Medical and Biomedical Approaches

Medications

While there are no drugs that can correct the underlying neurological problems in ASDs, drugs used for other conditions are sometimes used to treat autism symptoms or behaviours associated with autism. Medicines can relieve some symptoms and may be helpful for some people.

Severe hyperactivity, impulsivity, attention difficulties and anxiety may be reduced with anti-depressant medications or stimulant drugs used to treat ADD and other disorders, allowing the person with autism to benefit more from his/her educational and behavioural treatments. Anti-psychotic medications are sometimes used in extreme behavioural situations. Seizures will usually be treated with anti-convulsant medications.

There are widely differing opinions among researchers and experts regarding benefits and potential for harm when anti-depressants, anti-psychotic drugs and stimulant drugs are used for children with autism.

All medications should be prescribed by and discussed in detail with a doctor who treats autism. People with autism often have very sensitive nervous systems and normally recommended dosages may need to be adjusted. When new drugs are being discussed or prescribed, ask about the safety of use in children with ASDs, appropriate dosage, how it is administered (pills, liquid), and any long-term consequences, side effects or monitoring needed. Sometimes there are laboratory tests required before starting the drug and during treatment. Also ask about any possible interactions with other drugs, vitamins or foods.

Further reading:

The National Institute of Mental Health: Has established a network of Research Units on Pediatric Psychopharmacology (RUPPs) that combine expertise in psychopharmacology and psychiatry.

The Autism Research Institute (ARI): Has collected data from parents about their experiences with psychiatric medications and other treatments. The results of this ongoing collection of parent survey data is available at this web site.

Autism Collaboration: Site contains information on medications including an overview paper for parents of young autistic children based on the research and personal experience, of four different authors. The authors differ in their opinions on the role psychoactive drugs should play.

Drug3K - Prescription Drug Information for Consumers: An online drug encyclopedia.

Safe Use Project: Building Awareness of Safe Use of Medicines Among Family Caregivers of Seniors and Chronically Ill Children: The Canadian Association for Community Care, the Canadian Pharmacists Association, and VON Canada project aims to promote awareness about the safe use of medicines and the prevention of medication misuse.

MedTV.

Biomedical Approaches

Dietary Therapies and Interventions

People with autism frequently have medical issues that are unusual and sometimes challenging to treat. Intestinal disorders and chronic gastrointestinal inflammation are common with autism and studies have suggested that these problems may reduce the body's ability to absorb certain essential nutrients. In addition, some believe that the majority of autistic children have skewed immune responses, causing them to react differently to viruses, toxins or certain foods. Dietary and alternative medicine approaches attempt to address these issues to improve abilities and general health.

Many parents and an increasing number of doctors are reporting improvement in children with autism with the use of various nutritional supplements and changes in diet. Over the past decade, there have been suggestions that adding essential vitamins such as B6 and B12 and removing gluten and casein from a child's diet may improve digestion, speech production, allergies and behaviour. Experts and researchers disagree about whether these dietary therapies really work or if they are scientifically valid.

Supplements

Consult with your doctor and preferably a nutritional specialist before making changes to your child's diet. Vitamin and mineral levels can be measured through a blood test. Large doses of some vitamins and minerals are not necessarily harmful but others can be toxic. If vitamin and mineral supplements are recommended, they should be phased in slowly over several weeks. Depending on the supplement, it may take up to two months for any effects to be observed.

Secretin: is a substance approved by the Food and Drug Administration (FDA) for a single dose normally given to aid in diagnosis of a gastrointestinal problem. Anecdotal reports have shown improvement in autism symptoms, including sleep patterns, eye contact, language skills, and alertness. Clinical trials conducted in the last few years have found no significant improvements with secretin.
B Vitamins: The B vitamins are frequently used in autism treatment. Vitamin B plays an important role in creating enzymes needed by the brain. Many studies have shown that the use of vitamin B6 with magnesium (which is needed to make vitamin B effective) decreases behavioural problems, improves eye contact and attention span, and improves learning ability.
Di-methylglycine (DMG): Recently, there have been reports about the benefits of Di-methylglycine (DMG) as a nutritional supplement. DMG may help in general well-being and in improving communication skills.
Other Supplements: There are some studies showing that cod liver oil supplements which are high in vitamins A and D have resulted in improved eye contact and behaviour of children with autism. Vitamin C helps in brain function and may reduce depression and confusion if there is a Vitamin C deficiency. Increasing Vitamin C has been shown in a clinical trial to lessen symptom severity in children with autism.

Removal of Gluten and Casein from the Diet: The GFCF Diet

Seek Professional Advice If you intend to try a gluten and casein-free diet for yourself or your child, you should consult with your doctor or a nutritionist or dietician who can help ensure proper nutrition. Gluten and casein food products must be eliminated slowly from the diet as there can be withdrawal symptoms.

Research suggests that digesting certain proteins may be a problem for some people with autism. Gluten is a protein found in wheat, barley, oats and rye. Casein is a protein found in human and cow's milk and in other dairy products. Gluten and casein are also found in many medications and caregivers may want to check with their pharmacy regarding the content of medications.
Higher-than-normal levels of certain peptides have been found in the urine of children with autism, suggesting an incomplete breakdown of these proteins into amino acids. Over-absorption of peptides is thought to affect brain function. Removal of these proteins from the diet is thought to be the only way to prevent further neurological and gastrointestinal damage.

The effectiveness of this dietary intervention has yet to be been demonstrated in research studies. That said, many families report that elimination of gluten and casein in the diet has helped with regulation of bowel habits, improved sleep, resulted in better activity levels, reduced repetitive behaviors and helped in their child’s overall progress.

Further reading:

Autism Research Institute: Biomedical and other information available in several languages including Chinese, Arabic, and Japanese.

The Kid-Friendly ADHD & Autism Cookbook, Updated and Revised: The Ultimate Guide to the Gluten-Free, Casein-Free Diet, Pamela Compart, M.D., Dana Laake, R.D.H., M.S., L.D.N., Fair Winds Publishers, 2009.

No Wheat No Way: Gluten-Free Recipes You've Been Waiting For, Theresa Santandrea-Cull [Book].

Fondation Québécoise de la Maladie Coeliaque: French-Canadian website with information on Celiac disease.

Gluten Free-Casein Free Support Group: Support Group Website on the Gluten free-Casein free diet with information on use for ASD.

Yeast-free Diet

There is a theory that some people with autism have excessive levels of a type of yeast called 'candida albicans' in their intestinal tract. Overgrowth of yeast can cause a "leaky gut" where tiny holes appear in the intestinal tract. The yeast grows rapidly, releasing toxins in the blood which may affect the functioning of the brain. Some believe that this may contribute to behavioural difficulties, causing confusion, stomach problems, fatigue and hyperactivity.

Excessive candida albicans can be treated with medications such as Nystatin or by following a yeast-free diet. There are also non-drug anti-fungals that may have fewer side-effects, such as oil of oregano, grapefruit seed extract, Caprylic Acid, Monolauren, and others. Again all supplements should be approached carefully with the advice of a nutritionist. Over-use of anti-fungals can lead to fungal resistance.

The DAN! Protocol

A project of the Autism Research Institute, the DAN Protocol was developed as an alternative medical approach to the diagnosis and treatment of autism to be used by physicians as a guide for the clinical assessment of autistic patients, leading to appropriate treatment. DAN parents and physicians do not see psychotropic drugs as the best or only means of treating autistic patients.
The DAN Protocol involves a medically supervised combination of changes to the diet and implementation of vitamin and supplement therapy as a means of producing changes in autistic behaviors. These changes include a gluten and casein free diet, elimination of junk foods and other food products that contain refined sugars, and the addition to the diet of a number of dietary supplements such as Calcium, Magnesium, Vitamin C, Vitamin B5: (Pantothenic Acid) Vitamin B6: DMG: Pycnogenol and Gaba.
Treatments to detoxify the body are also a part of the Dan Protocol including Heavy Metal Chelation Therapy (used to remove toxins such as mercury).
Methyl-B12 shots are also used to improve symptoms of autism.

The Body Ecology Diet (BED)

BED was developed by Donna Gates to address the issue of systemic fungal infections, most notably of candida albicans. She extracted the principles from a number of established ecological diets along with principles from both Western and Eastern medicine, and combined them to form the BED. The BED has been used to improve symptoms of ulcerative colitis, Crohn's disease, various autoimmune diseases, and immune system issues including AIDS. It has also been used experimentally in the autism community. Besides having no gluten or casein, it is also free of sugar and bad fats. The diet is based on: