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Autism alternatives

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Sarah DeWeerdt
14 December 2012

Stories about alternative treatments for autism — ranging from supplements and special diets to hyperbaric oxygen therapy and chelation — are common in the popular media, but how widespread is their use?

According to a large study published 1 November in Pediatrics, 28 percent of children with autism receive some kind of complementary or alternative therapy. The most common are special diets, such as those without the wheat protein gluten or the milk protein casein.

Researchers analyzed survey data from more than 3,000 children who are part of the Autism Treatment Network, a patient registry run by the science and advocacy organization Autism Speaks.

According to information provided by parents, when the children enrolled in the network, 17 percent of them were on special diets, and 20 percent used other alternative treatments.

Some studies have pegged these numbers as closer to 50 percent. Those based on Internet surveys may have attracted people who support alternative treatments, the researchers suggest.

It’s also possible that the new survey underestimates alternative treatment use because it didn’t name popular treatments such as melatonin and sensory integration therapy. Still, the findings are on par with the use of alternative treatments by children who have other chronic conditions, the researchers say.

The study also characterized subgroups of children with autism who are most likely to use alternative therapies. The researchers found that children with gastrointestinal symptoms and those with seizures or behavior problems are most likely to be treated with these approaches.

Children diagnosed with classic autism are also more likely to try alternative therapies than those with a diagnosis of Asperger syndrome or pervasive developmental disorder-not otherwise specified.

One result that I find particularly striking is that children with autism who have behavior problems are more likely to use alternative treatments, but those who take psychotropic medications are less likely to do so.

Of course, this trend might result from parental preferences: Those who are comfortable with their children taking the medications may have a more positive view of conventional medicine overall, and be less likely to investigate alternative treatments.

But the pattern may also reflect the lack of treatment options for autism. Parents might try alternative medicines because they hope to find anything that helps.

Some options, such as gluten- or casein-free diets, have largely failed to show benefit in scientific studies. Others, such as chelation, may be downright harmful. Still others, of course, may yet prove helpful. Against this backdrop, the researchers’ call for more studies on this topic seems vital.


Name: ASD Dad
16 December 2012 - 7:05AM

To put this in perspective the research states clearly in the first paragraph.

"Data from the National Health Interview Survey indicate that 38.3% of US adults and 12% of US children use CAM,2 although a 2008 review indicated higher rates, with 20% to 40% of children using some CAM."

Diet, massage, stress relief interventions such as meditation have all been shown to be scientifically evidenced to have positive health effects.

Our children are just as or more likely to be more vulnerable to the negative effects of 'modern' life and all that it brings in terms of stress and nutrition.

Trying to portray CAM as some sort of unproven scientific 'boogeyman' is entirely unhelpful.


Name: ASD Dad
16 December 2012 - 7:14AM

"Use of CAM is higher in children and adults who have chronic health conditions."

The Co-Morbidity Burden of Children and Young Adults with Autism Spectrum Disorders


19.44% of ASD patients had epilepsy as compared to 2.19% in the overall hospital population

2.43% of ASD with schizophrenia vs. 0.24% in the hospital population

Inflammatory bowel disease (IBD) 0.83% vs. 0.54%

Bowel disorders (without IBD) 11.74% vs. 4.5%

CNS/cranial anomalies 12.45% vs. 1.19%

Diabetes mellitus type I (DM1) 0.79% vs. 0.34%

Muscular dystrophy 0.47% vs 0.05%

Sleep disorders 1.12% vs. 0.14% (95% CI 0.79–1.14%)

Three of the studied comorbidities increased significantly when comparing ages 0–17 vs 18–34 with p<0.001: Schizophrenia (1.43% vs. 8.76%), diabetes mellitus type I (0.67% vs. 2.08%), IBD (0.68% vs. 1.99%) whereas sleeping disorders, bowel disorders (without IBD) and epilepsy did not change significantly.

Comorbidity of allergic and autoimmune diseases in patients with autism spectrum disorder: A nationwide population-based study


A total of 1596 patients with ASDs were identified, and were found to have a significantly higher prevalence of allergic and autoimmune diseases than the control group.

Patients with ASDs had increased risks of

asthma (OR = 1.74, 95%CI = 1.51–1.99),

allergic rhinitis (OR = 1.70, 95%CI = 1.51–1.91),

atopic dermatitis (OR = 1.52, 95%CI = 1.30–1.78),

urticaria (OR = 1.38, 95%CI = 1.12–1.69) and

type 1 diabetes (OR = 4.00, 95%CI = 1.00–16.00),

and a trend toward increasing comorbidity with Crohn's disease (OR = 1.46, 95%CI = 0.90–2.35).

Our results support the association between ASDs and allergic diseases, and autoimmune comorbidities (type 1 diabetes and Crohn's disease). Further basic study is required to elucidate the possible underlying mechanisms and roles of allergy immunity and autoimmunity in the etiology of ASDs.

Name: Paul Whiteley
18 December 2012 - 3:18PM

Just one small point: ".... such as gluten- or casein-free diets, have largely failed to show benefit in scientific studies".
Might I direct you to two RCTs that did "suggest" some benefit albeit with questions about best responders and mechanisms involved:
1. http://www.ncbi.nlm.nih.gov/pubmed/12168688
2. http://www.ncbi.nlm.nih.gov/pubmed/20406576
(Conflict of interest: this was a study I worked on).
I'm not saying this is proof positive (as if such a thing exists in autism research) but the available peer-reviewed literature actually largely has suggested some potential benefits to be had for some on the spectrum.
Oh and I agree we need more investigation in this area... much more investigation...

Name: Gigi
23 January 2013 - 5:53AM

SFARI should be ashamed to print this trite, over-used rubbish about how "gluten free, casein-free diets have failed to show efficacy in autism." Get yourself a copy of the November 2012 supplement on autism in the Journal of Pediatrics, read the article where Fasano is one of the co-authors that explains the relevance of gluten in autism. Journal of Pediatrics is a clinical practice journal, hardly esoteric, about as mainstream as it gets. Try and keep up with the science in autism, OK?

Name: Sarah DeWeerdt
25 January 2013 - 5:47PM


Thanks for your comment. I noticed that the paper you refer to and the paper we are reporting on in this piece are both part of the same Journal of Pediatrics supplement on autism -- probably a reflection of just how open and contentious this question about the role of diet in autism remains! That studies so far have failed to show efficacy of these diets and that such diets might be useful in a subset of people with autism, as Paul Whitely suggests above, could both be true, it seems to me. Perhaps Dr. Fasano's discussion of the mechanisms potentially involved will guide researchers to design studies that can help resolve this difficult question.

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