CARD Study Finds Hyperbaric Oxygen Therapy Ineffective Treatment for Children with Autism

CARD, the Center for Autism and Related Disorders, Inc., has conducted a double-blind placebo-controlled trial which found that HBOT, consisting of 24% oxygen delivered at 1.3 atmospheres of pressure, does not have a significant effect on symptoms of autism. The study is summarized on the CARD blog.

autism

"Radical" Autism Treatments - HBOT AND Stem Cell Treatment

They are not choices I would make for autism treatments for my son. HBOT and Stem Cell therapy for autism disorders are by my understanding both invasive treatments and both carry some risk to the extent at least that the full effects of these treatments on the neurological development of young children are essentially unknown at this point in time.

The bottom line for me is that neither HBOT nor Stem Cell treatments are considered to be evidence based effective autism treatments by any credible authority. Conor has received ABA; although not much during the prime 2-5 year age range due to lack of available services. ABA has helped Conor in a number of different areas but it is not a cure.

Dad: Radical Treatment Helping Son With Autism Recover is the story of an "Autism Dad" who took a different approach than I have taken. Instead of going the evidence based approach as I have done in seeking ABA intervention for Conor Daniel Faiella has sought, at considerable expense, HBOT, and more recently Stem Cell treatment, for his autistic son Matthew. Daniel's anecdotal evidence is that his son has shown dramatic improvement going from 2 word sentences to complete sentences.

Although I would not seek an invasive, unproven autism treatment for my son, I hope that the procedures being followed by the Faiella family are done safely. It would be helpful if the procedures and results of the treatments are recorded for study purposes. HBOT and Stem Cell Treatment should also be the subject of study by the appropriate research authorities since the treatments are in fact being provided to autistic children anyway.

I hope that young Matthew Faiella suffers no harm and that he continues to make progress and fully recovers from his autism disorder. In a world where parents are increasingly under attack for trying to help their autistic children I thank the Faiella family for having the courage to share their story with all of us.

The Faiella family has a blog detailing their experiences with various treatments: Mild Hyperbaric Oxygen, Adult Stem Cell Therapy, & Cranial Electrical Stimulation.

autism

HBOT Treatment for Autism? Avoid the Autism Hub, Read "Translating Autism"

Anyone reading blog commentaries about the latest HBOT study, or any other autism treatment study, should seek credible analysis from detached, professional sources if they want a proper understanding of the study in question. Any bloggers listed at the Autism Hub should be avoided unless you are simply seeking an example of the anti-cure element of the neurodiversity cult and the extent to which it colors their commentaries. If you are seeking balanced, objective commentary about the HBOT study avoid the AH-ND bloggers and check out Autism Research Blog: Translating Autism by Nestor Lopez-Duran Ph.D.

Nestor Lopez-Duran is a a clinical child psychologist and neuroscience researcher working at a large Midwest university-based child psychiatric institute. His Translating Autism blog is easily one of the best on the internet for obtaining rational, balanced and professional assessment of autism studies of any kind. I mention it frequently on this blog and believe it should be a bookmark for anyone with a genuine interest in autism disorders and autism studies. Mr. Lopez-Duran has commented on the recent Rossignol HBOT study in Hyperbaric treatment for children with autism: First controlled clinical trials and provides an assessment of the studies strengths and weaknesses including the perception that the authors of the study are in a conflict of interest - not as a way to trash the study but to point out ways the study could have been improved. He comments on the merits of the study:

"The authors found that hyperbaric treatment resulted in significant improvements in overall functioning, receptive language, social interaction, and eye contact. These findings were affected by the age of the child, in that children over the age of 5 showed more improvement to the treatment than children under 5. In addition, the treatment did not seem to work for children with an initial ADOS score above 50th percentile. This indicates that the treatment is most effective with children with more severe autism (ADOS score below the 50th percentile).



In general, the study design was strong. The authors made great efforts to make sure that the two treatment conditions were nearly identical. That is, kids in the control condition were exposed to procedures that mimic the real hyperbaric treatment (being inside the chamber, etc). Thus, it is very unlikely that the results observed were due to a placebo effect. The study also moves in the right direction by presenting evidence for the efficacy of treatments that are usually considered controversial or untested. We need more research on alternative treatment interventions that will help us determine which interventions are actually effective."

By contrast to the objective, informed "translation" by Lopez-Duran of the Rossignol HBOT study, Autism Hub and Neurodiversity commentators simply mock this and any other study which suggests that an autistic child might benefit from a specific treatment for autism. The reason for the knee jerk, lock step reaction of AH-ND members to studies of autism treatments is simple - they are anti-cure, anti-treatment. They do not want to be treated for their autism, or do not want THEIR loved ones with autism treated, and they do not believe that parents and other caregivers should be permitted to treat or cure autism in their own autistic loved ones or patients. Any study which purports to show the effectiveness of an autism treatment is anathema to them. (Hence the hostility by AH-ND bloggers towards ABA, parents seeking ABA for their own children, and ABA practicioners).

Do'C at Autism Street is one of the leading AH-ND "scientific" minds. In a recent post about the Rossignol HBOT study he was kind enough to prepare a list of "skeptical" blog comments about the HBOT study. Several of the comments are at Autism Street and LB/RB, two Autism Hub blogs. You can tell by the titles that these comments are not going to be balanced or objective assessments of the HBOT study:

"Mild HBOT For Autism - A Brief Skeptical Guide


March 29, 2009 by Do'C Printer-Friendly Version Printer-Friendly Version


For readers who may be interested in a skeptical perspective with regards to “mild” hyperbaric oxygen therapy for autism, I’ve assembled a short list of links. These are articles that I’ve enjoyed reading, found interesting, or written myself.


In no particular order:


HBOT: Under Pressure
http://photoninthedarkness.com/?p=131


HBOT: Is it just a bunch of hot air?
http://photoninthedarkness.com/?p=127


Hyperbaric Oxygen for Autism
http://www.theness.com/neurologicablog/?p=496


Is there no end to unscientific treatments for autism?
http://www.sciencebasedmedicine.org/?p=249


Mild hyperbaric therapy for autism - Shh!…don’t say it’s expensive
http://leftbrainrightbrain.co.uk/?p=2041


Autism, HBOT, and the new study by Rossignol et al.
http://leftbrainrightbrain.co.uk/?p=1987


When High Does Mean Low: Autism, mHBOT, and Dan Rossignol
http://leftbrainrightbrain.co.uk/?p=686


Does Rossignol et al. show HBOT’s effective?
http://ebdblog.com/2009/03/21/does-rossignol-et-al-show-hbots-effective


Ridiculous Autism Treatment Statements - Part One - ICDRC Website on HBOT
http://www.autismstreet.org/weblog/?p=130


Hyperbarics and Hypotheses
http://www.autismstreet.org/weblog/?p=60


Nitpicking Sloppy Science
http://www.autismstreet.org/weblog/?p=40


Autism HBOT: First Look
http://www.autismstreet.org/weblog/?p=36


Hyperbaric Oxygen as a Treatment for Autism: Let the Buyer Beware
http://autism.about.com/b/2009/03/14/hyperbaric-oxygen-as-a-treatment-for-autism-let-the-buyer-beware.htm


Hyperbaric Oxygen for Autism? Not so fast
http://www.randi.org/site/index.php/swift-blog/492-hyperbaric-oxygen-for-autism-not-so-fast.html

As a parent of a severely autistic boy of 13 I am not prepared, on the basis of this one study, and notwithstanding indications of positive gains by severely autistic children in the study, to seek HBOT treatment for my son. I would want to see further studies done by other researchers, and I am not arrogant enough to believe that I am properly educated or prepared to assess these studies myself.

I will rely upon the information provided by informed, professional commentators like Lopez-Duran and credible, responsible agencies that review these studies. If further studies confirm the benefits suggested in the Rossignol study and if it is recommended by credible sources as an evidence based treatment then I would consult my son's pediatrician and consider HBOT treatment option for him. In the meantime though I will continue with ABA for my son which has helped him in so many ways and which has a solid evidentiary basis and overwhelming professional support for its safety and effectiveness. And I will give no weight to the Autism Hub and Neurodiversity commentators who are ideologically opposed to the development of effective treatments and cures for autism. Theirs is an ideological, not an evidence based, opposition to all possible autism treatments.

autism

HBOT Autism Trial Demonstrates Clinical Improvements In Autistic Children

The US National Institutes of Health have released a summary report of a "Controlled Trial of the Clinical Effects of Hyperbaric Therapy in Autistic Children" by Dr. Daniel Rossignol last updated in July 2007 which purports to demonstrate that HBOT may improve symptoms in autistic children. The trial used HBOT in 18 children between the ages of 2 and 7 with DSM-IV Autistic Disorder diagnoses (PDD-NOS and Asperger's Syndrome were excluded). Dr. Rossignol claims that the trial demonstrates significant clinical improvements in the autistic children on several standardized scales.

The trial has some limitations in that most of the scales were parent-rated but the parents were not blinded to the fact that their children were receiving HBOT. There was no placebo or control group. The NIH summary indicates that these factors could lead to bias and that the improvements could have been due to chance or the natural development of the children and suggests the need for a double-blind controlled study.

autism

Pilot Study of HBOT Effect on Autism Symptoms Published

A pilot study of the effect of Hyperbaric Oxygen Therapy on autism symptoms, oxidative stress and inflammation has been published in BMC Pediatrics. In The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study Daniel A Rossignol , Lanier W Rossignol , S. Jill James , Stepan Melnyk and Elizabeth Mumper report their findings and conclusions from a study of 18 children with autism aged 3-16 who underwent 40 hyperbaric sessions of 45 minutes duration each at either 1.5 atmospheres (atm) and 100% oxygen, or at 1.3 atm and 24% oxygen. On safety issues the authors report that maximum pressure of 1.5 atm with up to 100% oxygen was safe and well tolerated. In terms of improvements the report indicates, as set out in the abstract, that "HBOT significantly decreased inflammation as measured by CRP levels. Parental observations support anecdotal accounts of improvement in several domains of autism." The authors of the paper note that this was an "open label" study and "definitive statements regarding the efficacy of HBOT for the treatment of individuals with autism must await results from double-blind, controlled trials".

autism

Anecdotal Evidence Indicating HBOT Effective In Treating Autism

The autism community at large has benefited from the rise of evidence based approaches generally in treating and educating people with neurological and other disorders. An evidence based approach to evaluating interventions ranks the types of evidence available in support of the efficacy and safety of an intervention in treating a particular disorder. Parents seeking treatment for their autistic children have historically been confronted by a range of non evidence based, sometimes bizarre, and sometimes dangerous, interventions.

The insistence by various professional agencies on evidence based standards has helped sort the wheat from the chaff of autism interventions. Evidence based standards have been used to identify a useful intervention like Applied Behavior Analysis, to date the only autism intervention consistently ranked as an effective autism intervention based on the quantity and quality of the research and evidence in support of its effectiveness. Ineffective interventions such as Facilitated Communication, NAET, and swimming with dolphins, to name but a few, have been rejected.

In an evidence based system the lowest ranked type of evidence is anecdotal evidence, personal accounts of the effects of treatment. Such evidence is not subject to any controls which typify scientific inquiry. The interpretation of the evidence is typically very subjective and not subject to any measurement system to provide any accuracy of results. Anecdotal evidence can also be tainted by placebo effects. Despite all these drawbacks though anecdotal evidence is still evidence, albeit of the lowest order. While it should not, by itself, be taken as conclusive in determining the effectiveness of an intervention it should not simply be discarded either. Anecdotal evidence can suggest areas that should be investigated further by professionals conducting research in accordance with scientific procedure and standards.

In Honolulu the Hyperbaric Medicine Center has been conducting a study on the effects of Hyerbaric Oxygen Treatment (HBOT) on children with autism. In the procedure, as reported by KHNL 8, children are placed in a chamber pressurized down to about 18 feet of seawater wearing a mask. They receive 100 percent oxygen at which level they are supposed to receive the healing properties of hyperbaric therapy. Alyshia Busby's daughter was a participant in the HBOT study. The family had tried a range of different treatments for their daughter's autism without seeing any results. With HBOT treatment, according to Ms Busby, there was immediate benefit to her daughter who showed more spontaneous language, attention and focus.

Conclusive evidence of HBOT efficacy in treating autism? No, far from it. But it is some evidence and it will be interesting to read the published results of the Hyerbaric Medicine Center's study.

Autism Treatments - Keeping a Disciplined but Open Mind

The USAAA conference, Treating Autism as a Medical Disorder; Bringing Biomedical Treatments and Behavioral & Developmental Therapies Together, starts today in Boulder Colorado. When I first commented on the conference and the press release announcing that a major autism study would be disclosed I received a comment from a Neurodiversity blogger who asked whether I was now embracing "quackery". For the record, I have never accepted, to date, the evidence of a vaccine/thimerosal link. In my home province here in New Brunswick I have received criticism in the past for commenting on the shortfalls in the vaccine theories and for speaking against "conferences" at which unproven biomedical products are sold. My son does not receive any biomedical treatment, no medication, no dietary supplement. He does not receive HBOT (Hyperbaric Oxygen Treatment) or stem cell treatment. Conor receives Applied Behavior Analysis, ABA, intervention because, despite the fervent ideological opposition of the Neurodiversity movement, there are hundreds of studies demonstrating gains for autistic children receiving ABA intervention.

I have not embraced, to use the term offered by the ND blogger, biomedical treatments for my son's autism disorder. That does not prevent me though from keeping an open mind about biomedical, or any other autism interventions, if further studies provide evidence of their effectiveness. By open mind I do not mean an unquestioning, accepting, approach. I will try to take an open minded but disciplined approach to new studies and new evidence concerning autism treatments and interventions. If new studies and evidence are presented showing that interventions are effective then I will be prepared to examine the evidence, with the assistance of professionals in the field, and I will be prepared to change my personal assessment of a particular autism intervention.

Two interventions which have shown some promise as autism interventions are stem cell therapy and HBOT (Hyperbaric Oxygen Treatment). There is also anecdotal evidence of parents who swear by chelation as an effective autism treatment. None of the evidence of these interventions rises to the level, in my mind, of evidence based effective interventions for autism - to date. I do not know what intervention will be the subject of the study to be announced today. My guess was that the report will focus on HBOT but if you know my record on predicting the outcome of sporting events (I picked France over Italy in the World Cup, Ottawa over Anaheim in the Stanley Cup) you should probably assume that it will NOT be about HBOT. Regardless of what intervention turns out to be the subject of the study I intend to approach the announcement and the results of the study with an open but disciplined mind. Not out of desperation as some of the ND ideologues like to chant about parents seeking new treatments for their children's autism; but because it makes no sense to make a final decision about potentially helpful new treatments and to refuse to consider new evidence. It just does not make sense to close your mind forever on such important issues.

Autism & HBOT - Hyperbaric Oxygen Is NOT An Evidence Based Treatment for Autism

I have blogged previously on Hpyerbaric Oxygent Treatment as a treatment for autism. At this point in time HBOT is NOT considered to be an evidence based treatment for autism. There is a study going on which MAY or MAY NOT change that fact but for the present, as the authorities reviewed in the Chicago Tribune indicate, there is NO evidence to support the effectiveness of HBOT in treating autism.

http://tinyurl.com/2apv44

"Parents turn to long-shot therapy for autism

By Kirsten Scharnberg
Tribune national correspondent
Published April 23, 2007, 7:48 PM CDT

HONOLULU -- Kalma Wong has tried almost everything for her two autistic children: special diets, intense behavioral therapies, flying in experts from the U.S. mainland at exorbitant costs.

Some efforts have yielded modest success. Others have done next to nothing.

But like many other parents of the more than 500,000 children that the Centers for Disease Control estimates to be autistic in the U.S., Wong has vowed to keep trying until she pinpoints the treatment that most helps her kids.

Her latest attempt is one of the most long-shot therapies yet, a protocol some doctors praise but that others declare to be a waste of time that gives desperate parents false hope and exploits them financially.

It is called hyperbaric oxygen therapy, a treatment in which pure oxygen is delivered to patients confined to pressurized chambers for an hour a day for several weeks. The theory is that the extreme doses of oxygen essentially the same kind of treatment that has been used for decades to cure divers with decompression illness will spur dormant or damaged neurons in the brain to become reinvigorated or even transformed.

In the case of children with autism, considered the fastest-growing developmental disability in the U.S. today, the new treatment is claimed to have produced some stunning results: transforming non-verbal children into fluent speakers; helping children hypersensitive to outside stimuli become calm enough to attend public schools; changing kids once adverse to any personal interaction or touching into affectionate toddlers.

....

Markley said she has treated more than 30 autistic children with HBOT and "every single child of those 33 had consistent quality-of-life improvements." The improvements, she said, were more pronounced in kids most afflicted by the characteristics of autism: the repetitive behaviors and the impairments in sensory perception, social interaction and communication.

Critics argue that no studies have been done that use scientific models such a double-blind testing. They caution that the treatment has been tried only on a handful of children affected with autism nationwide, not nearly enough to draw valid conclusions.

"They are making extraordinary claims without extraordinary evidence," Iyama said.

Evidence is exactly what supporters of HBOT are hoping to get in the coming months. Beginning in May, the Honolulu clinic, along with some 20 hyperbaric oxygen clinics across the U.S., will launch a formal study into how autistic children respond to the therapy. A total of about 400 children will be included, and the results are to be evaluated by the National Institutes for Health.

Other studies are under way that HBOT proponents are closely watching. One of the biggest is a federally funded study on the effects of HBOT on children with cerebral palsy that is under way at Wright-Patterson Air Force Base in Dayton, Ohio.

One group watching the outcomes of these studies is the Undersea and Hyperbaric Medical Society, a non-profit group of doctors that investigates scientific claims linked to HBOT. Thus far the group has been skeptical of using HBOT to help neurological conditions such as autism or cerebral palsy.

"If we just had the evidence we'd be happy to support it. But it just isn't there," Dr. Donald Chandler, executive director of the UHMS, has said in statements regarding the therapy....