Physiological Interventions

Buy this book »

Medication Treatment

Treating the behaviors associated with autism spectrum disorders with drugs or medication has been occurring since individuals were placed in the care of the medical community in hospitals and institutions. Only those professionals who are trained with medical degrees, such as an M.D. or a psychiatrist, can prescribe medication.

“Unfortunately, little progress has been made over the past few decades in developing new and effective pharmacotherapies for autism” (Buitelaar & Willemsen-Swinkels, 2000, p. 93). Drugs that have been developed to treat other psychological (schizophrenia, depression) and behavioral (attention deficit disorder) symptoms have been used with individuals with ASD as a means of managing attention, arousal, aggression, and self-injury. An Internet survey of 552 parents of children with autism revealed that 52% reported that their child was currently using medication (Green, et al., 2006). Survey respondents of 195 parents with 2- to 8-year-olds involved in early intervention in Indiana revealed that 27.7% indicated involvement in medical treatment (Hume, Bellini, & Pratt, 2005).

Information on the drugs reported used with their children with ASD from 25,500 parents has been collected since 1967 by the Autism Research Institute (ARI), founded by Bernard Rimland. Parents volunteer the information about the prescriptions used, and their opinions about the effectiveness (Pangborn & Baker, 2005). It is clear from the placebo studies described in this chapter that parents are more likely to report positive effects even if they are not demonstrated by research.

Table was modified to include only drug interventions (Adams, 2007). The variety of drugs used is notable. The highest number of cases reported used Benadryl, with only 25% of parents indicating that there was an improvement. It is notable that the drugs used where parents have reported that their child got better for greater than 50% of the time were those used to control seizures.

The use of secretin, one of the hormones that controls and regulates digestion (Coleman, 2005), has been used to address the symptoms of ASD. An anecdotal report of a child with autism who improved after a single dose of secretin led to inflated claims by the media and resulted in many families asking for secretin injections (Buitelaar & Willemsen-Swinkels, 2000). Although this treatment has been reported to cause transient changes in speech and behavior, “overall it produced few clinically significant meaningful changes” (Coleman, p. 183). 

Sandler and Bodfish (2000) conducted a placebo-controlled study and found no difference between a placebo and a single dose of secretin. They reported an interesting finding that 75% of the parents continued to believe in the benefits of secretin even after being informed about the study results. In spite of this outcome, the researchers stated that we should strive to practice evidence-based medicine (Sandler & Bodfish). In their review of 17 quantitative studies, 13 of which that were randomized, double blind, placebo controlled, Esch and Carr (2004) report that only one study found any evidence of a causal relationship between secretin and changes in the symptoms of the 600 participating individuals with autism spectrum disorders. These authors discuss that the reasons why parents would elect secretin treatment may include stress due to the pervasiveness of their child’ s symptoms, a high degree of motivation to try any promising treatment, and hope for a drug made from a substance naturally found in the human body that may seem safe (Esch & Carr).

Diets

Parent surveys have revealed that 50% of the 121 parents who had children in applied behavior analytic treatment programs also tried elimination diets (Smith & Antolovich, 2000), and 27% of the 552 parents surveyed through the Internet indicated implementing a special diet (Green et al., 2006). It is advised that any special diet be supervised by a physician with knowledge about nutrition and the side effects of eliminating foods from the diet (Pangborn & Baker, 2005). There is a theory that some individuals with autism spectrum disorders have a “leaky gut,” in which proteins typically digested are passed through the stomach and travel to parts of the body, including the brain, resulting in discomfort and the display of the behaviors associated with ASD. Gluten, a common wheat product found in breads and cereals, is the main culprit for these events, and similar to celiac’s disease, gluten is thought to be undigested. Casein from milk products also breaks down into a similar peptide (casomorphine) as gluten (gliadnomorphins) (Lewis, 2002). Some of the peptides obtained from gluten and casein are very similar to those endorphins found in the brain. These opioid peptides act as neuroregulators.