Complementary and Alternative Medicine in Autism: An Evidence-Based Approach to Negotiating Safe and Efficacious Interventions with Families

Abstract

Summary: This review focuses on helping clinicians identify resources and develop strategies they may use to effectively negotiate safe and effective use of complementary and alternative medicine (CAM) treatments with families of children with autism spectrum disorders (ASD), as well as other neurodevelopmental disorders. Since new types of CAM continue to be introduced into the autism community, emphasis is placed on providing clinicians with tools to help families negotiate the myriad of available treatments and make decisions based on current safety and efficacy data, while remaining mindful of the reasons families may be considering these treatments.We familiarize readers with high-quality, evidence-based resources that providers and families may use to ascertain current information about specific types of CAM, verify the content of biologically-based treatments, identify ongoing CAM research and obtain toolkits designed to help healthcare providers raise the topic of CAM usage and facilitate disclosure and discussion of CAM use with patients and their families. Key Words: Complementary and alternative medicine, autism, integrative medicine, gluten-free casein-free diet, melatonin, chelation, hyperbaric oxygen treatment, evidence-based medicine.

High use of complementary and alternative medication among children with autism is not associated with the severity of core symptoms

“…The highly accessible world wide web opens up a myriad of information about ASD treatment possibilities for many vulnerable parents who are desperately seeking an effective treatment for their child with ASD [13]. However, this poses an inevitable risk for misinformation and an overwhelming amount of case studies that usually provide miracle testimonials and report benefit outcomes of various CAM therapies for children with ASD with limited consideration for the biological rationale, scientific rigor or safety of these treatments [52]. This is coupled with some CAM users having a misconceived notion that CAM is a safer option when compared with conventional medication because CAM is thought to be naturally derived [53].…”

“…Although CAM is well-tolerated in general, there is limited evidence for the efficacy of dietary and immune therapies, vitamin and fatty acid supplementation as a treatment for ASD [22,[24][25][26]. Some novel CAM practices such as inhaling 100% oxygen in a pressurized chamber termed as hyperbaric oxygen therapy or the administration of intravenous secretin have shown no evidence at all for its efficacy [22].…”

Communicating Concern about Early Signs of Autism to Parents

“…Rimland creates the Autism Research Institute (ARI) and supports the Defeat Autism Now (DAN!) approach to treatments for autism such as vitamin supplements (e.g., high-dose pyridoxine with magnesium) and restriction diets (gluten-and casein-free), some of which are harmful and some of which are ineffective [14,15].…”

Complementary and Alternative Medicine for Autism

“…The total number of RCTs in each SR ranged from 1 (Alcantara et al 2011) to 11 (Lee et al 2011a). The outcomes assessed in the included SRs were the core features of ASD (Cheuk et al 2011), communicative skills (Cheuk et al 2011; Reason for exclusion Akin 2010 (Akins et al 2010) Narrative review Angley 2007(Angley et al 2007 Narrative review Bolte 2002 (Bolte andPoustka 2002) Narrative review Cheuk 2009(Cheuk et al 2009 Review protocol Field 1995(Field 1995 Not Narrative review Rimland 1996 (Rimland andBaker 1996) Narrative review Simpson 2011 (Simpson andKeen 2011) Narrative review Weber 2007 (Weber andNewmark 2007) Narrative review Wigram 2002(Wigram 2002 Narrative review Narrative review Gold et al 2006) and behavioral problems . The overall effect on outcomes of multiple spectra was evaluated in 1 study (Whipple 2004).…”