This news release focusing on a small study of acupuncture treatment adherence published in the Journal of Alternative and Complementary Medicine does a good job framing what the study can and cannot tell us — for the most part. However, it strays a bit when it says the study should give parents of children with autism spectrum disorder (ASD) a “hopeful sign” and states it measured the effects of the intervention on the children’s behavior, ability to pay attention, sleep, and parenting stress — but shared none of these findings. There is no mention of quantified benefits, cost or potential harms.
According to the release, the study was designed to determine whether young children, ages 3 to 10, with autism were able to complete an eight-week regiment of acupuncture treatment. The key finding appears to be the fact that all 10 children completed the therapy, which was performed twice weekly over eight weeks. The release would have been improved had it included more details and some data from the study on those aspects of the things that were measured — the children’s behavior, attentiveness and sleep. Or, since this was such a tiny study whose results are likely to be unreliable anyway, perhaps those aspects should have been left out of the release entirely.
According to the CDC, approximately 1 in 68 children in the U.S. has ASD. In other words, a lot of people are affected. People who have ASD can present a wide variety of behaviors. ASD’s impact on an individual’s quality of life also varies, depending on each person’s situation and the behaviors he or she exhibits.
This study looked specifically at parents of young kids, between the ages of 3 and 10. Many, if not most, parents are willing to do whatever they can to help their kids. And if they think that acupuncture might help their child with ASD, they may seek it out. This release says, in its headline, that the relevant study “shows feasibility of acupuncture in young children with ASD.” We wish the release had also told readers why parents and caregivers should consider acupuncture for children with ASD in the first place.
The study was not intended to evaluate acupuncture as a therapy and the release could have spelled that out more plainly. The study was intended to determine the feasibility of using acupuncture on a population that requires a lot of time and effort to undergo therapy. The release might be helpful for other researchers but much less so for parents or the general public.
Costs are not mentioned at all. The costs of acupuncture treatment can vary widely, but most people can expect to pay at least $60 per session (and often considerably more). Given that this study involved 16 sessions, and that not all health plans would cover acupuncture to treat ASD, the expense could be considerable.
According to the news release, the researchers “identified the most positive outcome of the study as the high compliance rate, with all parents of the children ages 3-10 completing the intervention.” While it is good to know that the patients were able to complete the study, most readers probably wanted to know if the patients benefited from the treatment in any way. The release notes that “researchers measured the effects of the intervention on factors such as the children’s behavior, ability to pay attention, sleep, and aspects of parenting stress” — but doesn’t tell readers whether any of those things changed as a result of treatment.
The closest the release comes to quantifying a benefit is when it states that “most parents reported that the intervention had a positive impact on their relationship with their child.” It’s not clear what they mean by “most parents,” how much their relationship improved, how it improved, or why it may have improved. In fairness, the release states that the goal of the study was “to determine if young children with autism spectrum disorder and their parents would tolerate and adhere to an office- and home-based acupuncture/acupressure intervention.” However, the release also says “While a small study, the tolerance and adherence with acupressure this pilot [sic] are both hopeful signs for families of those in their care with autism spectrum disorder.” Why should families be hopeful? Who knows? Given that there had been more than a dozen clinical trials involving acupuncture and children with ASD as of 2012, it’s not clear what questions this new study has answered.
Potential harms aren’t discussed at all. To be clear, the risks here are low. As the Mayo Clinic notes, “The risks of acupuncture are low if you have a competent, certified acupuncture practitioner.” But, then again, the release also doesn’t mention the importance of finding a certified acupuncture practitioner. And even with certified practitioners, there are risks, from soreness and bruising to infections. In addition, individuals with bleeding disorders are not good candidates for acupuncture.
The release offers very little information about the study. For example, while the release refers to it as a “pilot feasibility study,” it doesn’t even tell readers how many patients participated (there were 10).
No disease mongering here.
The release doesn’t mention who funded the work. In this case, the work was funded by Autism Speaks. Many people have strong feelings about Autism Speaks, one way or the other, making the funding organization particularly worth mentioning here. It also doesn’t mention any conflicts of interest but there don’t appear to be any.
The release doesn’t describe potential benefits for ASD patients, so it’s not clear what alternatives are relevant in this context. Alternatives to what? Ergo, we’ll rank this as not applicable.
The release doesn’t address availability at all. While many (or most) readers are aware that acupuncture therapy exists, they may be less familiar with how widely available it is. Readers may not be aware of pediatric acupuncture at all, much less pediatric acupuncture for children with ASD. Is there a special certification for pediatric acupuncture therapy? What about for pediatric ASD acupuncture therapy? The release doesn’t tell us.
Acupuncture research related to ASD is not new. Here’s a systematic review of the relevant literature from 2011, and another from the same year. The Cochrane review, among the collection of studies included in the reviews above, concludes that: “We need high quality trials of larger size and longer follow-up as the evidence base at present has many limitations.”
But the study described here tackles the subject in a new way, that of the feasibility of being able to complete therapy. Prior studies haven’t shown that it’s feasible for families to commit to longer term acupuncture therapy.
The release doesn’t rely on sensational language. We do caution that when a news release includes a quote that says a study offers “hopeful signs for families,” it should be obvious why those families should be hopeful. This release doesn’t do that, because it is not clear how or whether these patients were better off at the end of the study than they were at the beginning. It’s not as egregious as releases (or news stories) that claim amazing results based on limited data, but no release (or news story) should leave readers no wiser at the end than they were at the beginning.