Autism

Autism spectrum disorder (ASD) is a developmental disability that is estimated to affect about 1 in 36 children and approximately 2.21 percent of adults. Autism often includes significant challenges in social communication and interaction, as well as repetitive behaviors and unusual or intense interests. Some individuals with autism have intellectual or language disabilities, and many experience sensory differences, including high or low sensitivity to sounds, light, textures, tastes, and physical touch. The autism spectrum encompasses a wide variation in the type, combination, and severity of challenges, as well as a range of abilities and strengths, which can change over the course of a person’s lifespan. 

The type and intensity of supports and services that a person on the autism spectrum may require, ranging from minimal to intensive, will vary depending on their individual needs. Some people with autism also have co-occurring physical and mental health conditions such as epilepsy, gastrointestinal issues, sleep disorders, attention-deficit hyperactivity disorder (ADHD), anxiety, or depression, which can impact daily life. 

Many individuals with autism and their families use complementary health approaches, often along with conventional medical care, to address concerns and improve their health and well-being.

Bottom Line

• A variety of therapies, including behavioral interventions, social skills training, and speech and occupational therapy, are used to help people with autism improve their daily life skills. Early interventions and supports can greatly enhance a child’s development.
• Medications are sometimes used to help with challenging behaviors or co-occurring mental or physical health conditions. Two medications are currently approved by the U.S. Food and Drug Administration (FDA) to treat irritability and aggression in autism; however, both drugs are associated with potential side effects such as drowsiness and weight gain.
• Complementary and integrative approaches are used by many individuals and families, including animal-assisted, arts (music, art, drama, dance), acupuncture, massage therapy, yoga, and exercise-based therapies. Research suggests that these approaches can be helpful in treating hypersensitivity, reducing anxiety, and improving social skills and mental health. Further research is needed on complementary and integrative health approaches to establish beneficial outcomes for individuals with autism.
• There is no scientific evidence that secretin (a gastrointestinal hormone), hyperbaric oxygen, chelation therapies, or antifungal agents can help people with autism. These treatments are not FDA-approved for autism, and inappropriate or off-label use may be harmful.
• Low doses of melatonin may help with sleep problems in people with autism, and pediatric-appropriate prolonged-release melatonin is generally well-tolerated in children with autism. However, health care providers should discuss the potential adverse side effects and the lack of long-term safety data.
• While the use of mindfulness-based practices is growing in popularity, this is still an emerging area of research with respect to autism. Current research in this area suggests that mindfulness-based interventions may be helpful for improving emotion regulation and co-occurring mental health conditions; however, more rigorous studies with larger sample sizes are needed to establish the evidence base for these approaches.
• Studies have examined omega-3 fatty acids, acupuncture, massage therapy (including qigong massage), and the hormone oxytocin. It’s not clear whether these approaches improve health and well-being for people with autism, and they should not be used in place of conventional treatments.
• Although some individuals and families may find that special diets improve their sense of well-being or health, research to date on the efficacy of dietary interventions in autism has had mixed results. Some people on the autism spectrum may have food selectivity that requires intervention to increase nutrition intake. Those who wish to try special diets should consult with their physician and have their overall nutritional needs evaluated before and while on the diet.
• There is limited research and no clinical guidance on the use of cannabis (marijuana) for ASD. However, it is used by some people with autism to alleviate conditions such as insomnia, hyperactivity, epilepsy, anxiety, and chronic pain.

Safety

• If you’re thinking about giving a child a dietary supplement or trying another complementary health approach, it’s especially important to consult your child’s health care provider. Few complementary approaches have been studied for children.¹
• If you’re considering a dietary supplement, remember that “natural” does not mean “safe.” Some dietary supplements may have side effects, and some may interact with medications or other dietary supplements. Taking too much of a supplement or substituting supplements for prescription medicines can be harmful—and even life-threatening.
• The effects of special diets, such as a ketogenic diet, aren’t fully understood. Dietary interventions focused on elimination diets, such as gluten- and/or casein-free diets, are also being used by some people with autism. People with autism need to be closely monitored when they are on a special diet to avoid any harmful side effects.
• Some people who use cannabis develop cannabis use disorder, which has symptoms such as craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. Adolescents using cannabis are four to seven times more likely than adults to develop cannabis use disorder. Research has shown that cannabis use can result in cognitive impairment that can last after intoxication and potentially affect daily functioning, including academic performance in school.
• Talk to your child’s health care provider to get help assessing what, if any, complementary approach would help your child, since children may respond differently to interventions.

For more information on ASD, please see the National Institute of Mental Health website, the Interagency Autism Coordinating Committee website, and the many sources listed on the MedlinePlus website.

¹ In the past, children were often excluded from research studies due to special protections, and findings from studies of adults were applied to children. Today, the National Institutes of Health requires that children be included in all studies, unless there are scientific and ethical reasons not to. In the autism scientific literature more broadly, children on the autism spectrum with higher support needs are often excluded from studies, which limits the ability to generalize study results.

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