Many families look to access complementary therapies in managing Autism Spectrum Disorder, with the hope of finding a solution that does not rely on pharmaceutical agents. Although, this approach may not afford every child or adolescent a significant reduction in behaviour, response and/or symptoms, the fact that there is a growing body of research supporting complementary therapies is grounds for consideration. The topics that follows will examine the most up-to-date research on complementary therapies for Autism Spectrum Disorder (ASD).
Complementary Therapy 1: Melatonin
Melatonin is a hormone released by the pineal gland (Brain) in response to decreasing levels of light. It causes drowsiness and sets the body's sleep clock. Interestingly, ASD is associated with a high frequency of sleep problems and melatonin is increasingly used to help children with ASD fall asleep. So what is the verdict? Of the 18 treatment studies on melatonin all have shown positive results. On average, a dosage of 2 to 10 milligrams of melatonin is capable of increasing sleep duration by approximately 44 minutes, and reducing sleep onset by 39 minutes. Despite the benefits associated with sleep outcomes, there was no change to nighttime awakenings.
Complementary Therapy 2: Omega-3 Fatty Acids
Omega-3 Long Chain Fatty Acid supplementation is reasonable to consider given that omega-3 fatty acids are essential to brain function and development. The two omega-3 fatty acids of primary interest are eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Low level of both EPA and DHA have been reported in children with ASD. So what is the verdict? Currently, there are 6 peer reviewed studies on the effects of omega-3 fatty acid on ASD. The evidence to support its use is weak, however, it is important to note that of the research undertaking thus far, demonstrated modest reductions in hyperactivity, hypersensitivity, anger and aggression and irritability have been reported. Moreover, the association between improved mood and attention is largely based on data from other disorders, not ASD.
Complementary Therapy 3: Methycobalamin (Methyl B12)
There is research to suggest that oxidative stress (more reactive molecules in the body than antioxidants to counteract them) is associated with ASD. Certain pathways in the body (largely influenced via the liver) assist in the clearance of reactive molecules. However, clearance requires particular nutrient co-factors to support this process, Methyl B12 is one of these co-factors. In a study of 40 children diagnosed with ASD, administration of Methyl B12 (important with elevations in a non-protein known as homocysteine) for 1 month resulted in a significant increase to the body's major antioxidant, glutathione. Along with an increase in glutathione came improvements in social relatedness, language and reductions in behavioural problems. So what is the verdict? Methyl B12 is typically administered at dosages of 64.5 to 75.0 mcg/kg with subcutaneous injections every 2 to 3 days. There are no peer reviewed studies in ASD of oral or nasal Methyl B12, which unfortunately are unable to maintain consistently high levels in the body, hence are considered less effective.
Complementary Therapy 4: N-acetyl-cysteine (NAC)
At the time of writing this article there was only one research publication available on the role of NAC in ASD. This study was a 12 week double blind randomised placebo controlled trial (the best possible study design, little room for variables) involving 31 boys and 2 girls, all between the ages of 3 and 10 years. So what is the verdict? NAC at 900 mg daily for 4 weeks was strongly associated with significant improvements in Aberrant Behavioural Checklist (symptom checklist for identifying problem behaviour) and irritability sub-scale. Yet, despite the success of the study the results will need to be replicated before recommendations can be offered.
Complementary Therapy 5: Pancreatic Digestive Enzymes
Enzyme deficiencies in children with ASD result in a reduced ability to digest protein, which affects the availability of amino acids crucial for brain function. For this reason there is a possible benefit in utilising a comprehensive digestive enzyme supplement with meals to aid digestion of all proteins and peptides, especially for those children with ASD that experience digestive issues. Moreover, probiotics have also been proposed to improve digestion and gut-brain activity in children with ASD. So what is the verdict? A recent high profile 2010 study demonstrated a modest improvement of ASD symptoms when utilising digestive enzymes. Yet despite a modest gain, what was largely exciting about this study is that showed that digestive enzyme supplementation allowed children diagnosed with ASD to consume a larger variety of foods, which they had not been previously able to tolerate. At present, there is a study underway known as the Cure-mark study. This study is looking to replicate and confirm the foregoing results. Researchers from The Institute of Genomics and Systems Biology in the United States have just released a groundbreaking paper that a Bacteroides fragilis probiotic is capable of relieving gastrointestinal symptoms in children diagnosed ASD! There are further trials underway. In case you did not hear my excitement. This is bloody fantastic!
Complementary Therapy 6: Micronutrients
Everyone likes to utilise multivitamins, yet, for the majority it is unfortunately a waste of money. That is, deficiencies provide grounds for multivitamin supplementation, not simply failing to feed yourself properly. However, given the nature of ASD and the accompanying symptomology of heightened sensitivity to foods, there is grounds for recommending micro nutrient supplementation if deficiencies exist. So what is the verdict? Two RCT clinical trials (Remember, the best studies, with little to no variable) have shown that micro-nutrient supplementation yielded significantly better sleep and reduced gastrointestinal symptoms (bloating, excess wind, loose motions, constipation). What was also interesting is that improvements were also noted in the pathways previously alluded too in the section, Methyl B12. Exciting!
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