Finding the Truth

Animal therapy is an increasingly popular treatment for autism. Many parents and caregivers say that their children enjoy animal therapy and that their children’s behavior improved with animal therapy. Here we discuss what animal therapy is and what the scientific literature says about animal therapy.

What is Animal Therapy?

Animal therapy is based on the pre-existing human-animal bond. Animal therapy has been shown to have a beneficial effect on various physical and mental conditions. Studies show that it can help reduce blood pressure and improve overall cardiovascular health.

Does it help people with ASD?

Maybe. One aspect of animal therapy that may benefit those with ASD is that this intervention can trigger a release of endorphins, which can produce a calming effect. When people are calmer, they usually show fewer behaviors related to anxiety. It should be noted however, that this treatment is still relatively new and not much research has been done on animal therapy and autism. As such, credible research showing that animal therapy is helpful for people with autism is sparse. It is also worth noting that support animals may come with safety, sanitation, and allergy concerns.

Is it safe?

Accredited organizations that perform animal therapy have processes for ensuring that animal therapy is suitable individuals with ASD and treatment is personalized for each patient. Consultation with your primary care provider is essential to find an appropriate animal accustomed to each individual. When contacting animal therapy providers, ask about their qualifications.

If you would like to learn more about animal therapy in ASD, please see the articles below:

• Pet Therapy
• Animal-assisted Intervention for Autism: Research is conducted by OHAIRE Lab at Purdue University about animal therapy benefits to those with ASD. This source concluded that animal-assisted intervention was associated with improved social facilitation, attentional focus, and non-judgmental companions. However, this study also noted the need for more high-quality research examining animal therapy.
• Autism and Equine-Assisted Interventions: A Systematic Mapping Review: This paper reviewed multiple studies on equine intervention for autistic people to see if there were any consistent findings across those studies. The authors found that although the studies they reviewed represented a new field of study, they seemed to indicate that equine-assisted interventions can broadly benefit children and adolescents with ASD.
• Companion animals and human health: benefits, challenges, and the road ahead for human-animal interaction: This study discusses the benefits and challenges of human-animal interactions with regard to health. The health benefits demonstrated included: 1) reduced depression and loneliness, 2) improved social skills, 3) decreased anxiety and arousal, and 4) increased physical activity. Problems associated with human-animal interactions were high expense, allergies, asthma, zoonoses, animal bites and scratches, and human falls. Additionally, there are inconsistent policies permitting animals into public places as well as housing developments. The study also reported that additional research is necessary to evaluate the efficacy of each type of animal therapy intervention on the overall health of humans.

Essential Oils and ASD:

Some people consider the use of essential oils to be a useful holistic care method for people with ASD. A variety of essential oils have been suggested as possible remedies for ASD symptoms. Parents and caregivers to children with ASD sometimes claim that the essential oils listed below can potentially reduce behaviors such as anger, anxiety, attention-deficit, hyperactivity, sensory overload, sleep issues, and meltdowns.

Please note: With the use of any essential oils, there is a risk for allergic reaction. Essential oils should not be ingested, applied undiluted to the skin, or overused. Essential oils are not regulated by the FDA; therefore, it is important to speak with your healthcare provider prior to use of the following:

Vetiver is an essential oil used as an aromatherapy that could help treat nervousness, insomnia, and joint and muscle pain. There is little accredited research done to prove vetiver aromatherapy as a beneficial holistic care method for individuals with ASD; however, it has been shown to have some antimicrobial factors as well as positive effects on insomnia.

Sources:

• Modification of sleep-waking and electroencephalogram induced by vetiver essential oil inhalation
• Anxiety-like behaviour and c-fos expression in rats that inhaled vetiver essential oil

Cedarwood is essential oil used as an aromatherapy originally to prevent moths from eating clothing and repelling ants. Further research reveals that it may provide benefit in acne treatment, antibiotic activity, and pain relief, and also swelling and inflammation and provide stress and anxiety relief. Research has also suggested that cedarwood can promote better sleep and help lengthen sleeping time when used with a diffuser. The EPA states there are no safety concerns with use, however essential oils can cause skin irritations. There is minimal accredited research supporting the benefits for individuals with ASD; however, the benefits discovered could show beneficial results for poor sleep and anxiety.

Sources:

• WebMD
• Characteristics of two cedarwood essential oil emulsions and their antioxidant and antibacterial activities
• The anxiolytic effect of Juniperus virginiana L. essential oil and determination of its active constituents

Frankincense as an aromatherapy is still being researched, but it has shown some results with regard to promoting relaxation. The research for this essential oil is in early stages, and doctors are not ready to make wide-ranging declarations about the effectiveness of frankincense on an ongoing basis. Many essential oils used as aromatherapies are not regulated by the FDA and could cause allergic reactions when used on the skin. Small doses are encouraged when oils are applied to skin and/or used as aromatherapy. You should speak with your primary care physician prior to use.

Sources:

• WebMD
• The Effects of Frankincense Essential Oil on Stress in Rats

Lavender is an essential oil that is thought to promote calming and relaxation, improve sleep, relieve pain, have antibacterial properties, and improve memory. The research involving lavender and individuals with ASD have mixed results supporting its effectiveness at improving sleep, although some parents support putting a few drops in bath water prior to bed. Lavender can be inhaled or applied to the skin as a lotion.

With all essential oils, there is a risk of allergic reactions; therefore, spot testing and beginning with small amounts is encouraged. When applying lavender oil to the skin, the oil should be diluted to prevent skin irritation.

Sources:

• Evaluating effects of aromatherapy massage on sleep in children with autism: a pilot study
• The Effect of Music Therapy and Aromatherapy with Chamomile-Lavender Essential Oil on the Anxiety of Clinical Nurses: A Randomized and Double-Blind Clinical Trial

Mandarin is an essential oil thought to have antispasmodic, antiseptic, digestive, nervous relaxant, and sedative properties. It can be used with a diffuser as an aromatherapy or applied to the skin.. Research on Mandarin essential oil and ASD is minimal; however, parents have claimed that it is particularly easy to use as an aromatherapy for anxiolytic purposes because the children are fond of the scent. There is a potential for skin irritation; therefore, essential oils should not be ingested or applied to the skin undiluted. If applied to the skin, it is important to ensure the oil is confirmed not to be phototoxic or oxidized to prevent irritation.

Sources:

• Biological Activities and Safety of Citrus Essential Oils

Peppermint is an essential oil used for GI distress, sinus congestion relief, anxiety relief, decrease in sensory overload, and headaches. There have been possible side effects noted with ingestion, such as heartburn, flushing of skin, headache, mouth sores, and diarrhea. Small dosages are recommended, as well as consultation with primary care providers prior to use. Pregnant and breastfeeding women should avoid use due to the lack of research performed about their safety during pregnancy and lactation. Research on the benefits of peppermint essential oil and individuals with ASD is lacking. There are potential benefits claimed by parents praising the calming effects and cooling sensations on the body.

Sources:

• A review of the bioactivity and potential health benefits of peppermint tea (Mentha piperita L.)

Ylang ylang is an essential oil that is thought to have positive effects on human emotions, alleviate anxiety, and increase blood flow to parts of the body. As with any essential oil, it is imperative to dilute the essential oil prior to application on skin. Ylang ylang essential oil has been linked to contact dermatitis, and it has been proven to be poisonous to dogs and cats. Research on ylang ylang essential oils in relation to individuals with ASD is limited, so the effects and benefits are not definite.

Sources:

• Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang
• Relaxing effect of ylang ylang oil on humans after transdermal absorption

Bergamot is an essential oil used in aromatherapy that helps to create a feeling of joy, freshness and energy by improving blood circulation. Practitioners of aromatherapy believe that inhaling essential oils or absorbing them through the skin transmits signals to the limbic system (the region of the brain that regulates emotions and memories). Some of the main uses of bergamot essential oil are acne, anxiety, chronic fatigue syndrome, headache, insomnia, and depression. The evidence supporting these claims are weak and only have a few positive findings in small clinical studies. As with any essential oil, topical application can cause skin irritation and should only be performed with diluted oil. Research with Bergamot essential oil and individuals with ASD yield varying results; therefore, benefits of this essential oil improving anxiety and sensory overload are questionable.

Sources:

• Bergamot Aromatherapy for Medical Office-Induced Anxiety Among Children With an Autism Spectrum Disorder: A Randomized, Controlled, Blinded Clinical Trial
• Acute Effects of Bergamot Oil on Anxiety‐Related Behaviour and Corticosterone Level in Rats

Chamomile is an essential oil popular for its various claims to anti-inflammatory effects, pain reducing abilities, anxiety relief, sleep improvement, congestion relief, and improvement in digestion. There is limited accredited research on the benefits of chamomile essential oil and individuals with ASD. With studies supporting various claims such as GI support, improvements with generalized anxiety disorder, depression reduction, and sleep aid, chamomile may have some benefits to those with ASD. Consultation with your primary care provider is encouraged prior to use.

Sources:

• An open-label pilot study of a formulation containing the anti-inflammatory flavonoid luteolin and its effects on behavior in children with autism spectrum disorders
• The effects of chamomile extract on sleep quality among elderly people: A clinical trial

Music therapy is a relatively new treatment for ASD that some parents and caregivers swear by. Below, we discuss what music therapy is and review scientific literature testing the efficacy of music therapy for treating ASD.

What is music therapy?

Music therapy is the clinical use of music to accomplish individualized goals such as reducing stress, improving mood, and self-expression. It is an evidence-based therapy that may include listening, singing, composing music, or playing instruments.

Does music therapy work?

Maybe. There is evidence both supporting and denying the efficacy of music therapy. Research supporting music therapy claims that it reduces anxiety and can alleviate social problems in children with ASD. However, other studies found that music therapy has no effect on improving social flexibility, responsiveness, or attentiveness. It is possible that different people may achieve different results with intervention. Similarly, music therapy may be a good treatment for certain symptoms of ASD but not others. It is important to note that music therapy should be discussed with your primary care provider to ensure efficacy and proper utilization of this intervention.

If you would like to learn more about music therapy in ASD, please see the articles below:

• Music Therapy as a Treatment Modality for Autism Spectrum Disorders
• Music therapy for people with autism spectrum disorder: This study assessed music therapy for those with autism spectrum disorder through randomized, controlled trials with different groups receiving music therapy, standard care, and no treatment. The findings of this updated review provide evidence that music therapy may help children with ASD to improve their skills in primary outcome areas that constitute the core of the condition, including social interaction, verbal communication, initiating behavior, and social-emotional reciprocity. Music therapy may also help to enhance non-verbal communication skills within the therapy context. Furthermore, in secondary outcome areas, music therapy may contribute to increasing social adaptation skills in children with ASD and promote the quality of parent-child relationships. In contrast to the studies included in an earlier version of this review, published in 2006, the new studies included in this update enhanced the applicability of findings to clinical practice. More research using larger samples and generalized outcome measures is needed to corroborate these findings and to examine whether the effects of music therapy are enduring. When applying the results of this review to practice, it is important to note that the application of music therapy requires specialized academic and clinical training.
• Music interventions for children with autism: narrative review of the literature: This is a literature review emphasizing the contradiction in support of music therapy in those with ASD. After searching relevant databases, 128 articles were identified, of which 20 met the study’s inclusion criteria. Composed songs and improvisational music therapy were the predominant music techniques used in the included studies. There was somewhat limited evidence to support the use of music interventions under certain conditions to facilitate social, communicative, and behavioral skills in young children with autism. The implications of these findings in terms of use of music interventions, issues related to generalization and maintenance, and future research are discussed.
• The Effect of Music Therapy and Aromatherapy with Chamomile-Lavender Essential Oil on the Anxiety of Clinical Nurses: A Randomized and Double-Blind Clinical Trial.: This study aimed to determine the anxiolytic (anxiety reducing) effects of music therapy, lavender essential oil, and chamomile essential oil. The study was performed by nurses and measured anxiety after usage of the targeted methods. Results showed that the interventions of music therapy and chamomile-lavender essential oil could reduce the anxiety of the participants and was recommended for use.

Gastrointestinal (GI) issues are frequently reported in people with ASD. As a result, it has been suggested that special diets may help alleviate GI discomfort and improve ASD symptoms generally. Here, we describe the dietary challenges associated with ASD, what different specialized diets entail, and what scientific literature reports for each diet.

Diet and Nutritional Challenges for those with ASD

• Nutritional Deficiencies: Nutritional deficiencies are very common in kids with ASD. This can be because children with ASD may have preferences for specific foods and reject other foods, leaving them with a limited diet. These unbalanced diets can lead to various kinds of holes in your child’s nutrition.
• Gastrointestinal (GI) Symptoms: GI issues are common among children with ASD. Common symptoms include: stomach pain, bloating, constipation, diarrhea, nausea, and vomiting.
• Food Sensitivities: In some cases, the GI issues mentioned above may be the result of food sensitivity, which is common in children with ASD. Some of the more common food sensitivities are casein and gluten.

Gluten-Free Casein-Free Diet (GFCF)

• What is Casein? Casein is a protein found in milks, eggs, yogurts, cheeses and other dairy products. Some individuals may be sensitive to this protein, causing GI issues. If casein is what is irritating an individual’s stomach, then a casein-free diet may relieve some of the symptoms.
• What is Gluten? Gluten is a wheat protein found in many breads. Crackers, baked goods, and cereals also contain gluten since many of these foods contain wheat products. Celiac disease, an autoimmune reaction to gluten, is common among those with autism.
• Why are Gluten-Free Casein-Free Diets Popular? Gluten and casein sensitivities are common among those with autism. Some parents have claimed this diet has helped relieve some of their child’s GI symptoms. Parents have also claimed that the GFCF diet helped improve their child’s ability to concentrate and alleviated repetitive behaviors.
• What do the Experts Say about the GFCF Diet? While a few parents have claimed improvements to their child’s behavior and GI symptoms, multiple studies have shown that the GFCF diet has no impact on improving GI symptoms nor behavioral issues. Experts do not recommend starting this diet unless your child has a casein or gluten sensitivity. There is a possible risk of nutrient deficiency due to the restrictive nature of this diet. Always speak to your doctor or a nutritionist before changing your child’s diet.
• If you would like to learn more about the GFCF diet,this review paper explains the science behind the GFCF diet and discusses its efficacy: Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems?
• This website that explains what gluten and a gluten free diet are, provides a list of foods that contain gluten, explains the risks and difficulty in maintaining this diet, outlines the nutritional deficits that can come from following this diet, and how to get started with this diet.
  • Gluten-free diet

Sugar Free Diet:

• Why do people try Sugar Free Diets? Many children with autism also have hyperactivity disorders (such as ADHD). Some people believe that this excessive energy can be linked to the amount of sugar their children eat. Some parents have claimed that a sugar-free diet has helped their child’s hyperactivity and behavioral issues.
• What do the Experts Say about Sugar Free Diets? There is very little research to back up claims that a sugar-free diet helps those with autism. In fact, the link between hyperactivity disorders and sugar intake is still being investigated. Some research shows that the consumption of high-sugar foods had no effect on hyperactivity in children. Other research suggests a link between insulin release and autism. Much more research needs to be done before the scientific community can reach a conclusion about the effect of a sugar-free diet on autistic or hyperactive children. Always speak with your physician before changing your child’s diet.

Ketogenic Diet (KD):

• What is a ketogenic diet? A ketogenic diet consists of a high fat, low carbohydrate diet. By consuming a high amount of fat and a low amount of carbohydrates, the body uses the fats to create a substance called “ketone bodies,” which the brain uses for energy. You may have heard of this kind of diet before. In recent years, it has become a popular diet for weight loss but has also shown to have potential for helping those who have ASD and/or epilepsy.
• Why do some parents try a ketogenic diet for children with ASD? Individuals with autism can sometimes also have epilepsy (recurrent seizures). Alongside other preventative measures and/or medications, a ketogenic diet has shown to help prevent seizures in some. In addition, some studies have shown that a ketogenic diet helped improve their child’s behavioral symptoms. Because of these two things, some parents try the ketogenic diet in hopes of preventing seizures in their child and improving the behavioral symptoms associated with ASD.
• What do the experts say about a ketogenic diet? Studies have shown a ketogenic diet to be beneficial in helping prevent seizures when used alongside other treatments like anti-seizure medications. Some studies have also reported that a ketogenic diet improved behavioral symptoms in children with ASD. Scientists believe this diet helps those with ASD by decreasing inflammation, balancing out certain neurotransmitters in the brain, and regulating bacteria in the gut. Overall, the ketogenic diet shows promise as a therapy for ASD.
• Are there any risks to starting a ketogenic diet?While a ketogenic diet as a therapy for ASD does sound promising, some side effects of this diet have been noted. Always speak with your doctor or nutritionist before changing your child’s diet.
  • Common side effects in children: GI issues such as constipation and vomiting, lack of energy, complaints of hunger
  • Risk of nutritional deficiencies: Many children with ASD are picky eaters and only eat a limited number of foods. Because of the restrictive nature of this diet, they may be even more limited in the foods that they eat, leading to nutritional deficits.
  • Long-term use of this diet in older individuals may lead to: High cholesterol, hyperuricemia (high amounts of uric acid in the blood), and kidney stones

Probiotics

• What are probiotics? People in favor of probiotics advocate for ingesting small amounts of live “good” bacteria and/or yeast to promote good health. In particular, probiotics are thought to restore or improve the microbiota (bacteria) of the gut. Though probiotics are generally thought to be safe, it is important to consult with your primary care provider prior to starting probiotic to ensure that they could be of benefit in treating GI symptoms.
• Why do some people with ASD use probiotics? Compared to their peers, children and adults with ASD tend to have more GI symptoms such as abdominal pain, constipation, and diarrhea. One concern regarding the health of children with ASD is the tendency to only eat a few foods (selective eating), sometimes preferring processed foods to fruits, vegetables, and whole grains. Using probiotics has been shown to help, prevent, and relieve GI symptoms experienced by those with ASD. In addition, recent studies have recognized a “microbiota-gut-brain axis” as a key modulator of neuropsychiatric health, meaning that maintaining a healthy gut microbiota could improve general health, depression, anxiety, and stress. Probiotics have beneficial effects regardless of ASD diagnosis and could be helpful in relieving some of the GI symptoms present. Encouraging a balanced, healthy diet is also helpful in preventing GI distress.
• If you are interesting in reading more about probiotics, please see the articles below:
  • 8 Health Benefits of Probiotics
  • Autism spectrum disorder and digestive symptoms
  • Effects of Probiotic Supplementation on Gastrointestinal, Sensory, and Core Symptoms in Autism Spectrum Disorder: A Randomized Control Trial
  • The Ultimate Guide to Supplements for Autism

If you Google information about autism, sooner or later you’ll probably come across “anti-vaxxer” groups. Anti-vaxxers are people who believe that vaccines cause autism and that children should not receive vaccinations against common childhood diseases. Below, we breakdown anti-vaxxer arguments and discuss how the anti-vaxxer movement got started.

Vaccines DO NOT cause Autism!

There is no credible evidence to suggest that the MMR (measles, mumps, and rubella) vaccine, or any childhood vaccination causes autism. Multiple studies have been conducted concerning the safety of childhood vaccinations and their link to autism, but no connection has been found.

Do Preservatives in Vaccines Cause Autism?

Since the anti-vax movement began, some have called into question the use of thimerosal, a preservative containing mercury, in vaccines. After many studies concerning the safety of thimerosal, the scientific community determined that thimerosal is safe to use in vaccines and does not cause autism. Even though it is safe, thimerosal was removed from or reduced to small amounts in almost all childhood vaccines as a precaution.

What Started the Anti-Vaccination (Anti-Vaxx) Movement?

• In 1998, a then-doctor named Andrew Wakefield published a paper in which he claimed that the MMR vaccine may cause autism. Thus began the anti-vax movement. Wakefield’s original paper was flawed: it misrepresented data to make it look like there was a connection between vaccines and autism. This misrepresentation later caused the publisher to redact the paper. Andrew Wakefield’s medical license was revoked, and the scientific and medical communities rejected his claims about vaccines. Since the late 1990s, many studies have been conducted to determine whether there is a link between autism and vaccines and to confirm the safety of vaccines. No link between vaccines and autism has been found.
• You can read more about the history of vaccines and the history of the anti-vax movement here: Do Vaccines Cause Autism? | History of Vaccines.
• This website explains the flaws of the Wakefield study in more detail: Vaccines and Autism

More Resources about Vaccines and Thimerosal:  Below is a list of scientific studies and resources that examined whether or not there was a link between autism and vaccines. The consistent conclusion was that there is no link between ASD and vaccines (click on the title of each subpoint to see the entirety of scientific article to which we’re referring).

• Vaccines and Autism: A Tale of Shifting Hypotheses. This review was written to address three specific concerns that have been raised:
  1. Does the MMR vaccine cause autism?
  2. Does thimerosal (a preservative sometimes used in vaccines) cause autism?
  3. Do vaccines given simultaneously weaken a child’s immune system?

This paper was reviewed at many different studies and determined that:

• The MMR vaccine does not cause autism.
• Thimerosal does not cause autism.
• Giving multiple vaccines at once is safe and does not overwhelm or weaken the immune system.
• Autism and Vaccines This website provides links to many studies that investigated whether vaccines caused autism, if preservatives in vaccines caused autism, and other questions concerned parents may have.
• Autism and Vaccines | Vaccine Safety Here, the CDC writes about the safety of vaccines and thimerosal. They also provide a list of scientific articles for further reading about vaccine safety.
• https://www.cdc.gov/vaccinesafety/pdf/cdcstudiesonvaccinesandautism.pdf This informational poster provides summaries and citations to many of the studies conducted on the safety of thimerosal.

The Importance of Vaccinations:

• Protecting your Child: By vaccinating your children, you are helping their immune systems learn to recognize and fight off an illness before they even get sick. Vaccines are a safe and effective way to protect a person from deadly and/or life-altering illnesses.
• Protecting the Community: Vaccinations not only protect the vaccinated individual, but they help protect the community from the disease as well! When many people are vaccinated in a community, it becomes harder for diseases to spread from one person to another. This concept is called “herd immunity.” Herd immunity is important because it helps protect those who cannot get vaccinated for medical reasons. By vaccinating yourself and your family, you are helping prevent the spread of disease in your community!
• You can learn more about the importance of vaccinations here!
• You can learn more about herd immunity by clicking on the topics below:
  • Herd Immunity Animation
  • Herd immunity