Source: VeryWell Health by Lisa Jo Rudy (Medically reviewed by Jonathan B. Jassey, DO)
Because there is no medical cure for autism, many complementary and alternative (CAM) treatments have been developed to treat its symptoms. Most of these treatments are low risk and have the potential to be helpful. Some, however, carry a level of risk—and still, others are known to be dangerous. According to some sources, well over half of children with autism receive some form of complementary or alternative treatment.
It can be difficult to make a smart decision about which alternative treatments to try because every individual with autism is different. The treatment that may be useful for one individual may actually increase symptoms in another individual. Before starting any alternative or complementary therapy, it’s wise to consult a physician to be sure the therapy is safe and has the potential to be helpful. It’s also very important to set goals and record outcomes to avoid the possibility of seeing improvement as a result of wishful thinking (the placebo effect).
Complementary and Alternative Treatment in Autism
Complementary and alternative treatments are defined in contrast to typical or mainstream treatments. In autism, there are only a few mainstream treatments available; they include:
• Behavioral therapy (ABA)
• Drugs such as risperidone and aripiprazole to relieve behavioral and/or anxiety issues (as well as more standard anti-anxiety medications)
• Speech, occupational, and physical therapy to help build communication and motor skills
While all of these treatments can be helpful, none can cure autism—and the reality is that the available drugs can have significant side effects. Meanwhile, therapists, doctors, and researchers have developed and/or recommend a very wide range of other medications and therapies that can (in some cases) be very helpful for symptoms related to autism such as sleeplessness, anxiety, gastrointestinal (GI) issues, aggression, lack of social skills, lack of speech skills, sensory challenges, emotional dysregulation, and learning disabilities. Available alternative and complementary treatments include but are not limited to:
• Food supplements
• Specialized diets
• Animal-assisted therapy
• Arts therapies
• Developmental therapies
• Alternative medical therapies such as hyperbaric oxygen and chelation
• Mind-body therapies such as yoga and biofeedback
• Non-medical alternative therapies such as craniosacral manipulation, acupuncture, homeopathy, chiropractic, and massage therapy
• Sensory therapies such as “sensory diets” and weighted vests
Most Often-Recommended CAM Options
When asked to recommend non-mainstream options for treating autism symptoms, physicians tend toward caution. In general, the most-recommended options are for specific symptoms such as sleeplessness or anxiety, and they tend to be the same options that are recommended for anyone with these issues.2 Specifically, they include:
• Melatonin, a hormone made by the pineal gland, which is known to be helpful for treating insomnia
• RDA/RDi multivitamin/mineral, a general vitamin supplement to ensure proper nutrition for autistic children who are picky eaters
• Massage therapy, a well-established and risk-free alternative to reduce anxiety and stress
In addition to these conservative recommendations, some doctors and therapists also recommend:
• Fish oil supplements (omega 3 fatty acids) for hyperactivity
• Vitamin B12 (for behavioral issues)
• Probiotics for gastrointestinal issues
These treatments may or may not be particularly effective for any given individual; there have been only a few studies exploring their efficacy, and all of the studies are quite small. Results are inconclusive. The reality, however, is that they could be helpful, are unlikely to do any harm, and are not terribly expensive.
Popular Low-Risk CAM Treatments
While the list of therapies that come highly recommended by doctors is short, the list of popular treatments is very long. Many such treatments are low-risk, though quite a few are pricey. In some cases, it’s possible for parents to learn to provide alternative therapies on their own.
Eastern and Holistic Therapies
Most hospitals and clinics now recommend a range of complementary options for any patient with issues related to anxiety, stress, and/or sleeplessness. These are readily available in most communities, though they are not usually covered by insurance. Some of the more popular options for both children and adults with autism include:
• Mindfulness meditation
• Craniosacral manipulation
Depending on the individual, many of these approaches can help to relieve anxiety or provide an important tool for self-calming. They are not, however, likely to have any impact on the “core” symptoms of autism which include challenges with social communication, abstract thinking, sensory and emotional regulation.
Special diets for autism have been popular for many years. This is the case despite the lack of compelling research surrounding nutrition and autism. According to the Interactive Autism Network (IAN), these diets include:
• Casein-free diet (casein is a protein found in milk; this diet eliminates milk and all by-products of milk)
• Gluten-free diet (gluten is a protein found in many grains; this diet eliminates such grains)
• Feingold diet (eliminates additives and chemicals)
• Specific carbohydrate diet (removes specific carbohydrates including all grains, lactose, and sucrose)
• Yeast-free diet (eliminates yeast and sugar)
While there is little solid research that suggests special diets are useful for people with autism in general, there are many cases of behavior improving as a result of dietary change. While some of these reports may be the result of wishful thinking, it is certainly the case that children with autism have a higher than usual rate of gastrointestinal problems. For children with sensitivities to gluten, casein, or other allergenic foods, a change in diet can relieve physical symptoms—thus paving the way to improved attention and behavior.
In 2013, the criteria for autism spectrum disorder changed to include sensory challenges—over- and under-responsiveness to lights, sound, touch, etc. Sensory challenges can be a major problem for children who must cope with the sensory stimulation associated with public school. With this change, more interest was paid to sensory integration therapy, an outgrowth of occupational therapy. Sensory therapies can include the use of weighted vests, sensory “diets” which include brushing and joint compression, as well as sessions with a licensed therapist.
Supplements and Natural Remedies
There is also a range of autism-specific and general food supplements that are often used to treat autism. Outside of a regular multivitamin (as is generally recommended by doctors), the most popular include vitamins A, C, B6, zinc, and folic acid.
The reality is that many children with autism are very picky eaters who may not get a full range of necessary nutrients. Thus, it does make sense to provide a multivitamin. There are few studies, however, that support the idea that (outside of the recommended supplements) additional large doses of supplements are likely to be helpful. In fact, overdoses of specific vitamins can be harmful.
One supplement that has become increasingly popular is CBD oil and edibles. CBD, a derivative of marijuana, does show some promise for treating anxiety and aggression in autism. Homeopathic and Chinese traditional remedies are also popular.
Developmental, Arts, and Animal Assisted Therapies
Non-behavioral therapies can be considered complementary or alternative treatment only insofar as they are not often provided by schools or paid for by insurance companies. They are risk-free, have been shown to have emotional and behavioral benefits, and can actually open doors to a wide range of interests and social opportunities.5 Just a few such therapies include:
• Hippotherapy (therapeutic horseback riding)
• Emotional support animals
• Play therapy (therapeutic play that teaches social skills, builds symbolic thinking skills, increases communication, etc.)
• Arts therapy (music, dance, visual art, or drama can all be helpful)
• Recreational therapy (therapeutic participation in community-based sports and recreation)
• Social skills therapy (therapeutic groups focused specifically on building skills for conversation and social interaction)
In addition to these therapies which are available for people with many different physical, developmental, and emotional challenges, there is also a range of therapies developed specifically for children with autism. A sampling of these include:
• Floortime (developmental play therapy intended to build skills in communication, empathy, emotional connection, and symbolic thinking)
• Early Start Denver Model Therapy (intelligence, autism symptoms, language, and daily living skills)
• Relationship development intervention (flexible thinking, social connection)
High-Risk CAM Treatments
Since the 1960s, researchers have been experimenting with a range of “biomedical” interventions for autism. Some, listed above, involve changes in diet or the use of food supplements. In general, if implemented with a doctor’s supervision, such interventions are low-risk and can be helpful.
Others, however, involve the use of risky chemicals and/or procedures; these techniques have the potential to be physically harmful,6 and many are based on now-debunked theories about the causes of autism. In particular, many of these treatments are based on the theory that autism is caused by particular vaccines or by “toxins” such as environmental chemicals. In order to cure children of autism, these techniques are intended to “detoxify” the child’s body.
Some of the riskier biomedical interventions available include:
• Chelation—removal of all heavy metals from the body to undo the presumed harm done by vaccines with trace levels of a lead-based additive
• Hyperbaric oxygen treatment—treatment in a hyperbaric oxygen chamber to reduce presumed inflammation
• Antifungal agents—to reduce presumed Candida overgrowth
• Miracle/Master Mineral Solution (MMS—a bleach-based “treatment” intended to detoxify the body
• Antibiotics—administered to reduce presumed underlying illness
Research into these treatments has shown that they are not only not helpful, but have the potential to be painful and even dangerous. Anecdotal evidence, however, keeps parents hopeful that these extreme measures may make the difference for their child.
A Word From Verywell
Complementary and alternative treatments have an important place in managing autism, though neither they nor any mainstream treatment is likely to lead to a cure. When selecting treatments, however, it is important to ask these questions:
• What is the hoped-for positive outcome?
• Are there risks associated with the treatment?
• What do researchers and other trusted sources say about the treatment?
• Can I afford the treatment if it is not paid for by schools or insurance?
Once you select an alternative treatment, it is important to make observations of your child’s present level of behavior or functioning in order to compare it to potential positive outcomes. Without a yardstick, it can be impossible to accurately gauge whether a treatment is making a difference.