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Autism Spectrum Disorder

Uses

Principal Proposed Treatments

  • None
Autism spectrum disorder (ASD, previously called "autism") is a poorly understood family of related conditions. People with ASD generally lack normal social interaction skills and engage in a variety of unusual and often characteristic behaviors, such as repetitive movements. There is no specific medical treatment for ASD and its cause remains unclear. Anecdotal evidence of remarkable cures with the use of the substance secretin had raised hopes, but these hopes faded when numerous formal research trials found secretin ineffective. 1–8
Despite public concerns that the measles, mumps, and rubella [MMR] vaccine may cause autism spectrum disorder, the balance of the evidence strongly suggests that this is not true. 14,15

Proposed Natural Treatments

Nutrients

Some physicians involved with natural medicine believe that autism spectrum disorder as well as many other illnesses are caused by genetic defects in the body that interfere with the metabolism of certain nutrients. For example, there is some evidence that children with autism spectrum disorder may have trouble metabolizing vitamin B 6 . 18 Based on this theory, various supplements have been advocated for the treatment of autism spectrum disorder. However, despite a number of favorable anecdotal reports, as yet there is no reliable supporting evidence from meaningful studies. As the secretin example shows (see above), anecdotes can easily be misleading.
One 10-week, double-blind, placebo-controlled, crossover study of 18 autistic children evaluated high doses of vitamin C for its effects on behavior. 9 Participants received 8 g of vitamin C for every 70 kg of body weight. In this rather complex study, all participants received vitamin C for 10 weeks. After that, half received vitamin C and the other half received placebo for 10 weeks. During the third and final 10-week period, the vitamin C and placebo groups were switched. The results indicated that use of vitamin C caused significant improvements in behavior when compared to use of placebo. This study was small and suffered from various design problems. Nonetheless, it does suggest that further research into using vitamin C for autism spectrum disorder might be advisable. Note: At this level of vitamin C intake, many people experience diarrhea.
Another double-blind, placebo-controlled, crossover study found indications that very high doses of vitamin B 6 may produce beneficial effects in the treatment of autism spectrum disorder. 10 Again, however, this study was small and poorly designed; furthermore, it used a dose of vitamin B 6 so high that it could cause toxicity.
It has been suggested that combining magnesium with vitamin B 6 could offer additional benefits, such as reducing side effects or allowing a reduced dose of the vitamin. However, the two reasonably well-designed studies using combined vitamin B 6 and magnesium have failed to find benefits. 11–13 Therefore, it isn’t possible at present to recommend vitamin B 6 with or without magnesium as a treatment for autism spectrum disorder.
One small study found that use of a multivitamin/multimineral supplement improved sleep and gastrointestinal problems in people with autistic spectrum disorder to a greater extent than placebo. 18

Other Natural Approaches

An eight-week, double-blind, placebo-controlled trial of 31 children found preliminary evidence that the supplement carnosine at a dose of 400 mg twice daily might be helpful for autism spectrum disorder. 16
Massage therapy has also been studied as a potential treatment for children with autism. 17,22 In a review of 4 randomized, controlled trials, researchers found that massage therapy may help improve symptoms, like language and social abilities. However, the authors point out that limitations with the studies (eg, small number of subjects) make the results less than reliable. 22
In a systematic review of 5 randomized trials and 13 observational studies, researchers concluded that melatonin can help children and teens with autism spectrum disorder fall asleep and stay asleep longer. 21
It has been suggested that food additives, food allergies , or other dietary factors may play a role in autism spectrum disorder, but meaningful supporting evidence for this theory has not been presented. One very small, but well-designed study failed to find benefit through eliminating gluten and casein from the diet. 19 The study followed a double-blind design; interestingly, parents generally thought they saw improvement, but perceived improvements were equally divided between the treatment group and the placebo group. And a 2008 review of all published randomized trials on the subject found no convincing evidence that the elimination of gluten and/or casein from the diet of autistic children lead to any significant improvement. 20
A review of 10 trials focused on the use of acupuncture as a potential treatment for autism. 23 Three hundred and ninety children and teens (aged 3-18 years old) with autism received treatment from 4 weeks to 9 months. Some of the trials compared real acupuncture to a sham version, while other trials compared acupuncture and traditional treatment plus traditional treatment alone. The authors concluded that there was not enough evidence to support the use of acupuncture to improve the core symptoms of autism (eg, impaired social interactions or thought processes).
Music therapy allows non-verbal social interaction. It involves concepts such as attention from all participants, eye contact, and taking turns. In a review of 10 small randomized trials, music therapy was associated with improved verbal communication skills, social interaction, parent-child relationship, and initiating behavior compared to placebo or traditional treatment. 24

References

1 Molloy CA, Manning-Courtney P, Swayne S, et al. Lack of benefit of intravenous synthetic human secretin in the treatment of autism. J Autism Dev Disord. 2002;32:545–551:2nd CD.

2 Unis AS, Munson JA, Rogers SJ, et al. A randomized, double-blind, placebo-controlled trial of porcine versus synthetic secretin for reducing symptoms of autism. J Am Acad Child Adolesc Psychiatry. 2002;41:1315–1321.

3 Sponheim E, Oftedal G, Helverschou SB. Multiple doses of secretin in the treatment of autism: a controlled study. Acta Paediatr. 2002;91:540–545.

4 Corbett B, Khan K, Czapansky-Beilman D, et al. A double-blind, placebo-controlled crossover study investigating the effect of porcine secretin in children with autism. Clin Pediatr. 2001;40:327–331.

5 Roberts W, Weaver L, Brian J, et al. Repeated doses of porcine secretin in the treatment of autism: a randomized, placebo-controlled trial. Pediatrics. 2001;107:E71.

6 Coniglio SJ, Lewis JD, Lang C, et al. A randomized, double-blind, placebo-controlled trial of single-dose intravenous secretin as treatment for children with autism. J Pediatr. 2001;138:649–655.

7 Dunn-Geier J, Ho HH, Auersperg E, et al. Effect of secretin on children with autism: a randomized controlled trial. Dev Med Child Neurol. 2000;42:796–802.

8 Owley T, Steele E, Corsello C, et al. A double-blind, placebo-controlled trial of secretin for the treatment of autistic disorder. MedGenMed. 1999;6:E2.

9 Dolske MC, Spollen J, McKay S, et al. A preliminary trial of ascorbic acid as supplemental therapy for autism. Prog Neuropsycholpharmacol Biol Psychiatry. 1993;17:765–774.

10 Rimland B, Callaway E, Dreyfus P. The effect of high doses of vitamin B 6 on autistic children: a double-blind crossover study. Am J Psychiatry. 1978;135:472–475.

11 Nye C, Brice A. Combined vitamin B 6 -magnesium treatment in autism spectrum disorder (Cochrane Review). Cochrane Database Syst Rev. 2002:CD003497.

12 Findling RL, Maxwell K, Scotese-Wojtila L, et al. High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study. J Autism Dev Disord. 1997;27:467–478.

13 Tolbert L, Haigler T, Waits MM, et al. Brief report: lack of response in an autistic population to a low dose clinical trial of pyridoxine plus magnesium. J Autism Dev Disord. 1993;23:193–199.

14 Madsen KM, Hviid A, Vestergaard M, et al. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002;347:1477–1482.

15 DeStefano F, Chen RT. Autism and measles-mumps-rubella vaccination: controversy laid to rest? CNS Drugs. 2001;15:831–837.

16 Chez MG, Buchanan CP, Aimonovitch MC, et al. Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders. J Child Neurol . 2002;17:833–837.

17 Field T, Lasko D, Mundy P, et al. Brief report: autistic children's attentiveness and responsivity improve after touch therapy. J Autism Dev Disord . 1997;27:333–338.

18 Adams JB, Holloway C. Pilot study of a moderate dose multivitamin/mineral supplement for children with autistic spectrum disorder. J Altern Complement Med . 2005;10:1033-9.

19 Elder JH, Shankar M, Shuster J et al. The Gluten-Free, Casein-Free Diet In Autism: Results of A Preliminary Double Blind Clinical Trial. J Autism Dev Disord . 2006 Mar 23 [Epub ahead of print].

20 Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database of Systematic Reviews. 2008;(2):CD003498.

21 Rossignol DA, Frye RE. Melatonin in autism spectrum disorders: a systematic review and meta-analysis. Dev Med Child Neurol. 2011 Apr 19.

22 Lee MS, Kim JI, Ernst E. Massage therapy for children with autism spectrum disorders: a systematic review. J Clin Psychiatry. 2011;72(3):406-411.

23 Cheuk DK, Wong V, Chen WX. Acupuncture for autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2011;9:CD007849.

24 Geretsegger M, Elefant C, et al. Music therapy for people with autism spectrum disorder. Cochrane Database Syst Rev. 2014;6:CD004381.

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