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The Treatment of Autism Spectrum Disorder (ASD)

The types of training, therapies and treatments that are available for ASD are very varied and new ones are being added to the list with each passing day. The Tohum Autism Foundation website has information on some of the most current and widely used methods and techniques.
The benefits of any training, therapy or treatment must be established through scientifically verifiable results. However, the fact that research exists on a given method does not necessarily prove the efficacy of said method. For research results to evince the effects of a method such research should adhere to two standards:

  1. The research must be empirical,*
  2. The research must be published in a peer-reviewed, scientific publication.**

The training, therapy or treatments that have been presented in the Tohum Foundation Website have been judged on the above two standards as follows:
* Empirical research is conducted using control groups and depends on establishing cause and effect.
** Peer-reviewed publications are those which every article has been peer-reviewed by more than one specialist in the particular area.
Good: There are numerous experimental research studies which show that the method has had a positive outcome on children with autism.
Average: There is only limited experimental research showing that this method has had a positive outcome on children with autism.
Poor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.

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Psychiatric Treatment Methods

Different psychiatric drugs are utilized to reduce hyperactivity, temper tantrums and obsessive behavior, and to increase attention spans. The assessment of a child’s suitability for such drugs and their administration can only be made by doctors who are specialists in child psychiatry and pediatric (child) neurologists. It is extremely important to know which drugs should be prescribed and in which doses. It is therefore necessary for the effects and side effects of these drugs to be closely monitored by specialist physicians. Children on these types of drugs should be given check-ups 1-2 times annually.
There is research that suggests some psychiatric drugs have certain positive effects on the above-mentioned behavioral issues. For those seeking further information on this, we recommend accessing the American Psychiatrist Academy 2007 Clinical Report.*

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*As psychiatric drugs are too numerous to list and only qualified doctors can decide which of these drugs are suitable for whom, we have not evaluated this treatment method any further.

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Alternative and Supporting Treatment Methods

The Gluten-free Casein-free diet, Vitamin-Mineral Support, Heavy-Metal Detox, Anti-Fungal Therapy, Hyperbaric Oxygen Therapy (HBOT), Neuro-Feedback, etc. are alternative and supportive methods that are used to treat autism.

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Gluten-free Casein-free (GFCF) Diet

Gluten is a protein found in grains, and casein protein is found in dairy. Gluten is in wheat, rye, and barley and in products that are made of these like bulgur rice and semolina. Casein is found in all dairy products (milk, cheese, yoghurt, etc.). It is thought that children with autism have very permeable intestines and hence cannot absorb gluten and casein proteins. The belief is that this dysfunction in absorption causes nerves in the brain to be affected. Even though this has not been proven scientifically, the GFCF diet is used widely for ASD. In this diet, wheat is substituted with rice or cornflour and soy milk replaces dairy.
Some parents and doctors have observed anecdotally that children who are on the gluten and casein free diet show reduced hyper-activity, increased perception and eye contact, as well as a reduction in issues relating to both the digestive and the immune system. For example, you can find many comments on the internet from parents who attest to the success of this treatment. However, research on the positive effects of the gluten and casein free diet for children with ASD do not go beyond a few case studies.
It must not be forgotten that the gluten and casein free diet can lead to a serious lack of proteins, vitamins, and minerals. One must not overlook that growing children need these important sources of nourishment available in grain and dairy products. Therefore, it is important that the child is tested for gluten and casein intolerance or allergies by a specialist before applying the diet and that as recommended for any diet, the child be monitored by said specialist. Additionally, the American Association of Pediatricians states that urinary tests are not a clinical trial for autism and as a result, should not be used to determine whether children should be placed on any diet.

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Sources
Elder, J.H. et al. (2006). The gluten-free, casein-free diet in autism: Results of a preliminary double blind clinical trial. Journal of Autism and Developmental Disorders, 36, 413-420.
NAC (2009). National Standards Report. USA: NAC.

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Evaluating this method
zayifPoor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effects on children with autism.

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Vitamin and Mineral Supplements

The belief is that children with autism have severe intestinal permeability, and because they tend to be very picky in what they eat, their bodies lack many vitamins and minerals. The most important of these is B6 and magnesium. It has been proven that the lack of B6 affects children’s central nervous system. Magnesium is critical for the formation of bones, maintenance of nerves and muscles, and the efficiency of enzymes.
Research on the effects of B6 vitamin and magnesium supplements on ASD is conflicting. In cases where there is reduced experimental control, the positive effects are reported, whereas the opposite is true for increased experimental control which shows no benefits at all. Thus, there is need for a wide-ranging and controlled experimental research.

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Evaluating this method
zayifPoor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.

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Chelation

Heavy metals such as lead, mercury, aluminum, arsenic etc. are thought to be factors causing autism. However, review of research on this subject shows that this barely goes beyond an unsubstantiated opinion. For example lead, which is one of the aforementioned metals, is present in MMR vaccinations. 19 scientists from 13 different universities have researched the connections on trials performed on hundreds of children with ASD. The results of this research proves that there is absolutely no connection between the vaccine and the occurence of autism symptoms (Richler et al., 2006).
Even though no evidence exits for the connection between heavy metals and autism, chelation therapy is used often. Chemical or herbal remedies are used to allegedly rid the body of heavy and toxic metals. Herbal detoxification utilizes plants like cilantro. It is not known for sure how the use of herbal or chemical agents to rid the body of heavy metals affects other bodily functions. However, side effects can be extremely serious and even result in death. American Association of Pediatricians and other related groups do not recommend such therapies unless absolutely necessary.
In summary, chelation should only be used in cases where it has been firmly established that heavy metals are affecting the child and where he/she is able to sustain this treatment (i.e. that they do not have liver, kidney or bone marrow diseases). In most children with ASD, it is impossible to determine whether such a situation exists.

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Sources
Richler, J. et al. (2006). Is there a “regressive phenotype” of autism spectrum disorder associated with the measles-mumps-rubella vaccine? A CPEA study. Journal of Autism and and Developmental Disorders, 36, 299-316.

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Evaluating this method
zayifPoor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.

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Anti-Fungal Treatment

The alleged connection between certain types of fungi that are present in the body and autism has been a contentious topic in medicine. Some doctors claim that the reduction of any excess fungi and related organisms can be helpful for ASD. However, the scant research on anti-fungal therapy’s effects on people with ASD, do not go beyond a few case studies.
Candida is a fungus that is similar to yeast, and normally found in the body in small quantities. It is claimed that long term use of antibiotics, hormones and/or some medications can lead to an increase of candida and similar fungi which causes related infections. Any excess fungi can create problems in bodily functions. Nevertheless, it is very difficult to test for an excess of the types of fungi that are present in all bodies. Also, treatments that are used to combat excessive fungal infections pose serious side effects. It is believed that natural remedies such as garlic and grape extracts are helpful in the eradication of fungal infections. Since fungi feed on sugar, yeast, and carbohydrates present in the body -alongside medical treatments- an elimination diet is suggested. In conclusion, there is no scientific basis as of yet for prescribing medicine or natural remedies against fungi in autism treatment.

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Evaluating this method
zayifPoor: There are no experimental studies showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.

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Hyperbaric Oxygen Therapy

In Hyperbaric Oxygen Therapy (HBOT) the patient is given 100% pure oxygen in a chamber or tube containing higher than sea level atmospheric pressure. The goal is to increase the amount of soluble oxygen throughout the body inhaled through lungs with the hope that those cells that have stopped functioning due to a lack of oxygen will be revived. This therapy is used worldwide to treat brain damage and burn patients. It has begun to be more widely used in Turkey in the last few years even though there is no research to support that it is effective for children with autism. Research conducted to date do not go beyond case or uncontrolled studies.
A recent controlled study (Jepson et al., 2010) showed that there is no effect of HBOT on children with autism. In addition, it is important to bear in mind that excessive oxygen intake can be harmful for the brain and the ears.

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Sources:
Jepson, B. et al. (2010). Controlled evaluation of the effects of hyperbaric oxygen therapy on the behavior of 16 children with ASD. Journal of Autism and Developmental Disorders, Online First, 3 August 2010.

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Evaluating this method
ortaPoor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.

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Neuro-Feedback

Neuro-Feedback aims to teach individuals to alter abnormal brain waves through exercise. An EEG which transmits the brainwaves to a computer with appropriate software is connected to the brain. The software translates these waves into animated forms that are simple for the user to interpret. The user can control the animation which is in the form of a computer game with his/her brain. When attention is directed more intensely on the game, the brain emits appropriate electrical activity triggering the winning of points; when attention is lost the game falls out of control. In long term trials, families claim they have witnessed positive behavioral developments. Additionally, the publication called Research in ASD has published two research papers which state that this method has caused changes in the brains of children with autism and some of their behaviors.

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Sources
Kouijzer, M.E.J et al. (2010). Neurofeedback treatment in autism. Research in ASD, 4, 386-399.

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Evaluating this method
zayifAverage: There is only very limited experimental research showing that this method has had a positive outcome on children with autism.

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Treatment Protocols

The best-known protocol for autism treatment is the “DAN”. This was developed by Dr. Bernard Rimland, founder of the Autism Research Institute in San Diego, USA, and the father of a child with autism. The DAN protocol comprises the following components:

  • Vitamins, minerals, amino-acid and fatty acid supplements
  • The Gluten/Casein Free diet
  • Determining food allergies and formulating a tailor-made diet
  • Treatment of gut bacteria with probiotic products
  • Chelation

An evaluation of the various components of the DAN protocol can be found under the related headings of this website. As is stated, other than the vitamin and mineral supplements, no scientific research exists on the other procedures. The majority of reported effectiveness data comprise uncontrolled, subjective opinions provided by either the technicians or families. Additionally, this protocol has yet to be officially approved in our country.

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Evaluating this method
zayifPoor: There is no experimental research showing the positive effects of this technique on children with autism or the research which has been done shows no positive effect on children with autism.