Parents of children with ASD sought for CAM treatment. (1) The approach in TCM is “holistic” with a philosophical background of balancing “Yin-and-Yang”. The patho-physiological basis aimed to improve “energy” or “body-flow” or “de-Qi”. Depending on the symptoms of ASD, clinical manifestations could be categorized into different TCM syndromes: “Delay in Development; Speech and Language problems; Hearing problems; or Emotion problems”. The sites of the pathological changes had been postulated to be in the ‘brain, heart, spleen, liver and kidney meridian”. In our experience, TCM approach for autism is postulated to be related to lower intelligence due to "Heart-meridian and Kidney-meridian imbalance” resulting in communication problem and “Liver-meridian imbalance” leading to behavioral problem. (2, 10)
Objectives:
We adopted a different approach to assess the efficacy of AC in improving the functional status with organ and meridian concept of TCM model as a fundamental basis to improve behavior, cognition or communicative ability.
Methods: During 1998-2008, we had conducted case study (2) and Randomized control trials (RCT) of using of short 80-12 weeks courses of AC. (3-9).
Results:
Our pilot case studies had demonstrated efficacy of acupuncture for ASD. (2). Our RCT Trials had demonstrated improvement in various modalities including behavior, language, functional status and cortical cerebral metabolism using Positron Emission Tomography. (3-9).
RCT 1- A pilot study with 30 ASD using Tongue Acupuncture had demonstrated improvement in core (language, social communication, cognition) and secondary features (hyperactivity, attention, aggression, temper tantrum, sleep, functional independence).
RCT 2- A single-blind RCT conducted on 50 children using acupuncture versus sham acupuncture in ASD had demonstrated statistically significant improvement in the Treatment as compared to the Control group in self care and cognition domains of the WeeFIM ®.
RCT 3 - RCT using Tongue Acupuncture in ASD with PET scan for clinical correlation was performed on 21 ASD and 9 Controls. The Treatment group had significant improvement on behavior (p=0.0211); language (p=0.0211); functional status (p=0.0011); Clinical Global Impression Scale (p=0.0003); and cortical cerebral metabolism using PET (p=0.0451).
RCT 4- This RCT studied short-term electro-acupuncture for ASD (n=30) versus Sham Electro-acupuncture (SEA) (n=25). There were significant improvement in language comprehension domain of WeeFIM® (p=0.02), self-care caregiver assistant domain of PEDI (p=0.028), and CGI-I (p=0.003) for the EA group.
RCT 5- A RCT was performed to study the sustainability of the acupuncture effect in Treatment (n=18) and Control groups (n=18 and showed that acupuncture could be useful in improving language, social skills, irritability and stereotypy in ASD. The effects could be sustained for at least two months after acupuncture.
Conclusions:
Short courses of AC can improve functional aspects in ASD. Acupuncture could be used as an adjunct therapy for early intervention program. Given the minimal side effects and potential usefulness, acupuncture could be recommended as an adjunctive treatment if available for children with ASD. We had submitted a protocol for Cochrane Review on Acupuncture in ASD. (9) Further research is needed to evaluate the optimal acupuncture protocol for different subtypes of ASD and the mechanism of acupuncture.