Autism Treatments

Autism is one of the most studied, yet unfortunately most misunderstood disorders of the mind, possibly because it encompasses such a wide variety of disabilities and symptoms. Fortunately, treatment research for ASD is one of the most cutting edge topics in neurobiology today. No cure has yet been discovered, but science is coming close, and has already made strides in either managing or in some cases eliminating some of the behaviors often associated with ASD such as aggression and hyperactivity [1]. Currently, treatments for autism spectrum disorders include hyperbaric oxygen therapy, education interventions, pharmaceutical treatments, and virtual reality treatments- these are some of the most cutting edge branches of science being studied today. Furthermore, there exists a slight gender bias in that young males are often studied much more than their female counterparts.

Hyperbaric Oxygen Therapy

This recent paper shows a key relationship between behavior and concentration of oxygen in the brain. After conducting a study of 64 boys, each having received 80 sessions in a hyperbaric oxygen environment displayed increased melancholy behavior at home, and less aggression [3]. The thought is that the increased oxygen in the surrounding environment will increase blood flow to the brain, as well as increasing hemoglobin concentration in the blood. The increase in oxygen will lessen the stress throughout the cortex. All of the subjects were able to improve their speech patterns, improve cognitive and motor functions, and overall expressed a melancholy behavior as opposed to the aggressive behavior that many had previously exhibited [3] [7]. Another recent study had 72 children sitting in chambers of 24% oxygen at 1.03 atm. The children were given 40 hourly sessions, and results were compared with a control group [7]. After the 40 sessions, the control group had no change whatsoever in behavior. In contrast, the ASD group displayed improved speech and less hyperactivity [7].

Education Interventions

Education interventions attempt to promote learning in children with ASD by applying different classroom dynamics, and promoting communication [10]. Parents and educators and children working together to ensure patience, smaller class sizes, and overall positive learning experiences are achieving this goal.

The P.L.A.Y. Project

Dr. Rick Solomon of the Ann Arbor Center created the Play and Language for Autistic Youngsters (P.L.A.Y.) project for Developmental and Behavioral Pediatrics [10]. His research and philosophy states that constant 1:1 ratio of parent/teacher/educator to student with ASD will improve overall cognitive function, and enable the child to focus with the educator while learning [10]. The PLAY project hopes to raise awareness as well as funds to be able to properly train educators in how to properly teach children with ASD so as to ensure a positive learning experience for both teacher and student.

Pharmaceutical Treatments

Although there are know pharmaceutical methods of curing ASD, there are some potential candidates that can make the condition more manageable. Serotonin is a neurotransmitter that is often associated with autism cases [9] as well as exposure to selective serotonin reuptake inhibitor SSRIs), which are commonly found in many anti-depressants. Simpson et al. showed that pre-natal exposure to SSRIs could seriously increase the risk of developing ASD [9]. Although SSRIs are linked to the etiology of ASD, antidepressant medication serves as the primary group of pharmaceutical treatments for ASD [9].

Haloperidol

The use of antidepressants however has been studied at great length. For example, the use of haloperidol has been extensive throughout history [2]. Children with ASD were given haloperidol, which aided in the inhibition of withdrawal behavior and promoted language acquisition. Unfortunately, the administration of haloperidol was linked to the increase in dyslexia cases [1] [2]. Another common adverse effect was weight gain. Children who were given haloperidol had an overall weigh increase of about 8-10kg [6] Haloperidol is a dopamine inverse agonist that is also used in the treatment of other neurological disorders [6].

Risperidone

Risperidone is a very effective drug and is often used in treating autism. Studies have shown that the use of risperidone has significantly decreased the potential symptoms. A double blind placebo-controlled study was conducted with children and adults by the research units of Pediatric Psychopharmacology Autism Network [8]. At the beginning of the study, all individuals had significant aggression, irritability, and self-injury. Each of these traits was quantified according to the aberrant behavior checklist [1]. After 8 weeks of treatment, patients displayed significant improvement in their aggression, irritability, and self-injury [8]. Again however, subjects experienced significant weight gain. The drug itself is a dopamine antagonist and is often used to treat schizophrenia as well [8]. It targets D1 and D2 receptors to decrease the levels of dopamine in the brain [8].

Aripiprazole

Aripiprazole is one of the newest available drugs in the United States, and has shown to be most effective to patients with ASD ranging from 6-17 [4]. Similar to risperidone, it is a dopamine antagonist that targets the D1 and D2 receptors to decrease overall dopamine levels in the brain. Only slight weight gain is associated with this drug [4]. Patients who were given aripiprazole experienced similar effects like decreased aggression and irritability [4]. The FDA approved the use of this drug for autism patients in 2009 after it showed a significant decrease in aggression, self-injury, mood swings, and irritability [4]. Over dosage of this drug can cause depression of the entire central nervous system leading to coma or even death [4].

Virtual Reality Dolphin Training

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One of the most cutting edge research discussions being had today in the field of ASD treatments is the creation of the virtual reality dolphinarium [5]. Cai, et al. are proposing the construction of an interactive virtual reality treatment facility for children with ASD. Studies have already shown that animal training and interaction with animals promotes melancholy behavior and inhibits aggression and irritability in children with ASD [5]. The idea of Cai and his team is to create that same phenomenon but in a secure environment where children can not only interact with virtual dolphins, but also learn about environmental concern and habitat destruction. The dolphinarium will help aid in the treatment of autism as well as raise awareness [5].

Gender Bias in ASD Treatment Studies

Most if not all autism studies use male subjects in the course of their work. This bias is due to autism being four times more common in males then in females. This is due in part to the SHANK-1 gene. In males, if they are missing a copy of the gene, the developmental process is affected, whereas in females, there is less effect [11].

Bibliography
[1] Aman, M.G., Singh, N.N., Stewart, A.W., Field, C.J. The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency. 5:485-491. (1985). [2] Armenteros, J.L. et al.Haloperidol-related dyskinesias and pre- and perinatal complications in autistic children. Psychopharmacology 31:363-365 (1995). [3] Bent, S. et al. Hyperbaric Oxygen Therapy in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 42; 1127-1132 (2012). [4] Burris, K.D., et al. Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors. Journal of Pharmacology. 302:381-389. (2002). [5] Cai, Y. et al. Design and Development of a Virtual Dolphinarium for Children with Autism. Neural Systems and Rehabilitating Engineering. 42; 35-40 (2013). [6] Perry, R., et al. Long-term efficacy of haloperidol in autistic children: continuous versus discontinuous drug administration. J. Am. Acad. Child Adolesc. Psychiatry. 28:87-92. (1989). [7] Rossingol et al. Hyperbaric treatment for Children with autism: a multi-cellular double lined controlled trial. BMC Pediatrics. 10: 1471-2431 (2009). [8] Research Units on Pediatric Psychopharmacology Autism Network. 2005. Risperidone treatment of autistic disorder: longer-term benefits and blinded discontinuation after 6 months. Am. J. Psychiatry. 162:1361-1369. [9] Simpson, K. et.al. Perinatal Anti-depressant exposure alters cortical network function in rodents. PNAS. 45: 18465-18470 (2011). [10] Solomon, R. et al. Pilot study of a parent training program for young children with autism. Autism. 11: 205-224. (2007). [11] Zhan Y. And Kong X. Synaptic Dysfunction attributes to autism spectrum disorder. North American Journal of Medicine and Science. 4(3): 112-15 (2011).

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