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Saturday, January 11, 2014

Complementary and Alternative Medicine

There is a new study in the Journal of Behavioral and Developmental Pediatrics:  Akins, Krakowiak, Angkustsiri,  Hertz-Picciotto, and Hansen, "Utilization Patterns of Conventional and Complementary/Alternative Treatments in Children with Autism Spectrum Disorders and Developmental Disabilities in a Population-Based Study.  The abstract:
Objective: To compare the utilization of conventional treatments and utilization of complementary and alternative medicine in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD).
Methods: Participants were 578 children who were part of an ongoing population-based, case-control study of 2- to 5-year olds with ASD, DD, and the general population. Parents completed an interview on past and current services.
Results: Four hundred fifty-three children with ASD and 125 DD children were included. ASD families received more hours of conventional services compared with DD families (17.8 vs 11;p < .001). The use of psychotropic medications was low in both groups (approximately 3%). Overall, complementary and alternative medicine (CAM) use was not significantly different in ASD (39%) versus DD (30%). Hispanic families in both groups used CAM less often than non-Hispanic families. Variables such as level of function, immunization status, and the presence of an identified neurogenetic disorder were not predictive of CAM use. A higher level of parental education was associated with an increased CAM use in ASD and DD. Families who used >20 hours per week of conventional services were more likely to use CAM, including potentially unsafe or disproven CAM. [emphasis added] Underimmunized children were marginally more likely to use CAM but not more likely to have received potentially unsafe or disproven CAM.
 Conclusion: Use of CAM is common in families of young children with neurodevelopmental disorders, and it is predicted by higher parental education and non-Hispanic ethnicity but not developmental characteristics. Further research should address how health care providers can support families in making decisions about CAM use.
At The Huffington Post, Catherine Pearson writes:
"CAM use is quite prevalent, especially in children with" autism spectrum disorders, said Dr. Kathleen Angkustsiri, an assistant professor of developmental and behavioral pediatrics at the University of California, Davis, MIND Institute and an author of the study. She emphasized that parents used CAM in addition to traditional, evidence-based treatments -- not as a replacement.
But researchers also found that 9 percent of the children had been treated with some form of potentially harmful CAM.
Some had used chelation therapy, used to remove heavy metals from the body. It has been shown ineffective in treating autism -- and unsafe. Others had used treatments the researchers considered invasive, such as vitamin B12 injections. Only one child had used secretin, a drug that has been shown to be ineffective treating autism. The authors said that shows the scientific community has successfully communicated the results of clinical trials to the general public.

Overall, Paul Wang, senior vice president for medical research at the nonprofit advocacy group Autism Speaks, said he was not surprised by the high use of CAM among children with autism, citing a larger study, published in the journal Pediatrics last year, which found that roughly 30 percent of children had used some form of CAM -- with higher usage among children with gastrointestinal issues.