The wide range in presentations of ASD has led to numerous treatments for it. These include behavioral and psychosocial interventions; occupational, speech, music, and sensory-integration therapy; immunotherapy; and several alternative and complementary therapies including nutritional therapy, chelation, and vitamin and other nutritional supplementation. The following sections describe a number of treatments investigated for autism, and their effects.
A small study of the effect of encapsulated human Ig in males with autism, conducted to test the theory that GI symptoms in the condition may stem from a deficiency in mucosal immunity, found reductions in GI signs and symptoms, as well as improvement in behavioral measures, in half of the treated individuals.44
A 30-week, double-blind, placebo-controlled study demonstrated a reduction in symptom severity in autistic children treated with ascorbic acid, supporting the hypothesis from animal models that this vitamin has a dopaminergic mechanism of action correlating with research suggesting a hyperdopaminergic state in autistic individuals.45-47 The antioxidant activity of ascorbic acid may also be of benefit in autism.
Carnosine, a dipeptide of alanine and histidine, exhibits antioxidant and antiglycating activity, in addition to binding heavy metals. A controlled study involving children with ASD found that an eight-week trial of l-carnosine at 800 mg per day produced a significant improvement in autistic traits as measured with the Receptive One-Word Picture Vocabulary test and the total score and the Behavior, Socialization, and Communication subscales of the Gilliam Autism Rating Scale.48
Hyperactivity and stereotypic behavior declined in children with ASD who were given supplemental omega-3 fatty acids at 1.5 g per day.
A study has indicated that children with ASD show significant improvement in sleep and reduction of GI symptoms when given nutritional supplementation with a multivitamin=mineral preparation.48 The pretreatment baseline finding of vitamin B6 levels that were 75% higher in these children than in a control group supported previous reports of deficient conversion of pyridoxal to the active pyridoxal-5-phosphate (P5P) by pyridoxal kinase in autistic children, and pointed to an indication for supplementation with vitamin B6 or P5P in autism.49,50
Lower red-blood-cell levels of magnesium have also been found in children with PDD than in controls, with nearly 70% of the affected children showing significant improvement, unaccompanied by adverse effects, upon supplementation with magnesium at a dose of 6 mg=kg per day and 0.6 mg=kg per day of vitamin B6.51
Other nutrient deficiencies and abnormalities have also been found in children with autism. Hair analyses have found lower concentrations of lithium as well as iodine levels 45% below those of controls, as well as a 38% lower level of chromium in autistic children with pica. A 31% greater level of zinc and a 66% lower level of potassium were found in autistic children with diminished muscle tone, suggesting possible avenues for additional vitamin treatment.52
In a controlled six-week trial, hyperactivity and stereotypic behavior declined in children with ASD who were given supplemental omega-3 fatty acids (eicosapentaenoic acid and doc-osahexaenoic acid) at 1.5 g per day.53
Limited evidence suggests that dietary restriction of gluten and casein may be beneficial in children with autism. A small controlled study found that such children showed significantly better development with a gluten- and casein-restricted diet than did controls.54 Food allergy may play a role in autistic symptomatology, as suggested by significantly increased levels of antibodies to casein, beta-lactoglobulin, and lactalbumin in autistic children than in controls, followed by reductions in behavioral symptoms with an eight-week elimination diet for these three food components.55 However, a small, double-blind, placebo-controlled study failed to find any significant changes in autistic children with a gluten- and casein-restricted diet, although the children's parents did report improvements in the children's conditions.56 Another study found behavioral improvement after six months in 60% of autistic children given a ketogenic diet.57
A small trial of meso-2, 3-dimercaptosuccinic acid combined with leuprolide acetate was conducted to test the concept that ASD may result from interactions between trans-sulfuration in the methionine cycle and androgen pathways as noted earlier, and in accord with a previous finding of abnormal detoxification associated with the methionine and trans-sulfuration pathways in children with autism.58 The results showed a dramatic reduction in severity of symptoms, from the 70th-79th percentile of severity to the 40th-49th percentile of severity. Behavior, sociability, and cognitive awareness were notably improved. In another study with autistic children, involving anti-androgen and anti-heavy-metal therapy, urinary levels of heavy metals increased and blood levels of androgens decreased.59
The antipsychotic drug risperidone has been approved by the Food and Drug Administration for treating ASD marked by self-injurious behavior, severe tantrums, and aggression in children ages 5-16. Risperidone has been found to improve social responsiveness and nonverbal communication, and to decrease hyperactivity and aggression in these children.60 Treatment with selective serotonin reuptake inhibitors (SSRIs) also modifies some symptoms of ASD, including anxiety and repetitive behavior, and improves global functioning.61
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