August 5, 2013
by Minji Kim
Autism Interventions: Medical
Medical interventions are intended to reduce the symptoms of autism (irritability, allergies, sleep disorders, etc), but do not directly target the three core characteristics of autism (social impairment, communication difficulties, and repetitive behaviors). Generally speaking, the medical interventions can be divided into three categories; pharmaceutical/prescribed medications, alternative medicines, and therapies.
While many of those with autism are prescribed pharmaceutical medications, the majority of those are prescribed “off label”. This means that doctors will prescribe a medication to an individual that either a) does not have the specific disorder the FDA has approved the drug for or b) does not fall into the age group approved by the FDA. For example, naltrexone, which is FDA approved for opioid addiction, can reduce self-injurious behaviors in autistic individuals. The FDA does have two prescription medications specifically approved for irritability in autistic children, risperidone and aripiprazole-better known as Abilify and Risperdal. However, most medications are prescribed off-label, and usually are aimed to help with anxiety, depression, seizures, hyperactivity, and behavioral problems.
In addition to or in lieu of prescription medicines, alternative medicines are widely used to reduce autism symptoms. They are not pharmaceutical, but still believed to be beneficial. The most common ones are listed below:
- Mg & Vitamin B6: improve communication, sociability, sensory/cognitive awareness, and behavior
- Methyl B12: increase methylation to improve social, cognitive, and language development
- Melatonin: helps maintain circadian rhythms, and the resulting better sleep leads to better behavior
- Omega 3 Fatty Acids: some argue that it helps with hyperactivity, others deny any effectiveness
- Gluten Free Casein Free Diet: widely used by parents who claim improved moods/behavior, speech, and gastrointestinal problems
Finally, some have turned to therapies to help soothe the symptoms of autism. Craniosacral therapy and hyperbaric therapy have no additional risks. In craniosacral therapy, a trained chiropractor, massage therapist, or other expert uses pumping motions to create balanced movement of brain and cerebrospinal fluid to improve behavior, sociability, speech, and overall well-being. Some claim that the improved well-being helps with gastrointestinal issues as well. In hyperbaric therapy, individuals inhale 100% pure oxygen in a pressurized room for hour long sessions, supposedly improving moods, behavior,and sociability.
More extreme, dangerous, uncertain therapies exist as well. In electroconvulsive therapy, brief seizures are triggered by electric currents (under general anesthesia) to treat catatonia present in autism. This is often a last resort, and fairly risky. In response to some claims that mercury in vaccinations triggered autism, some have tried chelation, in which chelating agents are used to remove heavy metals from the body. The FDA has only approved chelation for acute heavy-metal poisoning that is confirmed by blood tests. Chelation therapy is highly dangerous and little evidence exists attesting to its effectiveness.
Finally, stem cell therapy has recently begun to gain much more interest. Stem cells are administered intravenously to aid the immune system, which is influential in the development of autism. It is believed that the immune system is linked to the nervous system, and so a stronger immune system can help in moving, learning, behavior, and cognition. More research is needed to produce conclusive statements.
The success of the various interventions are most commonly measured by a wide variety of surveys and evaluations such as:
- Overt Aggression Scale (OAS)
- Aberrant Behavior Checklist (ABC)
- Autism Treatment Evaluation Checklist (ATEC)
- Social Responsiveness Scale (SRS)
- Vineland Adaptive Behavior Scale (VABS)
- Clinical Global Impression-Improvement (CGI)
- Parental Stress Index (PSI)
- Teacher Report (TRF)
Researchers have recently made many important discoveries in autism and how it works. Consequently, many new interventions are being tested and improved with the better understanding of autism, and we expect to see many improvements in the next decade.