Celebrating 30 years of better diagnosis

As was widely expected from leaks earlier this year a new study has been released that estimates that the current prevalence of autism in the UK is 157 per 10,000. That means that 1 out of every 64 children is expected to have some form of autism, or in a simple percentage form 1.5% of all children in the UK.

According to the same study, the accepted prevalence of autism in 1978 was 4 per 10,000. To get the proper perspective on the relative difference between those numbers, lets look at a picture -

For every child in 1978 that was thought to have autism there are slightly over 39 today.

If this growth pattern were seen in any other disorder I think people would sit up and take notice. The word epidemic might even be used.

But this isn't any other field, this is autism, so there is some magic wand that makes these numbers make sense, right? The authors of the study suggest -

1. improved recognition and detection
2. changes in study methodology
3. an increase in available diagnostic services
4. increased awareness among professionals and parents
5. growing acceptance that autism can coexist with a range of other conditions
6. a widening of the diagnostic criteria

Or in short - the criteria changed, we are better at seeing it because more people know what to look for, and there are more services so more people are likely to seek the diagnosis. These reasons make up what I call the holy trinity of denial.

To be fair there is some truth to some of these reasons. The criteria in 1978 was different that it is today and more people know what autism looks like and are less likely to call it something else. Given the history of autism I don't think the services part holds water but that is a subject for another day.

But lets accept for a minute that all three reasons are true and each had the effect of doubling the number of cases. We would then be talking about 32 per 10,000 which is still a far cry from the 157 per 10,000 number.

I think science needs to come up with some better reasons for this growth, something that fits the facts, rather than sticking their collecting heads in the sand. Because if autism keeps growing at the same rate 30 years from now we will be seeing autism in every 1 out of 2 children and then there really will be a problem.

Why [Insert Cause here] shouldn't be on the IACC

From the dueling lists department comes two different takes on why rival organizations should not be on allowed to be represented on the IACC.

In the right corner from Left-Brain Right-Brain is Sullivan weighing in with 6 reasons that Generation Rescue should not be included on the IACC.

In the left corner is Jonathan Mitchell from Autism's Gadly weighing in with 5 reasons that neurodiversity should not be heard by the IACC.

So, who has the better list? Lets put it to the judges and find out. Each valid argument will be awarded up to 1 point, each bogus one will be awarded no points.

Starting with the right corner -

1. Generation Rescue’s position is already represented on the IACC.
   
   That isn't really the point of representation, is it? It you look at the roster for the IACC you will see that several government agencies not only have their position duplicated by other agencies but they also have multiple seats themselves
   
   Zero points
   
   
2. Just because there are multiple organizations, doesn’t mean that the IACC has to include them all.
   
   Yeah, uhm, isn't this the same as the first reason?
   
   Zero points
   
   
3. This would lead to even more wasted time.
   
   I have to agree that the more members on a committee the longer it takes for anything to get done. But at the same time the point of the committee is to represent the various confliciting interests.
   
   Half point
   
   
4. Generation Rescue has clearly demonstrated itself to be anti-science.
   
   This statement is just plain silly - Generation Rescue is very much a science based organization. Just because you disagree with with their position doesn't mean that they are anti-science.
   
   Zero points
   
   
5. They don’t want their voice heard, they want to be able to outvote the scientists.
   
   If they want to outvote the "scientists" doesn't that mean their opinion runs contrary to what these "scientists" believe. And if that is the case wouldn't that mean that a vote against them would be making their voice heard?
   
   Zero points
   
   
6. They are rude.
   
   If we excluded everyone who could be rude then there wouldn't be anyone left talking.
   
   Zero points

Moving on to the left corner -

1. The combating autism act which the IACC grew out of was passed to prevent and cure autism.
   
   This is true but that doesn't mean that the entire purpose of the organization should be to cure autism.
   
   Half point
   
   
2. They already have representation on the IACC.
   
   They do have Stephen Shore and Alison Tepper Singer who for some reason felt that she was entitled to keep the seat from Autism Speaks when she resigned. And the new Autism Science Foundation does appear to be climbing into bed with the ND folks.
   
   One point
   
   
3. Foreign non American taxpaying ND's are encouraged by the autism hub to write about the IACC.
   
   While this is true in general the author of this list (Sullivan) is a US resident so he is allowed to have an opinion, even if it expressed on a UK site.
   
   Half point
   
   
4. They are anti-science in terms of promoting science that will cure and prevent autism.
   
   This is a good point - the ND movement is against finding a cure for autism and in some cases against looking at the genetics of autism. If you take these two items away there isn't a whole lot that the IACC can focus on.
   
   One point
   
   
5. They are rude.
   
   See above - Zero points

The final score is 0.5 to 3.0 - the winner of the better list contest is Autism's Gadfly.

Tune in next time when we compare the ND's "Top 5 stims and how they make me a better person" to the Age of Autism's "Top 10 places that the doctor can shove their vaccine", it should be a doozy.

A few changes

I made a few tweaks to the content on the site -

• I added a list of some of the other autism related blogs that I read on a regular basis. There are some on the list that I agree with and some that I don't but all of them tend to have interesting material.
• I added a search box in the upper left corner that will search the contents of the blog and other pages that I link to. Since there seems to be a decent amount of traffic coming from people looking for information about specific topics I thought this would be an easy way to help people find other related materials.
• I removed the list of recent studies from pubmed - I think I was the only one who thought that was interesting.

If anyone has any any comments about the changes feel free to leave them below.

Study Watch : Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children

In this month's Pediatrics is a study about parent's refusing vaccinations and an increased risk of whooping cough (pertussis) -

Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children

This isn't the type of study I would normally write about because to me it falls into the "duh" category. If you refuse a vaccination for a condition that is in circulation and that vaccine is even decently effective then it is obvious that you are running a greater risk of contracting the illness. However, there seems to be misinformation being reported so I thought I should address what is actually contained in the study.

The study examined records from the Kaiser Permanente Colorado (KPCO) health plan from 1996 to 2007 looking for cases of whooping cough in children of ages 2 months to 18 years. Over the 12 year period they found 439 patients with a diagnosis of pertussis and further narrowed this set down to 165 cases by limiting the group to the appropriate age age and cases that were confirmed using laboratory tests.

The vaccination status of each member of the cohort was determined by looking their medical charts and the cohort was broken up into two groups. The first group is the "vaccine refusers" which contains children whose parents refused vaccinations for "personal, non-medical" reasons. The second group contained everyone else - potentially including those who are unvaccinated for medical reasons - the study does not present any information on the composition of this group.

I think it is important to note that the study presents no data for the reason that vaccination was refused nor does it make any representations that any of these parents refused vaccinations because of fears of autism.

Returning to the 165 cases - a further 9 were excluded because the patients were either unvaccinated or partially vaccinated and the reason for the lack of vaccination was not documented.

So the final 156 case subjects were randomly matched with 624 control subject by a variety of factors. The authors excluded 29 of the control subject because the reason for lack of vaccination was not clear leaving 595 in the control group.

In the final analysis there were a total of 21 subjects in the case and control group who belonged to the "vaccine refusers" group - 18 of the subject were in the group that had whooping cough and 3 were in the group that did not.

The authors also performed a similar analysis of on a cohort of 27,748 children who were continuously enrolled in this health plan from 2 months to 20 months. In this set they matched 31 confirmed cases against 308 controls and found that there were 4 refusers in the case group and 2 who were not.

Based on the above data the authors assert that the vaccine refusers are 23 times more likely to develop whooping cough than the control group. In the secondary data set the figure was more like 19 times more likely.

The study seems to be pretty solid but there are a few potential weaknesses -

According the the CDC cases of whooping cough are primarily increasing in older children whose vaccinations are beginning to wear off - the vaccine is only effective for 6-10 years. While the study did provide information about the age brackets of the children in the case and control groups they did not provide information about how the vaccine refuser group was distributed across the age groups.

The other problem is that the size of the vaccine refusers group is very small when compared to the total number of subjects ( under 1%)

But overall the conclusions of this study are not that surprising. If you skip vaccinations you are more likely to catch what the vaccination is attempting to prevent.

Is the Flu Shot a good idea for kids?

According to an article at Science Daily children who receive the flu shot might have up to three times the risk of hospitalization for the flu. The article talks about a cohort study of influenza performed at the Mayo Clinic that looked at 263 children who were seen at the clinic with laboratory-confirmed influenza between 1996 and 2006. The study verified who had received the flu vaccine and who had not and determined that children who received the flu vaccine had three times the risk of hospitalization when compared to those who had not.

I have not been able to find the original source of the study but it was supposed to be presented at the 105th International Conference of the American Thoracic Society.

After reading this article I started to wonder at how well the flu shot works in general, so I went looking for some information. What I found made me wonder at why it is pushed so much.

First a little background - there are currently two styles of flu vaccines on the market now. The first is a the flu "shot" made from inactivated (killed) virus that you get via an injection at a doctors office or some other clinic. The second is a nasal spray that contains an attenuated (live weakened) viruses. This second form is a more recent development that is not as widespread yet.

I am going to be talking about the first form only - the traditional flu shot.

So lets start with the first problem - the flu shot is one of the few types of vaccinations that still contains thimerosal (ie mercury). If you don't know why that could be a problem just google autism and mercury and prepare to wade into a holy war.

The short version is that this preservative isn't a good idea and while there are no "proven" health problems associated with it there is no reason for it to still be there. The good news is that thimerosal free versions are available but you have to ask for them.

The second problem is that the flu shot isn't that good at preventing the flu. According to the (most likely over-optimistic) CDC the flu vaccine can prevent 66% of cases of influenza in young children. But the effectiveness of the shot can vary from year to year based on how well the the shot is matched to the strains of flu that are active that year.

I also looked for published research detailing how well the flu vaccine worked in children and found a mixed bag. Some research agrees with the 66% that the CDC says while some does not. I was particularly struck by this meta study published in Lancet in 2005 that found that the effectiveness of the vaccine in children older than 2 was about 38% but in children under two performed no better than a placebo.

So at worst the shot may have no little or no real effect and may lead to a greater risk of hospitalization but at best could have a better than 66% chance of preventing the flu.

As I have written about before I am a little leery about this shot because the one time that my twins received this shot they seemed to develop the flu shortly afterwards closing followed by their regression into autism.

So, is the flu shot a good idea for kids? I think the answer is a definite maybe.

Study Watch : A Genome-wide Association Study of Autism Reveals a Common Novel Risk Locus at 5p14.1

This is the second of two studies published last month that dealt with a potential discovery a generic risk factor for autism. This study was published in Annals of Human Genetics

A Genome-wide Association Study of Autism Reveals a Common Novel Risk Locus at 5p14.1

This study is looking for genetic risk factors for autism and to replicate an earlier finding of a relation between autism and the CNTNAP2 gene.

There were two data sets included in the study. The first was data from the Collaborative Autism Project (CAP) that included data from 1,537 subjects with autism from 487 families. The second data was from Autism Genetic Resource Exchange (AGRE) and included data on 3,512 individuals with autism from 680 families.

The authors looked for relations in both data sets individually and then jointly to attempt to find any associations with autism. Like the other study on the same topic there was no significant association in either data set alone but when taken together the results became more significant.

This study failed to replicate the association between the CNTNAP2 gene and autism.

I think the authors closing statement puts the the results of this study into the proper context -

Our results, in combination with the multiple rare variants already identified, suggest that the genetic architecture of autism is as exquisitely complex as is its clinical phenotype.

There are a few other things that I wanted to point out about this study as it relates to the other study. First and most importantly, the data sets used in this study (CAP and AGRE) were also included in the other study. Second, several of the authors on this study, including the principal authors, were also authors on the first study. So the findings of this study, while they confirm what the other study said about this data, are not really a separate finding of a relation.

Study Watch : Common genetic variants on 5p14.1 associate with autism spectrum disorders

There were two studies published at the end of last month with a large amount of fanfare announcing that a gene was discovered that might be responsible for as many as 15 percent of cases of autism.

I wanted to write about them earlier but the studies are complex and understanding what exactly they are saying has taken me some time.  I am going to start with the main study and should follow up with the second study shortly.  

The main study was published on April 28th in Nature -

Common genetic variants on 5p14.1 associate with autism spectrum disorders

This study has an large list of authors with over 50 people attaching their name to the study - I don't recall ever seeing a study with so many names attached to it.  The study itself is a very dense five pages of material although the supplementary material weights in 65 pages.

In this study the authors were attempting to identify common genetic risk factors for autism.  They first started by looking for associations in a data set from the Autism Genetic Resource Exchange (AGRE) that ultimately contained 3,101 subjects of European descent from 780 families.    

There were no associations found that were significant.  However, the authors proposed that there could be meaningful associations that among the results that showed some possible association yet did not rise to the level statistical significance.

To that end examined a second data set from an Autism Case-Control cohort (ACC) containing 1,204 case subjects and 6,491 control subjects that were provided from multiple projects across the country and from Childrens Hospital of Philadelphia.

No significant associations were found in this data set either.

However, the authors took it a step further and did a meta-analysis of the two data sets together using very recent techniques and found a result that reached significance and several others that came close.  The most significant association was found at 5p14.1 with the others being located at several nearby locations.

To confirm these findings two other data sets were examined. The first was the Collaborative Autism Project (CAP) cohort with 504 subjects and the second was the Center for Autism Research and Treatment (CART) cohort with 108 case subjects and 540 controls. 

Neither of these two data sets yielded a significant association on their own but like the AGRE dataset they showed some associations that did not reach the level of significance.  However, when these data sets were combined with the original two the areas identified above were again significant.

All of the areas of interest identified are location in a region between the CDH9 and CDH10 genes.  The authors hypothesized that the locations identified were showing functional variations in one of two two genes.

These genes and others that could be related are thought to be involved play a role in shaping the physical structure and functional connectivity of the brain.  These are two areas that other research as identified as potential issues in people with autism, so the results do fit with other theories of autism. 

As an aside, there is a post at autism.about.com where Lisa Jo Rudy published some questions and answers from the study's lead author that is worth reading.

I am not sure what to make of this study.

It is not straightforward at all and the amount of information published with the study is far larger than is normal.  I think this is likely because the authors wanted to cover all of their bases yet I have to wonder why those chose to add all of it.  

I am confused as to why a significant association was not present in any of the individual data sets but only appeared when the data sets were analyzed together.  I would think that if the claim of 15% of autism cases contained in the press releases for the study were correct that the association would have been more apparent from looking at any of the data sets individually.  Or I would have thought that it would have been identified in one of the other large genetic searches that were done prior to this.

I also have to wonder at the methodology used to perform the meta analysis of the data sets.  From what I can gather the technique is very new - the reference that the study provides to the methodology was published just a month or two (October 2008) before this study was submitted to the publisher (Nov 2008).  I did not investigate the methods in depth but from what little I did see gives me pause.  

The results of the study rest on the meta analysis of the data sets - if this methodology is flawed or was implemented badly then association found would fall apart. 

So all in all I would think that this is a potentially promising study but that further confirmation is required.

Neurodiversity : Stop the Insanity

Over at Newsweek there is an article by Claudia Kalb on Ari Ne'eman and neurodiversity.   It is a one sided slanted view of the world of autism according to how Ari Ne'eman sees it.  

According to Mr. Ne'eman, autism is not a "medical mystery that needs solving" but is "a different way of being" and should be "accepted by society".  He is pushing for accommodations in the classroom and supports to help adults live independently.  He is strongly opposed to a "cure" for autism.   He believes that "we're having a national conversation about autism without the voices of people who should be at the center of that conversation". 

Apparently he hasn't gotten the memo that a large number of people, possibly a silent majority, are unable to talk.  Yet here we have a person who says that they are on the spectrum and are  speaking for all people with autism - including those who can't communicate with the outside world.   Maybe he is telepathic and that is how he knows what all of the other people with autism want.

To be fair I should mention that Mr Ne'eman has a diagnosis of Asperger's rather than autism. As pointed out by Harold Doherty in a recent post these two conditions are different.   Aspergers does not have a disruption in communication skills and tends to be less severe than other forms of autism.

I don't think the difference is really that important.  Mr. Ne'eman is full of it.  I am not sure whether he truly has a form of autism, the description of him from the Newsweek article makes me wonder  - 

It's spring in Washington, and Ari Ne'e-man, with his navy suit and leather brief-case on wheels, is in between his usual flurry of meetings. Ne'eman is a master networker, a guy you'd think was born in a campaign office and bred in the halls of the Capitol. He's fluent in policy-speak and interacts seamlessly with high-level officials (...) and inquisitive reporters alike. He's formal but sociable and has a well-timed sense of humor.

This doesn't sound like many cases of  autism I have run across.  But in reality his exact malfunction is irrelevant, the important part is that he is not representative of what children with autism are dealing with and the problems that they face.  The author of the piece makes a big deal about how Mr Ne'eman has a problem with velvet - 

His father used to drive a car that had fuzzy velvet-like cushioning, and it made Ne'eman crazy to sit in it. "I'd wince because I'd think about how it would feel to get that under your fingernails," he says. I think I see him shudder at the 't .

If that is the worst sensory issue that he has then cry me a river.  I would take that any day of the week over what my daughters are having to deal with.

The only reason that this sort of story is printed is because it casts a favorable light on what is increasing becoming a crisis.  People don't want to read about the problems with autism, they want to think that people with autism are just a little quirky and are all secretly little Einsteins who will solve all of the worlds problems.  

There are other adults on the spectrum who have a different view of what autism is yet their story is never told.  Take for example Jonathan Mitchell's post in which he publishes his letter to the editors of Newsweek asking for a chance to tell a different side of the story.  Anyone think that Newsweek will publish an article giving his perspective?

Autism is a profound disorder that causes massive life long difficulties for its victims.  It is not something that should that should be ignored, "accepted", or left untreated.  Yet if the advocates of neurodiversity get their way that is exactly what will happen.

Publications like Newsweek should not be giving coverage to crazy talk about something as serious as autism. 

HBOT and FUD

I don't like being right.  As I suggested in an earlier post the tragic accident at the HBOT center Florida is being turned into a talking point against the potential use of this treatment for autism.

A have been a few more details released about the incident.  The two people injured were a young child with cerebral palsy and his grandmother.  The grandmother has died from her injuries and the child is still in critical condition.  This is truly a tragedy for the family.

As I pointed out before this accident does not diminish the excellent safety record of HBOT clinics and has nothing to do with autism.  Yet there is an attempt to turn this into a rallying cry against HBOT for treating autism. 

Starting with Lisa Jo Rudy's post at autism.about.com - Hyperbaric Oxygen Chamber Explosion Raises Questions for Families with Autism - in which she raises the alarm that  explosion is a risk of HBOT chambers -

Because HBOT involves the use of pressurized oxygen, it is obviously a fire and explosion hazard. Typically, hospitals and treatment centers that offer HBOT follow specific safety protocols, though clearly even such protocols aren't foolproof.

Of even greater concern, though, are home HBOT systems. Recent blogs and online discussions suggest that families are purchasing such systems and using them without a full understanding of the possible dangers. Parents, for example, join their autistic children in the chambers while using electronic devices such as ipods and laptops.

I don't believe that pressurized oxygen is an explosion hazard - pure oxygen can't explode but it can accelerate the combustion of other materials.  I am even less sure that home HBOT systems have enough extra oxygen to cause a problem - I think that a typical gas stove or gas fire place  would pose more of a fire hazard than a typical home HBOT.  But my grasp of physics isn't what it used to be so I could easily be wrong here.  

But lay that aside for a moment and consider the risks involved and the safety record of the technology involved.  I can't find another reference to an explosion like this in an HBOT center in this country nor any references to a commercial HBOT system causing fires at home.  So while it is clear that fire or explosion is a potential risk it is also clear that in practice the real risk here is very, very, very, very small. 

It is far more likely that your child would be injured in a swimming pool at someone's house than it is that they would be hurt by an explosion of an HBOT tank.

But simple facts can't get in the way of a good ideological on a rant.  Take for example the comments by Kev -

We have one study from Dan Rossignol et al which has some fairly serious issues with it as regards autism. There is also no indication it does a damn thing for cerebral palsy either. People being told it will help and who are paying hundreds of thousands of dollars as this family were are victims of quackery.

and this one -

Bottom line: there’s no good evidence, despite looking that HBOT does a darn thing for CP or autism. Despite that, this boy was in a chamber when it caught on fire. If he hadn’t been in the chamber nothing would’ve happened to him. Now he’s got 90% first degree burns - and all it cost his family was hundreds of thousands of dollars! Cool!

So the kid was hurt because his parents believe in "quackery".  By this logic if you are driving your child to any experimental therapy and you are in a car accident then clearly it is the fault of the experimental therapy because you clearly would not have been in the car at that point without it.    

And then we have another post back at Left Brain Right Brain by DoC - 

Fire, Fatal Injury, and Claims of Certification in an Independent HBOT Clinic

With a title like that I would be running for the hills - you have fire, death, and hints of fraud.  All the good things that FUD (Fear, Uncertainty, and Doubt) are made of.  However if you  look at the actual post though there is little in the way of fire and death - just a quick mention at the top of the post about the known facts of the case.  

The meat of the post, what little there is, is that the director of a medical center is not really "certified".  This claim is "proven" by doing web searches based on assumptions of how an organization works that are gleamed from its web pages.  

I know this is may be a radical concept, but, if I had questions about a doctors certifications, instead of guessing I would ask the doctor directly about their certifications and what entity  provided said certifications.  I would definately do this before publishing something a potentially slanderous article.

The conclusion of the post is lightly hung on the certification issue by a thread - 

...this may contribute to an explanation of why this facility appears to treat conditions like cerebral palsy and autism in the first place – conditions for which there appears to be very little legitimate scientific support behind the use of hyperbaric oxygen therapy (some have even called the use of hyperbaric oxygen therapy for such conditions, “quackery”).

I really like the "some have even called it quackery at the end".  It makes it sound so legitimate.  Too bad for DoC that the "some" that are calling it quackery are his co authors on the site.

The insinuation is that "little scientific support" plus "is he really certified" with a dash of fire and death makes this  potential treatment "quackery".  Most rational people would call it experimental or if they were feeling generous "promising" but that's ideologues for you, always grinding that axe.

Study Watch : From Traditional Medicine to Witchcraft

From PLoS one comes this entertaining study about why people use complementary medicines, traditional remedies, and home cures even though there are doubts about the treatment working - 

From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious

It is an open access study though I would not recommend reading it unless you are up for a lot of math.

The authors of the study developed "mathematical models of the spread of self-medicative treatments for medical conditions to explore the factors that lead to treatments becoming widespread, and how a treatment's efficacy affects its rate of spread."

Their conclusion?

"This study offers a simple, novel and counter-intuitive hypothesis for the prevalence of ineffective medical treatments: unbiased copying of new treatments can frequently lead to the prevalence of ineffective practices because such treatments are demonstrated more persistently than efficacious alternatives, even when there is enhanced abandonment of ineffective cures."

I think I like how the conclusion was summarized in article on the New Scientist site -

Quack remedies spread by virtue of being useless

Under a wide range of conditions, quack treatments garnered more converts than proven hypothetical medicines that offer quicker recovery, Tanaka found. "The very fact that they don't work mean that people that use them stay sick longer" and demonstrate a treatment to more people, he says.

Or to summarize, ineffective treatments tend to spread because of the fact that they leave the person suffering.  You would think that a moderately intelligent person would stop preaching about the benefits of something that wasn't working for them but the conclusion was proven by mathematical models so it must be correct.

The thing that I find most humorous about this article is how it lumps complementary medicines, traditional remedies, and home cures in with witchcraft.  Talk about a loaded association - that would be like listing a group of politicians and adding Hitler into their ranks.  

Fear, uncertainty and doubt

The good folks over at Left Brain Right Brain have sunk to a new low.  They are piggybacking on a story from today where 2 people, a woman and a child, were critically injured in an explosion at medical center that offers hyperbaric oxygen therapy (HBOT).  I have found two stories so far that have details about the incident, here and here.

This is clearly a tragic incident and I hope the the two people injured recover from their injuries.

So what does the thoughtful Kev from LBRB have to say about this?

He jumps at the fact that a doctor that he dislikes gave a presentation in 2004 at a conference that was sponsored by the center and immediately spins it to  -

And so, I have to wonder – was this child autistic and undergoing a totally pointless HBOT session when the chamber exploded? Time will tell..

So, what does this potentially exploding chamber have to do with autism?  

Absolutely nothing.

If the child that was injured had autism and was there for a HBOT treatment specifically for treating autism then what does this story have to do with autism?

Absolutely nothing.

This story has to do with a tragic accident at a medical facility.  It has to do with the potential risk of an HBOT chamber exploding.  If you read the stories I linked to above you run across this quote from a woman who runs another HBOT clinic - 

...if the hyperbaric chamber exploded, it could be the first such incident in the United States.

"The last accident was at least 15 or 16 years ago in Asia, because the patient brought in a hand warmer," she said. "These chambers are safe if you do it correctly. You have to take precautions because you're dealing with 100 percent oxygen."

So chambers aren't exploding all over the place and this isn't something has happened very often, if ever, in the US.  HBOT chambers tend not to explode nor do they have any extra incentive to explode when used to treat autism.

The purpose of the post at LBRB is fear, uncertainty, and doubt.  It is there to say "see we told you HBOT wasn't a good idea".   It is there to discredit HBOT for treating autism - "see you can be hurt doing the treatment".  But mostly it is there to twist a tragic event into a rhetorical point in their ideological war against treating autism.

How pathetic is that.

EDITIED TO ADD:

OK, I thought the post on LBRB was bad until I ran across this one at change.org -

When Treatment Goes Too Far: Boy Burned at HBOT Center

Where LBRB just hinted at the "we told you so" Kristina Chew comes out and says it -

While some have offered anecdotal reports about the effectiveness of HBOT in "treating" autism, HBOT is one of many experimental, unproven, biomedical treatments for autism---why is it that families willingly try "anything and everything to 'treat' autism? Why put a child's safety and even life at risk in the name of "treatment for autism"?

So there you have it, HBOT for autism puts your child's safety at risk