Seeking treatments for autism
Study emphasizes the urgent need for validated and effective treatments
Video with Robin Hansen
For the families of children with autism spectrum disorder there is one daunting reality — early educational intervention may help many reach their full potential. However, there still are no Food and Drug Administration-approved medical treatments for the core symptoms of a lifelong condition whose incidence has reached 1 in 88.
To help their children, many families turn to unconventional approaches, such as mind-body medicine (e.g. meditation or prayer), homeopathic remedies, probiotics, alternative diets or more invasive therapies such as vitamin B-12 injections, intravenous immunoglobulin or chelation therapy — some of which carry significant risks. Together, such treatments are called complementary or alternative treatments (CAM).
“In our Northern California study population, it does not appear that families use complementary and alternative treatments due to the lack of availability of conventional services, as has been suggested by other research,” said Hansen, who also is chief of the Division of Developmental Behavioral Pediatrics in the UC Davis School of Medicine.
"These findings emphasize the enormous and urgent need for effective treatments and for rigorous research that can identify them and verify their effectiveness and safety. Of course it is reasonable for parents to keep searching for ways to help their children, when there are few effective treatments and none that can help every child."
— Irva Hertz-Picciotto
“Rather, they use the treatments in addition to conventional approaches.”
Autism’s core features include a lack of social relatedness, repetitive thoughts and behaviors and, often, intellectual disability. Many children also suffer from a wide array of associated symptoms that may not be directly associated with their diagnoses. These can make their daily lives and those of their families stressful. Such symptoms include irritability, hyperactivity, gastrointestinal problems and sleep disorders.
The MIND Institute study included nearly 600 diverse children between 2 and 5 years with autism and developmental delay who were enrolled in the Childhood Autism Risk from Genetics and the Environment (CHARGE) study. Of the participants, 453 were diagnosed with autism and 125 were diagnosed with developmental delay.
CAM use was more common among children with autism than children diagnosed with other types of developmental delay, 40 percent versus 30 percent respectively. Nearly 7 percent of children with autism were on the gluten-free/casein-free (GFCF) diet, particularly children with frequent gastrointestinal problems.
“We were pleased to find that most families utilizing CAM therapies were choosing ones that were low risk," said Kathleen Angkustsiri, assistant professor of developmental and behavioral pediatrics and a study co-author.
A small but statistically significant number of families — about 9 percent — were found to use alternative treatments classified by the study as potentially unsafe, invasive or unproven, such as antifungal medications, chelation therapy and vitamin B-12 injections.
“Our study suggests that pediatricians and other providers need to ask about CAM use in the context of providing care for children with autism and other developmental disorders, and take a more active role in helping families make decisions about treatment options based on available information related to potential benefits and risks,” said Roger Scott Akins, lead study author and a former postdoctoral fellow at the MIND Institute, who now is chairman of the Division of Neurodevelopmental Pediatrics at Naval Medical Center Portsmouth, Va.
Irva Hertz-Picciotto, professor of public health sciences and principal investigator for the CHARGE study, said the research supports the emergent need for identifying validated treatments for neurodevelopmental conditions.
"These findings emphasize the enormous and urgent need for effective treatments and for rigorous research that can identify them and verify their effectiveness and safety,” Hertz-Picciotto said. “Of course it is reasonable for parents to keep searching for ways to help their children, when there are few effective treatments and none that can help every child."