Presidential candidates comment on causes of autism - Association says evidence-based approach should guide national autism

Noting that speech-language pathologists (SLPs) are often the first group of professionals to recognize that a child has autism and are central to providing treatment, the American Speech-Language Hearing Association (ASHA) sent letters this month to Presidential candidates Sens. John McCain and Barack Obama that advise taking an evidence-based approach to the vaccine controversy surrounding what causes autism and to policy development related to care.

ASHA's letters were prompted by an April 22 Washington Post story, "What the Autism Studies Show Isn't Reflected in What the Candidates Say" by Michael Dobbs. The article attributed comments to both senators related to the controversy over whether a potential link exists between autism and a preservative in childhood vaccines and also reported on a body of evidence that indicates that assertions of a link are unproven so far.

"The incorporation of the principles of evidence-based practice in clinical decision-making is a vital part of what speech-language pathologists offer moms, dads, and the children themselves," ASHA President Catherine Gottfred explained in her letters to McCain and Obama. "This approach integrates high quality research evidence with practitioner expertise and client preferences and values."

The Post article said McCain told a town hall meeting in February: "It's indisputable that [autism] is on the rise among children; the question is what's causing it. And we go back and forth, and there's strong evidence that indicates it's got to do with a preservative in vaccines."

The same story also reported that Obama told an April campaign rally: "We've seen just a skyrocketing autism rate. Some people are suspicious that it's connected to the vaccines. This person included. The science right now is inconclusive, but we have to research it."

In her letters, ASHA President Gottfred noted that "a key lesson that has been learned from the daily work of our member speech-language pathologists-namely, the importance of evidence-based practice-can help guide the autism conversation." She added: "While we very much applaud your interest in health issues of great concern to Americans, we also urge you to strongly consider the critical need for evidence-based practice."

ASHA principles and guidelines with regard to autism reflect a long history of relying on the best available scientific evidence. "When our member speech-language pathologists see families in desperation, grasping out for ineffective or unproven treatments," Gottfred wrote, "they realize how critical it is to advocate for care that is based on science."

ASHA has 130,000 members, most of whom are SLPs who work in elementary and middle schools. In her letters, Gottfred explained that SLPs are often sought out by parents when autism impacts their children's verbal and non-verbal communication.

The Post article that reported McCain and Obama's comments also reported that the "body of evidence assembled so far suggests no proven link" between autism and a preservative in vaccines.

According to the Post, that evidence includes five major studies. It also said that the World Health Organization, the Institute of Medicine, and the Centers for Disease Control and Prevention have all dismissed claims of a link. Additionally, the paper reported that a study released by the California Department of Public Health this past January found that the autism rate in children continued to rise even after vaccine manufacturers stopped using the preservative thimerosal in childhood vaccines seven years ago.

The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for more than 130,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists. Audiologists specialize in preventing and assessing hearing disorders as well as providing audiologic treatment including hearing aids. Speech-language pathologists identify, assess, and treat speech and language problems including swallowing disorders. For more information about noise, hearing loss, and noise prevention, go to www.asha.org or 1-800-638-TALK.