In a new population based study researchers compared the usage of conventional treatments and the usage of complementary and alternative medicine in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD).
There is no Food and Drug Administration-approved medical treatment for the core symptoms of autism spectrum disorder, a lifelong neurodevelopmental condition whose hallmarks are deficits in social relatedness, repetitive thoughts and behaviors and, often, intellectual disability.
Families seeking treatments to help their children may turn to therapies outside the use of standard medical care such as chelation therapy, homeopathic remedies, vitamin B-12 injections, or intravenous immunoglobulin with some of these therapies having significant risks.
Dr. Robin Hansen, MD, Director of Clinical Programs, UC Davis MIND Institute; Professor and Chief of Developmental-Behavioral Pediatrics, Department of Pediatrics, School of Medicine; Director, Center for Excellence in Developmental Disabilities (CEDD) and colleagues compared the therapies.
Participants included 578 children, aged two to five years with autism and developmental delay who were enrolled in the Childhood Autism Risk from Genetics and the Environment (CHARGE) study and the general populace. Among the participants 453 were diagnosed with autism and 125 were diagnosed with developmental delay.
Parents completed an interview on past and current services.
The researchers found the use of psychotropic medications was low in both groups (approximately 3%).
Overall, complementary and alternative medicine (CAM) use was not significantly different in autism spectrum disorders (39%) and developmental disabilities (30%). Almost 7% of of children with autism were on the gluten-free/casein-free diet, particularly children with frequent gastrointestinal problems.
A higher level of parental education was associated with an increased CAM use in autism and development disabilities. Families who used conventional treatments over 20 hours per week were more likely to use CAM.
A small but statistically significant number , about four percent were found to use alternative treatments classified by the study as potentially unsafe, invasive or unproven, such as antifungal medications, chelation therapy and vitamin B-12 injections. Under immunized children were marginally more likely to use CAM but not more likely to have received potentially unsafe or disproven CAM.
In their conclusion the researchers write “Use of CAM is common in families of young children with neurodevelopmental disorders, and it is predicted by higher parental education and non-Hispanic ethnicity but not developmental characteristics. Further research should address how health care providers can support families in making decisions about CAM use.”
According to Dr. Hansen, “In our Northern California study population, it does not appear that families use complementary and alternative treatments due to the lack of availability of conventional services, as has been suggested by other research.” “Rather, they use the treatments in addition to conventional approaches.”
Dr. Kathleen Angkustsiri, MD, Assistant Professor of Clinical Pediatrics, Section of Developmental Behavioral Pediatrics, School of Medicine and co-author of study commented We were pleased to find that most families utilizing CAM therapies were choosing ones that were low risk.”
“Our study suggests that pediatricians and other providers need to ask about CAM use in the context of providing care for children with autism and other developmental disorders, and take a more active role in helping families make decisions about treatment options based on available information related to potential benefits and risks,” said Dr. Roger Scott Akins, DO, lead author and a former postdoctoral fellow at the MIND Institute, who now is chairman of the Division of Neurodevelopmental Pediatrics at Naval Medical Center Portsmouth, Va.
According to Dr. Irva Hertz-Picciotto, PhD, internationally renowned environmental epidemiologist, principal investigator for the CHARGE study, Professor of Epidemiology and Chief, Division of Environmental and Occupational Health, said the research supports the emergent need for identifying validated treatments for neurodevelopmental conditions.
She continues “These findings emphasize the enormous and urgent need for effective treatments and for rigorous research that can identify them and verify their effectiveness and safety.” “Of course it is reasonable for parents to keep searching for ways to help their children, when there are few effective treatments and none that can help every child.”
This study appears in the Journal of Developmental & Behavioral Pediatrics.
