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CAM common treatment for children with ASD, developmental delay
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Families of children with autism and other developmental delays often use complementary and alternative medicine treatments, according to recent study findings published in the Journal of Developmental and Behavioral Pediatrics.
“Strengthening the evidence base for both conventional and [complementary and alternative medicine] treatments for children with [autism spectrum disorder] and other [developmental delays] is critical, and efforts should be directed toward identifying and supporting successful methods of communicating best practices to the community of families affected by neurodevelopmental disorders,” the researchers wrote.
Robin L. Hansen, MD, of the MIND Institute and department of pediatrics at the University of California, Davis, and colleagues evaluated children aged 2 to 5 years with autism spectrum disorders (ASD; n=453) or developmental delay (n=125) to determine the utilization of conventional treatments and utilization of complementary and alternative medicine (CAM).
Robin L. Hansen
Participants with ASD were slightly more likely to use CAM (39.3%) compared with participants with developmental delay (29.6%), although this did not reach statistical significance. Dietary supplement use was the most common CAM treatment, but was more prevalent in participants with ASD (24.7%) compared with participants with developmental delay (18.4%).
The gluten-free, casein-free diet was more common among the ASD group compared with the developmental delay group (P=.0009).
No participants in the developmental delay group used what the authors characterized as invasive, disproven or potentially unsafe CAM compared with 8.6% of the ASD group.
Families with a parent who had a bachelor’s degree were more likely to use CAM, in general (44.9%). Unsafe, disproven or invasive CAM use was twice as likely in families with a bachelor’s degree.
“We hope our study encourages pediatricians and other providers to ask about CAM use in the context of providing care for children with autism and other developmental disorders, and to take an active role in helping families make decisions about treatment options based on available information related to potential benefits as well as risks,” Hansen told Infectious Diseases in Children. — by Amber Cox
Robin L. Hansen, MD, can be reached at rlhansen@ucdavis.edu.
Disclosure: See study for a full list of researchers’ relevant financial disclosures.
Perspective
Back to TopThomas D. Challman, MD
This study expands on prior research looking at the use of complementary and alternative therapies (CAM) in children with autism spectrum disorders (ASDs). Similar to previous studies looking at this issue, CAM use, including (discouragingly) some potentially harmful interventions, was found to be common among children with ASD and other developmental disorders. A number of CAM therapies are based in erroneous beliefs regarding the etiology of ASD. An interesting finding in this study is that the identification of a neurogenetic disorder did not alter the likelihood of CAM use. However, the investigators do not provide information regarding the usual timing genetic investigations in their population. One wonders whether early recognition of a convincing genetic etiology (soon after significant developmental concerns are suspected) would dissuade caregivers from pursuing some of these unproven, potentially dangerous, or sometimes just plain silly ‘therapies.’
The Internet is always open for business, and there is no waiting list – this is often the first stop for parents at the first hint that their child might have a developmental disorder. Previous research has shown that parents may pursue nonstandard therapies for their children with ASD even before definitive diagnostic evaluation has been completed – suggesting that long waiting lists for developmental assessment could contribute to the problem of unproven or disproven interventions being used in children with ASD. Uncertainty about the cause of ASD, and anxiety about the future, may also increase the likelihood that parents will accept a therapy that has a pseudoscientific basis. Providers who see children with ASD should always inquire about CAM use. Children with developmental disorders will be best served by prompt access to expert diagnostic evaluation, and their caregivers should be given the tools to be able to rationally and scientifically interpret information regarding etiologies and treatments – this is truly family-centered care.
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