As a functional medicine practitioner, I’m often asked to give my thoughts on what causes autism, and what its symptoms and early signs are.
Inevitably, the next question is, “What’s the best way to approach autism treatment?”
While there are now many treatment options, they’re not all created equal. A complex and multi-faceted approach can yield better results than behavioral intervention alone.
In my decades of practice and education, one thing is clear: autism is not simply a behavioral disorder. It’s a multisystem condition that requires treatment to deal with the root cause throughout the body.
Evidence should come first and foremost, and treatment should be based on all of the data available. Effective treatment doesn’t stop at a prescription or behavioral therapy. No two children with autism have the same symptoms, and they likely won’t have identical autism treatment plans.
However, no matter the symptoms or situation, there are four facets of treatment that work together to improve quality of life for patients with ASD. It’s this approach I’ve seen effectively improve the symptoms of patients in my care.
Why Autism Requires a Complex Approach
As autism rates still rise in the US, we now know far more about the disorder than we ever have. We are now more aware than ever of the many factors that can lead to autism and are better equipped to diagnose it.
With these developments, what should intervention look like after diagnosis?
Autism doesn’t have one singular cause, and it shouldn’t be given only one treatment option. Factoring in individual differences builds an effective plan to treat autism.
Countless studies have shown the results from dietary changes, the addition of supplements, addressing gastrointestinal issues, and improving methylation. When these concerns are treated, overall symptoms improve as well.
This is why a complex, biomedical approach to autism treatment can yield far greater results than medications or therapies alone.
A 4-Pillar Biomedical Approach to Autism Treatment
There are four basic pillars in my approach to treating autism. Biomedical factors work together to not only relieve symptoms, but strike at some of the root causes of autism.
When taken as a whole, these pillars can greatly improve positive behavior, communication skills, and social abilities — but that’s only the beginning. Autistic patients see improvements in all their symptoms like, not just the traditionally recognized ones. Digestion, elimination, sleep, and immunity each improve.
Let’s take a look at how these four pillars work together for a holistic autism treatment plan.
This is the first pillar for a reason: Dietary intervention is one of the most effective sources of change in ASD symptoms. Changes in nutrition can help not only behavioral symptoms, but aid the overall health and wellbeing of the patient due to the possible roots of this condition beginning in the gut.
Research has shown that behavioral symptoms can improve based on nutrition changes alone. One study found an improvement in symptoms of autism in 81% of patients after three months of being gluten-free and casein-free.
Eliminating food allergies may be one of the reasons for this. Research indicates that infant food allergies and sensitivities may be one of the underlying causes of autism.
A diet specialized for autism spectrum disorder first involves removing casein, the protein found in dairy products. It is also advisable to eliminate gluten, the protein in wheat, barley, spelt, and some types of oats.
Allergy testing, a food sensitivity panel, and testing for types of antibodies created by reactions to different foods are some of the tests I implement to create an individualized diet plan. Gluten and casein are such common triggers that I recommend these be the first to go. Every child is different, and not all special diets work for each one with autism.
Dietary changes support the immune system, which is a key element in autism treatment — autistic people have historically poor immune function, often due to reactions to triggering foods. When individuals with autism spectrum disorder produce antibodies it usually attacks different organs and causes symptoms. These antibodies can travel to the brain where they interfere with brain activity, causing neurological symptoms. Removing inflammatory foods and increasing the gut microbiome diversity are all benefits of altering the diet of a child with ASD.
2. Basic Supplements
Supplementation is the second pillar of biomedical autism treatment. Studies show that children with autism spectrum disorder are more likely to experience malnutrition, perhaps in part to food allergies, poor absorption, and inflammation. Supplementing the diet of children with autism can improve many symptoms and have a positive effect on overall health.
A great supplement regimen for ASD will include a good multivitamin, broad spectrum probiotics with prebiotics, zinc, magnesium, and calcium. Research indicates that prebiotics and probiotics can actually relieve many of the symptoms of ASD, and alleviate the gastrointestinal issues, and help to improve gut health and the patient’s microbiome. Most children with autism also are lacking in calcium, possibly due to a casein-free diet. A combined calcium and magnesium supplement will improve muscle and bone health.
Adding in digestive enzymes like peptizyde, no-fenol, amylase, and lactase will aid in breaking down food and tolerating potentially inflammatory foods, like gluten, casein, and phenols. Furthermore, biotin and vitamin B6 can accompany these enzymes and provide a low oxalate diet support.
Most children diagnosed with autism get less than the recommended daily values of healthy fatty acids, and supplementing omega-3 levels using fish oils has been shown to improve core autism symptoms by up to 33%.
Epsom salt cream can be used to support magnesium need. Molybdenum can also aid in phenol sensitivity and inflammation. Low zinc levels can be a major factor in patients with autism. In fact, zinc deficiency is extremely common among children diagnosed with ASD, and the absence of zinc can lead to a poor ability to produce certain proteins needed in the body.
Supplementing properly based on personalized needs can aid in autism treatment and is an important part of health care.
3. Gastrointestinal Issues
Gastrointestinal issues are hallmark symptoms of autism. Children with ASD experience constipation, bloating, nausea, and other digestive problems at unusually high rates. In fact, improving these chronic issues has been shown to positively impact behavioral symptoms of autism.
No autism treatment plan would be complete without alleviating the gastrointestinal stress that plagues many patients. Not only will they experience a better quality of life, there is research that supports a healthy gut can actually improve all symptoms of ASD.
Invasive candida can be a painful and problematic issue for those on the spectrum. This overgrowth of candida fungus in the gut is linked to inflammatory bowel disorders and neurological problems. Children who have been diagnosed with autism are more likely to have markers of this overgrowth and accompanying bowel issues.
Clostridia bacteria can also wreak havoc on the digestive systems of little ones with autism. The amount of these harmful bacteria in the digestive system is 46 times higher in children with ASD than without the disorder. The prebiotic and probiotic supplements (in addition of natural antibiotics) are recommended. They are helpful in balancing the levels of the normal and pathogenic bacteria in patients’ microbiomes.
An organic acids test is not only a helpful tool in assessing many autism imbalances but also in pinpointing individual needs. Children with autism typically show very different organic acid markers than others who take the test. This testing system can show the above pathogens, mitochondrial function, and what nutrients are needed to balance out the gastrointestinal system. Not only that, but it is non-invasive and poses very little risk.
Treating the widespread and often painful gastrointestinal issues that accompany ASD can have a myriad of positive implications. From diversifying the microbiome to regulating digestion, absorption, and elimination, the patient’s quality of life can only improve with gastrointestinal treatment. Not only that, but the discomfort that dissipates when these symptoms are addressed may also positively impact the child’s behavior.
4. Methylation Issues
Proper functioning of the methylation system in the body is key to health and the prevention of a variety of disease processes. Essentially, when methylation is impaired, it can negatively impact brain development. Impaired brain development due to poor methylation is common to see in cases of autism spectrum disorder, and improving methylation can work wonders in autism treatment.
Poor methylation has been the culprit of poor social skills, slowed verbal communication, and development delays, to name just a few issues it impacts. In fact, a decreased ability to methylate may be one of the most significant root causes of autism. This also works in tandem with oxidative stress, which further decreases the body’s ability to detoxify itself.
A methylated form of vitamin B12 can also do wonders for absorption, digestion, and protein synthesis. It also is highly effective at detoxification and methylation, which can be a trouble spot for those with autism.
Increasing folate levels may also be helpful as many children with ASD have low levels of folate. Vitamin B12 and folate together play important roles in the methylation process and central nervous system. By boosting the generally low levels of B12 and folate found in children with ASD, the body may be able to better detoxify itself and boost healthy brain activity.
Conventional Treatments for Autism: What works?
Conventional autism treatment can often involve medications or therapies that are only somewhat beneficial. The 4-pillar biomedical approach can assist in a well-rounded autism treatment that goes past the traditional attitude. These non-traditional treatments address autism from the inside out, holistically.
However, there is still some benefit to some of the conventional treatments for autism.
Many of these address at least one of the three traditional hallmarks of autism, as summed up by the National Institute for Mental Health. These include “difficulty with communication and interaction with other people, restricted interests and repetitive behaviors, and symptoms that hurt the person’s ability to function properly in school, work, and other areas of life.”
In my experience with real-life patients, these conventional treatments will only ever be very limited in their effectiveness unless accompanied by the 4-pillar biomedical approach above.
Why? Because therapies and medications will never get to the root cause of autism. Only by getting to the bottom of what causes this disorder can we truly correct it holistically.
Here are some of the therapies, medications, and emerging research that can be used to treat behavioral symptoms of autism in conjunction with an overall biomedical approach.
The Centers for Disease Control and Prevention lists several types of therapy for autism: behavioral, communication, and sensory. No matter what therapy is recommended, early intervention matters. The earlier a child receives help, the more successful treatment can be.
The most varied, and arguably most widely accepted, autism treatment is applied behavior analysis, or ABA. As the name suggests, this is primarily a behavior-based model of therapy meant to promote positive behaviors, though communication skills can also be covered.
Specific treatments under this umbrella include:
- Discrete Trial Training
- Early Intensive Behavioral Intervention/Early Start Denver Model
- Pivotal Response Training (PRT)
- Verbal Behavior Intervention
Schools, health care professionals, and your pediatrician are all likely to be familiar with ABA. Overall, ABA has been shown to be fairly effective in its limited scope, with 47% of children treated showing normal intellectual and educational functioning by the end of their first grade year. However, while language and academic areas improved in clinical, ABA has much less impact on play and motor skills.
Types of communication therapy offered for autism include:
Sensory and Play
Various types of sensory and play therapies may aid children with ASD in dealing with sensory information, emotional skills, occupational behaviors, and social skills. These include:
- Sensory Integration Therapy (not enough evidence has been presented to consider this an evidence-based therapy)
- Play therapy
- Occupational therapy
The FDA has only approved two drugs for the treatment of autism, though many other products claim to “cure” the condition.
The first is Risperidone, which is designed to decrease self-injury, tantrums, and aggressive behavior. In the one long-term study available, 3 of the 12 patients experienced a relapse, but overall, it was effective in decreasing undesirable behavior.
However, side effects include weight gain, anxiety, and fatigue. Risperidone is only helpful in reducing some of the most violent signs of autism and could potentially worsen the digestive problems at the root of many patients’ disorder.
Aripiprazole is the second approved drug, designed to treat the irritability that often accompanies ASD. While it is safer for long-term treatment than risperidone, clinical trials found that 86.7% of subjects still experienced unpleasant side effects, especially vomiting. 10% of participants left due to aggression or weight increase.
Other Complementary and Emerging Treatments
Complementary and alternative medicine is available to aid in autism treatment. Interestingly, many of these “alternative treatments” seek to find a holistic treatment for autism that treats each patient as a whole person, rather than just a list of symptoms.
While evidence is still emerging, early results suggest that chiropractic care can relieve seizures, vomiting, and neurological symptoms. Another case saw a 96% improvement reported after only two weeks. A review of 11 cases in The Journal of Clinical Chiropractic Pediatrics showed improvement in each individual.
Fecal transplants for autism are also on the cutting edge of autism treatment. While this procedure isn’t available outside of clinical trials yet, it may be able to completely transform undesirable microbiomes in autism patients.
This treatment, also known as fecal microbiota transfer, is one of the most overwhelmingly effective autism treatments in modern science. While the research is limited so far, the future may see a day in which these treatments are one of the major ways to repair the damaged microbiome autism patients suffer.
Finally, music therapy is gaining traction as an emerging complement to autism treatments. A Cochrane review of recent studies found that music therapy could effectively improve verbal and gestural communication skills after just a week. More research is ongoing to see the clinical applications of this exciting report on incorporating music into autism treatment.
A 4-pillar biomedical approach to autism treatment can strike the roots of autism symptoms, which can’t be said about conventional treatments for ASD. These evidence-based pillars encompass a broader approach to the overall health of a patient with ASD.
While ABA and other interventions may alleviate some symptoms and address developmental delays, a holistic approach can do more for the patient’s quality of life and chance for recovery.
Unlike other treatments, the 4-pillar approach acknowledges the complex and layered nature of this condition.
Addressing underlying issues like nutrition, supplementation, gastrointestinal issues, and methylation can bring lasting change in autism spectrum disorder. Don’t limit your focus only to traditional treatment methods for autism: A biomedical approach can bring a well-rounded plan for autism treatment that’s as individual as your child.