The officials were also struggling to explain why David Geier, who has an undergraduate degree in biology and does not have a medical license, was identified by the Commission on Autism as its "diagnostician." The commission's website had listed him as a doctor until Wednesday, which officials said was a clerical error. The commission's listing also includes the Geiers' company, ASD Centers LLC, whose website lists a corporate center in Silver Spring but is not registered in Maryland.
Paulson said the state was aware of "the controversial nature of David Geier's views" when he was recommended for the position on the commission, which was formed by the legislature in 2009. But officials were looking for a "diverse" panel.
The statute that created the commission does not define the term diagnostician, and the legal definition is broad, Paulson said. "This issue is under review concerning the legislative intent of this word as written into the statute."
The Geiers' views, spelled out in papers and by the state Board of Physicians that suspended the senior Geier, have been discredited by the Institute of Medicine and mainstream medical science in general. They connect autism to the mercury in vaccines. Among the treatments the Geiers say they've developed is one that uses Lupron — a drug that a host of autism experts have called dangerous for children.
In suspending the senior Geier's license, the state board said that Lupron is approved to treat prostate cancer in men and endometriosis and fibroids in women. It's also used to chemically castrate sex offenders.
The Geiers, who operate offices in Rockville and Owings Mills under the name Genetic Counselors of Maryland and other offices in several other states, are well-known in the alternative medicine arena. Many parents, desperate to find a cure for autism, look to diets, vitamin, herbs and drugs used "off label," or without approval from the U.S. Food and Drug Administration.
Lupron suppresses testosterone, which the Geiers claim is elevated in autism patients and worsens their mercury toxicity. The board says the shots can cost $5,000 to $6,000 a month, and are typically covered by insurance for a diagnosis of the rare condition "precocious puberty" — a diagnosis that the board said Mark Geier improperly cited in patients.
The board also said Mark Geier failed to fully inform parents of the treatment dangers and misrepresented his credentials. He can appeal his suspension under these charges and is expected at a hearing May 11.
David Geier is listed as an executive in some of his father's businesses, and the board said that on at least one occasion a parent claimed he had diagnosed her child and administered an ultrasound scan. The board sanction, however, did not include David Geier. He told state health officials Wednesday that he would not resign from the autism commission until the Board of Physicians process was complete.
Mark Geier can't practice medicine while his case is pending.
David Geier did not return calls made to his home or office, and Mark Geier's attorney was unavailable. Both live in Montgomery County.
On Wednesday, the attorney, Joseph A. Schwartz III, told the Chicago Tribune, which first investigated Mark Geier's practices in 2009, that the root of the case was a "bona fide dispute over therapy. ... If you read the [order], you say, 'Holy God, this is awful.' But if it were so awful, they should have an injured child, and they don't."
Dr. Gary Goldstein, president of the Kennedy Krieger Institute, a premier institution for treating autism, said he'd been dismayed by reports of doctors prescribing Lupron for the disorder for years but did not know about the Maryland doctor.
He said there are drugs to treat symptoms and behavioral therapy, but no medication to treat the core disorder. About 1 percent of children have autism, which inhibits social skills.
"You have to take a step back and understand the frustration and desperation of parents with children with autism," he said. "We have no real medical treatments for the core symptoms of autism. Unfortunately, there are physicians out there, some well-meaning I suppose, who tell them herbs or medications will make a difference."
He said the placebo effect is huge, and parents take to the Internet to claim apparent initial successes. Many alternatives are likely harmless, he said. But some are dangerous, like Lupron. He likened giving Lupron to autistic children to giving chemotherapy to someone without cancer because "their brain cells were dividing too fast."
As for David Geier's position on the autism commission, Goldstein worried that it would give him, and the Lupron protocol, credibility. David Geier does promote his appointment on the websites for companies created by him and his father, some of which do not appear registered with the state or listed with the federal government as nonprofits.
It's not clear what specific element of his application won the seat on the panel, on which 60 people requested positions. Neither he nor his father has made political contributions, according to state data. And court records show that at one time, the family business owed more than $500 in back taxes to the state, which it was ordered to pay.
Renata Henry, the state's deputy secretary for behavioral health and the commission chair, said there are 26 members of the panel and there has been a wide range of opinion and information presented since the first meeting in the fall of 2009. An interim report to the governor and state legislature will offer an outline of the resources available in the state to those with autism and what needs to be done to improve services.
"The rate in Maryland and in other states continues to grow rapidly," she said. "One in 110 are now on the autism spectrum. We wanted to look at how we were planning for the increased prevalence."