AHRQ Views: Blog posts from AHRQ leaders
Helping Families Navigate the Challenges of Autism
In his recent blog recognizing Autism Awareness Month, HHS Secretary Dr. Tom Price said parents are "willing to go to the ends of the earth to ensure their children receive the medical care and services they need." As a primary care clinician who came to know many families confronting the challenges of autism, I certainly agree.
The mysteries and impacts of autism continue to challenges us all. An estimated 1 in 68 school-age children have been identified with autism spectrum disorder (ASD). Over time, we have become attuned to ASD's behavioral hallmarks, which may limit a child's ability to relate to others, adapt to change, or to play games. And, unfortunately, the search for strategies to effectively address ASD behaviors remains ongoing.
I am pleased to report, however, that two new research reports from AHRQ provide important updates about what tactics are known to be effective—and not effective—in managing ASD behaviors. These comprehensive evidence reviews, one on sensory-focused approaches and another on dietary and nutritional interventions, serve as reliable resources for clinicians and families who seek the best possible approaches for managing ASD.
A pair of articles published today in the journal Pediatrics highlight the findings. First, some promising developments regarding sensory-focused approaches. Published evidence shows:
- Activities such as massage, jumping on trampolines, and swinging exercises reduce sensory and motor impairments.
- Exposure to sensory stimuli improves nonverbal cognitive skills.
- Music therapy improves behavior and verbal and nonverbal communication skills, as well as children's ability to pay attention.
Meanwhile, some sobering news. Despite their widespread use, nutritional supplements and special diets have not been shown to substantially improve challenging autistic behaviors. According to the reviews:
- Omega-3 supplements don’t improve challenging behaviors and were associated with some minor harms, such as infections and fever, skin changes, and gastrointestinal problems.
- Some parents reported improved communication and behavior with gluten-free or casein-free diets, but the body of research is inadequate to make firm conclusions.
- And although some studies reported that Methyl B12 and levocarnitine reduced the severity of some symptoms, the benefits were small and the evidence was not strong enough to draw any conclusions.
As we pointed out today in our press release, more research is needed on these topics. Findings on nutrition and diet, for example, were based on only 19 published studies that met the research review criteria. Conclusions on sensory approaches were based on studies that covered time periods of 6 months or less.
ASD takes an enormous toll on parents who struggle each day to provide the best possible care for their children. It is imperative that we unravel ASD's causes and continue efforts aimed at ensuring that all children are equipped with the developmental tools to lead healthy, fulfilling lives.
For now, however, mothers and fathers deserve the facts about what has been shown to work—and what hasn't—in managing ASD. With the vital information in AHRQ's new research reviews, health care professionals and the families they serve are able to make informed decisions when it comes to care.
David Meyers is the Chief Medical Officer of AHRQ.