Autism Hope Versus Hype

A guide to unproven treatments

Experts don’t know much about the causes of autistic spectrum disorders for most children who have them, outside of the facts that they’re largely genetic and that conventional medicine so far offers no cures for them. “So, it’s understandable for families to look for a miracle in treatments that are as yet scientifically unproven,” says Susan Levy, M.D., of the Children’s Hospital of Philadelphia, whose research focuses specifically on certain interventions for autism that are outside of the medical mainstream. What follows are some of the most common of these:

Chelation Therapy Chelation therapy is an accepted treatment for acute lead or mercury poisoning; chelating chemicals are injected into the bloodstream, where they bind to toxic metals and then pass out of the body in urine and stool, bringing the toxins with them. Its unproven use as a treatment for autism is based on the controversial idea that symptoms stem from mercury poisoning. There’s absolutely no scientific evidence that chelation is a viable treatment for autism, says Dr. Levy. In addition, chelating agents can cause liver toxicity and kidney failure, as well as deplete the body of vital minerals such as calcium and iron.

Hyperbaric Oxygen Therapy Hospitals use hyperbaric oxygen to treat carbon monoxide poisoning and decompression sickness (“the bends”). Its use with autistic kids is based on the notion that they might benefit from increased oxygen to the brain. In one small study, 18 children received hyperbaric oxygen therapy and parents reported some improvement in symptoms. However, since parents knew their children were receiving this treatment, their perceptions could have been influenced by expectations, as there was no comparison group receiving a sham treatment (to rule out a placebo effect). Oxygen therapy also poses some safety issues: Oxygen is highly flammable, and there are reports that improper use of home chambers has resulted in fires, explosions and life-threatening burns. In addition, there have been reports of eardrum rupture.

Anti-Testosterone Therapy Three out of four autistic children are boys, which has led some doctors to conclude that autism stems in part from the male sex hormone testosterone. Some proponents of this theory believe that Lupron, a drug that shuts down the body’s production of sex hormones, is a viable treatment. Unfortunately, the potential side effects of this unproven treatment are serious: heart arrhythmias, dangerously high or low blood pressure and, in rare cases, heart attack. Lupron can also interfere with normal sexual development.

Secretin and Alkaline Salts Some children with autism have digestive problems such as chronic diarrhea or constipation. In 1998, a television show highlighted the story of three autistic children whose symptoms improved after they were given secretin, a digestive hormone. More than a dozen studies, with more than 600 autistic children, followed, but none showed a benefit. The research did, however, reveal side effects of the use of secretin, such as allergic reactions and, in rare cases, seizures. Less commonly, parents have used alkaline salts, which have been suggested to increase the body’s production of secretin. The practice has not been studied for safety or effectiveness, says Dr.Levy, and alkaline salts are potentially harmful to the liver.

Gluten-Free/Casein-Free Diets The possible link between digestive problems and autism has also inspired the use of gluten-free and casein-free diets, which exclude grain and milk products, respectively, to treat autism. Studies are underway, but as of yet neither of these diets has strong scientific evidence of effectiveness for autism. In addition, says Dr. Levy, it may be difficult for children on these diets to get enough protein, calcium and vitamin D. In fact, a recent study found that kids on casein-free diets had significantly thinner bones than those on unrestricted diets. Compounding the problem: Many children with autism are extremely picky eaters.

Vaccine Avoidance For quite some time, vaccines, particularly the measles-mumps-rubella (MMR) shot, and any vaccine containing the preservative thimerosal, have been reviled as a potential catalyst for the development of autism, but multiple large studies have shown no link between immunization and autism. Even so, some parents remain fearful, and those with autistic kids have been more likely than most to refuse to vaccinate them, leaving their children vulnerable to serious and, in rare cases, deadly infections. What’s more, unvaccinated children can spread the rubella infection to pregnant women—and prenatal brain damage from rubella infection during pregnancy may be one cause of autism.

Antibiotics Some researchers have proposed that autistic children may have excess growth of harmful bacteria in the gut. In a small, uncontrolled study of 11 autistic kids, eight showed a temporary improvement in symptoms after treatment with vancomycin. Unfortunately, vancomycin can have very serious side effects, including inflammation of the intestines, says Dr. Levy. It’s also considered the antibiotic of last resort for serious bacterial infections that don’t respond to other antibiotics; in many hospitals, therefore, its use is tightly controlled.

Antifungals Some doctors have proposed that autism is caused by an overgrowth of yeast in the gut—due in part to the overuse of antibiotics for conditions such as ear infections. Other possible contributors to yeast overgrowth include viruses or exposure to drugs or chemicals that compromise the immune system. The remedy: long courses of antifungal medications. The potential downside, says Dr. Levy, is that antifungals can, in rare cases, cause liver damage and anemia. In girls and women, their use commonly triggers bacterial vaginosis, an overgrowth of harmful bacteria in the vagina.

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