CAM therapies for autism questioned by researchers

A significant percentage of children recently diagnosed with autism receive complementary or alternative medicine treatments, some of which could be potentially harmful, writes a research team from the US in a new study.

Researchers from the Children's Hospital of Philadelphia reviewed charts for 284 patients evaluated at the Hospital's Regional Autism Center for autistic spectrum disorder. They found that 90 children, or 32 per cent of the total, were using complementary and alternative medicine, with 25 children (9 per cent of the total) using what was classed as 'a potentially harmful approach'.

"Some of these CAM (complementary and alternative medicine) treatments may alleviate problems associated with autism, such as sleep disorders and gastrointestinal problems, but the treatments are unlikely to resolve core symptoms of the disorder," said Dr Susan Levy, director of the Regional Autism Center at The Children's Hospital of Philadelphia.

She added that although there is no cure for autism, experts conclude that the best way to improve core symptoms involves intensive behavioural and educational methods. But parents of some autistic children may choose to try other sources of treatment in hopes of alleviating symptoms of the condition.

Published in the December issue of the Journal of Developmental and Behavioral Pediatrics, the study divides the non-traditional treatments into four categories. First, there are 'unproven but harmless biological treatments that have no basis in medical theory' (this includes vitamin B6, as well as gastrointestinal medications or antifungal agents). Another group includes 'unproven but harmless treatments with some theoretical basis', such as vitamin C, gluten-free diets or hormones.

A third category includes unproven, potentially harmful treatments (such as chelation, antibiotics, high-dose vitamin A, immunoglobins or withholding immunizations). The final group consists of nonbiological treatments, such as animal therapy.

The researchers caution that the data they found at one clinical location may not reflect figures for the entire population of children with autism.

Dr Levy also found that Latinos were seven times more likely to try one of these approaches. However, the small number of Latinos in the study (nine) may have partially accounted for the disproportionate results, she said.

The researchers also noticed reduced use of CAM among patients with additional diagnoses, including both medical ailments and mental retardation.

Use of 'potentially harmful' CAM was found at significant levels among those who had seen a health-care provider about the diagnosis before coming to the autism center. There was some evidence that patients who had to wait longer for an appointment at the center also were more likely to use riskier alternatives.

"Longer wait times for an appointment and the older average age of those who had seen previous providers may have been associated with greater frustration among the parents of these children, leading to use of complementary and alternative medicine with higher associated risks," said Dr Levy.

She did add however that use of CAM should not be dismissed out of hand, noting that the American Academy of Pediatrics strongly encourages clinicians to discuss such practices in a 'non-accusatory, non-judgmental manner'.