Use of Complementary and Alternative Medicine (CAM) in Children with Autism Spectrum Disorders (ASD): An Autism Treatment Network (ATN) Study

Background:

Complementary and alternative medicine (CAM) treatments are becoming widely used as an adjunct to conventional medical treatment for many conditions.  CAM treatments are often recommended by several ASD advocacy organizations as potential components of an overall treatment plan and families of children with ASD may be exposed to CAM treatments through various media outlets. 

Objectives:

The objective of this study is to determine the frequency of CAM treatments in a large ASD registry, and identify factors associated with the use of CAM treatments.

Methods:

Children and adolescents with a diagnosis of ASD (autism, Asperger disorder, or PDD-NOS) confirmed by ADOS, age 2 – 18 years were enrolled into the Autism Treatment Network (ATN) Registry which collects data on children with ASD at 14 sites across the US and Canada.  Upon entry into the registry, parents completed a medical history questionnaire including use of CAM treatments, GI symptom inventory, Child Sleep Health Questionnaire (CSHQ), and demographic data.

Results: 201 (17%) of 1,212 children were on special diets.  Of the 201 children, 53% were on a casein free diet, 53% were on an “other diet”.  19% of children diagnosed with Autism, 7% of children diagnosed with Asperger’s, and 14% of children diagnosed with PDD/NOS were on a special diet (P = 0.004 on chi-squared test.)We examined the relationship between GI and sleep problems and special diet use. Using a p-value of 0.001 as evidence of an association (Bonferroni adjusted for multiple looks) children with GI problems were more likely to be on any special diet and specifically were more likely to be on casein free/gluten free, no processed sugars, and “other” diets. No significant association was found for sleep problems. Approximately 21% of children received one or more complementary alternative treatments.  22% of children diagnosed with Autism, 20% of children diagnosed with Asperger’s, and 19% of children diagnosed with PDD/NOS received one or more CAM treatments. The most common treatment across the three diagnoses was taking other types of vitamins. 12% of children are taking 2 or more CAM treatments. Children with GI problems were more likely to be on any CAM treatment and specifically were more likely to have been treated with digestive enzymes, other vitamins or probiotics.  Chelation was used by 4% and hyperbaric oxygen treatment by 3% of those reporting CAM use, each accounting for less than 1% of all children in the ATN registry.

Conclusions:

CAM treatments for children with ASD are common. Children with autism were more likely to be receiving special diets than children with Asperger’s or PDD-NOS.  Children with GI symptoms were more likely to be receiving CAM treatments in the form of special diets, digestive enzymes, other vitamins or probiotics.  Health care providers should be aware of CAM use in patients with ASD and help families monitor their child’s response to these treatments.