CAM – Complimentary and Alternative Medical Treatments

There was an article put out by a journal called Education and Training in Developmental Disabilities last year–2007–called “State of the Evidence Regarding Complimentary and Alternative Medical Treatments for Autism Spectrum Disorders,” written by Gardner T. Umbarger (the 3rd, no less), from Bowling Green State University.

It mentions in the abstract that parents are frustrated by the lack of effective treatments out there for their children and “often resort to complementary and alternative treatments (CAMs) to treat the symptoms of their child’s ASD.”

<Well no shit.>

It goes on to say that many of these treatments have little or no evidence of efficacy (effectiveness).

<Ditto above comment.>

This article reviews the current state of some of these CAMs, and addresses the evidence or lack thereof concerning these specific areas.

Just in case you’re wondering, these are the CAMs that it covers:

  • Facilitated Communication and Auditory Integrated Training
  • Secretin
  • Dietary Interventions
  • Heavy-metal chelation
  • Dolphin-assisted therapy
  • Vitamin B6 interventions
  • Music Therapy
  • Hippotherapy and therapeutic riding

It takes its time actually getting to the meat of the article, but once it does, it divides these therapies into two distinct categories: Interventions which are not Recommended, and Interventions Considered Promising Practices (italics were added by me).

Interventions which are not Recommended

  • Facilitated Communication and Auditory Integration Training

There is an organization which has taken a “significant role in evidence-based practices by taking specific positions on certain CAM interventions.” That organization is the American Speech and Hearing Association (ASHA). They have recommended against both of these as interventions as evidence-based practices (or in other words they’re saying that these two practices can not be touted as interventions with a background of anything like conclusive evidence to back them up — just my interpretation).

ASHA has found that the research on these two areas don’t meet the standards for scientific protocols for effectiveness (or as the author said, “efficacy”), and thus they have proposed that there need to be new protocols put in place for further research. Plus, ASHA put forth concerns that the negative consequences of misinterpreted messages when using FC outweighed any positive benefits of this practice.

In addition, only 6 studies on AIT met the criteria for inclusion in this study, but thanks to inconsistent methodologies used in these studies, no meta-analysis could be made. And of those 6, only half had positive results, while the other 3 had no results pointing towards efficacy.

<This is the kind of language used in these articles. Let me see if I can’t cut it down to just the nitty gritty after this. I can’t be here all day you know.>

  • Secretin

Some CAMs are lacking the evidence to really make a judgment call on them. Secretin is not one of those CAMs. In fact, there have been a large number of studies done on it, and the evidence is overwhelmingly against its use.

However, this article does make one comment in passing that while secretin has not shown to be effective at treating ASDs, it does seem to have a positive effect on some people in regards to gastrointestinal problems. This effect is probably largely responsible for the positive results that many tout when pointing towards secretin as an effective intervention in ASDs.

<I can vouch for that. I know that when I feel crummy, my stimming levels shoot way up and my abilities to put up with small trivialities (like other people or . . . idk, light) are reduced significantly.>

  • Dietary interventions

As of yet, although many people have individually seen positive effects of its use, dietary interventions are not supported as an effective intervention, purely based on the results from the evidence/lack thereof.

The article doesn’t discount them completely though, because the very last sentence says that “larger and higher quality clinical trials are warranted.”

<So get on the horn to folks you know and tell them to get some clinical trials going if you really want to see this supported!>

  • Heavy-metal chelation

I must say that this section is certainly one of the longest in this entire article. As the article says, according to the Food and Drug Administration (as of 2007), there have been no inclusion of thimerosal in vaccinations since 2001, and currently the only things with mercury-based preservatives in them are flu vaccines. With that said, the link between them and autism is inconclusive still to this day.

It also describes this intervention as “potentially dangerous,” and brings up the fact that there has been a death of a child as a result of this treatment. It says that until further trials have been done by the National Institute of Mental Health regarding this treatment, chelation should “not be considered an appropriate intervention to treat the symptoms associated with ASD.” You can find out more about those clinical trials here.

  • Dolphin-based therapy

Did you know that dolphins are used with kids who have ASDs to improve socialization and communication skills?

Who knew.

If you want to know more about this, look up the name of its creator, David Nathanson. However, several of his earlier studies have been criticized for having significant methodological flaws. Also, there is an inability to recreate the effects as seen originally. It mentions the need of further research being needed.

Interventions Considered Promising Practices

  • Vitamin B6 interventions

A large number of studies have reported positive results, but many of these studies have unfortunately used poor methodologies and inadequate dependent variables (the dependent variable is what the independent variable, that which is brought in via the experiment, affects) measures. Currently, there is a lack of inconsistent evidence.

  • Music Therapy as an intervention for ASD

“Music therapy involves using music and musical activities as a basis for therapeutic interventions.”

The most comprehensive study done on music therapy interventions was a meta-analysis published by the Journal of Music Therapy, volume 41, issue 2, in 2004. It was done by Jennifer Whipple (I know all that not merely from the references section, but also because I’m using that article in my content analysis). The study found that all of the music therapy interventions were slightly effective in improving “one or more areas of communication and social skills development.” In three other small-sample studies, positive results in response to music therapies were found regarding verbal and gestural communication skills. In addition to that evidence, other studies also showed potential as interventions for individuals with ASDs. As Whipple said however, more robust research is still needed in this area.

<Music therapy, thus far, has been the only thing even looked upon in a semi-favorable light. I can address the need for more research though. Music therapy has only been officially in existence since 1950 (although it was practiced long before that–think 1919 and before). Being that it is such a young practice, more robust research is still needed on it. Music therapy had many of its roots in veterans hospitals and consequently in geriatrics. However, there was a movie from the 1970’s *goes and digs through her notes and Google* called “The Music Child” this is about music therapy and nonverbal children who are most likely autistic (this from the mouth of one of my profs).>

  • Hippotherapy and Therapeutic Riding

Hippotherapy uses horses as therapy, and therapeutic riding uses riding as a goal directed recreational activity.  The majority of the studies done on this kind of therapy have primarily had positive results regarding a wide range of children with disabilities.  However, many of these studies were negatively impacted by use of poor methodologies and poor control of confounding and external variables.  More research is needed with higher quality protocols.

<I’ve noticed that many children on the spectrum react favorably to animals and vice versa.  Personally, horses terrify me merely because of the size difference and the fact that I have a fear of heights.  Well, really, it’s not a fear of heights, but a fear of falling.  Right.  Anyways, this looks like a potentially promising therapy, should they get more conclusive results.>

As the article says later on, the unfortunate fact regarding ASDs is that far more is known about what doesn’t work as compared to what does.  From this article, I’d say that music therapy has one of the highest chances of actually doing something to help.  Besides, music therapy is treatment of the whole person, not just their symptoms.


~ by lastcrazyhorn on April 27, 2008.

7 Responses to “CAM – Complimentary and Alternative Medical Treatments”

  1. Metaanalyses can sometimes be no more than statistical junk.

    If the majority of the studies included in the metaanalysis themselves are unsound, then that will skew the stats of the meta study QED.

    Anyway I know bunk when I see it, if it has $ signs, and a big sales promotion then it is more than likely to be bunk.

  2. Without looking up all of the references I can’t completely respond to that, but the ones I recognize are quality refs.

    And the one for music therapy is a definite.

  3. But you would say that or is that just anecdotal on my part 🙂

  4. Well, it’s either that, or agreeing with you that everything I just wrote is shite . . .

  5. I don’t know from methodology, but Little Miss does very well with her hippotherapy, and I can bet if she had access to dolphins she’d be in heaven. 🙂

  6. Oh cool!

  7. […] Regarding Complimentary and Alternative Medical Treatments for autism Spectrum Disorders,??? written County community news briefs for Wednesday, May 7 North County TimesCLUB NEWS Fires […]

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