A Systematic Review of the Literature on the
Chiropractic Care of Patients with Autism Spectrum Disorder

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   Explore (NY). 2011 (Nov); 7 (6): 384–390

OPEN ACCESS

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Alcantara J, Alcantara JD, Alcantara J.

International Chiropractic Pediatric Association,
Media, PA, USA.
research@icpa4kids.com

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BACKGROUND:   In addition to impacting the affected child and his/her family's quality of life, recent estimates place the lifetime cost for an individual with ASD at $3.2 million and $35 billion for the entire birth cohort. Given the clinical heterogeneity of ASD, treatment approaches are multidisciplinary including alternative therapies, particularly when no pharmaceutical agent is effective for the core symptoms of ASD. Chiropractic is a popular alternative therapy for children. A systematic review of the literature was performed to provide context for future research endeavors in this field.

METHODS:   A systematic review of the literature on the chiropractic care of patients with ASD utilized 8 databases. Eligibility criteria for inclusion included: (1) the study was a primary investigation/report published in an English peer-reviewed journal; (2) the study involved patients =18 years; and (3) patients are diagnosed with autism, Asperger's Syndrome, PDD-NOS, or ASD.

RESULTS:   Our systematic review of the literature revealed a total of five articles consisting of three case reports, one cohort study and one randomized comparison trial. The literature is lacking on documenting the chiropractic care of children with ASD.

DISCUSSION:   At the heart of the core symptoms of ASD (ie, impaired social interactions, deficits in communication and repetitive or restricted behavioral patterns) is abnormal sensory processing. Preliminary studies indicate that the chiropractic adjustment may attenuate sensorimotor integration based on somatosensory evoked potentials studies.

CONCLUSION:   We encourage further research for definitive studies on chiropractic's effectiveness for ASD. However, given the ineffectiveness of pharmaceutical agents, a trial of chiropractic care for sufferers of autism is prudent and warranted.

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From the FULL TEXT Article:

Introduction

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) defines three core features of autism: qualitative deficit in social interaction, impaired communication, and stereotyped patterns of behavior. [1] According to the DSM-IV, and the International Classification of Diseases (10th Edition), [1, 2] the term Autism Spectrum Disorder (ASD) includes not only Autistic Disorder but also Asperger's syndrome, Pervasive Developmental Disorder—Not Otherwise Specified (PDD-NOS), Rett's syndrome, and childhood disintegrative disorder. For the purpose of this article, we use the term autism and ASD interchangeably unless otherwise specified. ASD diminishes the overall quality of life of the affected individual as well as their family and represents a great burden to society. The disorder impacts a family's finances, employment, and time, and not surprisingly, it places the parents and siblings of children with ASD at risk for great psychological distress. [3-6] In 2006, on average, approximately 1% or one child in every 110 was classified as having ASD based on 11 Autism and Developmental Disabilities Monitoring (ADDM) network sites in the United States. [7] Recent estimates place the lifetime cost to care for an individual with ASD at $3.2 million and approximately $35 billion for the entire birth cohort. [8]

Given the heterogeneity of the disorder, treatments that may be effective are typically multidisciplinary and may include auditory training, discrete trial training, vitamin therapy, antiyeast therapy, facilitated communication, music therapy, occupational therapy, physical therapy, and sensory integration. [9, 10] According to the Centers for Disease Control and Prevention (CDC), [10] these different care approaches can generally be categorized as: behavior and communication approaches (ie, applied behavior analysis), dietary approaches (ie, elimination of certain foods and use of vitamins and minerals), medication (ie, to address comorbidities), and complementary and alternative medicine (CAM) therapies.

Of the various practitioner-based CAM therapies used by the American population at large, chiropractic is the most popular and highly utilized by children. [11] Anecdotes and testimonials abound within the chiropractic profession on the benefits of chiropractic care for children with autism. This article seeks to use a systematic review to examine to what degree these claims are supported by the scientific literature.

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