Use of complementary and alternative treatments for children with autistic spectrum disorders is increasing.
Interventions considered to be CAM are in constant flux. New treatments emerge, older treatments become less popular, and the cycle recurs. Data supporting new treatments should be scrutinized for scientific study design, clinical safety, and scientific validity. Many families approach the clinician armed with brochures, handouts, and printouts from Web sites that are dedicated to the care and support of parents and children with ASD. A recent web search using "autism and detoxification" resulted in almost 8,000 sites. The Defeat Autism Now! (DAN!) Project arose in 1995 from collaboration of members of the Autism Research Institute. The DAN! Project advocates a specific and extensive protocol for diagnosis and treatment and can be viewed at http://www.autism.com/ari/#dan. The scientific validation and support for many interventions is incomplete and disparate from the recommendation in the American Academy of Pediatrics Policy Statement. Families should be encouraged to discuss all proposed investigations or treatments they wish to try with their primary care provider so the practitioner can serve as the medical home (Sidebar, page 688). The clinician should communicate and collaborate with the family and educational professionals to encourage objective identification of what works. With increasing access to health information and societal pressure for families to actively participate in their health management, continued growth of interest in CAM can be anticipated. Clinicians must remember that parents may have different beliefs regarding the effectiveness of treatment and different tolerance for treatment risks. Practitioners must keep avenues of communication open, remain open-minded, and not assume a "don't ask, don't tell" posture in the context of providing a medical home to the increasing number of children diagnosed with autism.
Levy
Susan E
SE
Division of Child Development and Rehabilitation, Children's Seashore House, Children's Hospital of Philadelphia, PA, USA.
Hyman
Susan L
SL
D001321:Autistic Disorder / Q000523:psychology*; D002675:Child, Preschool; D000529:Complementary Therapies / Q000009:adverse effects / Q000379:methods*; D019317:Evidence-Based Medicine; D005247:Feeding Behavior; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D001523:Mental Disorders / Q000209:etiology* / Q000628:therapy*; D010372:Pediatrics / Q000379:methods; D011368:Professional-Family Relations; D016032:Randomized Controlled Trials as Topic; D012633:Secretin / Q000627:therapeutic use; D017211:Treatment Failure
D005765:Gastrointestinal Agents; D012633:Secretin