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Complementary and alternative treatment use for autism spectrum disorders
... Moreover, research has demonstrated that many individuals are misinformed about the lack of scientific support for FC or are willing to overlook this element regardless, posing two separate concerns regarding the use of FC (e.g., Hall & Riccio, 2012;Price, 2013). Indeed, when testing the knowledge of a small sample of students of communication disorders and speech-language pathology on the effectiveness of FC, Price (2013) found that 100% of the undergraduate and 83% of the graduate students in the study believed that FC was research-backed. ...
... Indeed, when testing the knowledge of a small sample of students of communication disorders and speech-language pathology on the effectiveness of FC, Price (2013) found that 100% of the undergraduate and 83% of the graduate students in the study believed that FC was research-backed. Additionally, Hall and Riccio (2012) surveyed over 400 parents and caregivers of children with autism and found that "research support" was not considered a significant factor in influencing the varied choices to use alternative supports for autism, including FC. This indicates that participants were willing to overlook how research-backed a method was when deciding whether to use it. ...
... This indicates that participants were willing to overlook how research-backed a method was when deciding whether to use it. Also, 6% of the participants reported that their children had used FC at some point and 6.4% were currently using this method (Hall & Riccio, 2012). ...
The United Nations Convention on the Rights of Persons with Disabilities (2006) asserts that individuals with disabilities are entitled to effective and equal access to justice. This is especially critical for children with disabilities, many of whom are non-verbal and who face compounded marginalization due to their disability and status as minors. These children often experience greater challenges in providing court testimony yet are at higher risk of abuse, underscoring the crucial importance of their testimonies in legal proceedings. Augmentative and alternative communication (AAC) methods have been developed to support individuals with disabilities in expressing themselves. This commentary, viewed through a social work lens, examines the application of AAC for children with disabilities, evaluating both the benefits and limitations of these methods. It advocates for the use of empirically supported AAC approaches and cautions against those lacking empirical validation or discredited. A particular focus is placed on facilitated communication (FC), an AAC tool that has been empirically invalidated and associated with significant risks yet continues to be used despite widespread scholarly and organizational opposition. The commentary concludes with recommendations for advancing the field of AAC, emphasizing the importance of implementing and promoting only evidence-based AAC methods.
... Despite different categorizations and definitions for CAM by researchers and organizations, the treatments used with conventional medicine are defined as complementary treatments while alternative treatments are used as a substitute for conventional medicine or treatments such as applied behavior analytic practices. Unlike conventional treatments, CAM treatments are not always used by health professionals in that they are promoted by various individuals or groups (Hall & Riccio, 2012). With ...
... As to discontinuation of treatments, parents' belief that the child is not benefiting enough, regional proximity, and access to services affect their parental decisions (Bowker et al., 2011;Shepherd et al., 2018). Furthermore, research results indicate that many factors influence parents' choices of treatment use, including: Severity of ASD (e.g., Green et al., 2006;Hall & Riccio, 2012), individual needs of the child (e.g., Carlon et al., 2015;Hebert, 2014), parental educational level (e.g., Hall & Riccio 2012;Salomone et al., 2015). Carlon et al., (2013) reviewed studies exploring the parent-declared factors influencing their decision-making and concluded that frequently declared factors were recommendations from others, availability, regional proximity, and cost of the services. ...
... As to discontinuation of treatments, parents' belief that the child is not benefiting enough, regional proximity, and access to services affect their parental decisions (Bowker et al., 2011;Shepherd et al., 2018). Furthermore, research results indicate that many factors influence parents' choices of treatment use, including: Severity of ASD (e.g., Green et al., 2006;Hall & Riccio, 2012), individual needs of the child (e.g., Carlon et al., 2015;Hebert, 2014), parental educational level (e.g., Hall & Riccio 2012;Salomone et al., 2015). Carlon et al., (2013) reviewed studies exploring the parent-declared factors influencing their decision-making and concluded that frequently declared factors were recommendations from others, availability, regional proximity, and cost of the services. ...
We investigated parent reports of use of special education and support services, use of evidence-based practices (EBPs), use of past and current complementary and alternative medicine (CAM) treatments, non-use of CAM treatments, willingness, and unwillingness to use CAM treatments, reasons for use and non-use of CAM treatments, and perceptions of
EBPs and CAM treatments in their children’s functioning. We collected data from a total of 166 parents of children with autism spectrum disorder (ASD) through a web-based survey. 94% of the parents reported lifetime use of at least one CAM treatment. Parents weighed on a wide variety of factors in decision-making. CAM treatments use was positively associated with parental educational level, length of time since ASD diagnosis, and child’s ASD severity.
... In addition to surveying parents about their causal beliefs, Dardennes et al. (2011) also examined parent's education level but found no significant relationships between the parent's education and the use of any of the interventions examined. However, Hall and Riccio (2012), Salomone et al. (2015), and Wong and Smith (2006) all reported significant relationships between higher parent education levels and CAM use. In addition, Hanson et al. (2007) reported a positive association between maternal education levels and CAM use. ...
... Other researchers have investigated the relationship between severity of ASD symptoms and CAM use. Both Christon, Mackintosh, and Myers (2010) and Hall and Riccio (2012) reported that the total number of CAM interventions used increased with the apparent severity of ASD diagnosis. Hanson et al. (2007) reported that CAM use was significantly associated with a more severe diagnosis. ...
... A somewhat surprising finding was that parental CAM use was the only examined implicit factor that was significantly associated with the current or lifetime (current or previous) use of CAM interventions. In contrast, in previous studies CAM use with children with ASD has been associated with higher parental education levels (e.g., Hall & Riccio, 2012;Hanson et al., 2007;Salomone et al., 2015;Wong & Smith, 2006) and with increased severity of ASD as reported by the parent (e.g., Christon et al., 2010;Hall & Riccio, 2012;Hanson et al., 2007). It should be noted that these previous studies were conducted with mainly North American samples and included children of a wider age range than those in the present study. ...
Extant research addressing implicit factors related to intervention decisions made by parents of children with autism spectrum disorder (ASD) is limited and findings have been inconsistent. In the present study, 74 parents of preschoolers with ASD were surveyed regarding intervention use. The possible relationships between implicit parent factors (education level, age, causal beliefs about ASD, complementary and alternative medicine [CAM] use, and family income) and child factors (time since diagnosis, and perceived severity of ASD), and the number and type of interventions used were examined. Consistent with previous research, only a small number of significant relationships were found, including that family income, parent use of CAM, mother’s education, parent belief in an unknown aetiology of ASD, and time since child’s diagnosis were all related to the number of interventions used. Some specific findings of previous research were not replicated in the present study (e.g., neither beliefs in environmental aetiology of ASD nor parent education levels were related to the use of specific CAM interventions), indicating that factors affecting decision-making may not be consistent across samples. Nevertheless, future research including an expanded range of possible implicit factors with more diverse samples may provide a more accurate predictive model of parent decision-making.
... Christon et al. 2010;Senel 2010;Wong and Smith 2006;Wong 2009), with Gluten Free/Casein Free (GFCF) diets and diet supplements being the most common (e.g. Carter et al. 2011;Christon et al. 2010;Green et al. 2006;Hall and Riccio 2012;Hanson et al. 2007;Pillsbury Hopf et al. 2016). Younger children with ASD and those with more severe symptoms are reported to have higher rates of CAM use (Hall and Riccio 2012;Hanson et al. 2007;Perrin et al. 2012). ...
... Carter et al. 2011;Christon et al. 2010;Green et al. 2006;Hall and Riccio 2012;Hanson et al. 2007;Pillsbury Hopf et al. 2016). Younger children with ASD and those with more severe symptoms are reported to have higher rates of CAM use (Hall and Riccio 2012;Hanson et al. 2007;Perrin et al. 2012). Parents' own use of CAM may also be a predictive factor (Hall and Riccio 2012;Wong and Smith 2006;Wong 2009). ...
... Younger children with ASD and those with more severe symptoms are reported to have higher rates of CAM use (Hall and Riccio 2012;Hanson et al. 2007;Perrin et al. 2012). Parents' own use of CAM may also be a predictive factor (Hall and Riccio 2012;Wong and Smith 2006;Wong 2009). Parents may be more willing to use CAM when they believe that the CAM treatment has few side effects, high face validity and works on underlying causal mechanisms (Esch and Carr 2004). ...
Gluten free/Casein free (GFCF) diets are one of the most common types of Complementary and Alternative Medicines (CAM) used in Autism Spectrum Disorders (ASD) despite little evidence to support positive effects. There has been no theory driven literature that has investigated parent’s reasons for their use. The Theory of Planned Behaviour (TPB) was used to examine parent’s intentions to use GFCF diets for their child with an ASD. Treatment and causal beliefs were also examined. Parents (n = 33, children aged 3–17 years) were influenced by anticipated regret, positive outcomes and attitude. Future interventions should provide information to parents and health professionals about the possible causes of ASD and therapy options which are in line with current recommendations.
... In one study (Horovitz, Matson, & Barker, 2012) it was reported that a group of children using psychotropic medications had higher scores on a measure of ASD severity (i.e., the Baby and Infant Screen for Children with Autism Traits -BISCUIT, Part 1). In two studies (Christon et al., 2010;Hall & Riccio, 2012) it was found that use of CAM treatments was more frequent among children with higher ASD severity, measured by parents' report of severity. The remaining eight studies which reported on this factor (Alnemary et al., 2017;Dardennes et al., 2011;Granich et al., 2014;Irvin et al., 2012;McIntyre & Barton, 2010;Memari et al., 2012;Patten et al., 2013;Pickard & Ingersoll, 2015) reported no association between ASD severity and treatment use (CAM or conventional). ...
... In eight studies which focused on CAM, it was reported that children's use was higher when parents had a higher level of education (Akins et al., 2014;Bilgiç et al., 2013;Hall & Riccio, 2012;Hanson et al., 2007;Owen-Smith et al., 2015;Patten et al., 2013;Salomone et al., 2015;Wong & Smith, 2006). In another three studies (Alnemary et al., 2017;Salomone et al., 2016;Thomas, Ellis et al., 2007) other associations were found between years of education and the use of specific treatments (e.g., one investigation reported that the use of a picture exchange system and hippotherapy was more likely when parents had a college education). ...
... In one study which focused on CAM, it was reported that parents who were married were more likely to access CAM for their children with ASD (Hall & Riccio, 2012). Another study found a bivariate association between married parents and CAM use. ...
Background
There are many treatment options for children with Autism Spectrum Disorder (ASD). Misinformation and easy access to ineffective treatments complicates the decision-making process for parents. Research on implicit factors (e.g., parent or child characteristics) and declared factors (e.g., parent-reported reasons) contributes to an understanding of what influences these decisions.
Method
The aim of this systematic review was to examine the significance of factors associated with treatment selection. The review was conducted in accordance with the PRISMA protocol.
Results
The search revealed 51 studies which contained data on implicit and/or declared factors associated with treatment selection. The data were tabulated by factor and synthesised. The severity of a child’s behavioural problems, parental stress, and parent beliefs about ASD were consistently identified as implicit factors associated with the use of particular treatments. A wide range of reasons for treatment choices were declared by parent respondents, including; the individual needs of their child, recommendations from others, practical reasons (e.g., cost), child age, hope for recovery, hope for improvement, and concerns about side-effects.
Conclusion
A better understanding of these factors will inform targeted educational approaches which encourage evidence-based practice and a more informed view of treatments not yet supported by research.
... In addition, CHA use is more common in children with ASD compared to other children, even those with other developmental disabilities (Akins et al. 2014;Valicenti-McDermott et al. 2013;Wong and Smith 2006). ASD symptomatology (Hall and Riccio 2012;Hopf et al. 2016;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013), greater parent education (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Owen-Smith et al. 2015;Salomone et al. 2015;Wong and Smith 2006), and use of multiple health services (Akins et al. 2014;Owen-Smith et al. 2015;Salomone et al. 2015) are associated with an increased likelihood of parental CHA use for children with ASD. Discrepant findings have, however, emerged about the relationship of age, sex, and race/ ethnicity with parental use of CHA for children with ASD (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Hopf et al. 2016;Levy et al. 2003;Owen-Smith et al. 2015;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013;Wong and Smith 2006;. ...
... In addition, CHA use is more common in children with ASD compared to other children, even those with other developmental disabilities (Akins et al. 2014;Valicenti-McDermott et al. 2013;Wong and Smith 2006). ASD symptomatology (Hall and Riccio 2012;Hopf et al. 2016;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013), greater parent education (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Owen-Smith et al. 2015;Salomone et al. 2015;Wong and Smith 2006), and use of multiple health services (Akins et al. 2014;Owen-Smith et al. 2015;Salomone et al. 2015) are associated with an increased likelihood of parental CHA use for children with ASD. Discrepant findings have, however, emerged about the relationship of age, sex, and race/ ethnicity with parental use of CHA for children with ASD (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Hopf et al. 2016;Levy et al. 2003;Owen-Smith et al. 2015;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013;Wong and Smith 2006;. ...
... ASD symptomatology (Hall and Riccio 2012;Hopf et al. 2016;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013), greater parent education (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Owen-Smith et al. 2015;Salomone et al. 2015;Wong and Smith 2006), and use of multiple health services (Akins et al. 2014;Owen-Smith et al. 2015;Salomone et al. 2015) are associated with an increased likelihood of parental CHA use for children with ASD. Discrepant findings have, however, emerged about the relationship of age, sex, and race/ ethnicity with parental use of CHA for children with ASD (Akins et al. 2014;Hall and Riccio 2012;Hanson et al. 2007;Hopf et al. 2016;Levy et al. 2003;Owen-Smith et al. 2015;Perrin et al. 2012;Salomone et al. 2015;Valicenti-McDermott et al. 2013;Wong and Smith 2006;. Moreover, little research has qualitatively explored how these factors, together, contribute to parental use of CHA for children with ASD. ...
Knowledge of why parents use complementary health approaches (CHA) for children with autism spectrum disorder (ASD) is limited. We conducted a mixed methods study to better understand factors influencing parents’ decision to use CHA for ASD. Parent-reported data about CHA use were collected on a probability sample of 352 young children with ASD in Denver, Colorado; Los Angeles, California; or Portland, Oregon. Follow-back interviews were conducted with 31 parents. CHA use was negatively associated with older child age and positively associated with parents’ belief ASD has major consequences, living in Portland or Denver, and medication use. Nine themes help explain these results. Study findings may have utility for healthcare providers working with children with ASD and their families regarding CHA.
... In total, 23 full-text articles were obtained and further screened for possible eligibility. Of these articles, 17 studies (Akins et al., 2014;Bilgic et al., 2013;Carter et al., 2011;Christon et al., 2010;Goin-Kochel et al., 2007;Hall and Riccio, 2012;Hanson Harrington et al., 2006aHarrington et al., , 2006bHuang et al., 2013;Levy et al., 2003;Perrin et al., 2012;Salomone et al., 2015;Valicenti-McDermott et al., 2013;Witwer and Lecavalier, 2005;Wong and Smith, 2006;Wong, 2009) met the inclusion criteria. By searching all of the reference lists of the included articles and existing reviews, we discovered and included 3 more articles (Bowker et al., 2011;Granich et al., 2014;Green et al., 2006). ...
... the 19 studies that reported respondents' sex, 82% of the participants were boys and 18% were girls. Eight studies (Bilgic et al., 2013;Bowker et al., 2011;Carter et al., 2011;Christon et al., 2010;Goin-Kochel et al., 2007;Granich et al., 2014;Harrington et al., 2006b;Perrin et al., 2012) classified the type of disorder into the categories autistic disorder/autism, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger's syndrome (AS); two studies (Green et al., 2006;Hanson et al., 2007) used other forms of classification; and the remaining 10 studies did not specify the ASD subtype (Akins et al., 2014;Hall and Riccio, 2012;Harrington et al., 2006a;Huang et al., 2013;Levy et al., 2003;Salomone et al., 2015;Valicenti-McDermott et al., 2013;Witwer and Lecavalier, 2005;Wong and Smith, 2006;Wong, 2009). Of the 20 studies, 17 reported how ASD diagnosis was confirmed. ...
... All included articles were cross-sectional studies. Regarding recruitment approaches, participants were recruited from health care providers (Akins et al., 2014;Bilgic et al., 2013;Hanson et al., 2007;Harrington et al., 2006b;Huang et al., 2013;Levy et al., 2003;Salomone et al., 2015;Valicenti-McDermott et al., 2013;Wong and Smith, 2006;Wong, 2009), from a school (Witwer and Lecavalier, 2005), from two different registers (Carter et al., 2011;Granich et al., 2014;Perrin et al., 2012), via advertisement through autism-related organizations (Bowker et al., 2011;Christon et al., 2010;Goin-Kochel et al., 2007;Green et al., 2006;Hall and Riccio, 2012;Salomone et al., 2015), and conferences (Harrington et al., 2006a). The data collection methods included face-to-face interviews (Akins et al., 2014;Carter et al., 2011;Levy et al., 2003;Valicenti-McDermott et al., 2013), telephone interviews (Carter et al., 2011;Wong and Smith, 2006), interviewer-administered questionnaires (Bilgic et al., 2013;Wong, 2009), and self-administered questionnaires (Bowker et al., 2011;Christon et al., 2010;Goin-Kochel et al., 2007;Green et al., 2006;Hall and Riccio, 2012;Harrington et al., 2006a;Perrin et al., 2012;Salomone et al., 2015;Witwer and Lecavalier, 2005), including webbased questionnaires and mailed questionnaires. ...
Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.
... Rates of use were homogeneous across Europe with the exception of significantly higher rates in Eastern Europe (66 %). Prevalence data from US samples obtained from reviews of patients charts vary from 30-50 % [1,21,32] to 70-90 % [14,15]. In the total sample, parents reported using diets or supplements in 24 % of cases. ...
... A similar proportion of parents in our total sample reported using mindbody practices (24 %). Rates from previous studies ranged 20-30 % [14,15], but comparison should be made with caution as different definitions were used or CAM approaches were considered individually rather than as a class. ...
... Interestingly though, neither of these associations was found for use of mind-body practices. This suggests that previous evidence of higher use of CAM in low-functioning children [14,32] might be specific to some CAM types. The association of use of medication with use of diets but not mind-body practices might be due to the use of supplements or alterations in the diet as an attempt to counter-balance potential side effects of medications or to 'boost' their efficacy [15]. ...
This study examined the prevalence and correlates of use of complementary and alternative medicine (CAM) among a sample of children with autism spectrum disorder (ASD) < 7 years in 18 European countries (N = 1,680). Forty-seven percent of parents reported having tried any CAM approach in the past 6 months. Diets and supplements were used by 25 % of the sample and mind-body practices by 24 %; other unconventional approaches were used by 25 % of the families, and a minority of parents reported having tried any invasive or potentially harmful approach (2 %). Parents in Eastern Europe reported significantly higher rates of CAM use. In the total sample, children with lower verbal ability and children using prescribed medications were more likely to be receiving diets or supplements. Concurrent use of high levels of conventional psychosocial intervention was significantly associated with use of mind-body practices. Higher parental educational level also increased the likelihood of both use of diets and supplements and use of mind-body practices.
The high prevalence of CAM use among a sample of young children with ASD is an indication that parents need to be supported in the choice of treatments early on in the assessment process, particularly in some parts of Europe. What is Known: • Use of complementary and alternative medicine (CAM) in children with autism spectrum disorder is common. • In non-EU samples, parents with higher educational level and parents of low functioning children are more likely to use CAM with their children. What is New: • This study provides the first data on prevalence and correlates of use of CAM approaches in a large sample of young children with autism in Europe (N = 1,680). • Rates of CAM use were particularly high in Eastern Europe and correlates of use varied by type of CAM across Europe.
... , multiple comorbid diagnoses (Levy, Mandell, Merhar, Ittenbach, & Pinto-Martin, 2003;Perrin et al., 2012) and more severe symptoms (Hall & Riccio, 2012). ...
... H. Wong & Smith, 2006;V. C. Wong, 2009), unknown survey response rates (Bowker, D'Angelo, Hicks, & Wells, 2011;Christon et al., 2010;Goin-Kochel, Mackintosh, & Myers, 2009;Green et al., 2006;Hall & Riccio, 2012;Valicenti-McDermott et al., 2013) and lack of geographic diversity (R.S. Akins et al., 2014;Hanson et al., 2007;Harrington et al., 2006;Huang et al., 2013;Levy & Hyman, 2003;Senel, 2010;Valicenti-McDermott et al., 2013;H. H. Wong & Smith, 2006;V. ...
... Further, some of these studies have only asked respondents about which CAM therapies they have ever used with their child and have not also asked about recent or current use (Goin-Kochel et al., 2009;Harrington et al., 2006;Levy & Hyman, 2003;Senel, 2010), which does not allow for a nuanced assessment of CAM use in this population. Some of these studies have also not asked parents about their perceptions of the efficacy of various CAM therapies (R.S. Akins et al., 2014;Green et al., 2006;Hall & Riccio, 2012;Harrington et al., 2006;Perrin et al., 2012). Finally, several of these studies have only assessed CAM use not respondents' concurrent use of conventional therapies such as pharmacological medications (Christon et al., 2010;Hall & Riccio, 2012;Levy & Hyman, 2003;H. ...
Purpose:
The purpose of the present study was to examine the prevalence and predictors of complementary and alternative medicine (CAM) use as well as parental perceptions of CAM efficacy in a large, geographically diverse sample of children with Autism Spectrum Disorders (ASD).
Methodology:
Data were obtained from a web-based survey administered to parents of children with ASD at four sites participating in the Mental Health Research Network (MHRN). The web survey obtained information about services and treatments received by children with ASD as well as the caregivers' experiences with having a child with ASD.
Results:
Approximately 88% of the sample had either used CAM in the past or had recently used some type of CAM. The following characteristics were associated with CAM use: greater parental education, younger child age, a mix of regular and special classroom settings and prescription drug use in the past three months.
Conclusions:
The use of CAM was very prevalent in this large, geographically diverse sample of children with ASD. It is critical that providers be prepared to discuss the advantages and potential side effects with families to help them make well-informed health care decisions and prevent possible CAM-drug interactions.
... 36 However, in a web-based study with 453 participants, a positive significant relationship was found between symptom severity and CAM use in children with ASD. 37 In our study, there was no difference in terms of symptom severity according to the DSM-5 between the groups that did and did not receive CAM, indicating that the reasons for the families to try CAM treatments were independent of the severity of autism symptoms. ...
... questioning the lifelong use of CAM or cross-sectional, evaluation through treatment records, face-to-face with families or via telephone, selected Some studies have evaluated the relationship between the educational levels of parents and CAM use. However, the results were conflicting; some reported a correlation between the education levels of parents and the use of CAM 28,37 , whereas others found no such correlation. 36 In our study, no significant difference was found between the groups in terms of parental education levels. ...
Objectives: Complementary and alternative medicine (CAM) is widely used for individuals diagnosed with autism spectrum disorder (ASD). In our study, it was aimed to evaluate the use of CAM treatments in children with ASD and to determine the relationship between the CAM treatment methods and hopelessness, depression, and quality of life in the caregivers of patients with ASD.
Materials and Methods: One hundred-twenty six patients with a confirmed diagnosis of ASD was included in the study. All patients were evaluated in detail in terms of the CAM methods used. The caregivers of the child with ASD were evaluated in terms of the quality of life, depression, hopelessness, and their opinions about the vaccine.
Results: When the caregivers who did and did not use CAM were compared in terms of the scale scores, no difference was found. Vaccine refusal was more common in the parents of children who received CAM.
Conclusion: The preference of CAM use was not directly related to the quality of life, depression, and hopelessness of the caregiver. Keywords: Complementary and alternative medicine, autism spectrum disorder, vaccine, quality of life, depression
Amaç: Tamamlayıcı ve alternatif tıp (TAT) yöntemleri, otizm spektrum bozukluğu (OSB) tanısı konulan bireyler için yaygın olarak kullanılmaktadır. Çalışmamızda OSB’li çocuklarda TAT tedavilerinin kullanımının değerlendirilmesi ve OSB’li hastaların bakım verenlerinde TAT tedavi yöntemleri ile umutsuzluk, depresyon ve yaşam kalitesi arasındaki ilişkinin belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: OSB tanısı olan 126 hasta çalışmaya dahil edildi. Tüm hastalar kullanılan TAT yöntemleri açısından detaylı olarak değerlendirildi. OSB’li çocuğun bakım verenin yaşam kalitesi, depresyon, umutsuzluk ve aşı ile ilgili görüşler açısından değerlendirildi.
Bulgular: TAT kullanan ve kullanmayan bakım verenler ölçek puanları açısından karşılaştırıldığında fark bulunmadı. TAT uygulanan çocukların ebeveynlerinde aşı reddi daha yaygındı.
Sonuç: TAT kullanımı tercihinin, bakım verenin yaşam kalitesi, depresyon ve umutsuzluğu ile doğrudan ilişkili olmadığı görülmüştür. Anahtar Kelimeler: Tamamlayıcı ve alternatif tedavi, otizm spektrum bozukluğu, aşı, yaşam kalitesi, depresyon
... 36 However, in a web-based study with 453 participants, a positive significant relationship was found between symptom severity and CAM use in children with ASD. 37 In our study, there was no difference in terms of symptom severity according to the DSM-5 between the groups that did and did not receive CAM, indicating that the reasons for the families to try CAM treatments were independent of the severity of autism symptoms. ...
... questioning the lifelong use of CAM or cross-sectional, evaluation through treatment records, face-to-face with families or via telephone, selected Some studies have evaluated the relationship between the educational levels of parents and CAM use. However, the results were conflicting; some reported a correlation between the education levels of parents and the use of CAM 28,37 , whereas others found no such correlation. 36 In our study, no significant difference was found between the groups in terms of parental education levels. ...
Objectives:Complementary and alternative medicine (CAM) is widely used for individuals diagnosed with autism spectrum disorder (ASD). In our study, it was aimed to evaluate the use of CAM treatments in children with ASD and to determine the relationship between the CAM treatment methods and hopelessness, depression, and quality of life in the caregivers of patients with ASD.Materials and Methods:One hundred-twenty six patients with a confirmed diagnosis of ASD was included in the study. All patients were evaluated in detail in terms of the CAM methods used. The caregivers of the child with ASD were evaluated in terms of the quality of life, depression, hopelessness, and their opinions about the vaccine.Results:When the caregivers who did and did not use CAM were compared in terms of the scale scores, no difference was found. Vaccine refusal was more common in the parents of children who received CAM.Conclusion:The preference of CAM use was not directly related to the quality of life, depression, and hopelessness of the caregiver.
... This information can potentially be generalized to provide insight into CAM usage among the rest of the DD community. In the ASD community, CAM usage is associated with increased symptom severity, child irritability and hyperactivity, parental stress levels, and circumstances in which a child's condition is life-long 8,36,37 . These studies align well with our finding that when children with ASD have a medical condition, the likelihood of CAM usage notably increases. ...
... Studies have found that variation in the use of CAMs in children with ASD is not influenced by the level of research support for that particular modality 36 . This suggests that while the efficacy of CAMs should be further investigated to determine the benefits and risks, findings from randomized trials may or may not actively impact parental choices regarding CAM usage for their children with ASD. ...
Objective
The primary aim of this study was to evaluate differences in the prevalence of complementary and alternative medicine (CAM) usage among children with and without developmental disabilities (DD). Secondarily, the association between CAM usage and comorbid chronic medical conditions was explored among children with DD.
Design
Data come from the 2012 Child Complementary and Alternative Medicine Supplement of the National Health Interview Survey, a nationally representative sample of children in the United States between the ages of 4 and 17 (n = 10,218).Main outcome measures Multiple logistical regression models provided insight into the relationships between parent-report CAM usage, DD, and chronic medical conditions.
Results
Children with developmental disabilities were more likely to use CAMs compared to their typically developing peers (21% vs 16%). Children with DDs and comorbid chronic medical conditions used CAMs at even higher rates (23% vs 18%).
Conclusions
Results indicated that children with DD, especially those with a co-occurring chronic medical condition, use CAMs more often that typically developing children. Given scarcity of information on safety and effectiveness, clinical providers need to be alert to which children may be more likely to be exposed to CAMs. Communication between parents and providers needs to include discussion of CAM treatments.
... [8][9][10][11][12][13] The CHAs most commonly used have been previously assessed among certain condition-based subgroups of children with DDs. For example, children with ASD are commonly reported to use special diets (e.g., gluten and/or casein free), [14][15][16][17][18] certain natural products (e.g., specific vitamins/minerals and nonvitamin supplements such as probiotics), and/or mind and body practices (e.g., chiropractic or osteopathic manipulation). [14][15][16][17][18] Children with ADHD are reported to frequently use mind and body practices (e.g., chiropractic or osteopathic manipulation and massage therapy), special diets, and/or some natural products (e.g., specific vitamins/minerals and nonvitamin supplements). ...
... For example, children with ASD are commonly reported to use special diets (e.g., gluten and/or casein free), [14][15][16][17][18] certain natural products (e.g., specific vitamins/minerals and nonvitamin supplements such as probiotics), and/or mind and body practices (e.g., chiropractic or osteopathic manipulation). [14][15][16][17][18] Children with ADHD are reported to frequently use mind and body practices (e.g., chiropractic or osteopathic manipulation and massage therapy), special diets, and/or some natural products (e.g., specific vitamins/minerals and nonvitamin supplements). 19,20 Similarly, children with CP are most commonly reported to use certain mind and body practices (e.g., massage therapy, aquatherapy, and hippotherapy). ...
ABSTRACT:
Objectives:
Many US children use complementary health approaches (CHAs), including some modalities that may be ineffective, unsafe, and/or costly. Yet, little is known about the prevalence and correlates of CHA use among children with developmental disabilities (DDs), as well as parent nondisclosure of CHAs used for children with DDs to health care providers. We, therefore, aimed to profile the use and nondisclosure of CHAs among US children with DDs.
Methods:
We analyzed data from the 2012 National Health Interview Survey, which included the most recent Child Complementary and Alternative Medicine Supplement. The study sample was comprised of 2141 children with DDs aged 4 to 17 years.
Results:
Nearly one-quarter (23%) of US children with DDs used CHAs. Among those with a personal health provider, 42% of parents did not disclose some or all CHAs used to the child's provider. The adjusted odds ratios of using CHAs were greater among those with female sex, higher household income, residences not in the South, difficulty accessing care, or comorbid conditions. CHA was most commonly used because “it is natural.” Nondisclosure was associated with female sex, older age, having no functional limitations, less conventional services use, and use of fewer CHAs. The most common reason for nondisclosure was that the child's provider did not ask.
Conclusion:
Complementary health approach use is prevalent among US children with DDs, and nondisclosure is likely among those who use CHAs. Future intervention targeting education and communication about CHAs for parents of children with DDs and their health care providers may promote disclosure.
... La búsqueda de una cura para el TEA es uno de los principales 13,14 . Le siguen en frecuencia, el tratamiento de una variedad de síntomas específicos, incluyendo las agresiones, la irritabilidad, la hiperactividad, la inatención, los síntomas gastrointestinales y las dificultades en el sueño 2 . ...
El Trastorno del Espectro Autista (TEA) es una condición que afecta el neurodesarrollo y está ca-racterizada por presentar, como manifestaciones centrales, alteraciones en la comunicación y en las interacciones sociales, con dificultad para compren-der las perspectivas o intenciones de los demás, y comportamientos repetitivos, restringidos, estereo-tipados; afectando el funcionamiento del individuo a lo largo de su vida. Las características de las per-sonas con TEA varían según las etapas evolutivas y los contextos 1. AVANCE, TENDENCIAS Y CONTROVERSIAS RESUMEN El Trastorno del Espectro Autista (TEA) es una condición que afecta el neurodesarrollo caracterizada por presentar alteracio-nes en la comunicación, conducta y en las interacciones socia-les, y que afecta el funcionamiento del individuo a lo largo de su vida. Los tratamientos recomendados por la evidencia científica incluyen un enfoque interdisciplinario que combina intervencio-nes educativas, terapias psicológicas/conductuales, terapia del habla y el lenguaje, terapia ocupacional/física y tratamientos mé-dicos. Para muchas familias, barreras económicas y geográficas limitan el acceso a los tratamientos específicos. Este y otros motivos llevan a incorporar tratamientos alternativos y/o com-plementarios. El Centro Nacional de Medicina Complementaria y Alternativa (NIH-EEUU) define los Tratamientos Alternativos Complementarios (TAC) como "un grupo de diversos sistemas médicos y de cuidados de la salud; prácticas y productos que generalmente no son considerados parte de la medicina con-vencional". La prevalencia del uso de TAC en personas con TEA está entre las más altas respecto a otras patologías y a otros trastornos del desarrollo, con porcentajes entre 52% y 95%. Su uso debe ser preguntado en las consultas de seguimiento, y debe discutirse sobre riesgos, beneficios y costos. La cantidad y el tipo de intervención que reciben niños, niñas, adolescentes (NNyA) y adultos con TEA varían enormemente en todo el mun-do e incluso dentro de un mismo país y región. El pronóstico del TEA es mejorado cuando el diagnóstico es oportuno y temprano y el abordaje educativo terapéutico es iniciado y orientado a as-pectos funcionales y centrados en la familia. ABSTRACT Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by alterations in communication, behavior, and social interactions that affect the individual's functioning throughout life. Evidence-based treatments include an inter-disciplinary approach that combines educational interventions, psychological/behavioral therapies, speech and language therapy , occupational/physical therapy, and medical treatments. For many families, economic and geographic barriers limit access to specific treatments. This and other reasons have led to the incorporation of alternative and/or complementary treatments. The National Center for Complementary and Integrative Health (NCCIH-USA) defines complementary alternative medicine (CAM) as "a group of diverse medical and health care systems, practices and products that are not generally considered part of conventional medicine". The prevalence of the use of CAM in people with ASD is among the highest compared to other diseases and developmental disorders, with percentages ranging from 52% to 95%. Their use should be considered in follow-up visits, and risks, benefits, and costs should be discussed. The amount and type of intervention received by children, adolescents, and adults with ASD varies greatly around the world and even within the same country and region. The prognosis of ASD is improved with timely diagnosis and early, family-centered and functionally oriented educational and therapeutic approaches.
... In studies on the use of CT in autism in the literature, the rate of use varies between 31% and 92%. 19,20 The most common alternative therapies include special diets (e.g., gluten-and casein-free) and biologically based therapies such as vitamin/mineral supplementation. In particular, gluten-free/ casein-free diet, secretin, omega-3 fatty acid supplements, probiotics, glutathione, specific carbohydrate diet, SAM-E (S-adenosylmethionine), and melatonin are reported to be the most used ones. ...
Objective: The study aimed to determine the knowledge levels and attitudes of nurses working in pediatric clinics on childhood autism and which complementary therapies (CT) methods they recommend to support children with autism. Methods: The study was designed as a descriptive research and the data were collected online. This study was conducted with 135 pediatric nurses. Research data were collected through the Sociodemographic Information Form, the Societal Attitudes Toward Autism (SATA) Scale, and the Knowledge about Childhood Autism among Health Workers (KCAHW) Questionnaire. Results: While the mean score for the SATA scale of the nurses participating in the study was 48.46±9.84, the mean score of the KCAHW questionnaire was 8.13±3.81. The mean scores for the subdimensions of the SATA scale was 7.93±2.49 at the lowest and 28.33±6.11 at the highest. In this study, nurses suggested six different CT practices in total, with exercise being the most frequently recommended one. Conclusion: The level of knowledge on childhood autism among our participants was found to be above average. In addition, in this study, the knowledge level of pediatric nurses was related to their attitudes towards individuals with autism at a very high level. Therefore, it is recommended to prepare a guide on autism and CT suggested by the nurses. It is recommended to plan the necessary interventions to improve the knowledge and attitudes of pediatric nurses about autism and to prepare a guide about CT to be used by nurses.
... A number of studies have examined factors associated with both psychotropic medication and complementary and alternative medicine use, and suggest higher rates of dispensing and/or access among those on the autism spectrum who are male [40], of older age [40,48,49], caucasian ethnicity [48,507] and higher socio-economic status [50e52]. The presence of co-occurring conditions [53e56], higher rates of aggression [57], and increased severity of autism symptoms [58] have also been associated with higher rates of use. Likewise, research, while limited, suggests that melatonin use may be higher among males [44e46] and older children [43,46], and among those with co-occurring conditions [43,45,47]. ...
Objective/background
Sleep problems in children on the autism spectrum are prevalent and persistent. Such problems are the result of a combination of biopsychosocial factors, including abnormal melatonin secretion. Exogenous melatonin is an empirically supported and popular treatment for sleep problems. However, we know little about rates of melatonin dispensing and associated variables. This study investigated rates of melatonin dispensing and the sociodemographic and child characteristics associated with its use in New Zealand.
Methods
This nationwide cross-sectional study used linked administrative health data obtained via the Integrated Data Infrastructure (IDI). Data were obtained for 11,202, 0-18 year old children on the autism spectrum. Descriptive data, and adjusted and unadjusted risk ratios, were calculated for sociodemographic and child characteristics.
Results
Melatonin is accessed by almost one quarter of children on the autism spectrum in New Zealand, with higher observed rates among females and those aged between 5-11 years, of European ethnicity, and presenting with co-occurring mental health conditions.
Conclusions
Findings are largely consistent with research investigating both sleep disturbances and psychotropic drug use among children on the autism spectrum. High rates of melatonin use, age- and sex-related differences in its use, and the complexity associated with the presence of co-occurring conditions necessitates development of practice guidelines for melatonin dispensing. Further investigation into the duration of melatonin use and the interaction between child characteristics, co-occurring conditions, sociodemographic variables and melatonin dispensing is warranted.
... This could have been caused by too slow and/or lack of progress of the child in the conventional therapy used thus far or emergence of new problems. According to Hall and Riccio the child's functioning level is associated with selection of medical regimen, i.e. the more severe the form of autism, the more desperate caregivers are in seeking other, alternative solutions [7]. An increased length of time since the diagnosis may be associated with greater frustration among the families, giving risen to alternative medicine use. ...
Background:
Gluten-free and casein-free diet is frequently used in the support of therapy of children with autism spectrum disorders. In addition, many parents restrict the consumption of simple sugars for their children.
Objective:
The aim of this paper was to understand factors influencing purchase decision in case of family with children with autism spectrum disorders on gluten-free and/or casein-free and/or sugar-free diet and the difficulties associated with this type of nutrition.
Material and methods:
The study covered a group of 40 families with children with autism spectrum disorders (32 boys and 8 girls) aged 3 to 10 years. Data were collected with questionnaire included questions concerning overall characteristics of caregivers, availability of foods used in the special diet, factors affecting decision on the purchase of products, difficulties in maintaining the child nutrition method.
Results:
The factors having strongest impact on parents' decisions on the purchase of products were product composition, presence of a certificate confirming the absence of gluten and/or milk and taste values. Exclusion diet constituted a considerable obstruction for traveling, social gatherings and resulted in conflicts with family and the environment. The limited range of healthy gluten-free, casein-free and sugar-free foods, low taste quality and unsatisfactory quality impeded purchase and preparation of varied meals.
Conclusions:
The surveyed parents were aware consumers, paying attention primarily to product composition and safety. The respondents were looking for healthy, organic and nutritionally valuable products with low sugar content. Further development of the gluten/casein/ sugar free products market may considerably improve certain aspects of family's life with children with autism spectrum disorders.
... Fathers moved from looking at 'why' to 'how,' and hence instead of looking at causes or reasons they looked at the various treatment options, interventions, alternative medicines, and biomedical treatments. Despite the lack of factual evidence, alternative treatments are often used by parents of children with autism (Hall & Riccio, 2012). This can be explained through the 'Biomedical model' as the cause of autism which implied that some fathers thought of autism as a disease and hence a search and a hope for a cure. ...
This manuscript focusses on the experiences of fathers before and after the diagnosis of autism. Using a qualitative approach, the study mapped the passage of twelve fathers of children with autism. Though the diagnosis was perceived as being devastating and shocking it opened the pathways for treatment and interventions. The new situation led to confidence, cognitive valuation as well as a sense of empowerment for the fathers. The major challenges were their child's uncertain future, social survival, and the child's potential for future independence. This study makes a significant contribution to the existing literature as few studies focus on the personal experiences of fathers. The extent of involvement and the intense desire to work with their child clearly shows the evolving role of fathers in our society. There is a need to encourage, value their contribution, and engage them in the child's special education process and intervention activities.
... regulating the functions of the autonomic nervous system and neuroendocrine system (Wong, Chu, & Cheuk, 2014). Its effectiveness and safety have been previously demonstrated in both animal and human studies (Adams et al., 2011;Hall & Riccio, 2012;Levy & Hyman, 2015). Previous research showed that acupuncture Changqiang acupoint can eliminate mental retardation disorders, and increase learning ability and working memory in children with autism (Hong, Zhang, Hong, Huang, & Qiang, 2014). ...
Acupuncture therapy is an often-used traditional Chinese medicine intervention of autism spectrum disorder. Acupuncture is usually delivered by therapists; thus, its effectiveness highly relies on their experience. This paper designed a closed-loop electrical stimulation treatment system triggered by neurophysiological signals, in order to improve the conventional acupuncture in clinical trials. Electrooculogram (EOG) signals are collected and analyzed synchronously while autistic children are watching the specifically designed visual evocation system. The electrical stimulation is triggered once the attention state is determined, delivering stimulation to the Changqiang acupoint (between the tailbone and the anus). Three healthy volunteers and four autistic children participated in this proof-of-concept study. Prior to the online test, the subject-special EOG template was determined offline. We obtained the mean recognition rate of 95.45% for healthy participants and 89.43% for autistic children, and the mean false recognition rate of 2.51% for healthy participants and 7.23% for autistic children by template matching algorithm. The system was able to recognize the EOG pattern of attention to the state and successfully trigger the electrical stimulation. This study is the first time to combine acupuncture and bioelectrical signal to provide an automatic closed-loop electrical stimulation system for acupuncture therapy.
... Due in part to the lack of available empirically validated therapies, there has been an increasing trend toward using similar strategies in children with ASD [104]. In a study conducted by Hall and Riccio [105], parents commonly resorted to trying elimination diets (e.g., gluten-free/ casein-free) and/or dietary supplements including probiotics, omega-3 fatty acids, and melatonin. ...
This chapter reviews the literature surrounding autism spectrum disorders (ASD) and their relation to gastrointestinal (GI), behavioral, neurological, and immunological functioning. Individuals with ASD often have poor GI health, including bowel motility issues, autoimmune and/or other adverse responses to certain foods, and lack of necessary nutrient absorption. These issues may be caused or exacerbated by restrictive behavioral patterns (e.g., preference for sweet and salty foods and/or refusal of healthy foods). Those individuals with GI issues tend to demonstrate more behavioral deficits (e.g., irritability, agitation, hyperactivity) and also tend to have an imbalance in overall gut microbiome composition, thus corroborating several studies that have implicated brain–gut pathways as potential mediators of behavioral dysfunction.
... Parents may also have concerns about the safety of prescription medication. [23][24][25] This case points to potential conflict between parent choice and child well-being. As clinicians, our duty is to promote the best interests of our patients. ...
Children with autism spectrum disorder (ASD) are at risk for self-injurious behaviors that can be difficult to treat in the context of co-occurring low IQ and adaptive skills. Increased prevalence and decriminalization of cannabis in some states have led to more frequent questions for pediatricians about the use of cannabis for difficult-to-treat developmental and behavioral conditions. What do we know about the possible benefits and risks of cannabis use in children with ASD? How should the clinician respond to a parent who expresses interest in cannabis to manage behavior in a child with ASD? Ethical analysis that includes harm reduction, health concerns, and information sharing will be discussed. We present commentary on the ethical implications of cannabis use in children with ASD and severe self-harm behaviors.
... This pilot study addresses the research question: Is the TwiCs design feasible to assess the effectiveness of treatments for ADHD? For the study, two interventions with preliminary indications of effectiveness, considered complementary and alternative medicine (CAM) [30], have been selected. Parents of children with ADHD are trying these interventions, paying for them out of pocket. ...
Background
Attention deficit hyperactivity disorder (ADHD) is a common and growing problem and a leading cause of child referrals to Child and Adult Mental Health Services (CAMHS). It is a drain on resources across nationally funded support agencies and associated with negative outcomes such as early criminality, school disruption and antisocial behaviour. Mainstream interventions (pharmacological and behavioural) demonstrate effectiveness whilst implemented, but are costly, often have unwanted side effects and do not appear to be affecting long-term outcomes.
Development of a robust evidence base for the effectiveness of current and novel interventions and their impact over the long term is required. The aim of the Sheffield Treatments for ADHD Research (STAR) project is to facilitate a rigorous evidence base in order to provide information about the comparative (cost) effectiveness and acceptability of multiple interventions to key stakeholders.
Methods
The Trials within Cohorts (TwiCs) design was used to build a cohort of children with a diagnosis of ADHD and conduct a three-armed pilot trial of the clinical and cost effectiveness of two novel interventions: (a) treatment by nutritional therapists and (b) treatment by homoeopaths, compared to (c) treatment as usual.
Participants are recruited to the STAR long-term observational cohort, and their outcomes of interest (ADHD symptoms, health-related quality of life, school disruption, resource use and criminality) are measured every 6 months by carers and (blinded) teachers. Two promising interventions were identified for the first randomised controlled trial embedded in the cohort. A random selection of eligible participants is offered treatments (a) and (b). The outcomes of those offered treatment are compared to those not offered treatment using intention to treat (ITT) analysis.
The feasibility of recruiting to the cohort and the trial, delivering the interventions, the effectiveness of the interventions and the appropriateness, sensitivity and collectability of outcomes is trialled.
Discussion
The results of this trial will provide information on the feasibility of the TwiCs design to facilitate multiple trials of potential interventions for children with ADHD, and the acceptability, clinical and cost effectiveness of two potential interventions for ADHD to ADHD stakeholders including service providers. Future stages of the STAR project will test other treatments informed by the results in stage 1.
Trial registration
ISRCTN number 17723526. 10.1186/ISRCTN17723526. Date assigned 27/4/15.
... For example, Bowker et al. (2011) suggest that, in relation to those interventions lacking an evidence base, a "try and see" approach is adopted. However, Hall and Riccio (2012) reported that symptom severity was related to the use of alternative interventions, and so more data is required to confirm the direction of this relationship. ...
Understanding why parents choose some interventions but not others for their child with autism is important for a number of reasons. Estimating the proportion of evidence-based interventions engaged, identifying the agencies influencing parental decisions, and elucidating the barriers or reasons leading to intervention rejection or discontinuation can result in better service provision. New Zealand parents (n = 570) of a child with autism reported what interventions were being engaged, and why some interventions were engaged but not others. Funding was a major determinant of intervention engagement, while medical professionals exerted the most influence. Sources of support were not related to intervention engagement, but parental perceptions of their child’s symptom severity were. Finally, non-engagement does not necessarily reflect parental opposition to an intervention, but rather the existence of barriers.
... 36,[103][104][105] Furthermore, research has shown that between 62% and 95% of families access complementary and alternative therapies. [106][107][108][109] Altogether, families sometimes access up to seven forms of treatment concurrently 110 and the associated costs can accumulate. Moreover, highly stressed families utilize a greater number of services, perpetuating the cost-stress relationship. ...
Purpose:
The purpose of this study was to identify key factors associated with severe stress in families raising a child with autism spectrum disorder (ASD).
Methods:
Questionnaires were mailed to families with one or more children with a diagnosis of ASD. Data from 543 surveys were analyzed using univariate and multivariate logistic regression.
Results:
Forty-four percent (n = 241) of the caregivers reported severe family stress related to raising a child with ASD. Severe family stress was associated with (1) reduced ability to socialize; (2) not having accessed individual therapy; (3) negative co-parent relationships; and (4) high out of pockets costs due to the child's ASD. The specific ASD diagnosis, comorbid conditions, socio-demographic variables, and social support were not associated with severe family stress.
Conclusion:
The findings of the current study highlight the importance of a systemic approach to family stress, whereby individual, family, and ecological factors are investigated.
... In addition to therapy, many children with ASD have associated conditions that require medical management, such as epilepsy, gastrointestinal problems, sleep disturbance and comorbid psychopathologies [84,94]. Furthermore, complementary and alternative therapies are accessed by 62-95% of families [86,[95][96][97][98], possibly due to the limitations of conventional interventions and lack of evidence for its efficacy [99,100]. The time invested in managing the treatment needs of a child with ASD are logically exacerbated by the distance required to travel. ...
The purpose of this study was to identify key factors associated with negative co-parenting experiences in parents raising a child with autism spectrum disorder.
Questionnaires were sent to families with one or more children with a diagnosis of autism spectrum disorder. Parents of 142 children with autism spectrum disorder indicated that the diagnosis had a very negative impact on their co-parent relationship. A multivariate logistic regression model was run to analyze the association of these experiences with various demographic, family and community factors.
Three factors were associated with negative co-parenting relationships: (1) family stress due to the child's diagnosis, (2) effects of the diagnosis on parents' relationship with their other children and (3) distance travelled to the nearest medical facility.
Findings highlight the need to further explore family dynamics, particularly the relationships between the co-parenting alliance, other family members and the extra-familial environment.
... Secondly, marital status appears to have a different impact on male and female CAM users. While previous studies suggest that mutual support of married individuals may promote greater CAM use among married ones than among divorced counterparts [24][25][26], our findings reveal the contrary and show that male CAM users are more likely to be married compared to female CAM users. It is reported that single persons may have more time to focus on relaxation CAM modality such as yoga or other mind-body exercise than married couples who have other household commitments [27]. ...
We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews ( = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% ( = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use.
... These percentages are not comparable with those of the other surveys reported here, however, because they focus on the percentage use of FC among practitioners rather than among children. Hall and Riccio (2012) used an internetbased platform to collect data from 452 parents and other caregivers of children with an ASD. The authors recruited participants from approximately 800 support groups for parents and caregivers of children with autism and asked them to report on the frequency of use of various interventions with their child. ...
Communication disorder and mental health professionals may assume that once novel clinical techniques have been refuted by research, they will be promptly abandoned. Using facilitated communication (FC) for autism as a recent case example, we provide evidence to the contrary. Although FC was scientifically discredited by the mid-to-late 1990s, data we review demonstrate that it is still frequently administered in clinical and educational settings. We examine evidence for FC’s (a) continued use as an intervention for autism, (b) persistence in academic and institutional settings, (c) popularity in online and print sources, (d) promotion in the media, and (e) ongoing risk to caregivers accused of sexual abuse. We analyze the sources of these troubling developments, explore their ethical implications, and offer recommendations for addressing the spread of FC and other fad interventions.
... For instance, Harrington, Rosen, Garnecho, and Patrick (2006) reported that 66% of parents put their children with ASD on a GFCF diet. Other more recent figures are at the lower end of the range: Herndon et al. (2009) reported that 31.1% of children with ASD were put on the diet, while Bandini et al. (2010) indicated that 20.7% of children with ASD followed a GFCF diet; similarly, Hall and Riccio (2012) and Sharp, Jaquess, and Lukens (2013) found rates of 30%. ...
Adequate nutrient intake is essential for health.Due to food selectivity and restrictive
diets, people with autism spectrum disorder (ASD) may have impaired nutritional status,
which could affect their growth.We present a systematic review of publications (1970–
2013) on anthropometric measurements and nutritional assessment in this population.
The limited research published on growth and nutritional status has found
contradictory results. Nutritional assessment has indicated limited food variety in the
ASD population but has not confirmed significant differences with respect to
recommended intakes or controls.
In addition to the lack of control groups,studies in this area have suffered from
methodological weaknesses,including unclear selection criteria, analysis of single
individuals or small or age-heterogeneous samples,and failure to consider phenotypic
variability between individuals or alternative explanations.Therefore,further research is
warranted,particularly randomized controlled trials with larger sample sizes.
... autism, Asperger syndrome, pervasive developmental disorder not otherwise specified), regardless of whether or not the child was currently prescribed a behavioral medication (since currently pharmacological therapies are not first line treatments for ASD). (34)(35)(36)(37)(38) ...
To evaluate how having a child with both persistent asthma and a developmental disability (DD) affects caregiver burden and quality of life (QOL). 3-10 year old children with persistent asthma in urban Rochester, NY. Cross-sectional baseline survey (2006-2009). Parent report of autism spectrum disorder or other behavioral disorder requiring medication. Caregiver burden and QOL as measured by scores on previously validated depression, parenting confidence, and asthma-related QOL scales as well as an assessment of competing demands on the caregiver. Bivariate and multivariate regression analyses controlling for caregiver age, education, marital status, race, ethnicity, and child asthma symptom severity. We enrolled 530 children as part of a larger study (response rate: 74; 63 % Black, 73 % Medicaid). Of this sample, 70 children (13 %) were defined as having a DD. There were no differences in asthma symptom severity between children with and without a DD diagnosis. However, even after adjusting for potential confounders, caregivers of children with a DD reported worse scores on the depression (p = .003), parenting confidence (p < .001), and competing demands (p = .013) scales and worse asthma-related QOL (p = .035) compared to caregivers of typically developing children with asthma. Despite having similar asthma symptom severity, caregivers of children with both persistent asthma and a DD diagnosis report more burden and lower QOL compared to that of caregivers of typically developing children and persistent asthma. Further attention to this subgroup is needed to promote optimal support for caregivers.
Purpose:
The aim is to understand what therapies and interventions families in a low and middle income (LMIC) country, such as Vietnam resort to in their attempts to seek care for their children with ASD and why they choose these therapies.
Methods:
We undertook semi-structured qualitative interviews with 27 parents of children with autism and an online survey of 112 parents as part of a broader ethnographic study over one year augmented with recent interactional observations and a review of social media.
Results:
There is limited access to formal interventions for families with children with ASD in Vietnam. Rather, families resort to syncretic care using an average of 6.8 different interventions per child. These included: speech therapy; physical therapy; prescribed medicines; and ABA as well as geomancy, special dietary regimes, biochemical testing, stem cell therapies and religious and cultural practices. Despite having low incomes, the families surveyed spent an average USD 345 per month on interventions, many of which are not evidence-based. Desire to care and potentially "cure" their children within a context of stigma associated with ASD drives parents to seek all possible interventions for their children.
Conclusions:
There remains a large gap in access to appropriate evidence-based interventions or trained therapists for families. Further information for parents, culturally appropriate guidelines for effective interventions, more trained rehabilitation professionals and regulation is required.IMPLICATIONS FOR REHABILITATIONWithin low and middle income countries (LMIC), such as Vietnam there is a lack of intervention services, difficulties in accessing appropriate specialists, poor quality care and the costs of care.Families seek a range of formal interventions and costly informal therapies as well as culturally specific practices to care for their child/ren and require information on effective therapies.In LMIC training programs to build capacity for allied health professionals need to be implemented on the latest evidence-based therapies.It is important to develop culturally appropriate Vietnamese guidelines to support interventions for children with ASD.
Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.
Complementary and alternative therapy (CAT) methods for children with autism spectrum disorders (ASD) are widespread in European countries and the Russian Federation; however, their efficacy and safety is not routinely considered by parents and clinicians when recommended or used. The current narrative review presents the most widely known CAT interventions for children with ASD synthesizing data from meta-analyses, systematic reviews, and randomized controlled trials obtained from the PubMed database based on the safety-efficacy model. We have found that, of the reviewed CATs, only the melatonin intervention can be considered safe and effective for children with ASD with comorbid sleep problems. The methods that were classified as safe but had inconclusive efficacy are recommended to be implemented only when they do not interfere with front line treatment for ASD, Applied Behavior Analysis (ABA). Methods with the lack of current evidence for the efficacy such as auditory integration therapies, bioacoustic correction, sensory integration therapy, micropolarization, animal assisted therapy, and dietary interventions should not be recommended as alternative treatments and can only be used as complimentary to ABA-based interventions. We advise against the use of chelation, hyperbaric oxygen therapy, and holding therapy due their documented harmful psychological and physical effects. When considering CAT for ASD we recommend parents and clinicians use the criteria suggested by Lofthouse and colleagues [59]: only the therapies that are safe, easy, cheap, and sensible can be recommended and used, as opposed to therapies that are risky, unrealistic, difficult, or expensive that should not be recommended or utilized.
We compared anthropometric values, nutrient intake, the Healthy Eating Index and food variety in children with autism spectrum disorder (ASD), 20 on a gluten-free casein-free (GFCF) diet and 85 on a regular diet in Valencia (Spain) using 3-days food diaries. Those on the GFCF diet had a lower weight, body mass index, and total energy, pantothenic acid, calcium, phosphorus and sodium intake, but a higher intake of fiber, legumes, and vegetables. Further, the GFCF diet group had a better quality of fat intake, but needed supplementation with vitamin D. Randomized controlled trials are required to explore long-term effects of this diet on anthropometric and nutritional status (the focus of our study), but also behavioral symptoms, in children with ASD.
Studies examining the treatment choices of parents of children with autism spectrum disorder (ASD) have mostly addressed questions about the prevalence of certain treatments. Fewer studies have examined the factors that influence their treatment decisions. In this study, 18 parents of children with ASD rated treatments according to their knowledge about them and how effective they believed them to be. They then distributed tokens representing resources (i.e., money, time, and energy) amongst the treatments they were currently using, or would use were there fewer constraints. Finally, they distributed tokens amongst hypothetical treatments about which they were only given information regarding empirical support and immediacy of outcome. Without the constraints of cost and availability participants distributed resources broadly. However, participants showed a preference for empirical support over immediacy of treatment outcome.
Treatments for Autism Spectrum Disorder (ASD) vary widely. The disorder is now considered treatable, but some interventions have extensive empirical support, while other interventions have none. Despite these stark differences in the evidence base for interventions, and efforts to educate the public, little correlation exists between what treatments work and what treatments parents choose. This review covers treatments, what people choose, and possible reasons choices are made, plus what factors may influence these choices. Data of this sort are important for clinicians and researchers, since multiple issues dictate treatment selection.
In autism spectrum disorders, many parents resort to alternative treatments and these are generally perceived as risk free. Among these, the most commonly used is the gluten-free, casein-free diet. The objective of this work was to conduct a systematic review of studies published from 1970 to date related to the gluten-free, casein-free diet in autism spectrum disorder patients. Few studies can be regarded as providing sound scientific evidence since they were blinded randomized controlled trials, and even these were based on small sample sizes, reducing their validity. We observed that the evidence on this topic is currently limited and weak. We recommend that it should be only used after the diagnosis of an intolerance or allergy to foods containing the allergens excluded in gluten-free, casein-free diets. Future research should be based on this type of design, but with larger sample sizes.
Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, Journal of Autism and Developmental Disorders, 32: 447-461, 2002). The purpose of this study was to examine the types of treatments in current use by families of children with ASD. In addition, parents' perceptions of improvement in their child's functioning were explored. Through an online survey, a sample of 970 parents of ASD children reported on the treatments currently in use, those discontinued, and reasons for discontinuation. Results indicate that most families adopt multiple treatment approaches. Parents were most likely to discontinue non-evidence based treatments when they did not see improvement in their child's functioning.
Previous studies suggest that complementary and alternative medical (CAM) therapy use in children with chronic illnesses is higher than in children in the general population. In this study, we investigated patterns of CAM therapy use in children diagnosed with autism spectrum disorders (ASD, n = 50) as compared to a control population of children with no ASD (n = 50). Over half of the parents in the ASD group reported using, or had used at least one CAM therapy for their child (52%) as compared to 28% of the control group (P = 0.024). Seventy percent of therapies used in the ASD group were biologically based therapies comprised of special diets or supplements, and parents felt that 75% of the therapies used were beneficial.
Effective Programs for Treating Autism Spectrum Disorder is written for teachers, parents, and the many service providers who work with individuals with autism spectrum disorder (ASD). Part one reviews the characteristics of ASD, summarizes major theories and research findings regarding cause(s) of ASD, and discusses the most popular treatment claims, examining each approach's scientific base and value. Part two provides an informative overview of applied behavior analysis, focusing on the principles of learning and basic procedures based upon those principles. These two parts provide a foundation for understanding the strategies implemented by the outstanding treatment programs described in Part three. The eight models described in Part three represent comprehensive, evidence-based programs for the treatment of persons with ASD, from infancy through adulthood. Programs reviewed include the Lovaas Institute, Koegel Center, Strategic Teaching and Reinforcement Systems (STARS), Project DATA, New England Children's Center, May Institute, Princeton Child Development Institute, and Judge Rotenberg Center. Strategies explained include intensive early behavioral intervention, Pivotal Response Training, verbal behavior, script fading, social stories, visual activity schedules, functional analysis, the Picture Exchange Communication System, and the Family-Teaching Model.
Autism and its milder variants are not rare. Most pediatricians will have the opportunity to provide a medical home for a child with autism. This technical report serves to complement and expand on the information in the accompanying policy statement to increase the pediatrician's fund of knowledge and comfort level in caring for children with autism. In so doing, it is anticipated that earlier diagnosis and referral for appropriate intervention will be possible and that this will, in turn, have a positive effect on long-term outcomes for children with autism and their families.
Betty and Randy Williams have given parents, teachers, administrators, other professionals, and the interested public a valuable guide to the characteristics, causes, and treatment of autism spectrum disorder. They devote the first part of the book to introducing the reader to the disorder, its potential causes, and various categories of treatments. They do this by describing the evidence related to each aspect of the disorder, possible cause, and treatment category. Their approach is to provide the reader with an understanding of how to interpret the evidence related to each aspect, possible cause, and treatment category or program they are describing throughout the book. They do this by describing their own reasoning for the conclusions they provide regarding the disorder, its causes, and treatments. They provide a rationale for determining whether treatments are scientifically based, promising, have limited supporting evidence, or are not recommended. This approach is what takes this otherwise well written book and makes it into a valuable guide.
The second part of the book elaborates on the principles and procedures of Applied Behavior Analysis that form the basis for the scientifically based treatments and promising practices to be examined in depth in part three. It gives readers the introduction or review of Applied Behavior Analysis they will need to get the most out of the descriptions of effective treatment programs provided in part three. It provides sufficient details, examples, and references to allow the novice to understand how Applied Behavior Analysis comes to be the leading approach to the treatment of autism spectrum disorder while reminding the expert of the nuances of the approach.
The third part of the book reviews eight Applied Behavior Analysis based treatment programs serving persons with autism spectrum and other disorders. Betty and Randy visited all but one of the programs to observe first hand their operations and interview face to face the staff members and managers of the programs. This approach allowed them to gather information regarding the development of the program that may not always make it into the published program descriptions. They comment on aspects of the everyday operations of each treatment program that are not usually a part of the literature describing the programs. Sufficient details, examples, and references are provided to allow readers to judge for themselves whether a given treatment program is one they may want to access or recommend for persons with autism spectrum disorders in their lives or professional practices. Another benefit to be derived from their descriptions of the range of treatment programs is to see how each treatment program emphasized slightly different aspects of applying behavior analysis principles and procedures in the treatment of autism spectrum disorders. In this way readers come to understand the generality of these principles and procedures.
The fourth and final part of the book provides readers with the authors' integration of their experiences preparing this book and from across two lengthy careers serving persons with learning challenges and preparing others to do the same. Their optimistic summary of what the science of behavior analysis has offered, how others can be prepared to take advantage of what it has offered, and what the future might hold for continuing development of effective treatments for autism spectrum and other disorders is both reassuring and uplifting. I highly recommend this book to parents, teachers, administrators, other professionals, and interested others whose lives are enriched by persons with autism spectrum and other disorders.
This article discusses intervention and treatment options being used with the population of children and youth who have autism spectrum disorders. The discussion includes interventions based on relationship formation, skill-based treatments, physiologically oriented interventions, and comprehensive educational and treatment programs. In a follow-up article, court decisions related to intervention options for students with autism are discussed, along with recommendations for choosing interventions and treatments that have the best chance of producing desired outcomes.
The search for a magical cure may be one stage In a parent's adjustment to the diagnosis of a developmental disability in his or her child. The parent may try controversial treatments as part of this search. In this article, the author discusses the reasons parents chose alternative treatments, reviews a few specific treatments, and provides recommendations to professionals on how to talk to families about controversial therapies.
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Parents of children with autism spectrum disorders (ASD; N = 479) reported via web-based survey what pharmacological (drug), diet, and behavioral/educational/alternative therapies they had tried and were using now in the treatment of their children with ASD. Depending on type of ASD, children had tried, on average, between seven and nine therapies and were now using between four and six. Children with Asperger's syndrome had tried significantly more drug treatments than had those with autism or PDD-NOS, while those in these latter two groups had tried more behavioral/educational/alternative therapies. Adolescents had a higher prevalence of drug-treatment use compared with those in middle childhood, who, in turn, had a higher frequency of use relative to those in early childhood. For most behavioral/educational/alternative treatments, more children in early and middle childhood had tried them compared with adolescents. Likewise, children in both early and middle childhood were currently using a higher number of behavioral/educational/alternative treatments than were those in the adolescent group. Findings are discussed relative to both the extant literature on treatment use among ASD families and how parents choose among the plethora of available therapies.
Parents of children with autism spectrum disorders (ASDs) may elect to use complementary and alternative medicine (CAM) treatments with their children in place of, or in addition to, conventional treatments. CAM treatments are controversial and understudied and, for most, the efficacy has not been established. The current study (n = 248) examined reports (via an internet survey) from parents of children with an ASD, asking of CAM usage, recommendation sources, expectations, costs, parent-rated assessments of efficacy, and reasons for stopping use of CAMs. Over 70% had tried at least one CAM treatment with their child, and about half were currently using one or more CAMs. Parents entered treatment with high expectations, although they varied considerably in their assessment of whether CAMs helped their child. Odds ratios of parent-rated efficacy give small leaning toward improvement over non-improvement for CAM treatments. The findings highlight the need for methodologically sound research on CAM treatments. Also needed is dissemination about treatment efficacy to help parents and professionals make educated judgments regarding both CAM and routine interventions.
Use of complementary and alternative medicine (CAM) treatments have been increasing for children with autistic spectrum disorder (ASD). In this study, 38 Turkish parents of children with ASD were surveyed related with their use of CAM treatments, experiences, and views for each treatment. They mentioned "Vitamins and minerals", "Special Diet", "Sensory Integration", "Other Dietary Supplements", and "Chelation" as five frequently used CAM treatments. Communication, learning, health, and behavior were the main four areas rated as "improved" after five CAM treatments. Negative sides of treatments were listed as being expensive, difficult to apply, or harmful. The parents' views on some treatments have varied from great improvement to worse. Reported improvements were considerably higher than the negative sides of the treatments.
To present an overview of a variety of treatment approaches in individuals with autistic disorder.
Selected studies and articles are reviewed.
In the past three decades, great progress has been made in the treatment of autistic disorder, particularly in the area of education and parental involvement, with the objective to transfer to home and in other situations learning acquired in school. A role for psychoactive agents, when combined with psychosocial treatments, has been identified.
Although considerable advances have been made in a variety of interventions-educational, psychosocial, and biological-knowledge about the comparative and combined efficacy of the various treatment modalities is lacking. From the parents' perspective, particularly, support and continuity of services require improvement.
Patients with cancer often feel that they can improve their physical condition and prognosis by altering what they eat. Their quest for nutritional information may lead them to alternative and complementary dietary therapies. Although many of thesetherapies appear to be "nontoxic" or "natural" they are often restrictive and place patients at risk for various complications and adverse events. Weitzman (1998) adds that prospective, randomized trials of alternative and complementary dietary therapies are needed, and that these nutritional therapies must be used with great caution by pediatric patients because this population is at high risk for nutritional deficiencies and diet-related complications.
This study examined the prevalence and correlates of use of different types of complementary and alternative medicine (CAM) among a sample of children with suspected or recently diagnosed autism. The authors' review of 284 charts of children seen at the Regional Autism Center of The Children's Hospital of Philadelphia, Pennsylvania, found that more than 30% of children were using some CAM, and that 9% were using potentially harmful CAM. Having an additional diagnosis was protective against CAM use and being Latino was associated with CAM use. Having seen a prior provider regarding the child's health condition was predictive of potentially harmful CAM use. Further research is required on cultural differences in treatment decisions about CAM, as well as the reasons for the association between the use of prior providers and CAM. The high prevalence of CAM use among a recently diagnosed sample indicates that clinicians should discuss CAM early in the assessment process.
We developed an Internet survey to identify treatments used by parents of children with autism. The survey listed 111 treatments and was distributed via colleagues and through chapters of the Autism Society of America and Autism Organizations Worldwide. A total of 552 parents submitted usable returns during the 3-month survey period. On average the parents reported using seven different treatments. The number of treatments used varied as a function of the child's age and type/severity of disability within the autism spectrum. Speech therapy was the most commonly reported intervention, followed by visual schedules, sensory integration, and applied behavior analysis. In addition, 52% of parents were currently using at least one medication to treat their child, 27% were implementing special diets, and 43% were using vitamin supplements. Because parents were using a large number of treatments, many of which lack empirical support, future research should focus on understanding the decision-making processes that underlie treatment selection by parents of children with autism.
Complementary and alternative medicine (CAM) is used both alongside (complementary) and as a substitute for (alternative) conventional therapies. Although CAM use is reported to be high among children with typical development, reported rates for CAM use to address symptoms of children with developmental disabilities may be higher. Increased use in this population may relate to hope for amelioration of symptoms, concerns regarding side effects of conventional treatments, and a need on the part of families to participate in decision making regarding their child's care. Primary health care providers may find that the child's needs are best served when they maintain a dialogue with families to evaluate the evidence supporting novel therapies. Interventions need to be assessed in an evidence based fashion whether or not they are initially preceived as CAM. This issue of Mental Retardation and Developmental Disabilities Research Reviews contains reviews of CAM used to treat several developmental disabilities as well as some broader discussions related to the determinants of CAM use, current efforts to evaluate novel therapies, and how to consider the possibility of placebo effects.
There is little information available about how and why parents of children with autism spectrum disorders (ASD) make decisions regarding which of the many available treatments to implement with their children. Given the lack of available information regarding treatment efficacy, it is likely that parents' beliefs about child development, interpretation of the symptoms of ASD, its etiology and course, and their experiences with the health system influence treatment decisions. This article addresses these issues within the context of cultural influences. We review the small body of existing literature regarding cultural influences on decisions regarding ASD and draw implications for the study and treatment of ASD from the larger body of literature on culture and other health conditions of childhood. In addition to examining the potential for differences in clinical presentation by culture and different experiences with the healthcare system, we use Kleinman's framework of questions for understanding the role of culture in the interpretation and treatment of ASD. These questions address interpretation of symptoms and beliefs about their cause, course, and treatment. Finally, we present specific language for clinicians to use in discussion with families with different cultural beliefs about the use of less traditional treatment strategies.
This study examined the prevalence of the use of different types of conventional, complementary and alternative therapies by children diagnosed with an autism spectrum disorder (ASD). Of 112 families surveyed, 74% were using complementary and alternative medicine (CAM) for their child with ASD. CAM use was most strongly associated with parent report of child's diagnosis. Most CAM was reported by families to be either helpful or without effect, but not harmful. The main reasons for choosing CAM were related to concerns with the safety and side effects of prescribed medications. Conventional health care providers should be aware of the high prevalence of use among children with ASD and be prepared to discuss the use of CAM with families.
Dietary, complementary, and alternative therapies Evidence-based practices and treatments for children with autism
- Hyman Sl
- B Levy Se Reichow
- P Doehring
- Cicchetti Dv
- Volkmar
- Fr
Hyman SL, Levy SE. Dietary, complementary, and alternative therapies. In: Reichow B, Doehring P, Cicchetti DV, Volkmar FR, editors. Evidence-based practices and treatments for children with autism. New York, NY: Springer; 2011. p. 275e93.
Internet survey of treatments used by parents of children with autism
- Va Green
- Ka Pituch
- J Itchon
- A Choi
- M O 'reily
- J Sigafoos
Green VA, Pituch KA, Itchon J, Choi A, O'Reily M, Sigafoos J. Internet survey of
treatments used by parents of children with autism. Research on Developmental
Disabilities 2006;27:70e84.
Internet survey of treatments used by parents of children with autism
- V A Green
- K A Pituch
- J Itchon
- A Choi
- M O'reily
- J Sigafoos
Green VA, Pituch KA, Itchon J, Choi A, O'Reily M, Sigafoos J. Internet survey of
treatments used by parents of children with autism. Research on Developmental
Disabilities 2006;27:70e84.
Treatments for autism: parental choices and perceptions of change
- A Bowker
- N M Angelo
- R Hicks
- K Wells
Bowker A, D'Angelo NM, Hicks R, Wells K. Treatments for autism: parental
choices and perceptions of change. Journal of Autism and Developmental
Disorders 2011;41:1373e82.