Use of Complementary and Alternative Medicine in Children with Autism and Controls: Associations with Ethnicity, Child Co-Morbid Symptoms and Parental Stress

Background: Families of children with Autism Spectrum Disorder(ASD) frequently engage in the use of complementary and alternative Medicine(CAM). Little information is available about frequency/types of CAM used in an inner city, ethnically diverse population and associations with specific child co-morbid symptoms or parental stress.

Objectives: To examine the use of CAM therapy in a group of families of children with ASD and to assess the relationship of CAM with feeding, gastrointestinal, sleeping and behavioral problems and parent stress.
Methods: Cross sectional study with structured interview in 50 children with ASD and 50 children with other developmental disabilities(DD), matched by age and gender. Interview included: CAM questionnaire, Gastrointestinal (GI) Questionnaire, Child's Sleep Habits Questionnaire, Aberrant Behavior Checklist and Parenting Stress Index. Statistical analysis included chi-square, t test, and Logistic Regression.
Results: To date we have recruited 50 children with ASD and 30 children with other DD, 15% White, 44% Hispanic and 24% African American, mean age 8+/-3 yr. CAM use was reported in 67% of the ASD group including supplements (44%) and gluten-casein free diet (29%). The number of CAM therapies used ranged from 0 to 8. CAM usage was more prevalent in families of children with ASD (67% vs.28% p=0.001) and these families used more types of CAM (2+/-2 vs. 0.3+/-0.6 p<0.001) than families of children with other DD. Children with ASD presented more co-morbid symptoms such as GI (66% vs.40% p=0.04), sleeping (78% vs.33% p<0.001)and behavioral problems (78% vs.33% p<0.001) and their parents reported greater stress (45% vs.20% p=0.03).CAM use was associated with child irritability (73% vs.44% p=0.01), and parental stress (70% vs.40% p=0.04). The association between CAM use and ASD diagnosis persisted after adjusting for child-comorbidities, parental stress and level of maternal education (OR 4.7 95%CI 1.7-13.6). Compared to White mothers, Hispanic mothers used fewer types of CAM therapies (0.7+/-1 vs. 2.9+/-3 p=0.01). No association was observed between CAM use and feeding, GI or sleeping problems.
Conclusions: Families of children with ASD were more likely to utilize CAM than families of children with other DD. Hispanic families used fewer types of CAM therapies. CAM use seems to be related to child irritability and parental stress.