Hyperbaric oxygen therapy for autism spectrum disorder (ASD) in children and adults

Systematic review and guide to management of core and psychiatric symptoms in youth with autism

“…In addition to the NICE guideline, nine systematic reviews , and 10 Cochrane reviews were relevant to impaired social communication as a treatment target in ASD.…”

“…Meta‐analysis was not possible due to differences in outcome measures used . Finally, with respect to biomedical interventions, Cochrane reviews on gluten/casein‐free diets , secretin , chelation , hyperbaric oxygen therapy , omega‐3 fatty acids reinforce the NICE guideline's conclusions of not recommending any of these interventions for the treatment of core ASD deficits, including impaired social interaction and communication. In addition to lack of evidence of any benefit with treatment, Cochrane reviews highlight concerns regarding serious adverse events with chelation (e.g.…”

“…In addition to lack of evidence of any benefit with treatment, Cochrane reviews highlight concerns regarding serious adverse events with chelation (e.g. kidney impairment and reported death) , and risk of ear barotrauma with hyperbaric oxygen therapy , concerns that warrant emphasis in clinical discussions with parents considering these treatment options.…”

“…In addition to the NICE guideline , five systematic reviews and six Cochrane reviews on interventions for core ASD symptoms including repetitive behaviours were identified as relevant to stereotypic/repetitive behaviours as a treatment target.…”

“…Although a large significant secondary effect was found for a gluten/casein‐free diet vs. treatment as usual on ‘bizarre behaviour’ in a very small trial , another small trial of this dietary intervention showed no effect on stereotypic/repetitive behaviours in ASD (quality of evidence low to very low). One Cochrane review of gluten/casein‐free diets (two trials, with n = 35 children) , one systematic review of ketogenic diets , one Cochrane review of secretin (16 trials, with n > 900 children with ASD) , one Cochrane review of chelation (one trial, n = 77) , one Cochrane review of hyperbaric oxygen therapy and omega‐3 fatty acids , all found no evidence of efficacy for core ASD symptoms, including stereotypic/repetitive behaviours. See previous section regarding serious concerns regarding harm with chelation therapy and hyperbaric oxygen therapy.…”