Reply to B. Rimland's "Comments on 'Secretin and Autism: A Two-Part Clinical Investigation'"

Abstract

We stand by our data in concluding that secretin offers no observable clinical improvement in children with varying degrees of autism severity. In an effort to characterize our patient sample, we chose to employ the CARS due to its validity, reliability, brevity, ease of administration, and recognition as a standardized rating instrument used in the field. We acknowledge that there are other detailed assessment instruments available, such as those developed by Catherine Lord and colleagues at the University of Chicago. However, when media- and Internet-induced hysteria results from the promotion of an experimental treatment touted as a “cure,” time is of the essence. We elected not to use the detailed assessments because (a) the tools are designed to be insensitive to change over time; (b) there is considerable time involved on an individual basis; (c) we did not have financial resources available to support ADIS-R/ADOS-R testing. Furthermore, we assert that a six-point change on the CARS is a conservative estimate to indicate clinically meaningful change. Our patients are seen in a pediatric neurology prac