Hyperbaric oxygen in the treatment of childhood autism: a randomised controlled trial.
Sampanthavivat M1, Singkhwa W, Chaiyakul T, Karoonyawanich S, Ajpru H.
Abstract
BACKGROUND:
Promising results with hyperbaric therapy for children with autism have been reported, but most involved the use of only mild pressure with oxygen supplementation. To date, there has been no randomised, blinded trial of 100% oxygen administered at hyperbaric pressure. This study evaluated the efficacy of hyperbaric oxygen therapy (HBOT).
METHODS:
Sixty Thai children with autism, aged three to nine years, were randomly assigned to receive 20 one-hour sessions of either HBOT at 153 kPa (1.5 ATA) or sham air at 116 kPa (1.15 ATA). Effects on behaviour were measured using the Autism Treatment Evaluation Checklist score (ATEC) and clinical improvement was measured with the Clinical Global Impression (CGI) system; in particular the clinical change (CGIC) and severity (CGIS) sub-scores. These were evaluated by parents and clinicians, both of whom were blinded to the actual exposure.
RESULTS:
The mean total ATEC scores by both parents and clinicians were significantly improved after intervention in both arms of the study compared to the score before intervention (P < 0.001 in both groups by parents, P = 0.015 in HBOT group and P = 0.004 in sham group by clinician). There were no statistically significant differences in average percentage changes of total ATEC score and all subscales scores when comparing the HBOT and sham air groups, either by parents or clinicians. Changes in the CGI scores following intervention were inconsistent between parents and clinicians. For severity scores (CGIS), parents rated their children as more improved following HBOT (P = 0.005), while the clinicians found no significant differences (P = 0.10). On the other hand, for change scores (CGIC) the clinicians indicated greater improvement following HBOT (P = 0.03), but the parents found no such difference (P = 0.28).
CONCLUSIONS:
Children with autism who received 20 sessions of either HBOT or a sham air exposure had significant improvements in overall behaviour but there were no significant differences in improvement between groups. The inconsistent changes on CGI sub-scores between parents and clinicians are difficult to interpret, but no overall clinically significant benefit from HBOT could be shown. Both interventions were safe and well tolerated with minimal side effect from middle ear barotraumas.
http://www.ncbi.nlm.nih.gov/pubmed/22987458
FDA Warns Consumers About Common Off-Label Autism Therapy
http://www.forbes.com/sites/emilywillingham/2013/08/23/fda-warns-consumers-about-common-off-label-autism-therapy/
The FDA minces no words in its consumer alert about hyperbaric oxygen therapy :
No, hyperbaric oxygen therapy (HBOT) has not been clinically proven to cure or be effective in the treatment of cancer, autism, or diabetes. But do a quick search on the Internet, and you’ll see all kinds of claims for these and other diseases for which the device has not been cleared or approved by FDA.
Evidently, the list of conditions HBOT purveyors have promised the therapy will treat is a long one and includes Parkinson’s disease, hepatitis, and multiple sclerosis, in addition to autism and cerebral palsy.
Of course, none of these conditions has been linked to a lack of access to oxygen for your tissues, which is the only indicated use of HBOT as a therapy. In fact, the FDA approves use of HBOT for 13 specific conditions, all of them related to helping boost the body’s access to oxygen. They include HBOT for carbon monoxide poisoning and for burns resulting from heat or fire.
Like any medical intervention, HBOT carries risks, according to the FDA, including mild effects such as ear pressure or sinus pain all the way to very serious adverse effects such as paralysis and embolisms. Oxygen, feeding fire the way it does [correction], also means a fire risk for anyone undergoing HBOT, which have been involved in about 80 deaths worldwide. Not something you want to do with any old street corner practitioner.
In addition to these risks, the FDA cautions that people turning to HBOT for autism or cerebral palsy or for cancer or Parkinson’s might well be delayed from receiving effective therapies and interventions while they waste time and money on HBOT.
Proponents of HBOT as a treatment for autism argue that the controversy around it is “political, not scientific.” But that’s not actually the case. In addition to the risks associated with HBOT, all of which at the least involve pain and discomfort, research suggests that the therapy is ineffectual, and the costs suggest that it’s enormously expensive for an unproven, “off-label” intervention that parents could just “try and see.”