EVIDENCE BASED

TREATMENT IN AUTISM

A BALANCE OF BENEFITS AND RISKS

Ken Pittman, MDChild Psychiatrist and Autism Specialist

Agape Youth Behavioral HealthParkridge Valley Hospital

OVERVIEW Diseases and Disorders where there is no cure… Vast Number of Treatments

Therapy Interventions Medicinal Interventions Nutritional / “Alternative” Interventions

Different Levels of Evidence Established Some-Limited Support Theoretical or Not Studied Negative Studies

Different Levels of Risk None Known or Limited Mild-Moderate Significant

WHAT I AM NOT DOING… Telling you which treatment is best for

your INDIVIDUAL child Discussing every potential treatment Saying that no/negative evidence

means it can’t work for anybody Saying that established evidence means

it works for everybody Claiming to know every study out there

PROPOSED CLASSIFICATION

ESTABLISHED BENEFITNO/LIMITED RISK Applied Behavioral Analysis Early Intervention Services TEACCH Pivotal Response Therapy Parent Mediated Intervention Animal Assisted Therapy

ESTABLISHED BENEFITMODERATE RISK Risperdal Abilify Strattera

SOME-LIMITED BENEFITNO/LIMITED RISK Joint Attention Intervention Social Skills Treatment Neurofeedback Music Therapy DIR/Floortime/PLAY Omega 3 Fatty Acids

PROPOSED CLASSIFICATION

NO SIGNIFICANT BENEFITSIGNIFICANT RISK EDTA Chelation Immmunoglobulins Hyperbaric Oxygen Therapy

NO SIGNIFICANT BENEFITMILD-MODERATE RISK Lamictal Keppra Secretin Packing Therapy SonRise Therapy Acupuncture

THEORETICAL BENEFITSIGNIFICANT RISK ECT Stem Cell Transplant

PROPOSED CLASSIFICATION

SOME-LIMITED BENEFITMILD-MODERATE RISK Other Atypical Antipsychotics SSRI’s Stimulants Depakote Aricept Namenda Oxytocin Periactin (Cyproheptadine) D-cycloserine Melatonin TTD Chelation Vitamin C Gluten/Caesin Free Diet

THEORETICAL BENEFITNO/LIMITED RISK Exercise Therapy Craniosacral Therapy Specific Elimination Diets Probiotics

ESTABLISHED BENEFITSIGNIFICANT RISK Haldol Zyprexa

THEORETICAL BENEFITMILD-MODERATE RISK Topamax THC

NO SIGNIFICANT BENEFITNO/LIMITED RISK Auditory Integration Training Sensory Stimulation Patterning Dimethylglycine

SOME-LIMITED BENEFITSIGNIFICANT RISK High Dose Pyridoxine(B6)/Magnesium

QUESTIONS?