Current Treatments

1. Intensive Home-Based Behavioral/Educational Programs
   • Floor Time (Dr. Stanley Greenspan)
   • Applied Behavioral Analysis (ABA/Lovaas)
   • Son-Rise Program (The Option Institute)
   • The National Academy for Child Development

2. Biomedical Treatment Options
   • High dose vitamin B6 treatment
   • DMG (Dimethylglycine)
   • Anti-Fungal/Anti-Bacterial
   • Essential Fatty Acids
   • Secretin
   • IVIG therapy
   • Sphingolin
   • Transfer Factor
   • Other Immune system enhancing vitamins/supplements

3. Dietary Interventions
   • Dietary Modifications
   • Enzyme Supplementation

4. Pharmaceutical Interventions
   • Anti-Seizure Medications
   • SSRIs, Stimulants, and Tranquilizers
   • Steroids

5. Other Therapies
   • Auditory Integration Training (AIT)
   • Sensory Integration
   • Other Miscellaneous Treatments

• Floor Time
  Dr. Stanley Greenspan designed this play therapy. The foundation of the program is to follow the child's lead first. For example, if the child were lining up cars, then the person playing would join in that activity. By doing this, the child then learns that his activities are meaningful and the therapist is able to build bridges to facilitate ideas and concepts. Eventually, the person doing Floor Time begins to take the lead and make requests of the child. The approach focuses on linking intent or emotions to behaviors and or words.

  Dr. Greenspan recommends 8-10, individual, 20-30 minute sessions each day, seven days per week. In some school districts, parents are taught this method. Dr. Greenspan also recommends that the parent find friends or relatives that will learn this method and help play with the child. Floor Time can be done anywhere. He understands that one or two people may find it difficult to put in the number of hours he suggests. Speech and Occupational Therapists are sometimes trained in this method, which may be covered by insurance. For further information read The Child With Special Needs by Stanley Greenspan and Serena Wieder.

• Applied Behavioral Analysis (ABA)
  Dr. Ivar Lovaas founded this approach, which involves a therapist working in a structured environment to develop skills. The child and therapist work alone in a quiet room for a 2-3 hour session. During a session, the child engages in a specific task for a short period of time and then takes short breaks. The therapist sits across from the child and rewards the child for desired responses. New skills are broken down into small tasks. Initially, the child is provided with assistance or prompts early on, in order to achieve success. Prompts are gradually faded out, allowing the child to master each task independently with minimal frustration. Then, peer play and typical preschool learning is added as part of the overall program.

  The recommended time depends on the child's needs and usually ranges from 30-35 hours per week. The parents can learn this program for approximately $1500.00 plus materials for a two-day training. Usually the parents will hire therapists and train them in this style of teaching. Pay is usually from $8-12 per hour.

• Son-Rise Program
  Barry Neil Kauffman and his wife founded this approach after working with their own autistic child who became "normal" after 3 years of therapy. This program is also based on following the child as in Floor Time. However, the Son-Rise program is much more in depth.

  The therapist would actually flap his hands or bang his head (lightly) against the wall, if that is what the child does. As in Floor Time, the child will see that his activities are meaningful and that someone is just like them. The therapist tries to enter the child's world first, so he can better understand where the child is coming from. After bonding with the child, the therapist will then "invite" the child to look into our world by making it very exciting. One aspect of this program that is similar to ABA is that the child is alone with the therapist in a room for a number of hours at a time.

  There are many unique features in this program. The first unique feature is that the person working with the child, have a "loving and accepting" attitude, meaning that they accept the child fully as they are and they would be ok if the child never changes. The program feels that through acceptance, one can come from a place that can enable them to become a more effective teacher. The Son-Rise Program believes that a child can feel if he is fully "accepted". When a child is fully accepted then he will feel "safer" and as a result his confidence and ability to express himself will increase." Eye contact is strongly emphasized, as the program sees learning as secondary to social interactions. Only through the eyes can a child learn facial expressions and be able to see the form the mouth and tongue make as a person speaks. The playroom has all of the toys on shelves, out of the child's reach. Therefore, the child must use words (although not necessarily at first) to get what he wants. Lastly, all of the people that work with the child are volunteers that the parents recruit.

  The recommended time is as much as the parents are willing to put into the program. The Son-Rise program feels that if the parents can do 1 hour a day, than that is ok. They also feel if the program can do 40 to 50 hours that would be even better. The cost is $1995.00 plus travel for a one-week training in Massachusetts. The volunteers are people that choose to do the program at no charge to the parents. The parents are responsible for training the volunteers. Parent training is now available off-site in select cities. For more information call The Option Institute at (413) 229-2100.
  The Option Institute

• The National Academy for Child Development
  Developed by Robert J. Doman Jr., the NACD program teaches that learning difficulties and behavioral problems are due to breakdowns in the child’s neurodevelopmental stages and inefficient sensory systems. Through specific, high intensity input or structured exercises, NACD’s goal is to normalize the way a person takes in information, processes it and responds. These programs address all areas including auditory and visual processing and acuity, body awareness and motor function, speech and language, as well as academic issues. When one chooses to do an NACD program, the child is evaluated every four months by an NACD Neurodevelopmentalist. This NACD specialist then designs an individualized program for the parent to follow at home. The parent determines how much time they want to spend on a program and the program is designed to fit that schedule. The programs usually consist of short games or activities that can be divided up during the day or done in longer sessions depending on preference. Cost for a yearly program which includes evaluations, ongoing support and most supplies, is approximately $1200-$1500. For more information visit www.nacd.org.

• High dose B6 vitamin treatment
  Numerous studies have shown this supplement to be helpful in many areas of autistic children, including, language, eye contact, and behavior. About half of all autistic people that try high doses of B6 vitamins (with magnesium) show at least some improvement. Less than 5% show any negative affects. The B6 must be taken with magnesium to avoid an imbalance that can worsen symptoms. B6 has shown anticonvulsant effects. It is often a much better choice than taking anticonvulsants that have side effects. B6 is a critical component of enzymes. Many autistic children have digestive problems. It is therefore possible that improvements may occur due to a better functioning digestive system, which in turn enables the child to absorb more needed nutrients. These vitamins can be obtained through many sources. Kirkman Labs (800) 245-8282 has a couple of different choices to try, including the liquid Super Nu Thera.

  Some people have had difficulty getting their child to try, or stay on the B6 due to the bad taste. One "trick" that has worked for some, is to place 1/8 to 1/4 of a teaspoon of non-buffered ascorbic acid (vitamin C) into water with the Super Nu Thera. The taste and look is almost like orange juice. Start out slow! If you put in the recommended dose the first time, your child will not want to drink it. Start out with a tiny amount and, each day build up. After a week or two, your child may get used to the taste and actually like it.

  Kirkman Labs

• DMG (Dimethylglycine)
  This nutrient is actually considered a "food", although it is sold as a supplement and is available at most health food stores. Studies of DMG have shown similar results as with B6. Again, about half show some improvements. About half have no change. And about 7% have some negative results. DMG also can have anticonvulsant effects. DMG is said to be an immune system enhancer. Thus, DMG may help autistic children due to the fact that most have numerous dysfunctions with their immune systems. TMG (Trimethylglycine) is a newer product that is DMG's "big brother". TMG reduces harmful homocysteins and increases serotonin by stimulating the production of a precursor called SAMe. Contact Kirkman Labs for information on any of these two products.

• Anti-Bacterial/Anti-Fungal Treatments
  If it is believed that yeast in the intestinal tract, such as Candida Albacans is the cause of autism in a specific child, or at least a secondary problem, than it would be wise to do all that one is able, to eliminate this problem. Liquid garlic, Medium Chain Triglycerides (MCT), Cranberry juice extract, and “good” bacteria such as Acidophilus, can all help reduce the number of damaging fungi and microbes in the intestinal tract. Lactobacillus GG sold by Aspen Benefits Group (800) 539-5195 is a commonly used probiotic in treating gastrointestinal problems in autism. Kirkman Labs (800) 245-8282 sells a product that seems to be almost the same as the Lactobacillus GG, but at a reduced price.

  Nystatin is one of the most common anti-fungal medications used due to the fact that it has almost no side effects. There are other drugs that can be used such as Diflucan, but they can have undesirable side effects, which must be weighed against the potential benefit. Long-term regression of some children has been noted, possibly due to a “die-off” reaction or an increase in harmful bacteria. It is not uncommon that once one harmful organism is reduced or eliminated, that another will thrive in its place. Thus, if an individual’s immune system is not functioning properly, if one were to reduce or eliminate yeast such as Candida Albacans, then it is very possible that a bacterial colonization such as Clostridia can occur. The “die-off” reaction usually only lasts a few days or a week, but can stay in some individuals until the treatment is stopped because even with the medication the yeast continues to reproduce and die leaving toxins in the GI tract of the child. An important first step in trying any anti-fungal drug therapy would be to determine if, indeed, the child does actually have a yeast problem. A stool test from The Great Smokies Lab (800) 522-4762 can help determine this. Also, a urine test called an organic acid test can test for many different bacteria and fungi. The Great Plains Laboratory is one lab we know of that does this. The phone number is (913) 341-8949.
  Great Plaines Laboratory

  If Nystatin were to be used, the best choice would be to get the product in a stevia base or Nystatin powder. Most Nystatin will come in a sugar base, which would actually feed the yeast and therefore, not be the best treatment. The Apothecary Inc. (301) 530-0800 can make the appropriate formula at a nominal cost. A prescription is required.

• Essential Fatty Acids (EFA)
  Essential Fatty Acids (EFA) such as Evening Primrose Oil and Omega 3 Oils have been shown to be helpful to some children. These essential fatty acids are important for proper neurological functioning. Anti-oxidants such as Picnogenol or Enzogenol are said to have health benefits as well. Since autistic children have a difficult time eliminating toxins from their bodies, then these “toxin removers” would seem to be a helpful item to try.

• Secretin
  This naturally occurring hormone has proven to be very effective in many children. When the benefits of secretin were discovered a few years ago by Victoria Beck, secretin was given by IV infusion. Then people started giving it transdermally (on the skin) via an agent called DMSO. There is some controversy about the safety of DMSO, but it appears to be safe thus far. Lastly, we have heard that FDA approval for a “new” secretin is to happen in the very near future. We are unsure if this will be oral or IV. A company called Repligen is working hard to make this a reality.

  Secretin was designed as a test for intestinal problems. When Parker Beck (Victoria’s autistic son) was tested in a hospital and wonderful changes took place, she began to search why. After much frustration and difficulties with the medical establishment, she finally was able to find a doctor that would try giving her son secretin. Secretin was not originally designed to treat autistic children. Once she and others that followed saw the positive changes that occurred, the secretin treatment caught on.

  Side effects can include temporary hyperactivity, extreme sluggishness/tiredness, rashes, and possible many others, as this drug has not been used for the treatment of autism. Thus far, however, thousands of children have been infused, used it transdermally, or orally, with very little negative side effects. The positive results that have been repeatedly documented are, better eye contact, attention span, use of more/clearer words, less tantrums, sounder sleep, and better stool. Secretin stimulates the pancreas to excrete enzymes and in turn most likely help the child absorb nutrients in a more efficient manner than they have been used to. Is this why the child improves? We don’t know for certain, but many children have been helped, whether their stools were runny or normal. There is no candidate as of yet that does the best on secretin.

• IVIG Therapy
  Intravenous Immune Globulin (IVIG) Therapy works in theory, by correcting underlying antibody deficiencies or abnormalities, as well as possibly remyelinating the brain. An infusion of human antibodies from a number of different donors is given on a monthly basis, generally for at least six months. In two separate studies, a 10% RECOVERY rate has been shown. Dr. Gupta in California should have the results of the largest study relating to autism and IVIG soon.

• Sphingolin
  Sphingolin is a supplement made from bovine (cow) spinal cord. It contains myelin sheath extract. We are currently unaware of any scientific studies that have been done involving this form of treatment. Sphingolin is relatively new in treating autism and therefore the number of people who have tried it is small. Yet, some parents are reporting improvements in speech, behavior, and sleep. L & H Vitamins (800) 221-1152 sells this product. It comes in 200 mg capsules, which contain 30 mg of ascorbic acid (vitamin C). Some people are recommending 2-8 capsules per day. Others say no more than 1/2 - 1 capsule per day. Early reports indicate that if sphingolin is used in conjunction with secretin, aggressiveness and moodiness can be greatly increased. Therefore, secretin may not work well with sphingolin. We are unaware of studies regarding side effects, so please do your homework.

• Transfer Factor
  Transfer Factor therapy is based on the fact that an immune system dysfunction has occurred. Most likely this dysfunction occurred from a nutritional deficiency via a virus/vaccine leading to autoimmunity, and thus autism.

  There are different types of Transfer Factor. In 1985 Dr. Fudenburg used Transfer Factor on twenty-two children with “classic” autism. He found that twenty of the children had Myelin Basic Protein Antibodies (MBPA). These children were treated for three and a half years, receiving Transfer Factor three days every six weeks. After the treatment twenty-one out of twenty two had improved. Ten were considered normal, in that they no longer exhibited autistic symptoms and were mainstreamed in their schools. Unfortunately, this type of disease specific Transfer Factor is not available for use today and is still being researched.

  According to 4 Life Research, a company that produces 4 Life Transfer Factor, “Transfer Factors have been made from colostrums produced by cattle and are naturally occurring immune system messengers that teach the body’s immune system to identify infectious agents.” According to Kenneth Bock, MD, numerous anecdotal reports have been accumulated on the use of Transfer Factor in children with ASD and improvement in their clinical behaviors.

• Other immune system enhancing vitamins/supplements
  As stated previously, there is most likely more then one cause of autism. Therefore, many of the following items are specific for a probable cause.

  Colostrum, the first liquid that a baby receives from its mother before the milk flows, is full of antibodies that help the infant's immune system. Bovine (cow) colostrum can be purchased through Kirkman Labs. It is GFCF. It comes in a sweet-tasting liquid, and also a powder. According to the company, they have seen better results with the liquid. Vitamin C is helpful as an immune system enhancer and studies have shown similar result to that of Vitamin B6. It may be a wise supplement for any child. Liquid Chlorophyll is believed by some to help remove metals from the body. Emerson Ecologics (800) 654-4432 sells this product. Calcium, Zinc, Folic Acid, and Vitamin B3 have also shown similar results to that of the B6. An over-the-counter "mega dose" of B vitamins, may include many of these nutrients. It would be wise however, to check the amounts of each in the formula, as each vitamin or mineral may not be present in the exact amount that each child needs. There are clinics that test blood, hair, and urine to determine specific deficiencies a child may have. The Pfeiffer Clinic in Warrenville, IL (630) 505-0300 is one such clinic.

• Dietary modifications
  This topic alone could take up an entire book. We encourage you to research this area, as well as any other topic on these pages. Some of the information is factual, and other information is speculative. As with most of the topics on these pages, opinions will vary quite a bit among the "professionals". Again, please do your own research and decide for yourself.

  Many parents feel that food is not an area they want to make changes in. However, when examining the diets of most autistic children, some interesting findings are apparent. High dietary sugar seems to be common. Although natural juices may be better than soda, they still generally have large amounts of sugar. If a child has a yeast overgrowth in his or her intestine, this would be an important area in which to consider making some changes. Even if the child does not have a yeast problem, many parents have seen improvements in behavior after removing excessive sugar from the diet.

  It is a fact that many autistic children have gastrointestinal problems. Furthermore, many of these children are unable to fully digest the food that they ingest. Many researchers feel that a large number of autistic children are lacking enzymes that break down certain foods. Gluten (from wheat products) and casein (from dairy products) are proteins that can be difficult for autistic children to fully break down into usable amino acids. These "partially" digested proteins, called peptides, are similar in chemical structure to the narcotic drug, morphine. As a matter of fact, the names of these partially broken down peptides are gluteomorphine and casomorphine, respectively.

  When researchers have given naltrexone (an anti-narcotic drug) to autistic children, many have shown short-term improvements. The interesting finding here is the fact that many children have improvements in pain perception, aloofness, and "self-stimming", even though it is short-term. Many autistic children do not appear to feel pain in a typical way. They seem to have a higher pain threshold. Given these facts, the "opioid-excess" theory seems to make a lot of sense.

  This is where dietary intervention plays a role. When gluten and casein are removed from the diets of autistic children, many show significant improvements in numerous areas. While the task of completely changing the diet of a usually finicky eater may seem difficult or impossible, many parents have been able to do so. Gathering information is surely the key to success. Most parents will have a weekly menu planned out in advance. While this treatment is not a cure, it has been proven to be a very helpful tool for improving the lives of many people, and there have been dramatic improvements in many children. The effects of the casomorphine and gluteomorphine can linger on for days and months, respectively. Therefore, some recommend the diet be tried for a full year before giving up.

  Another dietary modification that The BHARE Foundation would like to see explored is the Ketogenic Diet. While known for its anti-seizure effects, little information is available on this diet as a potential treatment for autism. One small study was done in Crete that showed very positive results. See Seizures and Epilepsy to learn more.

  Finally, an organization called The World Community Autism Project www.saras-autism-diet.freeservers.com is reporting good results using a Lutien free diet for autistic children and adults. See their website for more information.

• Enzyme Supplementation
  As many autistic children have digestive problems, it would be a wise choice to see if digestive enzymes have any effects on a specific child. Many different types are available. SerenAid and EnZymeAid are two products that we are aware of that have been specifically designed to break down gluten and casein peptides that may cause autistic symptoms. Other products that have been brought to our attention include: Peptizyde, HN-Zyme Prime, and No Fenol. For information on these products see www.houstonni.com.

  SerenAid is sold through Wellness Health at (800) 227-2627 and also through Autism Coach at www.autismcoach.com. EnZymAid is sold through Kirkman Labs (800) 245-8282. Great Smokies Laboratory (800) 522-4762 can test stool for many different things, including undigested protein and fat. Having a child’s stool tested would be a smart first step before trying the digestive enzymes.

• Anti Seizure Medication
  These drugs are helpful in certain situations. However, if one were to compare the adverse side effects as compared to the above vitamins and supplements, one would see a clear difference. While 30% of autistic children show improvements behaviorally on Depakote (Valproic Acid), 27% actually become worse. Liquid Depekene or Depakote Sprinkles would seem to be the best choice for children if one were to use this medication. This medication requires periodic blood monitoring as it can damage the liver. Visit the Seizures and Epilepsy section of the web page to learn more.

• SSRI’s, Stimulants, and Tranquilizers
  SSRIs (Selective Serotonin Reuptake Inhibitors), Stimulants, and Tranquilizers are sometimes used to control symptoms of autism or perhaps ameliorate certain features. These medications have been used by healthcare providers to help with attention, sleep, impulsivity, anxiety, obsessions, and compulsions. If a parent chooses to use these medications for their child then it would be wise to consult a specialist with experience in treating children with autism. Furthermore, it is critical the parent tell the doctor what other interventions are being used so to avoid drug interaction complications. For example, anti-fungal medication can interact with certain psychotropic agents. It is important that the parent questions the healthcare practitioner about side effects and understands the unpredictability regarding the use of theses medications in children with ASD. Allow adequate time to try different medications or combinations of medications, as each child is different.

  The Autism Research Institute has some enlightening information about parent feedback with medications they have tried with their autistic children. Ritalin for example, has 26% of the children becoming better behaviorally, while 47% actually get worse. Again, these and other medications have their place. If a child did not improve from trying many other treatments, this may be a choice to fall back on.

• Steroids
  Steroids, such as prednisone are used to treat autism if it is thought that the root cause is autoimmune. IVIG would also treat an autoimmune problem however; steroids work in a different manner. Steroids “shut down” or partial “shut down” the immune system thereby preventing the autoantibodies from attacking the brain cells. Also, neurologists sometimes use steroids to treat underlying seizure disorders.

• Auditory Integration Training (AIT)
  Most parents would agree that their autistic child has some type of sensory difficulty. Sound sensitivity is a common problem that occurs in autistic children. Studies have shown that through AIT, sound sensitivity can be reduced and behavior improved. AIT involves listening to "filtered" music. Depending on the AIT practitioner, the amount of listening time may vary. For example, one protocol includes listening for 1/2 hour followed by at least 3 hours of "not" listening, followed again by listening for another 1/2 hour. This occurs for 10 days in a row. Cost is approximately $1000.00.

  One alternative to AIT would be Ease CD. This involves listening at home or school for the same time period as AIT. You would need to purchase a special CD, which cost about $80.00, as well as a set of headphones. The CD can be purchased from Vision Audio, Inc. (410) 679-1605. Another method used is Samonas Sound Therapy www.sonas.com. This can be done through headphones or speakers. Individualized programs are written for the specific needs of a person and involve listening once or twice a day for periods of 5 minutes to 2 hours (longer times are for speaker programs) for 6-9 months. The cost is approximately $500. The Listening Program is a home or school program developed by the National Academy of Child Development www.nacd.org. It involves listening through headphones for two 15-minute segments a day for six weeks. The cost is $300.

• Sensory Integration
  Most autistic people are calmed by what is known as sensory integration. Generally, deep rubbing or pressure to certain areas of the body seem to aid in helping restore focus, and reduce the number and intensity of tantrums. Some children wear weighted vests that seem to help them. Other parents have reported some improvements following cranial sacral therapy. Brushing the child with a certain type of surgical brush has helped others. Therapro, Inc. (800) 257-5376 sells this brush at a very low cost. Temple Grandin, a highly functional and successful, autistic woman, developed her own "squeeze machine" that she used to help focus herself. This product can be purchased from Therafin (800) 843-7234. Clearly there is a powerful positive effect from sensory integration. Any successful program will have Sensory Integration in its arsenal in some way.

• Other Miscellaneous Treatments
  Biofeedback, Cranial Sacral Therapy, Interactive Metronome, Neurofeedback, Neuronet, Vision Therapy, Fast Forward, Hyperbaric Oxygen Therapy, Prism Yolk Glasses, Epsom Salt Baths, Acupuncture, Reiki, and Mozart effect music, are all areas the parent may want to research.

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