Today’s “Got Questions?” answer comes from Robert L. Hendren, D.O., director of child and adolescent psychiatry at the University of California, San Francisco, and a member of Autism Speaks Treatment Advisory Board. Dr. Hendren will be answering more questions on next week’s “The Doctors Are In” webchat.
What alternative or complementary medicine approaches help with autism?
Complementary and alternative medical (CAM) treatments are widely used by individuals with autism. Research suggests that between 30 and 95 percent of children with autism spectrum disorder (ASD) have been given CAM treatments. However, research on the safety and benefits of CAM treatments for autism remains in its infancy. Because many popular alternative treatments have yet to be studied in a rigorous manner, it’s difficult for families to decide whether or not to try one or more of them.
Before discussing CAM treatments further, I want to caution parents and individuals that these therapies should be used to complement, not replace, proven behavioral treatments or safe and effective medications for associated medical conditions. We know that many parents do research on their own – whether exploring PubMed, the medical journal database, or by comparing notes with other parents or individuals. It’s important to remember that another person’s experience is not the same as evidence from a carefully designed and conducted study. Also, because autism encompasses a complex group of disorders, some treatments may work for one person but not another.
Given the relative lack of information on the effectiveness of alternative treatments, I recommend the following when considering one: First and foremost, look at the evidence for its safety and effectiveness. Next consider the costs in money and effort. A costly intervention that lacks clinical evidence of effectiveness is an expensive shot in the dark.
Based on safety, affordability and research, these are the CAM treatments that I most often recommend:
- Melatonin. This hormone helps regulate the sleep-wake cycle and has been found to improve sleep and reduce insomnia in children with autism, most notably by improving their ability to fall asleep at bedtime. (See the latest research findings here.)
- Omega 3 fatty acids. Our pilot study found that this supplement eases hyperactivity. Other studies have found that it also improves socialization for many persons. Such benefits, when they occur, most often do so after several weeks of taking this supplement regularly.
- Multivitamins. Some evidence suggests that children with autism tend to be deficient in certain nutrients and show some improvements when taking multivitamins.
Currently, an Autism Speaks grant is allowing us to further study the potential benefits of the antioxidant methyl B12, given by injection. These injections are a current CAM treatment for autism, with anecdotal reports of improvement in some children. The suggestion is that the injections protect against oxidative stress, signs of which have been found in some children with autism. In our pilot study, the treatment was associated with improved social behaviors, language and communication in 25 to 35 percent of participating children. Autism Speaks has funded an expanded study to confirm safety and efficacy, and to determine which individuals stand to benefit the most from this treatment.
I feel more cautious about several other relatively popular CAM treatments because they both lack clear evidence of benefit and pose considerable expense and difficulty for individuals and their families. They include hyperbaric oxygen therapy and chelation therapy. More research is needed to determine their safety and effectiveness.
Got more questions about CAM treatments? Dr. Hendren will be joining Autism Speaks “The Doctors Are In” webchat next Thursday, May 3, along with psychiatrist Joe Horrigan, M.D., Autism Speaks assistant vice president and head of medical research . You can submit advance webchat questions and join the chat here. As always, you can also send your questions to GotQuestions@autismspeaks.org. Autism Speaks funded a number of the studies mentioned in this blog post. You can explore these and other CAM-related treatment grants here.