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Marnie Willing

Dean Leonard

English 1201

21 March 2020

Treatment/s for Autism Spectrum Disorder

Old School or Modern Advancements Which Yields the Best Results?

It is said as many as one in fifty-nine children in the U.S are on the Autism Spectrum.

Furthermore, these numbers have been steadily increasing over the past twenty years. Our family

is one of these 1 in 59 we have a child on the Autism Spectrum. She is one of the kindest

sweetest children you could be blessed with meeting, however she struggles immensely every

day to fit into a world that she does not understand. And moreover, fit into a world that does not

understand her. She does this with grace and a smile on her face, never giving up, never losing

hope. However, as parents we want the best, we want her to live her best life and look to

treatments to assist with this mission. Autism is a disorder that effects a child’s ability to

communicate and socialize. It is also marked by many repetitive behaviors and habits. Autism

Spectrum Disorder does not have a cure, in fact it is still unknown what exactly causes it.

“Many people with ASD benefit from treatment, no matter how old they are when they

are diagnosed. People of all ages, at all levels of ability, can often improve after well-designed

intervention” (NICHD). Unfortunately, Autism does not have a clear-cut treatment plan;

caregivers are left negotiating a variety of treatments to find which works best for their child as

not every treatment will work for every child. This can be time consuming and thankless as a

task. Oftentimes yielding little to no results

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The current routes for treatment are varied in nature and can be used alone or in combination.

Deciding which of these treatment options is best for your child is difficult and oftentimes

confusing there is traditional medicine, therapies such as Applied Behavioral Analysis (ABA),

Speech therapy or occupational therapy. Or the more modern innovative treatments such as a

multitude of diets such as ketogenic and gluten free and finally Marijuana as medication is being

explored and gaining in popularity . All of which help in very varied and different ways and have

diverse consequences and results from their usage. This brings us to my purpose and that is to

examine the most common treatments for Autism examining their effectiveness. Specifically,

the new modern innovations that appear to be proving to be more effective than the older more

traditional treatments.

Typically, the first line of treatment offered to parents is traditional pharmecuetical drugs.

While these drugs do not cure autism, they can help to alleviate some of the symptoms and

behaviors. “Healthcare providers often use medications to deal with a specific behavior, such as

to reduce self-injury or aggression. Minimizing a symptom so that it is no longer a problem

allows the person with autism to focus on other things, including learning and communication”

(NICHD). There are currently 13 medications approved for treatment of ASD symptoms. The

treatments range from SSID’s, tricyclics, anti-psychotic medicine, stimulants, anti-anxiety

medications and anticonvulsants.

Unlike the other therapies that will be examined pharmaceutical drugs do carry with

them the high risk of side effects. “Parents and health care professionals must closely monitor a

child’s progress and reactions while he or she is taking a medication to be sure that any negative

side effects of the treatment do not outweigh the benefits” (The Centers for Disease Control

[CDC] 2020). Side effects can include anything from making the behavior worse to an upset
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stomach and everything in between Families are often left with the heartbreaking decision of

risking side effects versus possible alleviation of the symptoms. A final noteworthy point is that

oftentimes these drugs do not work for every person, leaving the job of prescribing these drugs

as a try and see type operation that can yield little to no results or sometimes negative results.

Oftentimes it takes four to six weeks for these medications to show if they are working, thus

parents and caregivers are left with this long waiting process which oftentimes can yield no

results, leading them to have to start the process over again.

Another thing to consider with pharmaceutical medication is that it can be a huge

financial burden on families. Even if families have exceptional health insurance the cost can still

be exorbitant. Of course, for those who do not have health insurance the cost is staggering. While

medication has been the gold standard in care it is recommended that it is administered along

with therapies such as ABA, speech or occupational therapies. It has also become clear that

parents and caregivers are nowadays looking for more results from the treatments they are

seeking.

Therapies whether they are stand alone or in addition to medication have been considered

very effective for many years now. Unlike medication they are free from side effects, however

their results can be slow to be observed. The video Measuring the Success in Treatment for

Autism attempts to explain the often-daunting world of Applied Behavioral Therapy by

following 2 boys Jake and Andrew through many years of therapy. The positives and negatives

for the therapy are presented giving a very balanced overview of how the therapy works and the

outcomes that are possible both successful and not so. (00:01-23:00). “ABA encourages positive

behaviors and discourages negative behaviors in order to improve a variety of skills. The child’s

progress is tracked and measured” (CDC,2020). ABA therapy while still prevalent has gone out
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of favor somewhat since its introduction decades ago. It is very intensive, and results take

months or possibly years to achieve depending upon the child. However, it is a wonderful option

within school settings and many Autism schools rely heavily upon it.

Occupational therapy “teaches skills that help the person live as independently as

possible. Skills might include dressing, eating, bathing, and relating to people” (CDC,2020).

Usually it is done in weekly sessions over several weeks to months and sometimes even years

depending upon the skill that is being worked on. “Speech-language therapy can help people with

autism spectrum disorder (ASD) improve their abilities to communicate and interact with others”

(NICHD). Patients can learn such things as sign language, better speech abilities, how to use

computers to express themselves and much more depending on abilities that need to be

developed. While these therapies are extremely effective and can yield wonderful results, they

are extremely slow to have effect. Results can take a very long time and a lot of hard work to

accomplish. Again, these therapies can place tremendous financial burden on those families with

insurance and are somewhat unobtainable to those without insurance.

Something that has immediate effects is dietary changes. Cekici and Sanlier state that

recent studies have shown that various nutritional approaches have managed to decrease the

severity of core ASD symptoms in individuals with ASD (2). The question with dietary changes

is which route you will take as there are many options currently showing potential as successful

treatment options. Several “medical nutritional therapies specific to ASD have been developed.

The ketogenic diet, the gluten free casein free diet, camel milk, curcumin and probiotics stand

out as the current nutritional approaches” (Cekiki and Sanlier 3). In addition, vitamin D3,

vitamin B12 and melatonin can also be effective in treating ASD symptoms.
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Proving to be the most promising is the ketogenic diet. The diet itself has been around

for decades and used as a treatment for seizures, however recently it has come into favor as a

treatment for ASD. The ketogenic diet consists of high fat intake with low carbohydrate

consumption along with normal protein levels. While results are very promising for the

ketogenic diet Rajczewski and Gibas-Dorna caution that “Based on the current scientific data,

KD holds promise for ASD affected patients as an alternative treatment strategy. However,

human studies in this field are scarce and establishing accurate recommendations for all ASD

patients requires further large multicenter trials” (224). In addition, the CDC cautions that “many

of these treatments do not have the scientific support needed for widespread recommendation.

An unproven treatment might help one child but may not help another” (CDC,2020). The

ketogenic diet does have many promising studies that have been completed on mice. These

studies have proven to show changes in behavior by making the simple dietary changes. One

study noted by Rajczewski and Gibas-Dorna described “improvement in behavioral symptoms of

ASD, expressed by decreased self-directed repetitive behavior and better social communication,

in ketogenic diet-fed BTBR mice”(218). In another study in which 45 children were studied they

found that “At 6-month follow-up, the Childhood Autism Rating Scale (CARS) and Autism

Treatment Evaluation Test questionnaire (ATEC) showed significant improvements in both, KD

and GFCF-fed patients including speech, social and cognition parameters”( Rajczewski and

Gibas-Dorna 221). So whilst more study and much broader far reaching studies are needed, the

initial research is proving to be very positive and promising.

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Figure 1 Cekici and Sanlier. The Nourishing Hope Food Pyramid 2019.

The gluten free casein free diet (GFCF) is another popular dietary option. “Researchers at

Penn State surveyed the parents of nearly 400 kids with autism and found evidence that a GFCF

diet improved symptoms such as hyperactivity, temper tantrums, problems with eye contact and

speech skills, and physical ailments such as skin rashes and seizures for certain groups of

children”(Kuzemchak). The negative to the GFCF diet is that it needs to be very strictly adhered

to in order to have an effect. Unlike the ketogenic diet that leaves a little wiggle room and room

for error, GFCF must be followed strictly. Often involving reading all food labels and completely

eradicating gluten and casein even in trace amounts. “Some parents notice improvements
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quickly, within a matter of days or weeks. But for others, improvements can take months, and

some parents may not see any change at all” (Kuzemchak). Dietary changes are relatively safe in

comparison with other treatments such as pharmaceutical medications. Dietary changes are also

affordable and obtainable to everyone unlike the more traditional treatments. Since all one has to

do is make changes to the food they buy and consume this treatment is accessible by most.

Finally, a somewhat controversial treatment that is gaining popularity is Marijuana and

its botanical relative CBD. Both Marijuana and CBD are becoming more and more available as

many U.S states start to legalize it for either recreation or medicinal uses. CBD has been known

as a treatment for seizures for quite some time. In recent times however it has become

recognized as a possible treatment to alleviate the symptoms of ASD also. Karmin in her article

titled “Is Marijuana the World’s Most Effective Treatment for Autism? Marijuana may be the

world’s most effective remedy for autism-if only it could reach the children who need it”

discusses a trial in Israel in which she and her son participated in. Israel leads the world in

marijuana studies, it currently has 113 in progress. The medical and legal system there is a lot

more lenient than it tends to be here. The results for Karmins son where life changing. His

symptom were greatly reduced. The doctors running the trial began in 2015 with epileptic

children, however soon noticed that epileptic children have high rates of co morbid autism. It

was then that they observed that the symptoms of autism were greatly reduced in the children

with both epilepsy and autism bringing them to the conclusion that this medicine could have

great effects on autistic children. Here in the U.S.A there was a very famous case of a girl called

Charlotte whose family found themselves moving to Colorado back in 2013 so that their

epileptic daughter Charlotte could be treated with CBD oil. She went from having over 300

seizures a week to having her seizures practically disappear after taking CBD twice a day since
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the age of 5. The question with marijuana like with other alternative treatments is that there is a

lack of research on the topic. “There are especially few studies examining neurocognitive and

psychiatric outcomes among children and adolescents with developmental or behavioral

concerns who are exposed to cannabis, and this remains a critical area for future study” (Hadland

et al). As of 2017 the Children’s Hospital of Philadelphia was undertaking a study to research the

effects of marijuana on children. It was the first of its kind study in the U.S.A, essentially

because marijuana is still considered a schedule 1 substance under the federal government. Even

after it has been legalized by so many states. The study was not able to give the children CBD or

marijuana due to legal reasons however it was able to monitor the children of parents who were

opting to give this treatment to their children. So, while the medicine shows great potential its

long term effects remain unknown at this point, largely due to the inability to study it. However,

it is natural and has been around for a very long time and used by many without major effects.

After examining all of the major available treatments I have determined that there are two

that stand out. Whilst they all have positive and negatives the newer natural treatments of Dietary

changes and medical marijuana seem to offer parents a new type of hope. While medical

marijuana is not legal, I have faith that there is hope for the day that it will become legal in the

U.S.A for those who suffer from the symptoms of ASD. While it is clear more study is needed to

test its long term effects, that is also a question many parents have with the current medications

on offer that have been tested. Even though they have been through the testing process, there are

still many unknowns as to how they actually work and what long term effects they are causing.

In the past prescription drugs have taken many families on a journey of trying pill after pill only

to find that negative side effects or the drug not working or furthermore the drug making

symptoms worse. Or worse families find that these drugs are too expensive or are not covered by
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their health insurance. Of course there are also those who do not have health insurance who find

the pills are out of their reach. All of this pieced together shows the stress families must endure

when considering prescription medications.

Unlike prescription medication dietary changes offer little to no side effects, are

inexpensive and are available to all families regardless of their income or social situation. For

those who can embody the discipline needed to stick with these diets, the results are oftentimes

life changing. Yes it can be said that not every child will respond to dietary changes, however

that can be said of all treatments. The small amount of research that has been done is

encouraging in terms of positive results. Plus the thing dietary changes have over all other

treatments is that it is fast, some say immediate.Parents have the ability to learn right away if this

is something that is working or not for their child. This is an amazing turn around. Compared to

therapies that take weeks, months and sometimes years to get results. The financial burden of

therapies can also be staggering especially if the desired result takes years to accomplish. Dietary

measures however as well as being fast acting are affordable only costing as much as it costs to

buy food.

The question of how to treat your child’s autism is one that is tremendously difficult. It is

one that personally I have faced as a parent of an autistic child. The options are broad and all

have pluses and minuses. Every parent of an autistic child wants their child to suffer less,

whether it be the repetitive behaviors or the frequent outbursts. The social awkwardness or the

ability to communicate. Parents are looking to alleviate the symptoms to give their child relief

and help them to be living their best potential. The question of which route to take to help your

child is an emotional one. The options offered far ranging and differ significantly in how they

treat the symptoms and in what results they have. It is a decision that can often be filled with
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disappointment as treatment fail or do not have the desired effect. But parents of autistic children

never give up, they are advocates for their children and keep searching for more. That brings me

to the two newer treatments for autism, dietary changes and marijuana as a therapy. These

approaches are new there is a lot we still need to learn about them. However there is a lot we

already know and what is known is that many children are getting relief from these treatments.

That really should be the focal point here, that children are getting relief from these treatments.

They are not suffering a multitude of horrible side effects only to be left disappointed by the

treatment not working, as happens with traditional pharmaceutical treatments. They ar not

waiting years to see results as with therapies, they are simply seeing results. Results for the

average parent of an autistic child are what matters above anything else. We want to see our

children happy and smiling those infectious smiles. Free from those things that bring them down

and living their best life possible. As parents I think we are saying lets look to these modern

advancements to help us along in the future. The old school treatments of the past belong exactly

there in the past as we move forward and study what can be in the future.
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Works Cited

“Autism Spectrum Disorder (ASD).” Eunice Kennedy Shriver National Institute of Child Health and

Human Development, U.S. Department of Health and Human Services ,ww.nichd.nih.

gov/health/topics/autism. Accessed 20 Feb. 2020

Cekici, Hande, and Nevin Sanlier. “Current Nutritional Approaches in Managing Autism Spectrum

Disorder: A Review.” Nutritional Neuroscience, vol. 22, no. 3, Mar. 2019, pp. 145 155 .EBSCO

host,search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=134346594&site=eds-live.

Accessed Feb. 20 2020.

Cekici,Hande and Nevin Sanlier”The Nourishing Hope Food Pyramid” Nutritional Neuroscience, vol.

22, no. 3, Mar. 2019, pp. 145 155.EBSCOhost,search.ebscohost.com/login.aspx?

direct=true&db=s3h&AN=134346594&site=eds-live. Accessed April 10 2020

Hadland, Scott E. MD, MPH; Knight, John R. MD; Harris, Sion K. PhD “Medical Marijuana Review of

the Science and Implications for Developmental-Behavioral Pediatric Practice” Journal of

Developmental & Behavioral Pediatrics: February/March 2015 ,Volume 36 - Issue 2 - p 115-

123doi: 10.1097/DBP.0000000000000129.

Kamin, Debra. "Is Marijuana the World's Most Effective Treatment for Autism? Marijuana may be the

world's most effective remedy for autism--if only it could reach the children who need it."

Newsweek, vol. 170, no. 8, 23 Feb. 2018. Gale In Context: Opposing

Viewpoints,https://linkgalecom.sinclair.ohionet.org/apps/doc/A527737248/OVIC?

u=dayt30401s&sid=OVIC&xid=31dd17b0. Accessed 26 Feb. 2020

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Kuzemchak, Sally,“Facts About the 'Autism Diet' Gluten-Free Casein-Free Diet.” Parents,

www.parents.com/toddlers-preschoolers/health/autism/autism-diet/.

Measuring Success in Treatment for Autism. [Electronic Resource]. Films Media Group,

2006.EBSCOhost,search.ebscohost.com/login.aspx?

direct=true&db=cat01128a&AN=scc.b1349466&site=eds-live.

Rajczewski, Aleksander, and Magdalena Gibas-Dorna. “Ketogenic Diet as Possible Therapy of Autism

Spectrum Disorder -- Review and Implication.” Journal of Medical Science, vol. 87, no. 4, Oct.

2018, pp. 218–224. EBSCOhost, doi:10.20883/jms.297.

The Centers for Disease Control “Autism Spectrum Disorder”

https://www.cdc.gov/ncbddd/autism/index.html . Accessed 26 Feb. 2020