvement for an individual. Financial resources could be wasted on a treatment that is ultimately ineffective (Zane et al., 2008). Finally, side effects of dangerous treatments could lead to immediate or delayed ill health effects and cause other problems, as illustrated by bleach therapy.
Shouldn’t a Treatment Be Believed if Based in Science and Logic?
There are several different ways in which a family or treatment provider may obtain information about potential treatments for autism including, but not limited to logic, authority figures, religious or spiritual beliefs, advertisements, testimonials, and/or experimental reports (Cooper, Heron, & Heward, 2007). When the claim is made that a treatment can help an individual with autism, the first question to ask is, “How do you know and what is the basis for this claim?” (Maurice, Green, & Luce, 1996). A pseudoscientific treatment is a treatment that seems to have a basis in science and logic when really there is little to no empirical evidence of effectiveness. A scientifically validated treatment is a treatment that has been shown to be effective through direct objective observation and measurement such that alternative explanations for the results are ruled out and the results can be replicated.
Pseudoscientific treatments can be very persuasive for several different reasons (Levy & Hyman, 2008). First, these treatments may be more appealing than scientifically validated treatments. Often scientifically validated treatments are reported to appear cold and difficult to implement, while pseudoscientific treatments appear easier to administer, are cheaper, and seem more humane. However, consumers must keep in mind that appearances are not always accurate and more financial resources may be wasted if invested in pseudoscientific claims.
Second, pseudoscientific claims sometimes closely align with an ideology already adopted by consumers (Levy & Hyman, 2008). When the theory supporting a treatment matches with a consumer’s pre-existing view of the world, that theory is much more convincing. For example, there is a common view that a positive attachment or bonding between parent and child leads to normal and healthy child development (e.g., Ainworth, 1969; Gutstein, 2009; Zane, Weiss, Dunlop, & Southwick, 2016). If one believes this, then pseudoscientific and fad treatments that flow from that belief – gentle teaching, holding therapy, and other relationship-based therapies – will be more attractive and believable (Smith, 2016). However, this should not be confused with scientifically validated information (Foxx & Mulick, 2016). When evaluating the validity of a treatment, scientific evidence should weigh more heavily than pre-existing beliefs or views of the world.
Finally, the repertoire or professional title of the person making the claim and/or simply the numerous amount of people making the same claim can make pseudoscientific treatments more persuasive. For example, in regard to bleach therapy, Dietrich Klinghardt, MD, PhD says,
“Kerri Rivera has done it…she has condensed and simplified the core elements of the biomedical approach, those that work 90% of the time on 90% of the children. Her focus on using a unified and affordable approach to reduce the body burden of chronic infections and infestations is addressing the very core issue of most autistic children and adults. It has made her method the most powerful tool to this day to help many children recover safely, inexpensively and solidly. Her research is validated by the enormously positive response from parents from all over the world.” (https://www.worldcat.org/title/healing-the-symptoms-known-as-autism/oclc/1000490125
This statement is quite convincing. The speaker is a medical doctor who references a “biomedical approach,” “research,” and responses from parents “all over the world.” However, regardless of who makes the claims or how many people agree with a claim, statements like these should always be questioned and investigated thoroughly. “The use of scientific language…does not add weight to evidence. Scientific language alone does not make a science” (Silvestri & Heward, 2016, pp. 149-150).
What Type of Evidence Should Consumers Seek When Validating a Treatment?
When attempting to avoid pseudoscientific treatments and find scientifically validated treatments, consumers should avoid subjective evidence and seek objective evidence. Subjective evidence is information that is based on a personal perspective that may be biased for any number of reasons. Proponents of specific autism treatments often offer testimonials speaking about the amazing improvements in behavior observed after implementing a given treatment. Unfortunately, whether a parent, a practitioner, a promoter of a treatment, or a well-trained scientific researcher, people tend to see what they want to see (Shermer, 1994). This makes subjective reports inherently biased and inconsistent. This is especially true when reports come from people who are predisposed (i.e., those with strong wishes or investments) to report a specific outcome.
The American Psychological Association set criteria for treatments to be considered evidence-based (i.e., valid). Specifically, two or more group studies or nine or more single-subject studies must be conducted providing objective evidence that a treatment produces superior or equivalent outcomes to alternative treatments already available (Hoagwood, Burns, Kiser, Ringeisen, & Schoenwald, 2001). To obtain objective evidence, precautions should be taken to minimize human bias. Conclusions should be drawn from evidence collected through observable and measureable events and outcomes should be replicable. Ultimately, the more objective and rigorous the means by which evidence is produced for a given treatment, the more confident consumers can feel about the degree to which a treatment is scientifically validated (Jacobson, Foxx, & Mulick, 2015).
Conclusion
The decision to implement a given treatment for an individual with autism is in the hands of the parent or caregiver. So much is still unknown about the cause of autism, making the treatment decisions more challenging. Therefore, when examining claims about a treatment for autism, the goal should not be to identify professionals who may be qualified to recommend treatments, but instead to identify the quality of evidence behind a given treatment. Personal accounts and promising claims are intriguing, but ultimately worthless for evaluating the effectiveness of a given treatment. Consumers should be wary of practitioners who make grandiose claims about their treatment and should instead demand experimentally-based evidence. Doing so may allow us to abolish such harmful treatments as MMS and promote the use of better, safer, and more effective treatments for autism.
References
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Citation for this article:
Harrison K. L., & Zane, T. (2017). Focus on science: Is there science behind that? Bleach therapy. Science in Autism Treatment, 14(1), 18-24.
