1. Novel and emerging treatments for autism spectrum disorders: a systematic review.

Rossignol DA.




International Child Development Resource Center, Melbourne, FL 32934, USA. rossignolmd@gmail.com



Currently, only one medication (risperidone) is FDA-approved for the treatment of autism spectrum disorders (ASD). Perhaps for this reason, the use of novel, unconventional, and off-label treatments for ASD is common, with up to 74% of children with ASD using these treatments; however, treating physicians are often unaware of this usage.


A systematic literature search of electronic scientific databases was performed to identify studies of novel and emerging treatments for ASD, including nutritional supplements, diets, medications, and nonbiological treatments. A grade of recommendation ("Grade") was then assigned to each treatment using a validated evidence-based guideline as outlined in this review: A: Supported by at least 2 prospective randomized controlled trials (RCTs) or 1 systematic review. B: Supported by at least 1 prospective RCT or 2 nonrandomized controlled trials. C: Supported by at least 1 nonrandomized controlled trial or 2 case series. D: Troublingly inconsistent or inconclusive studies or studies reporting no improvements. Potential adverse effects for each treatment were also reviewed.


Grade A treatments for ASD include melatonin, acetylcholinesterase inhibitors, naltrexone, and music therapy. Grade B treatments include carnitine, tetrahydrobiopterin, vitamin C, alpha-2 adrenergic agonists, hyperbaric oxygen treatment, immunomodulation and anti-inflammatory treatments, oxytocin, and vision therapy. Grade C treatments for ASD include carnosine, multivitamin/mineral complex, piracetam, polyunsaturated fatty acids, vitamin B6/magnesium, elimination diets, chelation, cyproheptadine, famotidine, glutamate antagonists, acupuncture, auditory integration training, massage, and neurofeedback.


The reviewed treatments for ASD are commonly used, and some are supported by prospective RCTs. Promising treatments include melatonin, antioxidants, acetylcholinesterase inhibitors, naltrexone, and music therapy. All of the reviewed treatments are currently considered off-label for ASD (ie, not FDA-approved) and some have adverse effects. Further studies exploring these treatments are needed. Physicians treating children with an ASD should make it standard practice to inquire about each child's possible use of these types of treatments.

PMID: 19917212

[PubMed - indexed for MEDLINE]


2. Outcomes of a pilot training program in a qigong massage intervention for young children with autism.

Silva LM, Ayres R, Schalock M.




Teaching Research Institute, Western Oregon University, PO Box 688, Salem, OR 97308, USA. lmtsilvaqigong@comcast.net


Sensory impairment is a common and significant feature of children on the autism spectrum. In 2005, a qigong massage intervention based on Chinese medicine and delivered by a doctor of Chinese medicine was shown to improve sensory impairment and adaptive behavior in a small controlled study of young children with autism. In 2006, the Qigong Sensory Training (QST) program was developed to train early intervention professionals to provide the QST intervention. This article describes the preliminary evaluation of the QST program as piloted with 15 professionals and 26 children and outcomes testing using standardized tests of sensory impairment and adaptive behavior. Results of outcomes comparing delivery by QST-trained therapists with delivery by a doctor of Chinese medicine showed that both groups improved and that there was no difference in outcome between the two groups. The intervention and training program are described, and implications for future research are discussed.

PMID: 18826014

[PubMed - indexed for MEDLINE]


3. Attention-deficit/hyperactivity disorder and complementary/alternative medicine.

Sawni A.




Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48301, USA. asawni@med.wayne.edu


The use of complementary and alternative medicine (CAM) for treatment of attention-deficit/hyperactivity disorder (ADHD) has increased both by parents and health care providers. Despite scientific evidence supporting the effectiveness of stimulants in the treatment of ADHD, the use of stimulants has received negative publicity and, for many parents, is worrisome. Concerns regarding adverse effects and the prospect of long-term use of pharmacologic treatments make many parents uncomfortable thus they seek "alternative treatments." With the information explosion produced by the Internet, marketing for alternative therapies such as herbal remedies, elimination diets, and food supplements for ADHD has increased. Many people use CAM because they are attracted to the CAM philosophies and health beliefs, dissatisfied with the process or results of conventional treatments, or concerned about adverse effects of stimulants. Although some scientific evidence exists regarding some CAM therapies, for most there are key questions regarding safety and efficacy of these treatments in children. The aim of this article is to provide a general overview and focus on the evidence-based studies of CAM modalities that are commonly used for ADHD.

PMID: 18822835

[PubMed - indexed for MEDLINE]