Complementary medicine is commonly used to treat children with autism

Treatment for autistic children is often seen using alternative medicine in complement to medicine treatments.

In a study of the range of treatments being employed for young children with autism and other developmental delays, UC Davis MIND Institute researchers have found that families often use complementary and alternative medicine (CAM) treatments and that the most frequent users of both conventional and complementary approaches are those with higher levels of parental education and income.

There is no Food and Drug Administration-approved medical treatment for the core symptoms of autism spectrum disorder, a lifelong neurodevelopmental condition whose hallmarks are deficits in social relatedness, repetitive thoughts and behaviors and, often, intellectual disability.

In the search for treatments to help their children, families may turn to unconventional approaches such as mind-body medicine (e.g. meditation or prayer), homeopathic remedies, probiotics, alternative diets or more invasive therapies such as vitamin B-12 injections, intravenous immunoglobulin or chelation therapy -- some of which carry significant risks.

The research is published online today in the Journal of Behavioral and Developmental Pediatrics. It was led by Robin Hansen, director of the Center for Excellence in Developmental Disabilities at the MIND Institute and chief of the Division of Developmental Behavioral Pediatrics in the UC Davis School of Medicine.

"In our Northern California study population, it does not appear that families use complementary and alternative treatments due to the lack of availability of conventional services, as has been suggested by other research," Hansen said. "Rather, they use the treatments in addition to conventional approaches."

The cause or causes of most neurodevelopmental disorders are not known, and the conditions have no cure. Many children suffer from a wide array of associated symptoms that may not be directly associated with their condition and that make their daily lives and those of their families stressful. Such symptoms include irritability, hyperactivity, gastrointestinal problems and sleep disorders.

The study included nearly 600 diverse children between 2 and 5 years with autism and developmental delay who were enrolled in the Childhood Autism Risk from Genetics and the Environment (CHARGE) study. Of the participants, 453 were diagnosed with autism and 125 were diagnosed with developmental delay.

CAM use was more common among children with autism than children diagnosed with other types of developmental delay, 40 percent versus 30 percent respectively. Nearly 7 percent of children with autism were on the gluten-free/casein-free diet, particularly children with frequent gastrointestinal problems.

"We were pleased to find that most families utilizing CAM therapies were choosing ones that were low risk," said Kathleen Angkustsiri, assistant professor of developmental and behavioral pediatrics and a study co-author.

However, a small but statistically significant number -- about 4 percent -- were found to use alternative treatments classified by the study as potentially unsafe, invasive or unproven, such as antifungal medications, chelation therapy and vitamin B-12 injections.

"Our study suggests that pediatricians and other providers need to ask about CAM use in the context of providing care for children with autism and other developmental disorders, and take a more active role in helping families make decisions about treatment options based on available information related to potential benefits and risks," said Roger Scott Akins, lead author and a former postdoctoral fellow at the MIND Institute, who now is chairman of the Division of Neurodevelopmental Pediatrics at Naval Medical Center Portsmouth, Va.

Irva Hertz-Picciotto, professor of public health sciences and principal investigator for the CHARGE study, said the research supports the emergent need for identifying validated treatments for neurodevelopmental conditions.

"These findings emphasize the enormous and urgent need for effective treatments and for rigorous research that can identify them and verify their effectiveness and safety," Hertz-Picciotto said. "Of course it is reasonable for parents to keep searching for ways to help their children, when there are few effective treatments and none that can help every child."

Read more here

Study: Complementary & Alternative Medicine Use In Youth With Recurrent Headaches

A new study published in Pediatrics claims that children with chronic recurring headaches, especially those with another chronic condition, are more likely to use complementary and alternative medicine.

OBJECTIVE: To identify prevalence and patterns of complementary and alternative medicine (CAM) use among youth with recurrent headaches (HA) and evaluate associations with co-occurring health problems and limitations as well as with the use and expenditures for conventional medical care.

METHODS: Variables were constructed for youth aged 10 to 17 by using linked data from the 2007 National Health Interview Survey and the 2008 Medical Expenditures Panel Survey. Bivariate, logistic, and 2-part regression analyses were used.

RESULTS: Of the 10.6% of youth experiencing HA, 29.6% used CAM, rising to 41% for the many HA sufferers who also experienced difficulties with emotions, concentration, behavior, school attendance, or daily activities. Biologically based products (16.2%) and mind-body therapies (13.3%) were most commonly used, especially by the 86.4% of youth with HA experiencing at least 1 other chronic condition. Compared with non-CAM users, youth with HA who used CAM also had higher expenditures for and use of most types of conventional care.

CONCLUSIONS: CAM use is most common among youth with HA experiencing multiple chronic conditions and difficulties in daily functioning. Associations among CAM use, multiple chronic conditions, and higher use of conventional care highlight the need for medical providers to routinely ask about CAM use to meet the complex health needs of their patients and facilitate the optimal integration of care. Research is needed to identify models for coordinating complementary and conventional care within a medical home and to understand the health benefits or risks associated with CAM use in conjunction with conventional treatments for patients with HA.

Read more here

Full article is here

How to tell if your child should be checked for ADD or ADHD

This article gives much information on ADD/ADHD including medicines and other treatment options.

Does the child have ADD/ADHD?
 

Attention Deficit Disorder (ADD) is a medical condition with problems in attention, focus, distraction, organization and impulse control. Attention Deficit Hyperactivity Disorder (ADHD) also has more motor hyperactivity than expected for children of similar age/maturity levels.
 

Valid, reliable screening forms for ADD, such as the Connors Scale or the free Internet-available Vanderbilt Scale, are much more accurate when filled out by multiple teachers observing children in groups, in addition to rating parental and therapist/nurse/doctor observations. These multiple observer’s rating scales do as well as specific “on/off task” computer tests especially now that kids are so familiar with video games.
 

Although we know that certain brain areas mediated by neurotransmitters dopamine and norepinephrine may be the source of impulse and focus problems, we have not been able to translate research into a clear ADD/ADHD test. No brain image, blood or neurological test is currently available. So parents and teachers use observations and rating forms to screen for possible ADD/ADHD.
 

What to try before medicines?
 

How helpful an active parent/school evaluation can be! It is important to find out the child’s academic ability as measured by cognitive and achievement tests. Are there specific areas of underachievement (eg., just the math) or is there general lack of success? It is necessary to diagnose defiant, manipulative, negative-attention-seeking behavior. Does the child do more homework than texting, video games and phone time?
 

Parental supports and consequences for school grades should be clarified. Is the student anxious, frustrated, sick, unable to see well, depressed, hungry, sleepy, worried about home life or using illegal substances? Once a parent/school evaluation has been done, parents and school can try accommodations to help needy students receive tutoring, prompts, sessions with school counselors and better communication with parents. Is there homework, and has the homework been done and brought to school?
 

School accommodations such as a 504 Plan and Individual Education Plan have helped many impatient, disorganized, distracted students, but these plans depend on 100 percent student and parent participation with the school.
 

Medicines for ADD/ADHD
 

Try school evaluations, academic extra help, therapy, and good pediatric evaluation first. Because there are potential benefits and possible major adverse side effects, all custodial “parents” need to be part of the medicine discussion. Today, this may include married, divorced, or never-married parents or custodial relatives.
 

Types of medicines
 

Stimulants are controlled substances. They are written on a special nonrefillable script for medicines with abuse and addiction potential. Each script is follow by the U.S. Department of Justice Drug Enforcement Administration. Urine drug screens and Kasper reports (indicate prescriptions from multiple doctors) follow controlled substance stimulant scripts. Stimulants are increasingly used inappropriately without prescriptions by older students who hope for “cognitive enhancement,” or a quick fix at the last minute as they cram for exams or finish papers.
 

Types of stimulants
 

Methylphenidates are Ritalin, Methylin, Focalin, Metadate, Concerta and Daytrana.
Mixed amphetamines are Dexadrine, Adderall and Vyvanse.
 

Possible adverse side effects
 

1. Cardiac risk, especially for unrecognized pre-existing heart problems.
2. Increased pulse and blood pressure.
3. Appetite suppression and rebound binge eating.
4. G.I. upset.
5. Decreased growth.
6. Transient tics or twitches
7. Insomnia
8. Rare brief psychotic reactions or obsessive over-focus.
 

Nonstimulant Strattera: It can be used with seizure disorder. Takes one to two months for maximum benefit.
Possible adverse side effects: Similar to stimulants except no tics.
 

Nonstimulants Intuniv (Tenex, Guanfacine) and Kapvay (Clonidine)
Possible adverse side effects:
 

1. Sedation
2. May lower pulse and blood pressure
3. Do not discontinue quickly!
 

Thanks for your attention, and I hope you were not reading this with one hand on your phone and the other on the steering wheel! Our whole society is distracted, hurried, overstimulated and overstressed.
 

First, try to set priorities in your own life. Limit the video games. Turn off the TV. Increase your child’s exercise and active learning time. Second, work with your school, child and therapist. See your child psychiatrist when you are already trying the nonmedical approaches and we will work with you to coordinate nonmedical and possible medical intervention.

Read more here

Study: Alternative Medicine Use High Among Children With Chronic Conditions

This study discusses how the use of alterative medicine is very high (71%) among children with chronic health conditions. This may pose an issue if the alternative medications and therapies are not discussed with a doctor.

Children who regularly see specialists for chronic medical conditions are also using complementary medicine at a high rate, demonstrates recently published research from the University of Alberta and the University of Ottawa.

About 71 per cent of pediatric patients attending various specialty clinics at the Stollery Children's Hospital in Edmonton used alternative medicine, while the rate of use at the Children's Hospital of Eastern Ontario in Ottawa was 42 per cent. Nearly 20 per cent of the families who took part in the study said they never told their physician or pharmacist about concurrently using prescription and alternative medicine.

Sunita Vohra, a researcher with the Faculty of Medicine & Dentistry at the U of A, was the lead investigator on the study, which was recently published in the peer-reviewed journal Pediatrics. Her co-investigator was W. James King from the University of Ottawa.

"The children in this study are often given prescription medicines," says Vohra, a pediatrician who works in the Department of Pediatrics and the School of Public Health at the U of A.

"And many of these children used complementary therapies at the same time or instead of taking prescription medicine. We asked families if they would like to talk about the use of alternative medicine, more than 80 per cent of them said, 'yes, please.'

"Right now, these families are getting information about alternative medicine from friends, family and the Internet, but a key place they should be getting this information from is their doctor or another member of their health-care team, who would know about possible drug interactions with prescription medicines." Vohra said the study "identified a gap in communications" in dealing with pediatric patients and their families.

"It's important to get these conversations going with every patient, especially when you consider it's not widely recognized how common it is for children with chronic illnesses to use alternative medicine," says the Alberta Innovates-Health Solutions scholar.

"We need to make sure these families are comfortable telling their specialists they are taking other therapies," she said. Right now, Vohra and her colleagues at the U of A have developed curricula for undergraduate medical students about the use of alternative medicine by pediatric patients, which is considered innovative and novel. Ensuring medical students receive information about alternative medicine is key because it arms them with more knowledge about potential interactions with prescription medicine, says Vohra.

"Considering parents are saying they want this information, we have an obligation to ensure future physicians have the education and resources they need for these conversations," Vohra says.

Read more here