Be Wary of CARE Clinics and the Center for Autistic Spectrum Disorders (CASD)

Be Wary of CARE Clinics and the Center for
Autistic Spectrum Disorders (CASD)

Stephen Barrett, M.D.

The Center for Autistic Spectrum Disorders (CASD) was founded in 2001 by Kazuko Curtin. Curtin is also doing business as CARE Clinics at the same address in Austin Texas. Clinic literature states that she became interested in "biomedical treatments" when her 2-year-old son (now 13 years old) was diagnosed with autism [1]. CARE opened a second clinic in Tampa, Florida in September 2008.

"Biomedical Treatment"

Biomedical treatment for autism is said to correct "biochemical imbalances" and provide "detoxification." [2] It is aggressively promoted through Web sites, blogs, and conferences and by posts on at least five Yahoo newsgroups that have from 4,000 to 13,000 members. CARE Clinics was the lead sponsor of the National Autism Association's 2008 National Autism Conference [3].

CARE's Web site states:

Children with autism commonly have certain genetic predispositions, nutritional deficiencies, immune system compromises, and toxic overloads. To best address these challenges, CARE Clinics develops a personalized care plan which when used over time, cumulatively works to heal each child [4].

and

CARE NutriGenomics provides personalized advice beyond diet, including supplementation and even life style advice based on your assessed Biomarkers, including the genomic valuations that we determine at CARE Clinics. The technology of health science is quickly improving, however, before CARE Clinics, the clinical use of Biomarkers and Nutrigenomics have not yet begun to be sufficiently used for the recovery of our children. In the treatment of cancer, Alzheimer’s, anti-aging, and some other conditions, BioMarkers have already been introduced and are making progress. Here at CARE Clinics, we have been successfully treating children by using the latest medical diagnostic technique, CARE Clinics BioMarkers™ to design your child’s CARE Clinics Health Blueprint™ and create an individualized treatment plan [5].

CARE literature claims that its Biomarkers evaluation "helps to identify subtle abnormalities that may prevent the ability to achieve optimal health" and is the "most comprehensive lab testing available." The evaluation includes genomic testing, various routine blood tests; and tests for amino acids; organic acids; peptides; uric acid; oxalates; metallothionein; melatonin; iodine; kryptopyrrole; essential fatty acids; neurotransmitters; oxidative stress; vitamins and minerals; heavy metals; food allergies; inhalant and mold allergies; viruses; bacteria; intestinal permeability, and thyroid function [1]. These tests, most of which are nonstandard, have no proven relevance to autistic spectrum disorders.

The current minimum charge for people who do not have insurance appears to be $8,500 for the CARE BioMarkers evaluation plus $500 for a "first-time patient fee." In cases I have investigated, however, the insurance company was billed more than $40,000 per person.

CARE's "personalized" treatment plan may include amino acid therapy; vitamin, mineral, and antioxidant supplementation; intravenous nutrient therapy; "IV detoxification" (chelation therapy); diet modification; hyperbaric oxygen; ultraviolet light therapy; far infrared sauna; steam ozone sauna; and gastrointestinal treatments (enzymes, probiotics) [1]. CARE's guidebook lists more than 50 "supplements" that may be recommended [1]. None of these modalities has any proven benefit or plausible rationale for treating autism.

The labs processing CARE's tests include Doctors Data, Genovation, and The Great Plains Laboratory. The Hopewell Pharmacy and Compounding Center (Hopewell, New Jersey) provides some of the supplement products.

Genetic Testing

The centerpiece of CARE's evaluation is genetic testing performed by Genova Diagnostics (formerly called Great Smokies Diagnostic Laboratory) of Asheville, North Carolina. The tests are claimed to identify genetic data associated with the development of various diseases so that nutritional strategies can reduce the chances of developing those diseases later in life. This concept, while appealing, has no validity and has never been demonstrated to work [6,7]. The test reports themselves include this disclaimer:

This test has been developed and its performance characteristics determined by Genova Diagnostics, Inc. It has not been cleared or approved by the U.S. Food and Drug Administration. Commentary is provided to the practitioner for educational purposes, and should not be interpreted as diagnostic and treatment recommendations. Diagnosis and treatment are the responsibility of the practitioner. Any positive findings in the patient's test indicate genetic predisposition that could affect physiologic function and risk of disease. We do not measure every possible genetic variation. The patient may have additional risk that is not measured by this test. Negative findings do not imply that the patient is risk.

In other words: "We'll be happy to pocket the money for providing the test report, but don't hold us responsible for anything it says."

Even worse, the tests do not even appear to be related to autism. CARE's "information guidebook" includes a sample "DetoxiGenomic Profile" report for a 7-year-old boy, which advises that he have a comprehensive cardiovascular assessment, an evaluation for high blood pressure [1]. Reports I have seen on another young child include discussions of "health implications" and "treatment options" related to cholesterol regulation, high blood pressure, and blood clotting. None of these conditions had any relationship to the child's actual health or could possibly influence the child's autistic behavior.

CARE Staff Members

CARE Clinic literature includes the following members of its "professional team":

Chief operating officer: Kazuko Grace-Curtin, who is also described as founder and CEO of Nutrigenomics and inventor of "the patented Visual Learning Method Therapy for Children with Autism and Related Disorders." [8] Note: The U.S. Patent Office database says that Curtin's learning system was not patented because she failed to respond to requests for further information.
Research and laboratory director: Anthony Ron Torres, M.D., who directs the immunosciences laboratory at Utah State University.
Clinical research director: Dennis Odell, M.D., who directs the biomedical division of the Center for Persons with Disabilities at Utah State University.
Medical director (Austin facility): Jesus Antonio Caquias, M.D., who is said to have directed the treatments (including over 10,000 intravenous treatments) since February 2006. He is also identified as "medical consultant" for the Tampa facility. Note: Caquias has been disciplined twice by the Texas Board of Medical Examiners. In 2006, the board concluded that he had failed to maintain adequate medical records and ordered him to (a) resign from his role as a gatekeeper in the county indigent program, (b) undergo remedial training in recordkeeping, and (c) have his practice monitored for two years. In 2007, he signed an agreed order under which he was fined $5,000 and agreed to stop (a) advertising in a manner that would cause confusion to the public, (b) using overly broad claims that would "tend to mislead the public as to cures for diseases" and (c) advertising with references to organizations not recognized by the American Board of Medical Specialties.
Medical director, Care Clinics (Tampa): Lynne Deng, M.D., a board-certified pediatrician said to provide "biomedical treatments as well as conventional primary pediatric care." [She is licensed under the name Hui Ling Deng.]
Director, nutritional and medical education: Jeff G. Baker, N.D., is said to "work full-time at CARE Clinics, providing his skill and experience in making complex information understandable as part of your child's 'personalized' treatment plan." Before that, for six years, he worked at Genova Diagnostics, which does some of the tests CARE orders. Note: Naturopaths are not licensed in Florida or Texas, which means that Baker is not licensed to advise patients.
Director, CARE Clinics medical staff: Suzanne Bauer, RN, said to be a registered nurse in Florida and Texas.

How "Charitable" Is CASD?

CASD is a 501(c)(3) nonprofit corporation that represents itself as a charitable organization. To be tax-exempt under section 501(c)(3) of the Internal Revenue Code, an organization must be organized and operated exclusively for exempt purposes set forth in section 501(c)(3), and none of its earnings may inure to any private shareholder or individual. The exempt purposes set forth in section 501(c)(3) are charitable, religious, educational, scientific, literary, testing for public safety, fostering national or international amateur sports competition, and preventing cruelty to children or animals. The term charitable is used in its generally accepted legal sense and includes relief of the poor, the distressed, or the underprivileged; advancement of religion; advancement of education or science; erecting or maintaining public buildings, monuments, or works; lessening the burdens of government; lessening neighborhood tensions; eliminating prejudice and discrimination; defending human and civil rights secured by law; and combating community deterioration and juvenile delinquency [9].

CASD's federal tax returns state that its program services consist of providing "special testing" for children with autism. They further state:

The testing of autistic children is consistent with our mission of providing services to families with autistic children and to the medical professionals that care for these children. Our testing also serves as an educational service in that the parents are educated on the results of the testing, which better prepares them to care for their autistic child.

The tax returns for the years 2004 through 2006 indicate that a total of $1,819,619 was delivered as "program services" in the form of 6,710 tests for 727 children. The returns also state that CASD received $2,625,233 as income from its program services [10]. If I understand correctly, the numbers mean that families (or their insurance companies) paid about $2.6 million for tests that cost CASD about $1.8 million. ImpluCorporation states that CASD's 2007 income was $6,504,391, but I have not yet seen its 2007 tax return.

**Data from CASD Form 990 Tax Returns**
Category	2004	2005	2006
Gross receipts	$223,415	$744,122	$1,822,067
Expenses: management and general	$61,074	$180,167	144,446
Fundraising expenses	$32,413	$86,188	0
Laboratory expenses	$12,236		$315,530
Program service income from testing	$59,044	$744,122	$1,822,067
Program services provided (testing children)	$54,639	$507,067	$1,257,913
Number of children tested	427	150	150
Number of tests	1,710	2,500	2,500
Net income from special events (conferences)	$71,776
Compensation, Kazuko Curtin as officer/director of CASD as independent contractor	0	$30,122 0	0 $203,833
Loan to Nutrigenomics to purchase laboratory equipment			$84,000

Documents I have collected indicate that when services are rendered to insured patients, some claims are sent from CARE and some from CASD, both of which have received payments from insurance companies. I don't know what percentage of their combined income is reported as "program service income" on the Form 990s. Regardless, I doubt that that selling medical tests is a charitable purpose.

The Bottom Line

CARE Clinics and CASD offer services that are unsubstantiated and lack a plausible rationale. I am very skeptical of their activities and would like to hear from parents of autistic children who have used them. I can be reached at (919) 533-6009. All information provided to me will be confidential.

References

CARE Clinics Information Guidebook, Volume III: Putting Our Children on the Road to Recovery. Austin, TX: CARE Clinics, 2008.
Vatakar B. What is biomedical treatment? The Journal of ASA Broward, March 2006.
National Autism Conference Web site, accessed Nov 23, 2008.
Announcement for CARE Clinics workshop on the biomedical approach to autism, scheduled for Nov 14, 2008 in connection with the National Autism Association's 2008 National Autism Conference
CARE Clinics home page, accessed Nov 24, 2008.
Barrett S. Hall H. Dubious genetic testing, Quackwatch, Nov 24, 2008.
"Genovations" genetic test kits. GeneWatch UK, July 2002.
Curtin K. Visual learning aid system and method. Application filed Feb 22, 2001.
Exempt Purposes - Internal Revenue Code Section 501(c)(3)
CASD Form 990 tax returns for 2004, 2005, and 2006.

This page was revised on November 25, 2008.