To battle her son's autism, Kazuko
Curtin did more than look into a treatment she started a clinic for
it.
Twelve years ago, Curtin was told by doctors that her son had
autism. In subsequent years, while attending conferences, she heard
about treatment in a hyperbaric chamber, where pressure is increased
in an attempt to boost the amount of oxygen in the child's brain.
Curtin bought a machine, and today a hyperbaric chamber is one of
the treatments offered by the CARE Clinics in Austin, Texas, and
Tampa, Fla., which she opened last year.
"Hyperbaric is very useful," said Curtin. "You never think autistic
children are going to stay inside the hyperbaric for 90 minutes,
because they are very restless. What's amazing they like it! For
some reason, they are very calm inside."
Curtin is the not the first to use hyperbaric therapy, a procedure
with little scientific backing for the treatment of autism. But a
new, small study of 56 children treated at several small clinics may
change that if the findings can be replicated.
"We wanted to do a formal study that looked to see if this was even
a valid treatment," said Dr. Daniel A. Rossignol of the
International Child Development Resource Center in Melbourne, Fla.,
and the study's lead author. "We hoped to stimulate more research."
Several experts contacted by ABC News for this story refused to
speak on the record about hyperbaric therapy. And others who did
speak on the record harbored some skepticism.
"I am concerned that the data don't support the authors'
conclusions," said Dr. Max Wiznitzer, a pediatric neurologist at the
Rainbow Babies and Children's Hospital in Cleveland.
Still, perhaps because the therapy, while still unproved as a
remedy, does not appear to physically harm a child, this study may
draw less controversy than many autism studies have in the past.
Rossignol and the study's other physicians offer therapy in a
hyperbaric chamber in their own practices a potential conflict of
interest that they noted in their paper. They said that this means
that results will need to be replicated before the therapy can be
recommended.
"Obviously, we need other people who've studied this as well," he
said.
The Search for a Cure
Rossignol said he was first introduced to the therapy when his wife
wished to use it in an attempt to treat their own two children, who
have autism.
For the study, researchers looked at 56 children ages 2 to 7 who had
varying degrees of autism. Each received 40 treatments of an hour
each.
Thirty of the children had the pressure in the chamber increased by
30 percent, while the 26 children in the control group had the
pressure increased by 3 percent.
In the end, researchers reported that 30 percent of the children who
received the treatment reported greatly increased functioning, while
8 percent in the control group did.
Despite an influx of research dollars in recent years, autism
research has yet to yield either the cause of autism or a cure. And
the lengthy path from finding a cause to using that information on a
cure has left many parents frustrated.
That, in turn, has led to the use of a number of therapies
considered risky, including chelation, the removal of heavy metals
from the body.
But while its positive effects remain unclear, hyperbaric chamber
therapy does not present the dangers that other therapies do.
"I think the biggest drain would be a financial drain," said Dr.
Paul Offit, chief of the section on infectious disease at the
Children's Hospital of Philadelphia and author of "Autism's False
Prophets," a book that chronicles some of the dangerous treatments
parents of autistic children have tried.
Offit noted that parents of autistic children have been known to
take out second mortgages in order to buy hyperbaric chambers, so
the therapy, which remains unproved, presents a risk to a family's
financial health.
"One should make certain that you get it right," he said.
Dr. L. Eugene Arnold, interim director of the Nisonger Center for
developmental disabilities at Ohio State University, echoed those
sentiments.
He said that because of the "expense and difficulty of 40 treatments
in a hyperbaric chamber [it will] require more evidence before it
could be recommended as a standard treatment."
Recent news accounts have placed the cost of hyperbaric treatment at
$100 to $900 per treatment at a center. Children in the recent study
received 40 treatments.
Research for the Future
While he remains skeptical, Offit said the treatment does merit
further research.
"It would be of value for the study to be repeated by an academic
group that doesn't have a financial desire to see it work," he said.
"I think it's good, certainly, that there was an attempt to do this
study in a prospective, placebo-controlled way."
Offit also said, however, that some changes would need to be made in
a future study, as certain factors may have biased the results of
this one. The main problem he cited was observer bias; since parents
were sometimes present in the hyperbaric chamber with their
children, they were likely aware of whether or not their children
received increased pressure, and this may have affected their
impression of their child's progress.
"I just think it was a lost opportunity," said Offit. "I don't think
it really matters who funds the study. What matters is the strength
of the data."
Another problem some doctors had with the study was the theory
behind why, exactly, treatment in a bariatric chamber might help.
Since the cause of autism remains unknown, there are doubts whether
any one specific therapy could help.
Researchers speculate in the paper that the oxygen flow to the brain
is reduced in autistic children, a condition known as cerebral
hypoperfusion, and the hyperbaric chamber is able to reverse that.
"This is purely speculative and not really supported by the
references they cite. The authors appear to be 'stretching' the
contents of the references beyond the original intent," Wiznitzer
said.
Offit added that he, too, is skeptical of that idea because autism
has been shown to affect specific areas of the brain, but if
cerebral hypoperfusion was the problem it should be affecting the
entire brain rather than specific regions.
Ultimately, more study will be needed to make any recommendations on
hyperbaric therapy for autism. In the meantime, any parents seeking
to try it may not have to worry about its effect on their child's
health but will need to worry about their finances.
"This treatment has no apparent negative effects except for the cost
[of out-of-pocket payments]," said Wiznitzer. "I tell parents that
use of complementary and alternative treatments can be explored as
long as there is no significant risk of injury, it does not
interfere with other interventions, it is affordable and it has a
defined endpoint."
Offit urged parents to be cautious.
"The way we work in this country ... when a paper comes out, we tend
to take it as fact," he said. "We should wait until we see if this
is reproduced."
Rossignol agreed that further study is needed.
"This is not a cure for autism or anything like that," he said. "It
may be an adjunct and be helpful, but it's certainly not going to
cure anybody."
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