Executive dysfunction refers to difficulties in response inhibition, mental flexibility, self monitoring, planning, and/or working memory. Such cognitive deficits are common in individuals diagnosed with Autism Spectrum Disorders (ASD). Executive dysfunction is suggested, at this point in time, to account for the typical clinical manifestations of ASD, including uncontrollable behavioural and emotional reactions, repetitive behaviour, strong need for sameness, restricted interests, and inappropriate social communication and action. This being so, deficiency of executive function has far-reaching effects on everyday activity, and independent living, for individuals diagnosed with Autism.
Given the pervasive impact of executive dysfunctions in ASD, new research has sought to investigate potential interventions for enhancing executive functions in people diagnosed with ASD. Currently, the majority of interventions are behaviour-based, several showing positive outcomes - Extremely Important! Nonetheless, one drawback is that behaviour based interventions, such as applied behaviour analysis, is regarded as time consuming and relatively intensive (Who Cares! If it works for your child - brilliant). Moreover, some methods of behaviour-based intervention may not be applicable or less effective in the context of limited intellectual functioning or severe autistic symptoms (profound autism). For this reason, individuals identified as profoundly autistic may benefit from pharmacological interventions for the stabilization of mood, improved attention and behavioural problems.
It is important to appreciate that despite approximately 30 percent of the ASD cohort prescribed psychotropic medications, there remains no standard medication guideline for treating ASD. Furthermore, some individuals are refractory to medication or intolerant to the medication prescribed. While pharmacological treatments are predominately administered peripherally (e.g. oral administration) there is a growing trend in research of exploring the application of medication delivery intra-nasally, as a way to treat central nervous system dysfunction. Intra-nasal treatment, regarded as a non-invasive means of administration, not only allows medication to bypass the blood brain barrier but also increase the bioavailability of the active drug reaching the brain. Empirical findings support intra-nasal administration for the treatment of various brain disorders, including benzodiazepines for epilepsy, stem cells for Parkinson's Disease and insulin for dementia (Alzheimer's).
In a recent study (2014) undertaken at The Chinese University of Hong Kong, researchers aimed to examine an intra-nasal herbal formulation as a potential intervention for enhancing executive function in children diagnosed with ASD. 30 children with ASD, aged between 7 and 17 years old, were assigned to the study, with 15 individuals receiving six month intra-nasal application of the herbal formula (active ingredients = Borneol and Borax - NB: see patent number ZL 2008 1 0176088.7). The other 15 children did not receive treatment, serving as a control group. All ingredients in the formulation are within the allowed daily dosage as prescribed in the Chinese Herbal Medicine, published by the Educational Board of the National Drug Administration. Moreover, the product was manufactured under strict Good Manufacturing Practice (GMP) standards, as well as tested for heavy metals, toxic elements, microbes and pesticide residue. Further confirmation for toxicity was undertaken through the results of a blood assay for all children in the experimental group, at the end of the the first and sixth month of intervention, with all liver function indices shown within normal range.
Results showed that individuals assigned to the experimental group experienced positive changes in executive function compared to controls (42 percent improvement!), post intra-nasal herbal application. Amazing! Nonetheless, the researchers wanted more compelling evidence to see whether improvements observed under experimental conditions could be generalised to everyday behaviours. This being so, a further pre-post comparison was performed on the parents evaluations of their child's executive behaviours in everyday life based on three standardized questionnaires. While there was no difference in parental ratings before intervention for both groups, after six months of intervention, parents of the children in the experimental group, but not those in the control group reported fewer behavioural problems related to executive dysfunctions.
What is amazing about this research is that it has revealed enhancements in both the experimental test results and the real life behaviours related to executive function in children with ASD, post intra-nasal application of the herbal medicine for a period of six months. Moreover, given that the control group, which did not receive the herbal treatment, failed to show the same degree of improvement in executive function, the positive outcomes observed in the experimental group could only be attributed to the herbal nasal drops, rather than natural developmental growth. Interestingly, this is not the first time for this outcome to be demonstrated, as the therapeutic effects of the herbal formula are now consistent with previous pilot data that revealed greater improvements in some frontal lobe functioning, specific to initiation and inhibition of speech and actions, as well as some pro-social behaviours after the first month of treatment. Unfortunately, the mechanism of action by which the herbal formulation exerts its effect is unknown at this point in time. I am certain this will be identified soon :).
If you have any questions regarding this post please make contact:
B: Mark Hinchey Naturopathy, Newcastle Naturopath, 601 Glebe Road Adamstown, New South Wales, Australia.
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