Intended for healthcare professionals

Rapid response to:

Primary Care

Relation of childhood gastrointestinal disorders to autism: nested case-control study using data from the UK General Practice Research Database

BMJ 2002; 325 doi: (Published 24 August 2002) Cite this as: BMJ 2002;325:419

Rapid Response:

Re: Re: No Competing Interest ????

Dr Rumbold, it may interest you to know that one of the main
difficulties of effective communication experienced by those outside my
sons immediate social circle was his inability to conceive that you would
not know his reference base for a random comment or verbal association. He
would make no effort to explain himself, assuming that you too would have
immediate access to the same cultural reference or experience.

I note you make comment on the Secretin trials, I can only assume you
intend to draw a parallel with the use of dietary or behavioural
intervention for those diagnosed on the Autistic spectrum of disorders.

If one accepts the idea that “Basically, the number of parameters
causing autism are multiple, interdependent and work in synergy” (1) then
it is unlikely that a condition which may have multiple variants in
aetiology would respond to a one size fits all approach in treatment, if

I would invite you to listen to the voices of parents from all walks
of life, including the medical profession, on any one of the global myriad
of Autism Support web sites. You will find that by sharing personal
experience, discussing recent research, usually hot off the presses, each
parent then builds a network and database of knowledge beyond anything you
could conceive.

How much of it is then applicable or put into practice for their
child is based on what is appropriate to the personal needs of their child
and the individual family culture and structure. Some strategies are
discarded as unsuitable, some are beyond the means of the parent. They do
what they can. This is not consumerism, this is delivering healthcare
through love on an N=1 basis.

The great sadness is, as has been mentioned before, this living
database and network of knowledge is not available to all. Paucity of
central support via the NHS agencies in delivering a robust and meaningful
care pathway to those diagnosed on the Autistic spectrum compounds
inequality of access.

(1) Saadedine Tebbal, “No competing interest” rapid response BMJ

Competing interests:
parent of child diagnosed ASD

Competing interests: No competing interests

02 November 2004
MC Feliciello