Written by Renata Filiaci, MSHW

Autism Spectrum Disorder (ASD) is a group of life-long neurodevelopmental conditions, first introduced in the 1980s, categorized as autism, Asperger disorder, and child disintegrative disorder all grouped within the spectrum. Commonly diagnosed during early childhood and affecting boys more than girls (4:1), ASD is defined by social and communication deficits, idiosyncrasies, and repetitive behaviors. Other clinical symptoms could appear as obsessive-compulsive tendencies, intellectual impairment, irritability or aggressiveness, poor motor imitation, tone, and interaction, hyperactivity, and depression. Considering the spectrum of the disorder, many individuals can live independently, but with many others, it might significantly interfere with quality of life (Banasik & Copstead, 2019; Brondino, Fusar-Poli, Rocchetti, Provenzani, Barale, & Politi, 2015).

There are no known causes for the development of ASD. However, there are speculations that it is related to the measles-mumps-rubella vaccination though the research is unsupported. Quantifiable analysis has also proposed that the development of ASD is a genetic predisposition and increased if older parents give birth as well as it is more likely to occur if first-degree family members have anxiety, major depressive disorder, motor tics, rigidity, and aloofness. There have been clinical studies that suggest there are pre- and perinatal risk factors implicated in ASD as it could occur before, during, and after childbirth. However, there have also been associations between etiology and environment and low to middle-income households as epidemiological data has shown higher statistics within those factors due to the lack of availability and option to receive proper testing (Elsabbagh, Divan, Koh, Kim, Kauchali, Marcín, Montiel-Nava, Patel, Paula, Wang, Yasamy, & Fombonne, 2012; Banasik & Copstead, 2019).

There is no established medicinal protocol for ASD, but rather conventional psychosocial therapies which are applied to behavioral symptoms. Risperidone and aripiprazole, as well as selective serotonin reuptake inhibitors, are typically used as a treatment for people with ASD. Risperidone and aripiprazole are used to target the irritability and treat schizophrenia and bipolar disorder caused by autism. Selective serotonin reuptake inhibitors are antidepressants for major depressive disorder and anxiety disorders, which are potential symptoms (Banasik & Copstead, 2019; DeFilippis & Wagner, 2016). However, within the use of these drugs, adverse effects are apparent, including sexual dysfunction, weight gain, fatigue and sleep disturbances, and increased appetite (LeClerc & Easley, 2015; Ferguson, 2001). Complementary and alternative medicinal (CAM) therapies have been assessed as useful due to promising reported results although inconclusive as there is little information on the efficacy of these desired treatments.

Within the realms of CAM therapies for ASD, there have been promising results from implementing music therapy, sensory integration therapy, acupuncture, massage therapy, herbal medicine, chelation, and specific nutritional guidelines. Through surmountable database research, the authors, Brondino, Fusar-Poli, Rocchetti, Provenzani, Barale, and Politi (2015), found that within 80 studies, the use of CAM protocols, such as hyperbaric oxygen therapy, music therapy, audio integration training, sensory integration training, drama therapy, dance therapy, acupuncture, massage, yoga, pet therapy, and chiropractic care, all had promising and beneficial results for ASD. These alternative treatments had an optimal safety profile and fewer side effects than conventional medications. Although there is a lack of proof regarding the efficacy of CAM, these modalities impact and relieve several symptom areas such as communication, social reciprocity, reduce anxiety and enhance positive response to behavioral   as well as stimulate better quality of life (Brondino, Fusar-Poli, Rocchetti, Provenzani, Barale, & Politi, 2015).

Specific nutritional diets and the addition of nutrients and vitamins have been examined as favorable for ASD. Kantor (2016) explains that the inflammation response is different in ASD brains, which can cause poor hormonal regulation, such as in regards to insulin mechanism. Excessive inflammation can lead to addictive behaviors and cravings within people with ASD (Kantor, 2016). Also, children with ASD have impaired methylation, decreased glutathione, and increased oxidative stress, and an observed diet, such as a healthy gluten-free, casein-free, soy-free (HGCSF) diet with special vitamin/mineral supplement and essential fatty acids, Epsom salt baths, carnitine, and digestive enzymes is effective at improving nutritional status, non-verbal IQ, and autism symptoms. Essential fatty acids, like omega-3, can reduce inflammation and oxidative stress. Increasing vitamins A, B2, B5, B6, B12, folic acid, and Coenzyme Q10 intake regulates methylation and controls epigenetics, which is helpful with neurological response (Adams, Audhya, Geis, Gehn, Fimbres, Pollard, Mitchell, Ingram, Hellmers, Laake, Matthews, Li, Naviaux, Naviaux, Adams, Coleman, & Quig, 2018).

Toxic metals have been detected in people with ASD. Chelation therapy is the detoxification of these toxic metals, such as arsenic, cadmium, lead, and mercury, by using an organic molecule, which is the chelating agent. Toxic metals can be absorbed from the chemicals in everyday products, continuous emissions from toxic wastes and industrial and electricity-generating activities, mining, lead paint, gasoline, and old drinking pipes. Potent chelators for  heavy metals can be metallothioneins, glutathione, and also found in plants, including bran from grains, cilantro, garlic, broccoli as well as fruit as they aimed to detoxify, modulated intestinal flora, reduced levels of metals found in the brain and blood, showed symptomatic improvement, enhanced excretion, and decreased oxidative damage (Sears, 2013).

A review of 32 different Chinese herbal remedies was reported as having therapeutic and pharmacological effects on people with ASD by researchers. The authors, Bang, Lee, Cho, Yu, Kim, Lu, Chang, and Min (2017), evaluated that herbal medicines for the treatment of ASD showed immune system improvement, memory enhancement, gastrointestinal tract improvement, and calming of the nerves; however, because of herbal medicine diversity and small sample size, the data was inconclusive, and further clinical trials should be examined. The most commonly used herbal treatments were Poria cocos, Panax ginseng, Acorus gramineus, Schisandra chinensis, as well as Glycyrrhiza uralensis and they were received as a decoction, pill, or in capsule form (Bang, Lee, Cho, Yu, Kim, Lu, Chang, & Min, 2017). The administration of oral drops of cannabidiol oil (CBD) to 53 children between the ages of 4-22 years old has exhibited a reduction in comorbid symptoms such as aggression, hyperactivity, and anxiety due to its anti-inflammatory effects from its terpene content; however, clinical trials to receive congruent data are still ongoing. Parents’ reports through supervision suggest that cannabidiol may improve ASD comorbidity symptoms (Barchel, Stolar, De-Haan, Ziv-Baran, Saban, Fuchs, Koren, & Berkovitch, 2019).

Autism Spectrum Disorder (ASD) is a group of life-long neurodevelopmental conditions categorized as autism, Asperger disorder, and child disintegrative disorder all grouped within the spectrum. Commonly diagnosed during early childhood, there is still no known pathogenesis behind the development of ASD; however, there is evidence that it could be linked to parent’s age, mental health, environment and availability in pre-perinatal testing. The symptoms range depending on where they lie on the spectrum, but clinical signs could appear as obsessive-compulsive tendencies, intellectual impairment, irritability or aggressiveness, poor motor imitation, tone, and interaction, hyperactivity, and depression. Conventional medication is necessary; however, they can cause adverse effects including sexual dysfunction, weight gain, fatigue and sleep disturbances, and increased appetite. Complementary and alternative medicinal (CAM) treatments were evaluated as beneficial, yet inconclusive due to limited sample size and amount of clinical trials. The CAM protocols that were seen as useful ranged from implementing music therapy, sensory integration therapy, acupuncture, massage therapy, herbal medicine, chelation therapy, to introducing specific nutritional guidelines. Therapeutic effects were calculated throughout each trial, showing reduced behavioral symptoms, comorbid symptoms, inflammation, oxidative stress, and toxic metal build up.

References

Adams, J. B., Audhya, T., Geis, E., Gehn, E., Fimbres, V., Pollard, E. L., Mitchell, J., Ingram, J., Hellmers, R., Laake, D., Matthews, J. S., Li, K., Naviaux, J. C., Naviaux, R. K., Adams, R. L., Coleman, D. M., & Quig, D. W. (2018). Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder-A Randomized, Controlled 12-Month Trial. Nutrients, 10(3), 369. doi:10.3390/nu10030369

Banasik, J. L. & Copstead, L-E. C. (2019). Pathophysiology (6th ed.). St. Louis, MO: Elsevier Inc.

Bang, M., Lee, S. H., Cho, S. H., Yu, S. A., Kim, K., Lu, H. Y., Chang, G. T., & Min, S. Y.(2017). Herbal Medicine Treatment for Children with Autism Spectrum Disorder: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2017, 8614680. doi: 10.1155/2017/8614680

Barchel, D., Stolar, O., De-Haan, T., Ziv-Baran, T., Saban, N., Fuchs, D. O., Koren, G., & Berkovitch, M. (2019). Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities. Frontiers in pharmacology, 9, 1521. doi:10.3389/fphar.2018.01521

Brondino, N., Fusar-Poli, L., Rocchetti, M., Provenzani, U., Barale, F., & Politi, P. (2015). Complementary and Alternative Therapies for Autism Spectrum Disorder. Evidence-based complementary and alternative medicine : eCAM, 2015, 258589. doi: 10.1155/2015/258589

DeFilippis, M., & Wagner, K. D. (2016). Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacology bulletin, 46(2), 18-41. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044466/

Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcín, C., Montiel-Nava, C., Patel, V., Paula, C. S., Wang, C., Yasamy, M. T., & Fombonne, E. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism research : official journal of the International Society for Autism Research, 5(3), 160-79. doi: 10.1002/aur.239

Ferguson J. M. (2001). SSRI Antidepressant Medications: Adverse Effects and Tolerability. Primary care companion to the Journal of clinical psychiatry, 3(1), 22-27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/

Kantor, K. D. (2016, September 20). How Nutrition, proper specific Hydration, Inflammation and Body Flora Affect Autism. Retrieved from https://namedprogram.com/how-nutrition-proper-specific-hydration-inflammation-and-body-flora-affect-autism/

LeClerc, S., & Easley, D. (2015). Pharmacological therapies for autism spectrum disorder: a review. P & T : a peer-reviewed journal for formulary management, 40(6), 389-97. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450669/

Sears M. E. (2013). Chelation: harnessing and enhancing heavy metal detoxification—a review. TheScientificWorldJournal, 2013, 219840. doi:10.1155/2013/219840