Autism Information and Autism Treatment
Natural Treatment Options for Autism by Ray Sahelian, M.D.


Subscribe to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with a discussion several new studies on various supplements and natural medicine topics and their practical interpretation by Ray Sahelian, M.D. We will mention research updates on autism when available.

 

Autistic disorder, or autism, is a developmental disorder resulting in social, language, or sensorimotor deficits. Autism occurs in approximately six out of every 1,000 children. Early detection and intervention of autism significantly improve outcome, with about one third of persons with autism achieving some degree of independent living. Indications for developmental evaluation of autism include no babbling, pointing, or use of other gestures by 12 months of age, no single words by 16 months of age, no two-word spontaneous phrases by 24 months of age, and loss of previously learned language or social skills at any age. Autism is frequently associated with fragile X syndrome and tuberous sclerosis, and may be caused by lead poisoning and metabolic disorders. Children with autism often suffer form mental retardation, seizure disorder, and psychiatric disorders such as depression and anxiety. Autism symptoms have a tendency to lessen with age.
   One out of four toddlers born prematurely have early signs of autism.

Diet and Autism
Research indicates that a gluten and casein-free diet may be helpful in autism. Therefore, it would be a good idea to try a gluten free diet for a period of a few weeks in children with autism to see if there is any response. Since fish oils have benefited some children with autism, it may be a good idea to include more cold water fish in the diet.

Natural supplement for the treatment of Autism - Vitamin for autism
There is a scattering of research that indicates nutrients may be of some benefit in treating autism, but  much more research is needed before we have a better understanding the role nutritional supplements in the treatment of autism. However, here are some possible options that I have come across that may or may not be helpful.

Children with autism given carnosine showed statistically significant improvements on several tests including an improvement in vocabulary and recognizing a picture. The dose should be probably be low for kids, much much  less than the adult dose.

Children with autism may be deficient in fish oils, hence a role of diet in autism.

A multivitamin supplement may  be considered.

The serotonin system could be involved in autism, since there is a different metabolic response to 5HTP administration in children with autism compared to controls (see study below).

Q. What would be the appropriate dosage for the various supplements that are suggested for autism? The child is just 2 years old.
   A. Research in the area of supplement use for children at various ages with autism is quite recent and little is known about the benefits, risks, or effectiveness of these natural supplements. Please consult with your pediatrician. My best guess would be about a tenth of 500 mg capsule although I have no studies to support this dosage recommendation.

Autism and fish oil
Childhood autism may be linked to a deficiency of fatty acids found in oily fish. A pilot study at the University of Stirling found that children with autism had cells that broke down fatty acids more rapidly than normal cells. Autism rates in Scotland have risen dramatically in the past ten years, a trend mirrored across the developed world. In Scotland, an estimated 50,000 people, nearly 7,000 of them children, suffer from autism. Brain cell membranes are composed primarily of omega-3 and omega-6 fatty acids, substances found in oily fish such as mackerel and salmon. A study of about 20 autistic children last year revealed that cell membranes in their blood metabolised, or processed, fatty acids at a faster rate than other children. The discovery led to speculation that a fatty acid deficiency may be partially responsible for the onset of autism. "We have already seen a connection between omega levels and schizophrenia and dyslexia," said Dr Gordon Bell of the university. If cell function in the brain is changed, the behavior of the brain will change as well. Dr Bell compared cell membranes to a "brick wall" of fatty acids. Bricks fall out, but as long as they are replaced, then the wall holds strong. Problems occur when bricks fall out faster than they can be replaced. If the scientists confirm this is what causes autism, they may conclude that the answer is to replenish "bricks" of fatty acids at a greater rate; in short, eat more fish.

Autism, vitamin B6 and multivitamins
Pilot study of a moderate dose multivitamin / mineral supplement for children with autistic spectrum disorder.
J Altern Complement Med. 2004 Dec;10(6):1033-9. Adams JB, Holloway C.
Arizona State University, PO Box 876006, Tempe, AZ 85287-6006, USA.
Determine the effect of a moderate dose multivitamin/mineral supplement on children with autistic spectrum disorder. Twenty (20) children with autistic spectrum disorder, ages 3-8 years. A Global Impressions parental questionnaire found that the supplement group reported statistically significant improvements in sleep and gastrointestinal problems compared to the placebo group. An evaluation of vitamin B(6) levels prior to the study found that the autistic children had substantially elevated levels of B6 compared to a control group of typical children. Vitamin C levels were measured at the end of the study, and the placebo group had levels that were significantly below average for typical children, whereas the supplement group had near-average levels. The finding of high vitamin B(6) levels is consistent with recent reports of low levels of pyridoxal-5-phosphate and low activity of pyridoxal kinase (i.e., pyridoxal is only poorly converted to pyridoxal-5-phosphate, the enzymatically active form). This may explain the functional need for high-dose vitamin B(6) supplementation in many children and adults with autism.

Autism symptom
The main feature of autism is impaired social interaction. Children with autism may fail to respond to their names and often avoid looking at other people. They often have difficulty interpreting tone of voice or facial expressions and do not respond to others' emotions or watch other people's faces for cues about appropriate behavior. Another autism symptom is being unaware of others' feelings toward them and of the negative impact of their behavior on other people.

Autism Sign
Many children with autism engage in repetitive movements such as rocking and hair twirling, or in self-injurious behavior such as biting or head-banging. They also tend to start speaking later than other children and may refer to themselves by name instead of "I" or "me." Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Cause of autism
Current research links autism to biological or neurological differences in the brain. MRI ( Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans show abnormalities in the structure of the brain, with significant differences within the cerebellum, including the size and number of Purkinje cells. In some families there appears to be a pattern of autism or related disabilities, which suggests there may be a genetic basis to the disorder, although at this time no one gene has been directly linked to autism. Men who become fathers in their 40s or older are much more likely to have autistic children than younger dads, bolstering evidence that genetics contributes to autism.
   Disturbances in the serotonin system is another possibility, see study below.
   Having a parent or a mother with psychiatric problems such as schizophrenia increases a child's risk of having autism.

What does not cause autism
There does not appear to be a link between the season or month a child is born and the subsequent risk for autism. There does not seem to be a link between mercury levels (as determined by analyzing hair samples for mercury) and the risk for autism.

Autism treatment
There are three large categories of autism treatment: Behavioral modification and communication approaches, dietary and nutritional approaches, complementary approaches.
     Despite anecdotal evidence suggesting that secretin is a useful treatment for autism, the results of a new review do not support a therapeutic role for this gastrointestinal hormone.

Autism and growth hormone
Boys with autism have higher levels of growth hormones than other boys, which may explain why children with the condition often have larger heads. Boys with autism and autism spectrum disorders are also heavier than boys without these conditions

Autism Research Update
 Serotonergic disturbances in autistic disorder: L-5-hydroxytryptophan administration to autistic youngsters increases the blood concentrations of serotonin in patients but not in controls.
Life Sci. 2005 Mar 25;76(19):2171-83.
Some studies have suggested that disorders in the peripheral and central metabolism of serotonin (5-HT) may play a role in the pathophysiology of autistic disorder. This study examines the whole blood concentrations of 5-HT and 5-hydroxy-indoleacetic acid (5-HIAA) in baseline conditions and during a challenge with L-5-OH-tryptophane (5-HTP; 4 mg/kg in non enteric-coated tablets), the precursor of 5-HT, in a study group of 18 male, post-pubertal, Caucasian children with authism (age 13-19 y.; I.Q.>55) and 20 matched healthy volunteers. In baseline conditions, no significant differences in 5-HT or 5-HIAA levels could be found between autistic youngsters and normal controls. 5-HTP administration significantly increased the levels of 5-HT in sutism youngsters but not in normal controls. Following 5-HTP challenge the 5-HT levels were significantly higher in autistic patients than in healthy volunteers. After challenge with 5-HTP, no significant differences were found in the concentrations of 5-HIAA or the test substance between autistic youngsters and normal controls. Differences in the peripheral metabolism of 5-HT which may not be observed in baseline conditions but which became clear after loading with 5-HTP, suggest that an increased synthesis of 5-HT from its precursor 5-HTP might be a one factor responsible for differences in the serotonergic system between autistic post-pubertal youngsters and normal controls.

A form of therapy that focuses on parents' interactions with their children could help treat autism at a far lower cost than other strategies for the disorder. A therapy called responsive teaching, given over one year, led to gains in language and behavioral development among young children with autism. Children with autism have, to varying degrees, difficulty in using and interpreting verbal language and body language, and in interacting with other people, including their parents. Responsive teaching works on strengthening this interaction, encouraging parents to "follow their child's lead" and respond to their actions. The approach is "child-centered," says Dr. Gerald Mahoney, a co-author on the new study, who co-directs the Center on Intervention for Children and Families at Case Western Reserve University in Cleveland. This stands in contrast to the widely held belief that education for autistic children must be highly structured and "direct" them in learning particular skills. Another way the tactic differs from other forms of autism therapy is in cost. Contact with therapists is limited to about once a week, and the yearly price tag for the program is about $5000 -- a fraction of the cost of many other therapies. For the current study, reported in the Journal of Developmental and Behavioral Pediatrics, Mahoney and colleague Frida Perales followed 50 children whose parents began responsive teaching when the children were around the age of 2. Some of the children had a pervasive developmental disorder, or PDD -- most commonly autism -- and some had other forms of developmental disabilities. The idea behind responsive teaching is that by enhancing parents' interactions with their children, the children will "acquire and use pivotal developmental behaviors," which in turn will improve children's language skills and social and emotional development. For instance, if stronger parent-child interactions improve the pivotal behavior of cooperation, the result could be fewer behavioral problems. Similarly, improving the pivotal behavior of "joint attention" between a parent and child could aid in the child's learning of language.  After a year, the researchers found, the children showed large gains in their cognitive development, especially when it came to communication skills. Their rate of development in terms of expressive language increased by an average of 167 percent, while their ability to understand language improved by nearly as much, according to the report. Between 70 and 80 percent of the children showed such improvements. SOURCE: Journal of Developmental and Behavioral Pediatrics, April 2005.

Mercury released primarily from coal-fired power plants may be contributing to an increase in the number of cases of autism. A study published in the journal "Health and Place" found that autism, a developmental disorder marked by communication and social interaction problems, increased in Texas counties as mercury emissions rose. For every thousand pounds of environmentally released mercury, there was a 17 percent increase in autism rates. About 48 tons of mercury are released into the air annually in the United States from hundreds of coal-burning plants.

Expectant mothers suffering from asthma, allergies or a type of skin disease have a higher risk of giving birth to an autistic child. Asthma, allergies and psoriasis symptoms during pregnancy — especially if diagnosed in the second trimester — doubled the risk of autism in children compared to children who were not afflicted.

A new brain-imaging study suggests that people with autism use different parts of the brain when remembering letters -- regions normally associated with processing shapes rather than language. The study also found that compared with other adults, individuals with autism showed less synchronization among certain brain regions while performing the letter-recall task. The findings support their theory that autism involves an underdevelopment of the complex circuitry that allows different brain areas to work together. Autism is a developmental brain disorder that impairs, to varying degrees, a person's use of language and ability to communicate, interact socially and form relationships. In addition, some people with autism excel at "detailed" tasks but have trouble performing more complex ones. They might do well when it comes to spelling words, for example, yet be unable to grasp the overall meaning of something they read.

Children with autism have inflammation in their brains, although it is not yet clear whether the inflammation actually causes the condition. Tests on the brain tissue of 11 patients with autism who had died and spinal fluid from six living children with autism showed the activation of immune system responses. Autism is a brain disorder usually seen as children become toddlers. Affecting an estimated two to five out of every 1,000 children, autism has a spectrum of symptoms that include difficulty with social interaction and repetitive behaviors. In a study published in the online edition of the Annals of Neurology, researchers said they found abnormal activity by immune system signaling chemicals called chemokines in the autistic patients. This ongoing inflammatory process was present in different areas of the brain and produced by cells known as microglia and astroglia.

Mothers of children with autism are more likely to have asthma or allergic disorders. This finding may point to immune function abnormalities to play a role in this disorder.

Identifying environmental contributions to autism: Provocative clues and false leads.
Ment Retard Dev Disabil Res Rev. 2005 Jan 21;10(4):292-302
The potential role of environmental factors in autism spectrum disorders (Autism) is an area of emerging interest within the public and scientific communities. The high degree of heritability of Autism suggests that environmental influences are likely to operate through their interaction with genetic susceptibility during vulnerable periods of development. Evaluation of the plausibility of specific neurotoxicants as etiological agents in Autism should be guided by toxicological principles, including dose-effect dependency and pharmacokinetic parameters. Clinical and epidemiological investigations require the use of sufficiently powered study designs with appropriate control groups and unbiased case ascertainment and exposure assessment. Although much of the existing data that have been used to implicate environmental agents in Autism are limited by methodological shortcomings, a number of efforts are underway that will allow more rigorous evaluation of the role of environmental exposures in the etiology and/or phenotypic expression of the disorder. Surveillance systems are now in place that will provide reliable prevalence estimates going forward in time. Anticipated discoveries in genetics, brain pathology, and the molecular/cellular basis of functional impairment in Autism are likely to provide new opportunities to explore environmental aspects of this disorder.

Mercury Preservatives and Autism
A study of specially bred mice suggests that a mercury preservative in vaccines could potentially cause some of the brain changes in autism. The publication of the study gives fuel to an alliance of environmentalists, parents of children with autism, anti-vaccine advocates and politicians who say they will continue to fight to prove that vaccines can cause autism in susceptible children. But experts who issued a report last month saying there was no link between vaccines and autism said they had already seen the study and rejected it. Dr. Mady Hornig of Columbia University in New York said her study shows the possibility that a genetic predisposition could leave certain children vulnerable to a range of toxins in vaccines, including a mercury-based preservative called thimerosal. Writing in the journal Molecular Psychiatry, Hornig said specially bred mice that have deficient immune systems did show changes in behavior after getting the equivalent of the childhood vaccinations given to U.S. babies and toddlers. "I think that these findings suggest that it is very plausible that there could be a genetic factor that creates risk for some individuals with autism," Hornig said. But Dr. Marie McCormick of Harvard University's School of Public Health, said Hornig's research stretched credibility. For instance, it is not clear that children with autism have impaired immune systems. And the findings from specially bred mice can not be extended to humans. "Even though she says these behaviors are like autism, it is not clear that these behaviors are analogous to autism," McCormick added.

Carnosine Helpful in Autism
From the day she was born, Betty seemed different from other infants. At an age when most infants enjoy interacting with people and exploring their environment, Betty sat motionless in her crib and didn't respond to rattles or other toys. It wasn’t too long before Betty was diagnosed with autism. Unfortunately, modern medicine has little to offer as a cure for this condition. But supplements may be helpful. Researchers at the Autism and Epilepsy Specialty Services in Lake Bluff, Illinois, investigated 31 children with autism in an 8-week, double-blinded study to determine if carnosine would result in changes. Carnosine is a natural substance composed of 2 amino acids. It is found in relatively high concentrations in several body tissues, muscles, and nerve tissue, including the brain. The exact role of carnosine is not well understood, but studies indicate that this nutrient has antioxidant potential and may also act as a neurotransmitter (chemical messenger in the nervous system). The children with autism received 800 mg of carnosine a day and were compared with a group of children on placebo. After 8 weeks, children given carnosine showed statistically significant improvements on several tests including an improvement in vocabulary and recognizing a picture.
     Dr. Sahelian says: Carnosine, also known as L-carnosine, is sold in health food stores most commonly in capsules of 500 mg. It would be worthwhile for children with autism to try 100 to 200 mg of this nutrient before breakfast and lunch for a few weeks under a pediatrician’s supervision.

Gluten- and casein-free diets for autistic spectrum disorder.
Millward C, Cochrane Database Syst Rev. 2004;(2):CD003498.
It has been suggested that peptides from gluten and casein may have a role in the origins of autism and that the physiology and psychology of autism might be explained by excessive opioid activity linked to these peptides. Research has reported abnormal levels of peptides in the urine and cerebrospinal fluid of persons with autism. If this is the case, diets free of gluten and /or casein should reduce the symptoms associated with autism. OBJECTIVES: To determine the efficacy of gluten- and/or casein- free diets as an intervention to improve behavior, cognitive and social functioning in individuals with autism. SELECTION CRITERIA: All randomised controlled trials involving programmes which eliminated gluten, casein or both gluten and casein from the diets of individuals diagnosed with autism. As only one trial fitted the inclusion criteria, no meta-analysis is currently possible and data are presented in narrative form. MAIN RESULTS: The one trial included reported results on four outcomes. Unsurprisingly in such a small-scale study, the results for three of these outcomes (cognitive skills, linguistic ability and motor ability) had wide confidence intervals that spanned the line of nil effect. However, the fourth outcome, reduction in autism traits, reported a significant beneficial treatment effect for the combined gluten- and casein- free diet. REVIEWERS' CONCLUSIONS: This is an important area of investigation and large scale, good quality randomised controlled trials are needed.

Autism.
Tuchman R. Miami Children's Hospital, 2900 South Commerce Parkway, Weston, FL
Neurol Clin. 2003 Nov;21(4):915-32
Autism is a neurologic disorder with impairments in language, social communication, and behavior, which may improve over time, but which persist throughout the lifetime. The evaluation of autism requires a separation of clinical and research objectives and is done best in close cooperation with professionals in the fields of communication, education, and psychology. There are no biologic markers of autism. Regression in language and social communication is present in approximately 30% of children with autism and is most likely to occur between 18 and 24 months of age. Early deficits in social communication can be identified by the assessment of joint attention, affective reciprocity, and metacognition. Current evidence suggests that deficits in social cognition and communication in autism may be related to dysfunction in the amygdala, hippocampus, and related limbic and cortical structures. Other neuroanatomic structures, such as the cerebellum, also may form part of a distributed neuronal network responsible for social cognition and communication. Genetics play a major role in autism, but what is inherited and how broad the inheritable phenotype is remain unclear. At a neurochemical level, the principal neurotransmitter implicated in autism is serotonin. Seizures and epileptiform discharges are common in autism and are linked to cognitive dysfunction. The role of medication is to target specific symptoms and open windows of opportunity that allow implementation of a multimodal individualized educational plan.

Plasma fatty acid levels in children with autism.
Prostaglandins Leukot Essent Fatty Acids. 2001 Jul;65(1):1-7.
Phospholipid fatty acids are major structural components of neuronal cell membranes, which modulate membrane fluidity and hence function. Evidence from clinical and biochemical sources have indicated changes in the metabolism of fatty acids in several psychiatric disorders. We examined the phospholipid fatty acids in the plasma of a population of autism subjects compared to mentally retarded controls. Our results showed a marked reduction in the levels of 22: 6n-3 (23%) in the autism subjects, resulting in significantly lower levels of total (n-3) polyunsaturated fatty acids (PUFA) (20%), without significant reduction in the (n-6) PUFA series, and consequently a significant increase in the (n-6)/(n-3) ratio (25%). These results open up interesting perspectives for the investigation of new biological indices in autism. Moreover, this might have new therapeutic implications in terms of child nutrition. autism research

Secretin is an ineffective treatment for pervasive developmental disabilities: a review of 15 double-blind randomized controlled trials.
Research in Developmental Disabilities 26:87-97, 2005
A review of secretin for autism has concluded: "Almost none of the studies reported any significant effects and none concluded that secretin was effective."

Some people consider autism to be part of the obsessive compulsive disorder spectrum

Autism emails
I was reading about autism on your site "Great site by the way!" and came across this statement " Serotonin is the principal neurotransmitter in autism." My questions is this, was the article stating that too little serotonin may be implicated in autism, or too much?
   A. I don't know enough about autism and the biochemical abnormalities to know whether serotonin is found too much, too little, or serotonin levels in autism are affected only in certain areas of the brain.

Q. I just wanted to let you know that kava kava has saved our family. We have a 17 year old son with autism. With puberty and the teenage years presenting challenges of size, rages and inability to control some emotional behaviors we were desperate. When we see our son beginning to become agitated we give him kava kava and he completely calms down and is able to focus and maintain at school, home and in the community. Not wanting to medicate our son, we are thankful for the discovery of the effects of kava kava on the behaviors of autism.
   A. Kava should not be used more than 3 days a week due to potential liver harm.

Q. Does chelation work for autism?
   A. We have not come across any good research that indicates chelation works for autism.

Q. We have an 8-year old son that has autism and we've been working with him for the last 4-years with therapy. We didn't see as big of a change in him until the last 3 months when we put him on a GFCF diet ( flucose free casein free ) and had a local allergy doctor, Dr. Baptist recommend a bunch of supplements and B-12 injections. He still has some behavior issues but his vocabulary has increased. Any opinions about chelation therapy?
   A. We are glad your child has improved. I am not familiar with the use of chelation therapy for autism.

Q. Do you know how to deal with a 8 year old child who has autism and is obsessed with doors. Either opening or closing or staring at them. What sort of therapy should be used?
   A. Sorry but we have not looked into the role of supplements in the treatment of children with this kind of behavior.

Q. Autism is said to be the result of toxins or toxic metals in the child's body, Is there any natural antioxidant that you can recommend a 12 year old with autism?
   A. I have not seen any evidence that autism is a result of toxins or toxic metals.