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Medical Intervention
Medical interventions usually treat specific activities associated with Autism. They have shown beneficial effects in improving certain behaviours that children with Autism may have. Please see your doctor for any kind of medical treatment as it should be undertaken with his or her strict supervision.
Medication
Autism Spectrum Disorder ASD or commonly known as Autism is a neuro-developmental disorder. In other words, it is a condition in which certain brain networks or circuits are not properly developed, and this results in impairments in development of functions in many areas. There is currently no known cure or medicine that can treat Autism, however, there are some associated conditions which may be present in an individual that may require medical treatment.
Some examples are as follows:
Epilepsy or seizure disorder: About 25% of individuals with Autism develop seizures in their lifetime, most commonly in childhood & adolescence. Different types of seizures can occur, for example in the form of convulsions, or attacks of staring with impaired consciousness. These attacks can be controlled with appropriate anti-epileptic medication. Children with a convulsion or seizure will require a special test called an EEG (Electro-encephalogram) which is usually conducted in a specialist hospital. Based on the results the doctor will decide on the type of medication, dosage, timing of medication and duration of treatment. Like other drugs, these medications also have side effects. As a parent you must ask your doctor about the benefits and side effects of medication being prescribed.

Associated (or co-existing) psychiatric disorders: Individuals with Autism sometimes have symptoms of another psychiatric disorder over and above the features of Autism. Common examples of disorder which may co-exist are attention deficit hyperactivity disorder (ADHD), anxiety disorders, obsessive compulsive disorder and tic disorder. These conditions require careful evaluation by a doctor who is experienced in treating Autism. This may include a developmental paediatrician or a psychiatrist. When the symptoms are very persistent, severe and interfere with the activities of the child, appropriate medication may be required to manage these co-existing problems. As with all medications; insist on getting all the information on any medication that your child is prescribed.

Sleep difficulties: In some children, troublesome and persistent disturbances of sleep such as inability to fall asleep, repeated awakening, or sleep rhythm disturbances (for example sleeping in daytime and awake in night) can occur. There are specific medications that can help such children.

Difficult behaviours: Sometimes, children with Autism may have self-injurious behaviours, uncontrolled aggression or excessive stereotypes. Occasionally these behaviours interfere with other interventions that the child is being given. . If these behaviours cannot be addressed by providing predictability or occupational and sensory therapy, judicious and careful use of medication can be considered in such children and youngsters under close monitoring and supervision of a specialist.

Attention deficit hyperactivity disorder: characterized by persistent hyperactivity in many situations, easy distractibility, inability to concentrate on most activities, and impulsivity.

Anxiety disorders: are characterised by excessive, unwanted worrying and fearfulness.

Obsessive compulsive disorder is characterised by repetitive or ritualistic behaviours, such as arranging, cleaning, checking, washing, and excessive insistence on sameness; with the child typically resisting any attempt to change these behaviour.

Tic disorder are characterised by sudden, jerky, brief-lasting, repetitive movements of face (blinking, grimacing, pursing of lips), neck, shoulder, trunk, and making of repetitive sounds (such as clearing ones throat). These are different from the repetitive movements or behaviours that children with Autism may have; however it is often hard to tell these apart and hence should be evaluated by a specialist.
4.2 Alternative interventions
There are a number of interventions and treatments that are being offered to parents of children with Autism. Many do not have good research evidence and some often are very distressing for the child with Autism. Below are listed some therapies which are not commonly accessible but may be available to you as a parent, along with the expert group’s consensus opinion on them.

The website has looked at current worldwide research evidence to understand what may help a child with Autism. The best evidence always compares a group of children who get a treatment against a matching group of children who did not get it. This is called a randomised control trial. There are very few of the following treatments which have had such trials conducted and hence our opinion is moderated by this lack of information.
 
1. Stem Cell Therapy:
This involves taking bone marrow from the child’s hip bone (often a painful procedure), and injecting it back into the blood of the same child. Often this treatment is followed by very intensive therapy at the centre providing the treatment. The International Society for Stem Cell research in it’s ‘Patient Handbook’ has issued the following statement http://www.isscr.org/home/publications/patient-handbook ‘The International Society for Stem Cell Research (ISSCR) is very concerned that stem cell therapies are being sold around the world before they have been proven safe and effective. Stem cell therapies are nearly all new and experimental. In these early stages, they may not work, and there may be downsides.

Make sure you understand what to look out for before considering a stem cell therapy. Remember, most medical discoveries are based on years of research performed at universities and companies. There is a long process that shows first in laboratory studies and then in clinical research that something is safe and will work. Like a new drug, stem cell therapies must be assessed and meet certain standards before receiving approval from national regulatory bodies to be used to treat people.’
References:
  • Charles Arber andMeng Li “Cortical interneurons from human pluripotent stem cells: prospects for neurological and psychiatric disease” Frontiers in Cellular Neuroscience; www.frontiersin.org; March 2013 | Volume 7 | Article 10
  • “China’s stem-cell rules go unheeded” Health ministry’s attempt at regulation has had little effect. 12 APRIL 2012 | VOL 484 | NATURE | 149
  • Diseases”Guo-Li Ming, Oliver Bru ̈stle “Cellular Reprogramming: Recent Advances in Modeling Neurological The Journal of Neuroscience, November 9, 2011 • 31(45):16070 –16075
  • Flora M. Vaccarino, Hanna E. Stevens, ArifKocabas “Induced pluripotent stem cells: a new tool to confront the challenge of neuropsychiatric disorders” Neuropharmacology. 2011 June ; 60(7-8): 1355–1363. doi:10.1016/j.neuropharm.2011.02.021.
  • Flora M. Vaccarino, Alexander Eckehart Urban “The promise of stem cell research for neuropsychiatric disorders” J Child Psychol Psychiatry. 2011 April ; 52(4): 504–516. doi:10.1111/j.1469-7610.2010.02348.x.
  • Philip H Schwartz “The potential of stem cell therapies for neurological diseases”
  • Siniscalco D, Sapone A, Cirillo A, Giordano C, Maione S, Antonucci N. Autism spectrum disorders: is mesenchymal stem cell personalized therapy the future? J Biomed Biotechnol. 2012.
  • Careaga M, Van de Water J, Ashwood P(2010). Immune dysfunction in autism: a pathway to treatment. Neurotherapeutics. 2010 Jul;7(3):283-92.
  • Michael G. Chez* and Natalie Guido-Estrada (2010)Immune Therapy in Autism: Historical Experience and Future Directions with Immunomodulatory Therapy. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics.
  • Ghanizadeh A. c-Kit+ cells transplantation as a new treatment for autism, a novel hypothesis with important research and clinical implication. J Autism DevDisord. 2011 Nov;41(11):1591-2.
  • Ichim TE, Solano F, Glenn E, Morales F, Smith L, Zabrecky G, Riordan NH. Stem cell therapy for autism. J Transl Med. 2007 Jun 27;5:30.
2. HBOT or Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is a medical treatment where in oxygen is delivered under pressure thus increasing the oxygen content in the blood and other affected areas. The whole process is conducted in a HBOT chamber, which may be frightening for some children with Autism. There is no evidence available currently to suggest that HBOT has any positive effects for children with Autism.
References:
  • “Hyperbaric oxygen therapy for treatment of children with autism: a systematic review of randomized trials”. Ahmad Ghanizadeh Ghanizadeh Medical Gas Research 2012, 2:13 http://www.medicalgasresearch.com/content/2/1/13
  • “Using Behavior Analysis to Examine the Outcomes of Unproven Therapies: An Evaluation of Hyperbaric Oxygen Therapy for Children with Autism ”
  • Dorothea C. Lerman, Ph. D., TesaSansbury, Behavior Analysis in Practice, 1(2), 50-58.
  • “The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study ”
  • Daniel A Rossignol, Lanier W Rossignol, S Jill James. BMC Pediatrics 2007, 7:36 doi:10.1186/1471-2431-7-36
  • Research article “Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial ”
  • Daniel A Rossignol, Lanier W Rossignol, Scott Smith. BMC Pediatrics 2009, 9:21 doi:10.1186/1471-2431-9-21
3. Yoga
Yoga's traditional knowledge concerns physiological and psychological processes that change physiological parameters through respiratory manipulation (breathing technique), postures (asanas), and cognitive controls (relaxation and meditation). Improvements in sensory integration, attention, sensory defensiveness, and increased verbal receptivity for commands related to spatial perception are reported in persons with Autism.

A study done by Shanta Radhakrishna (Application of integrated yoga therapy to increase imitation skills in children with ASD- International Journal of Yoga, Jan-Jun, 2010), indicate that yoga can be an effective tool to increase imitation, cognitive skills and social-communicative behaviour in children with Autism. In addition, children exhibited increased skills in eye contact, sitting tolerance, non-verbal communication and receptive skills to verbal commands related to spatial relationship. (See for details: http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2010;volume=3;issue=1;spage=26;epage=30;aulast=Radhakrishna Since this is not an intervention with any side effects; we can recommend it. It is certainly not harmful.
References:
  • “Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders” Susan E. Levy, M.D. and Susan L. Hyman, M.D.
  • Child AdolescPsychiatrClin N Am. 2008 October; 17(4): 803–ix. doi:10.1016/j.chc.2008.06.004.
4. Dietary Therapy
These diets may be highly exclusionary (that is may prevent the child from eating a normal balanced diet) or may target only one kind of specific food group (e.g., stopping wheat and or milk).
5. Dietary supplements
Because some people believe that their is something missing in the child with Autism’s diet they advise additional doses of these missing nutrients (e.g., Vitamin B6, Vitamin B12, Vitamin C, minerals such as iron, zinc or a mixture of such products).There is no evidence that these have any benefits and one must caution that some of these supplements may be dangerous if the child overdoses on them.
References:
  • Paul Whiteley1, Paul Shattock, Ann-Mari Knivsberg“Gluten- and casein-free dietary intervention for autism spectrum conditions”. Frontiers in Human Neuroscience www.frontiersin.org January 2013 | Volume 6 | Article 344 | 1
  • M. Mousain-Bosc, M. Roche, A. Polge. “Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6 II. Pervasive developmental disorder-autism” Magnesium Research 2006; 19 (1): 53-62 ORIGINAL ARTICLE
  • James B Adams, Tapan Audhya, Sharon McDonough-Means.
  • Adams et al “Effect of a vitamin/mineral supplement on children and adults with autism”BMC Pediatrics 2011, 11:111 http://www.biomedcentral.com/1471-2431/11/111
  • Susan E. Levy, M.D. and Susan L. Hyman, M.D.“Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders”
  • Child AdolescPsychiatrClin N Am. 2008 October ; 17(4): 803–ix. doi:10.1016/j.chc.2008.06.004.
  • Nye C, Brice A. Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane Database Syst Rev 2005:CD003497. [PubMed: 16235322]
  • Nye C, Brice A. Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane Database Syst Rev 2002:CD003497. [PubMed: 12519599]
  • Millward C, Ferriter M, Calver SJ, Connell-Jones GG
  • “Gluten- and casein-free diets for autistic spectrum disorder” (Review)
  • Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
  • Williams K, Marraffa C (2012). No evidence yet to support omega-3 fatty acids as a treatment for autism. J Paediatr Child Health. 2012 Jun; 48(6):534-6.
  • James S, Montgomery P, Williams K (2011). Omega-3 fatty acids supplementation for autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2011 Nov 9;(11).
  • Munasinghe SA, Oliff C, Finn J, Wray JA (2010). Digestive enzyme supplementation for autism spectrum disorders: a double-blind randomized controlled trial. J Autism DevDisord. 2010 Sep;40(9):1131-8.
  • http://autism.asu.edu/Docs/2013/Summary_of_Treatments_for_Autism-2013.pdf
  • Summary of dietary, nutritional and medical therapy 2013 version. Arizona State University Autism Research Program)
  • http://www.autismspeaks.org/news/news-item/ian-research-report-special-diets
6. Chelation therapy
Believers in the unproven theory that Autism may be caused by the accumulation of heavy metals, recommend this therapy where very toxic drugs are given to the child. These drugs may cause very severe adverse effects and this treatment is not recommended.
7. Probiotics or gastrointestinal medication
We all have millions of healthy bacteria in our intestine, which protects us from many infections. There is a belief that abnormal bacteria in the gut may result in the symptoms of Autism. Some proponents of this theory suggest giving supplements like yoghurt for children with Autism. There is no evidence to support this treatment, though most medications are harmless.
7. Music therapy
Currently, this is one of the most sought after and harmless treatment options for individuals with Autism. Supporters claim that the music has an effect on all the developmental domains especially improving communication and joint attention and possibly helping motor skills. There are a number of approaches some which are structured and others which are more improvisational
.
8. Animal assisted therapy (AAT)
This involves a structured and supervised therapeutic interaction with animals (e.g. Horse riding, interactions with dogs etc), which are seen as transitional objects for initial bonding for individuals with ASD before generalizing this attachment to people. AAT appears safe (if done under trained supervision) sensible and possibly easy, though there is no evidence that this works to address the core symptoms of Autism.
Centre in India which offers AAT:
Dr. DOG – A Programme for children with Autism
See http://www.autismindia.com/article14.htm

9. Acupuncture

Acupuncture involves the systematic insertion and manipulation of thin needles into the body, to improve health of body/mind by unblocking the flow of “energy” and is a form of traditional Chinese medicine. For ASD, some evidence shows that this treated was tolerated by most patients with few or mild adverse-effects. Some outcomes for this therapy include improvement in attention, receptive language, self-care, language, overall functioning, and communication.

10. Exercise

In children with ASD, exercise may reduce hyperactive and repetitive behaviour through the release of certain chemical in the brain. This therapy seems sensible, cheap, safe, and easy and is therefore acceptable especially for those with repetitive behaviour.

11. Complementary and Alternative medicine (CAM)

Complementary and alternative medicine include a range of therapies that include mind-body therapies, manipulative and body based therapies ( including yoga), energy medicine ( including Pranik healing and acupuncture) or whole body treatments ( Homeopathy and Ayurveda). Although current data is insufficient to make clear suggestions as long as the therapy is not harmful or painful to the child with Autism a parent can be reassured that they are not hurting their child. However parents should be cautioned to utilise only those medication that come from reliable sources. For more on CAM: http:www.nccam.nih.gov

Making a decision

A parent may be confused by the choices being offered. Talking to other parents, developmental paediatricians and special educators may help you to make a decision. However, the website below can also help you make this decision though it is not directed at families of children with Autism.

http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/guidelines-for-using-complementary-and-alternative-methods

For a more you can explore the field of Autism Research the following site is very informative Click here:

http://researchautism.net/pages/autism_treatments_therapies_interventions/

References:

  • Lofthouse, N. HendrenR , Hurt E, Arnold L. E., and Butter E ,A Review of Complementary and Alternative Treatments for Autism Spectrum Disorders Autism Research and Treatment Volume 2012, Article ID 870391
  • SrinivasanS.MandBhat A. N. A review of” music and movement”therapies for children with autism: embodied interventions for multisystem development, Frontiers in Integrative Neuroscience, April 2013, Volume 7, Article 22.
  • AccordinoR.,ComerR.,Heller W.B., Searching for music’s potential: A critical examination of research on music therapy with individuals with autism, Research in Autism Spectrum Disorders 1 (2007) 101–115.
  • Autism Research Institute. Treatment options for mercury/metal toxicity in autism and related developmental disabilities: consensus position paper. San Diego: Autism Research Institute, 2005.
  • Hardy W.M. and LaGasse B.A., Rhythm, movement, and autism: using rhythmic Rehabilitation research as a mode for autism; Frontiers in Integrative Neuroscience, March 2013 ,Volume 7 ,Article 19
  
 
  Autism Spectrum Disorders or ASD is commonly called Autism Neuro- typical: A term used for people who do not have Autism or ASD  
 
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