Alternative Treatment in Autism Spectrum Disorders
Introduction
Autism spectrum disorders (ASD) involve a range of neurodevelopmental and neuropsychiatric disorders, common among them being autism. Both typical and atypical forms of autism are common within the range, typical autism being more common among the affected. Autism spectrum disorders are characterized by a spectrum of behavioral, cognitive, communicative and psychiatric disabilities in the affected individuals. Challenges are majorly faced in the areas of sociability; victims lack the interest to socialize with others. Deficient in language and communication are common in these disorders. Both verbal and non-verbal communications are lacking; inappropriate and unresponsive facial expressions are also observed. Cognitive disability is common to many autistic individuals; recognition becomes difficult for these individuals (Wong et al., 2014). Many of the affected individuals show inability in sensory activities like smelling, burning, sensation of touch. Autism spectrum disorders are characterized by an incredibly wide and varying range of symptoms from individual to individual.
Symptoms
Autistic symptoms appear early in life, onset of symptoms being common during first and second year of birth. Parents often notice unresponsive behaviors from their children while calling their names. Children affected with autism shows no interaction with other children of their age. Delayed responses to communication are observed during this period. Lack of social reciprocity and meaningful gestures are observed in many autistic children. Cognitive impairments account among most of the autistic cases (Truedsson, Bohlin & Wåhlstedt, 2015). Children often show repetitive and lesson like monologues during the initial stages. Medical research has not yet found any specific underlying cause for the development of such disorders.
Predicted factors
Many genetic and environmental factors give rise to autistic features, other factors are also involved. Many risk factors behind the progression of ASD involve genetic, prenatal and perinatal abnormalities, neuroanatomical and environmental factors. Genetic inheritability has been observed in many cases of autism. Prenatal complicacies like gestational diabetes, pregnancies beyond 30 years of age have resulted in autistic development among newborns (Modabbernia, Velthorst & Reichenberg 2017). Research till date has not yet been to identify any single or particular cause of autism. A number of factors together lead to autistic disorders, although research is still inconclusive of this fact. Affected individuals with neurological and behavioral complexities are reported, a heterogenic variation of symptoms associated with these disorders make the development of particular specific treatment highly difficult.
Diagnosis occurs during the initial first year of birth. There are no particular treatments or complete cure for the disorder. Various interventions are developed with the goal of improving behavioral problems and communication inabilities. No generalized or universal approach can provide help due to symptomatic variations among autistic children. Sometimes, autism remains undetected and undiagnosed in earlier tears of life, this results in severe cognitive and behavioral disturbances with anxiety and emotional outbursts in older age which become impossible to provide with curing interventions. Any specialist interventions would have to be individualized approach. These interventions involve intense care and effort, extensive directive approach based on child, extreme patience and energy to attend to the autistic individuals.
Role of parents
Parents of autistic children have a crucial role to play in their cure and long term treatment procedure. Parents are given special education and are involved in special programs on how to attend to their autistic children, how to respond and provide care to these children. Parents form an intense support system for these children beside therapists and specialists (Yingling et al., 2018). Therapists and specialists are common guides to these children in helping them through behavioral, communicative, psychosocial and psychiatric improvements. Continuous medications are also provided on a long term to lessen anxiety, depression and mental impairments. Non-medication interventions are the choice of interest to treat autism spectrum disorders. Medications are also recommended alongside for lifelong purpose to control the behavioral complexities and impairments.
Discussion
Common therapies in treatment
Behavioral therapies and educational therapies are central to treatments of autism. Behavioral therapies are aimed to improve the sociability, communication problems and cognitive impairments. This therapy helps to improve social reciprocity, build up responsive behavior and improve communication skills and language skills (White et al., 2015). Stereotypical patterns of behaviors are targeted for improvement through behavioral therapy. Cognitive therapies help in interpreting and improving the gestures and facial expressions of autistic children. These non-medical therapies are provided for life long purpose, yielding beneficial outcomes, both behaviorally and socially (Wood et al., 2015).
What is CAM
Medical research is still going on to bring about improvements in treatments of autism; alternative non-medical treatment therapies are being proposed, although a lot of controversies surround them. Various new interventions for treatment of autism are now being developed with a focus on alternative therapies for autism management. Management of autism is difficult and involves an extensive patient approach. Parents of autistic children are involved in conventional treatment methods for improving the autistic conditions. Research in recent years have shown that alternative therapies are being in use for medical improvement for many chronic illnesses, even cancer. This beneficial application of Comparative and Alternative Medicine (CAM) has been extended to treatment of autism and its spectrum of disorders. CAM includes non-medical treatment methods like herbal remedies, dietary supplements and exercises (Hendren et al., 2017).
The incidence of Autism Spectrum Disorders has increased through the years, facing a lot of challenges in the medical treatment and management of the disease. Although the behavioral therapy has remained the core strategy of therapy in autism, various CAM interventions are burgeoning due to increased cases of autism reported annually. Comparative and Alternative Medicine (CAM) are non-medical interventions focusing on the symptomatic cause of a disease. These are healing practices to promote health care through self-defined ideas of a health practitioner aiming to improve the well-being and health status of the affected (Höfer, Hoffmann & Bachmann, 2017). CAM practices and interventions are in demand and use, their efficacy in healing process is controversial due to dearth of evidences about the effectiveness of CAM applications.
Necessity for CAM practices
Throughout the years, medications are ongoing in treating and managing autism and its disorders. Drugs are a permanent inclusion in autism treatments. Research through the years have shown that administration of drugs in variation of dosage and in individualized drug therapy have resulted in potential side effects in these autistic children. Parents are worried about these potential side effects on their children. There are evidences that show that the potential side effects upon administration of drugs have resulted in adversity in health conditions in autistic individuals instead of an improvement; in many of the cases aggressiveness, anxiety, depression and various behavioral attributes have shown an increased negative outcome as a consequence of side effects (Heilbrun et al., 2015). CAM practices of healing are widely known and more in demand for a number of chronic ailments, but its role and efficacy in autism and related disorders is quite controversial; therefore a more sound and scientific research methodology is required to know the extent of effectiveness.
Details of CAM practices
CAM practices and interventions include mainly the biological treatment remedies; dietary supplements, vitamin supplements, elimination diets and probiotics, herbal remedies are inclusive. Dietary interventions through elimination diets have been incorporated as a CAM remedy (Owen-Smith et al., 2015). Gluten or casein free diets have been recommended to autistic individuals. This nutritional regime has shown a beneficial impact in autistic individuals who received this diet. Elimination diets have shown popularity in demand as a CAM intervention. Mainly gluten or casein free diet is recommended to these individuals (Brondino et al., 2015). Gluten often acts a food allergen for many cases of autistic children, as a result this elimination diet has been administered with the fundamental of preventing any autoimmune triggers in these individuals that may arise as a result of gluten intake. Autistic individuals are often characterized with gastrointestinal abnormalities and bacterial infections; gluten free diet serves as a remedy to improve the condition and eliminate the bacterial infections (Ghalichi et al., 2016). Metabolic impairments have been observed among autism disorders; gut abnormalities associated with abundant microbial colonization have resulted in complexities among autistic individuals. Therefore they suffer from impaired bowel syndrome, dyspepsia, diarrhea, vomiting episodes. This has been intervened through the use of probiotics in recent years. Probiotics, administration of live microorganisms to alter the micro biome in autistic children have shown a promising effect in autism, thereby improving the gastrointestinal abnormalities (Shaaban et al., 2018). Animal studies have been performed with probiotic administration in rat infants to show their efficacy in controlling the gut abnormalities. Administration of Lactobacillus with human milk as a probiotic has shown promising outcome for rat infants in the study (Navarro, Liu & Rhoads, 2016). Elimination diets and probiotic treatments have been successful, as evidenced from data on animal studies. Gastro-related abnormalities often cause behavioral abnormalities and deficient social reciprocity in the autistic individuals. Therefore probiotics and elimination dietary regimes would provide positive impact in treatment with a more prospective study design and approach.
Adverse side effects of drugs have necessitated the parents of autistic children to look for more secure methods of treatment. Herbal remedies have been implemented as a CAM practice in treatment of autism. Acupuncture, massage therapy and music therapy have been included in treatment of autism as a method of alternative therapies. Integrative therapies also work wonders in developmental improvement of autistic individuals. Acupuncture has shown an improved trend in cases of autism; as a result it has been incorporated as an alternative non-medical treatment. It has shown improvement in both behavioral and developmental attributes in autistic children (Yang et al., 2015). Herbal healing practices have shown a decreased pattern of anxiety and aggressiveness, promoting soothing of the nerves (Bang et al., 2017). Chinese herbal medicines have been included as a part of treatment, which has shown improvement in memory enhancement, immune response and gastrointestinal abnormalities.
Another dietary supplementation has shown considerable positive impact in cognitive behavior and communication. Omega-3 is an essential fatty acid which has immense benefits in improving brain connectivity and neurological features. Clinical studies have been performed with supplementation of omega-3 fatty acid to autistic individuals at initial ages of life (Boone et al., 2017). This dietary supplementation regime has been continued on a regular basis with 1 gram of omega-3 fatty acid administered since first year of diagnosis. Omega-3 administration has shown a significant improvement in the communication and language coherence development (Posar & Visconti, 2016). This supplemental diet has improved both verbal and non-verbal communication, increased social interactions, improved cognitive functioning; behavioral anomalies and personal autonomy were noticeably improved.
Methyl B12 and vitamin supplements have also been included within the alternative e interventions for autism. Limited studies have been performed which h showed tolerable data and beneficial outcome for methyl B12 treatment. It is required in frequent injections for the patient, as a result this limited its use although it showed beneficial results. Vitamins have shown to reduce gastrointestinal anomalies commonly observed among autistic individuals (Mazahery et al., 2018). Efficacy of this vitamin supplementation strategy need to be determined through an extensive study and analysis.
CAM: A better treatment for ASD
Drug administration has resulted in side-effects, posing potential health adversities on the autistic individuals. On the contrary, parents who have switched to alternative non-medical therapies from medications have undergone satisfaction to a considerable extent. All the alternative therapies that have been involved in treating autism and related disorders till date, have shown a slow progress in improvement of the neurodevelopmental attributes. Though this treatment does not have a pronounced impact, however, no negative impact or side-effects have been found as a result of alternative healing interventions.
Comparative and Alternative Medicine (CAM) is primarily an integrated therapy aimed to benefit the autistic children who are already undergoing medications. Traditional methods of treatment like cognitive and behavioral therapies and administration of drugs like risperidone and aripiprazole are commonly recommended to parents of autistic individuals, however, their increasing evidences of potential risk factors and adversities in health conditions are a cause of worry for these parents who are always seeking secure treatments for their children. These drugs often work differently for other autistic children, thereby bringing no positive results in many. These alternative therapies have shown beneficial outcomes as evidenced by researches. Clinical trials have been performed on rats which show a moderate yielding health benefit as a treatment method. These are safe interventions and can be changed according to the individual autistic pathology (Hollander & Uzunova, 2017). All the researches till date, have been performed on a limited number of autistic patients; few parents have been involved in the studies related to the CAM so far. Alternative interventions have shown noticeable positive outcomes, however, controversies still emerge about their efficacy in curing autism. Autism along with its heterogeneous disorders cannot be completely cured, the conditions can be improved through conventional treatments, medications and alternative therapies (Levy & Hyman, 2015). These alternative interventions are not meant to replace or eliminate the conventional methods of treatment, rather they are designed to complement the traditional methods of treatment. CAM therapies along with medications can reduce the abnormalities in autism, leaving no side-effects (Atkins et al., 2014). Considerable research is required to determine the efficacy of these alternative or integrative therapies in autism. Prior evidences of CAM interventions are based on a randomized approach. Few study subjects were involved to confirm the evidences. Many parents did not respond after the CAM therapies. More rigorous studies are required to be performed with a properly designed approach. A larger pool of autistic patients need to be treated with alternative methods of treatment and assessed to get a quantitative data. Few evidences that are available on the benefits of CAM are all qualitative data; confirmation cannot be based on qualitative data performed on a small sample size (Hopf, Madren & Santianni, 2016). The paucity of considerable quantitative data is a limitation to the understanding of considerable positive impact of integrative therapies. Time and considerable effort with funding approaches are required to perform a systemic study on the efficacy of comparative and alternative treatments. These alternative or integrative therapies need not be generalized, it should be designed and implemented according to the individual autistic patient, as one alternative treatment beneficial for one autistic child may not have an impact on the other child. Extensive patience and collaborative effort should be involved in designing such healing interventions. Placebo clinical trials have been performed, which are randomized samples with no statistical significance of the data on efficacy.
Recommendations
Autism and its related disorders demands treatments with considerable benefits on the conditions associated with the neural disturbance. Since beneficial impacts have resulted in few of the autism reported cases through Comparative and Alternative Medicine, research should focus more on this treatment method with the inclusion of both qualitative and quantitative data on the efficacy of these treatments. Greater amount of statistical data needs to be addressed for suggesting these alternative therapies to the parents of autistic individuals. Dietary interventions should be recommended as they target the metabolic functioning impaired in autistic individuals, dietary supplements can in turn positively impact the autistic children in improving their bowel disorders and associated gut anomalies. Omega-3 fatty acid should be incorporated as a dietary component during initial stages after birth; omega-3 deficit has been attributed to the progression of autistic behavior. Elimination diets also should be a recommended intervention to improve the gastrointestinal abnormalities due to micro biome diversity. Probiotic incorporation, herbal remedies and acupuncture should be given a primary concern as they have yielded significant benefits in alleviating the gut related anomalies and improving the condition. As a result, treatment should focus more on alternative therapies compared to conventional methods in order to achieve maximum improvement since autism cannot be completely cured.
Conclusion
Autism with heterogeneous neurodevelopmental disorders cannot be cured completely, the anomalies of the developmental and behavioral patterns can be improved through traditional and alternative treatment methods. Since the conventional treatment methods with administration of drugs pose potential risks and adversities in health status of the autistic individuals, parents are more worried and they look for more secure methods of treatment programs for their children. This has necessitated medical research in discovering and implementing alternative non-medical treatment approaches to improve the autistic conditions. Comparative and alternative medicine (CAM) are now the ‘hotspot’ of treatment for autism spectrum disorders. More reliance should be given on the alternative therapies for improving autistic conditions, since they target the physiological and brain abnormalities mostly common to autism without yielding any side-effects and risk factors. It can therefore be concluded that, rigorous research is required to evaluate the efficacy of alternative treatment interventions in autism and its spectrum of disorders in order to prescribe it to parents of autistic individuals. The better way to improve autism is to include alternative treatment methods other than drugs causing multi side-effects. It is conclusive of the previous evidences till date that, reliance on the alternative integrative medicines beside conventional approaches would be highly recommended and beneficial to autistic individuals, provided better methodological approaches are taken to develop such treatments.
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