Beware of Fringe Therapies for Autism

The world of treatments for Autism Spectrum Disorder (ASD) can be confusing for many parents and families of children with ASD. The wealth of available information and treatment approaches can be overwhelming and challenging to understand. Which treatment(s) will best support my child’s needs? Is it safe? Is there research to support its effectiveness? How much will it cost? Parents are faced with many difficult questions and considerations as they navigate the process of finding the best treatment for their child with ASD.

Often considered the gold standard evidence-based treatment for ASD, applied behavior analysis (ABA) therapy is one of the most common treatments for symptoms of ASD. ABA therapy has been around for over 60 years, and can have tremendous benefits for an individual with ASD, such as improved language and adaptive skills (Anagnostou, 2014). Despite the many benefits of ABA therapy, it is a costly and time intensive treatment that may not help all children. Waitlists to receive services can be months long. As a result, parents often seek alternative treatments to help manage their child’s symptoms. The problem is that while these treatments are often well marketed, they typically lack thorough research to validate their effectiveness. It is important to be extremely cautious when seeking out these treatments, as these alternative treatments can be costly, and often cause harm.

Several complementary and alternative medicine (CAM) treatment approaches have emerged that are often used either in place of, or in conjunction with, the more better-known and research-based therapies for ASD. CAM treatments have become increasingly popular in recent years, and research has indicated that approximately 50-75% of children with ASD are treated with a CAM treatment at some point. In addition, many families often believe that these treatments can be helpful (Levy & Hyman, 2008).

Despite the emerging popularity of CAM treatments, very little research has been conducted to test the effectiveness or safety of these treatments. Below is a review of some common CAM treatments, including gluten-free and casein-free diets, hyperbaric oxygen treatment, chelation therapy, detox foot pads, Miracle Mineral Solution (MMS), and chiropractic interventions, as well as the possible risks that may be involved in using CAM treatments for individuals with ASD.

The Gluten-Free Casein-Free Diet

The gluten-free and casein-free diet involves restricting gluten and casein consumption. It is based on the idea that gluten (found in barley, wheat, and rye) and casein (found in dairy) causes excess gastrointestinal inflammation. Some children with ASD are thought to have greater amounts of gastrointestinal inflammation and can be sensitive to certain foods. It is important to note that not all individuals with ASD present with such sensitivities. Furthermore, restricting gluten and casein intake can be challenging to manage, while ensuring that children are getting all the nutrients that they need to grow and develop.

While this diet may help alleviate gastrointestinal symptoms for individuals with gluten or casein sensitivities, a gluten-free, casein-free diet is not a treatment that effectively targets symptoms characteristic of ASD (Pennesi & Klein, 2012; Christison & Ivany, 2006; Irvin, 2006; Johnson, Handen, Zimmer, Sacco, & Turner; 2010; Seung, Rogalski, Shankar, & lder, 2007).

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (on average $300-$400 per session for dozens of sessions) involves sitting in a pressurized chamber and breathing in highly concentrated oxygen. The goal of this treatment is to reduce possible inflammation in the brain that is thought to be found in individuals with ASD. Research has indicated that hyperbaric oxygen treatment has not been found to produce significant improvements in ASD symptoms (Granpeesheh, Tarbox, Dixon, Wilke, Allen, & Bradstreet, 2010; Jepson, et al., 2011). In fact, research has shown that using hyperbaric oxygen treatment can actually lead to bruised eardrums, sinus pain and seizures (Opar, 2016). Hyperbaric oxygen therapy has not been approved by the Food and Drug Administration (FDA, 2017), meaning that the FDA has not found that the benefits of this treatment outweigh the potential risks.

Chelation

Chelation (about $4000 for 30 sessions) is a medical procedure that involves administering chemical substances to a person’s body, allowing them to flush out certain metals like mercury and lead. There is no evidence to suggest that using chelation helps individuals with ASD (Davis et al., 2013). In fact, the majority of studies have indicated that chelation is dangerous to use, as the chemicals administered may lead to other health risks, including brain damage (Brondino et al., 2015) and heart failure (Opar, 2016). The FDA has also not approved chelation as a beneficial treatment.

Detox Foot Pads

Detox foot pads are another CAM treatment that claims to decrease autism symptoms and other mental health symptoms. These detox foot pads are placed on a person’s feet while they sleep, and the minerals in the pads reportedly attract toxins and heavy metals, ultimately cleansing a person of these toxins (Moody, 2018). Despite claims that these detox pads are effective, only three tests have been done studying the effects of these pads, and they show no benefit at all (Opar, 2016).

Miracle Mineral Solution

Miracle Mineral Solution (MMS), also referred to as Master Mineral Solution and Miracle Mineral Supplement, is a substance that is marketed as a healing solution that can cure many “ailments”, including autism. Though it is sold as a non-mainstream treatment and cure, it can actually cause great harm (Grimes, 2015). In the Guardian article by Grimes, he explains that MMS is a toxic compound, and that when it is combined with an acidic agent, it is equivalent to a bleach solution. These types of solutions and “cures” are marketed as quick ways to eradicate symptoms of autism, when in fact, the cause of autism is intricate and still mostly unknown. The FDA has warned consumers of serious harm that can be caused from drinking MMS (FDA, 2010).

Chiropractic Interventions

Another emerging CAM treatment in the field of ASD treatment is chiropractic intervention. Chiropractic services are based on the idea that the nervous system affects an individual’s’ overall health. Thus, chiropractic interventions involve adjustment or manipulation of an individual’s spine to improve health outcomes. There is a lack of research examining the safety of chiropractic treatment approaches and low quality evidence supporting the use of chiropractic services to treat symptoms of ASD (Alcantara, Alcantara, & Alcantara, 2011; Gouveia, Castanho, & Ferreira, 2009). Overall, research on the benefits of chiropractic treatment is inconclusive and further research is needed to determine the effectiveness and safety of chiropractic treatments (Alcantra, Alacantra, Alcantra, 2011).

Despite research findings that many CAM therapies have little to no research support, many people believe that these treatments are beneficial (Levy & Hyman, 2008). Given that many CAM treatments have been shown to cause more harm than good, we encourage parents and families to discuss treatment options with their primary care physician. For further information regarding CAM treatments for autism, we encourage you to check out the consumer report produced by the FDA last year titled “Autism: Beware of Potentially Dangerous Therapies and Products”.

References:

Alcantara, J., Alcantara, J. D., & Alcantara, J. (2011). A systematic review of the literature on the chiropractic care of patients with autism spectrum disorder. Explore: The Journal of Science and Healing, 7(6), 384-390.

Anagnostou, E., Zwaigenbaum, L., Szatmari, P., Fombonne, E., Fernandez, B. A., Woodbury-Smith, M., … & Buchanan, J. A. (2014). Autism spectrum disorder: advances in evidence-based practice. Canadian Medical Association Journal, 186(7), 509-519.

Brondino, N., et al. (2015). Complementary and Alternative Therapies for Autism Spectrum Disorder. Hindawi. Retrieved from https://www.hindawi.com/journals/ecam/2015/258589/

CBD Oil and Autism. (n.d) Retrieved from: https://discovercbd.com/pages/cbd-oil-and-autism

Christison, G.W. & Ivany, K. (2006). Elimination Diets in Autism Spectrum Disorders: Any Wheat Amidst the Chaff? Developmental and Behavioral Pediatrics, 27, 162-171.

Davis, T.N., O’Reily, M., Kang, S., Lang, R., Rispoli, M, Sigafoos, J. … Mulloy, A. (2013). Chelation treatment for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 7, 49-55.

FDA. (2017). Autism: Beware of Potentially Dangerous Therapies and Products. Retrieved from: https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm394757.htm

FDA. (2010). 2010 Press Announcements – Health Fraud. Retrieved from: https://www.fda.gov/ForConsumers/ProtectYourself/HealthFraud/ucm432070.htm

Gouveia, L. O., Castanho, P., & Ferreira, J. J. (2009). Safety of chiropractic interventions: a systematic review. Spine, 34(11), E405-E413.

Granpeesheh, D., Tarbox, J., Dixon, D.R., Wilke, A.E., Allen, M.S. & Bradstreet, J.J. (2010). Randomized trial of hyperbaric oxygen therapy for children with autism. Research in Autism Spectrum Disorders, 4, 268-275.

Grimes, D.R. (2015). Autism: how unorthodox treatments can exploit the vulnerable. The Guardian. Retrieved from: https://www.theguardian.com/science/blog/2015/jul/15/autism-how-unorthodox-treatments-can-exploit-the-vulnerable

Irvin, D.S. (2006). Using Analog Assessment Procedures for Determining the Effects of a Gluten-Free and Casein-Free Diet on Rate of Problem Behaviors for an Adolescent with Autism. Behavioral Interventions, 21, 281-286.

Jepson, B., Granpeesheh, D., Tarbox, J., Olive, M.L., Stott, C., Braud, S. … Allen, M.S. (2011). Controlled Evaluation of the Effects of Hyperbaric Oxygen Therapy on the Behavior of 16 Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 41, 575-588.

Johnson, C.R., Handen, B.L., Zimmer, M., Sacco, K. & Turner K. (2010). Effects of Gluten Free/Casein Free Diet in Young Children with Autism: A Pilot Study. Journal of Developmental and Physical Disabilities, 23, 213-225.

Levy, S. E., & Hyman, S. L. (2008). Complementary and alternative medicine treatments for children with autism spectrum disorders. Child and adolescent psychiatric clinics of North America, 17(4), 803-820. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597185/

Moody. (2018). Detox Foot Pads: Healthy or Hoax?. Retrieved from: https://www.thehealthyhomeeconomist.com/detox-foot-pads/

Opar (2016). The Seekers – Why parents try fringe therapies for autism. Retrieved from: https://spectrumnews.org/features/deep-dive/the-seekers-parents-who-find-fringe-therapies-for-autism/

Pennesi, C. M. & Klein, L.C. (2012). Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: Based on parental report. Nutritional Neuroscience, 15, 85-91.

Seung, H., Rogalski, Y., Shankar, M., & lder, J. (2007). The Gluten- and Casein-Free Diet and Autism: Communication Outcomes From a Preliminary Double-Blind Clinical Trial. Journal of Medical Speech-Language Pathology, 15, 337-345.

The power of the placebo effect. (2017). Harvard Men’s Health Watch. Retrieved from http://link.galegroup.com.proxy.lib.umich.edu/apps/doc/A489396543/ITOF?u=lom_umichanna&sid=ITOF&xid=f5b9da63