Summary of autism treatments

Our collaborator at Arizona State University, James Adams, has put together a useful summary and analysis (with references) of the incredibly diverse array of autism treatments out there – including many pharmaceuticals, diets, dietary supplements, chelation, hyperbaric oxygen, etc. This is intended for the lay public.

Another fascinating feature of this PDF is a table showing the results of ratings of all of these treatments obtained from surveys of >27,000 parents of autistic kids. Such results must be taken with a grain of salt because these are not double blind clinical trials but rather the opinions of parents on the benefits and drawbacks of treatments they have tried. Thus, there is the risk of a placebo effect. Nonetheless, there are so many negative ratings on this list that the placebo effect may not be such a big problem – altho it could still be relevant to particular treatments. I reprint this summary table below. Altho it may be too small read all the entries, below the table I’ve picked out some of the points that are of particular interest to me.

I’m struck by the nearly total failure of the plethora of pharmaceuticals; we knew this before, but seeing so many in one table is impressive. One bright spot is the apparent success of two anti-fungals, Diflucan and Nystatin. These were used selectively, where indicated by evidence of infection. In my opinion, this points to the gut microbiota. In this same context, it is surprising to find that antibiotics failed, as I know of two double blind studies that showed positive effects of antibiotics on ASD symptoms, altho the symptoms returned after the antibiotic was discontinued. Maybe the latter finding is the reason for the negative rating. A really impressive finding in this survey is the marked success of a variety of special diets. 8 of these were rated very highly. Similarly, many dietary supplements were rated highly, the best being fatty acids. On the other hand, I was quite surprised to see that both chelation and hyperbaric oxygen treatments were rated highly. The section on the latter treatment summarizes situations in which it can be quite dangerous, and the lack of strong support from double blind studies. The same caveats  apply to chelation.