BIOMEDICAL INTERVENTIONS

Biomedical intervention for Autism or Asperger’s syndrome consists of a wide range of therapeutic approaches for treating these developmental disorders in children, adolescents, and possibly adults. A major problem for most biomedical interventions is not meeting the criteria as evidence-based treatments due to a lack of rigorous research. This does not necesarily mean biomedical interventions won't help, but caution and personal research are recommended.

Biomidical intervention may be vitamins, probiotic diets, a gluten-free casein-free diet, chelation, medications, the Feingold diet and others.

The case for and against Biomedical intervention

Some parents and medical professionals report improvements in the behavior of autistic children enrolled in restrictive diets, detoxification therapies, and a range of treatments, collectively known as biomedical intervention for Autism. Some of these claims are contested by specialist doctors, who fear that the failure of conventional medicine to address parental concerns, and the meager resources committed to scientific research, has led to Autism and Aspergers syndrome becoming a magnet for quacks and charlatans.

Others believe that without rigorous testing, it is easy to see improvements as a ‘cure’ when they may have been due to the placebo effect, or simply natural development. Others believe these therapies don't actually treat Autism or Asperger's syndrome but rather help with the comorbid conditions often associated with Autism Spectrum Disorders.

There is plenty of anecdotal evidence to support biomedical intervention – some parents who try one or several therapies report some progress, and there are stories of children who have undergone these programs and become seemingly completely neurotypical, able to return to mainstream education. However, this evidence may be confounded by the dramatic improvements often seen in autistic children as they grow up, with or without such interventions. There are calls for double-blind studies regarding various treatment approaches.

Theory behind Biomedical intervention

The premise for biomedical intervention is that certain neurological disorders are caused by environmental shocks that in turn compromise the children's gastrointestinal, immunological and neurological systems. Based on this premise, what is often diagnosed as Autism, Asperger's or other Autism Spectrum Disorders may be a physiological syndrome that can and should be treated as a physiological disorder. This runs contrary to scientific consensus on what is likely to be the cause of Autism and other Autism Spectrum Disorders.

Problems in these three areas are seen to be:

Gastrointestinal

Children with Autism or Asperger’s tend toward constipation or diarrhea and often have abnormal cravings for certain kinds of food

Immunological

Autistic children are prone to allergies, migraines, and react abnormally to infectious diseases

Neurological

Children with Asperger’s or Autism are consistently hypo- or hypersensitive to sensory impressions.

General improvement is claimed in all three systems with a restrictive diet, with regression if the diet is then unrestricted. A major problem with the model is that the above problems do not appear in the Autism diagnostic criteria but are rather comorbid conditions.

This point of view is consistent with wider evidence that diet and nutrition can affect behavior generally, but there is no medical literature evidencing claims that Autism can be fully cured. Some of the most prominent advocates of various therapies have autistic children who manifestly display serious behavioral difficulties.

What is a typical approach to Biomedical intervention?

Biomedical intervention usually starts with a restrictive diet, such as the gluten-free, casein-free diet. Typically, foods will be restricted in a particular sequence, for example by eliminating:
• Dairy products - casein and/or lactose
• Gluten, found in grains such as wheat, barley, rye, oats, spelt, etc.
• Eggs, nuts, and berries that are known provoke allergic reactions in children
• Fruits and vegetables that contain salicylates, phenols, and other reactive substances
• All artificially colored food, i.e., the Feingold Diet
• All bi- and poly-saccharides, such as lactose, fructose, starch, etc. (the Specific Carbohydrate Diet).

Parents report varying success with these diets, and combinations of them. Some have seen major benefits simply from eliminating milk; others need to eliminate salicylates or phenols to reach a tipping point; others have found a workable, effective diet in the Specific Carbohydrate Diet. Many parents report no benefit from a restrictive diet at all.

LEVELS OF PROOF AND POTENTIAL HARM OF BIOMEDICAL INTERVENTIONS

Levy and Hyman (2002) reviewed the safety and effectiveness of non-traditional approaches to the treatment of Autism according to evidence-based criteria, and divided treatment approaches into the following categories:

• unproven benign biological treatments that have some basis in theory
• unproven benign biological treatments that are commonly used but have no basis in theory
• unproven, potentially harmful biological treatments.

Using these categories, biomedical interventions could be categorized as:

Unproven but some basis in theory

• Gluten and casein free diets

• Vitamin C

• Secretin.

Unproven and no basis in theory

• Vitamin B6 and Magnesium

• Gastrointestinal medications

• Antifungal agents.

Unproven and potentially harmful

• Chelation

• Immunoglobulins

• Large doses of Vitamin A

• Antibiotics

• Antiviral agents

• Alkaline salts

• Withholding immunizations.

a brieF introduction to some BIOMEDICAL INTERVENTIONS

Gluten-free diet for autistic children

Dr. Karl Ludwig Reichelt claims to have found peptides from casein and gluten that worsen the symptoms of autistic children, many of whom have digestive disorders. These peptides are casomorphines and gluten exorphins, which influence the brain. The primary proponent of the possible link between digestive disorders and Autism is Dr. Andrew Wakefield, a United Kingdom gastroenterologist who has described the disputed condition as autistic enterocolitis.

According to Dr. Reichelt, significant improvement has been seen in the symptoms of some of his patients with Autism who had been put on a diet that omits these peptides. The diet is called the gluten-free, casein-free diet. Some physicians see diet as a central part of the treatment, but in addition to many other treatments at the same time. See the Casein and gluten-free diet fact sheet for more information.

Medication as an autistic intervention

The benefits of drugs is widely disputed. There are many parents whose children have experienced dramatic improvements in certain behavioral issues or comorbid disorders with correctly prescribed medication. However, while anti-seizure medication is indicated for some children with seizures, many parents are opposed to using psychopharmacology to treat their children. Many autistic people themselves are against the overprescription of neuroleptic drugs in autistic people to control behavior whilst some of those with co-morbid disorders have been relieved to have medication to manage these and some psychiatrists are just now beginning to explore minimal doses of medication for this group. See the Drug therapy fact sheet for more information.

Vitamins and herbs for autistic children

The use of high doses of vitamin B6 with or without magnesium is gaining popularity among parents. Some studies do validate its effectiveness; including some double-blind ones. However, there appear to be some significant risks associated with high doses of vitamin B6, including peripheral neuropathy. Some people argue that vitamin B6 only helps children in the following groups:
• Those with nutritional deficiencies (ie.fussy eaters)
• Those with vitamin B6 deficiency (related to seizures).

The Ayurvedic herb bacopa has been used in several cases of Autism with promising effect according to anecdotal evidence. Bacopa is used medicinally in India for memory enhancement, epilepsy, insomnia, and as a mild sedative. This herb commonly grows in marsh areas throughout India. Some studies have shown that Bacopa has antioxidant effects specific to the cerebral tissue. See the Vitamins & herbs fact sheet for more information.

Detoxification as an Autism therapy

Based on the speculation that heavy metal poisoning may trigger the symptoms of Autism, particularly in small subsets of individuals who cannot excrete toxins effectively, some parents have turned to alternative medicine practitioners who provide detoxification treatments, via chelation therapy, as a treatment method. However, evidence to support this practice has been anecdotal and not rigorously tested.

Furthermore, there is strong epidemiological evidence that refutes links between environmental triggers, in particular thimerosal containing vaccines, and the onset of autistic symptoms. The death of a five-year-old boy in August 2005 has been linked to this practice; however, the isolated case has been attributed to the accidental administration of an incorrect agent. In this instance, the death was due to the administration of disodium EDTA instead of calcium disodium EDTA. See the Detox fact sheet for more information.

Low Salicylate diet

Researchers such as Rosemary Waring (Birmingham University) found a significant proportion of people with Autism were Salicylate-intolerant, meaning they were unable to properly metabolize Salicylates ; a natural plant toxin common in most stone fruits, berries, citrus fruits (with the exception of lemon), some vegetables and very high in honey, yeast extracts and almonds. The low Salicylate diet is commonly known of in ADHD/ADD circles as the Feingold Diet and includes eliminating artificial colorings, flavorings, preservatives and nitrates. Salicylate intolerance has been particularly linked to attentional problems and hyperactivity but more recently to mood and anxiety disturbances. See the Low salicylate diet fact sheet for more information.

Gold salts

Gold salts have recently come into focus as a potential treatment for Autism. Boyd Haley, a University of Kentucky professor and leading proponent of the much disputed mercury-Autism hypothesis (see Have vaccinations caused Autism?), has suggested that gold salts may reverse conditions attributed to mercury administration in the form of thimerosal that was used as a preservative in vaccinations until recently. See the Gold salts fact sheet for more information.

Holistic healing

Evidence exists which may explain why the individual therapies listed above do not necessarily work for all sufferers of Autism. A more comprehensive approach may be required, in which the genetics of each individual Autism sufferer is studied and understood, followed by a personalized therapy schedule which may include diet restrictions, heavy metal detoxification, vitamin supplementation, etc.

Probiotic diet for Autism or Asperger's

Probiotics are dietary supplements containing potentially beneficial bacteria or yeast. The use of probiotic diets for children with Autism has been reported to have improved the concentration and behavior of the study subjects so much that medical trials collapsed because parents refused to accept placebos.

According to the researchers, the effectiveness of the treatment caused some of the parents involved in a blind trial to realize that their children were not taking a placebo. The parents then refused to switch to the placebo as scheduled, resulting in the collapse of the trial. As a result, it was difficult for researchers to draw firm conclusions. Further research is being planned. See the Probiotic diets fact sheet for more information.

Click here for the full range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU Free Documentation. It is derivative of an Autism and Asperger's syndrome-related articles at http://en.wikipedia.org