Autism is a complex condition with several etiologies granted by the varying symptoms related to it. Symptoms can vary from difficulties in communication and interaction, special interest and repetitive behaviors, to sensory sensitivities. For this reason, biological research on treatments and therapies has been extensive to determine the best form of treatment for autism spectrum disorder (ASD).
It is important to note that, while scientists drive research to determine the best form of treatment for ASD, one should not consider the findings from research as possible “cures” for autism, but rather as suggestions on ways to manage autism symptoms to assist with daily living.
This article looks at some of the most recent treatments based on the findings from biological research studies for the treatment of ASD symptoms.
What are some new treatments for autism?
Research by Medavarapu, et al. (2019), provides a comprehensive insight into biological therapies that have been proven to be effective and those that don’t have proven benefits. Treatments with proven benefits include symptomatic treatments such as psychopharmacology agents risperidone and aripiprazole. Non-biological treatments with promising results include Applied Behavioral Analysis (ABA) which includes discrete trial training (DTT), early intensive behavioral intervention (EIBI), verbal behavioral intervention (VBI), pivotal response training (PRT). Other non biological treatments with benefits include the TEACCH method, picture exchange communication system (PECS), responsive teaching (RT).
Breakdown of the proven biological treatments
If you’ve ever wondered how biological treatments are approved, the answer is biological treatment methods are tested through clinical trials. The most common and best type of clinical trial is thought to be double-blind placebo-controlled trials; in this form of trial two key factors are important and adhered to: firstly, the participants are either administered a placebo (that looks like the real drug but contains nothing) or the test drug. The participants are divided into two groups and half is administered the placebo and half the other the drug. Secondly, neither the researcher nor the participants know what is being administered.
Each person in the groups is given a code that the computer registers and that code is assigned a trial treatment (placebo or test-drug) randomly. After a period, the participants return for a follow up and the computer registers the results according to each participant’s code. Fun fact: the placebo group is known as the control group and the group receiving the actual drug is known as the treatment group. In addition, participants have to be within the same population group i.e. age group, some trials specify same gender, or ethnicity etc.
Clinical trials can take years, if not decades to be approved by the Food and Drug Administration agency (FDA). With that said, let’s look at some of the new biological treatments that have proven benefits for the treatment of ASD symptoms.
Psychopharmacologic agents are drugs used for behavior modifications and to alleviate symptoms. The two types of psychopharmacological agents are risperidone and aripiprazole commonly used for treating autism symptoms such as anxiety, irritability, inattention, aggression, self-injurious behavior, repetitive behaviors, mood lability, sleep disturbance, and/or hyperactivity.
- Risperidone is an atypical antipsychotic psychopharmacological treatment that is FDA approved. It is commonly used to treat disruptive behaviors among autistic individuals. This treatment is aimed at treating symptoms of ASD in children over five years old for symptoms such as irritability, self-injurious behavior, and aggressive behavior. One of the side effects of Risperidone is weight gain
- Aripiprazole is also an atypical antipsychotic psychopharmacological treatment that is FDA approved. This treatment is approved for the treatment of irritability among children with autism between the ages of six and 17 years. A clinical trial also found that this treatment has benefits in the reduction in stereotypy (persistent repetition), irritability, and hyperactivity in children and this was measured by the Aberrant Behavior Checklist and Clinical Global Impressions-Severity scale. Some side effects of Aripiprazole include vomiting, weight gain, and fatigue
Like most pharmacology treatments, dosage and mode of application is important—several pharmacological treatments are trial and error; supplementation of these treatments differs for every child with ASD—some factors to consider include weight, ASD-related symptoms, and age, to name a few. Sometimes, a dosage that may have been effective previously may no longer be. It is always important to consult with your child’s medical doctor.
Although psychopharmacology agents have some benefits, these should be used secondary to environmental and behavioral interventions in autistic children. Changes in social behavior and communication are not necessarily guaranteed, however, these changes can occur indirectly to the treatment depending on the symptoms that the treatment is targeting.
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Other psychopharmacologic agent treatments
Stimulants are treatments or drugs that stimulate or excite the brain or central nervous system (CNS). Double-blind placebo-controlled trials have conducted studies for stimulants believed to have benefits in ASD; these stimulants include: SSRIs, methylphenidate, and alpha-adrenergic agonists.
Typically, stimulants have been found to be effective in increasing alertness and mood, wakefulness, increase in speech and motor activity, and also decreasing appetite.
Selective serotonin reuptake inhibitors (SSRIs) are the most common types of treatments used in treatment symptoms such as impulsivity, anxiety, and repetitive behaviors among autistic children. The reason behind this is that, according to research, it counters the low serotonin levels found in some ASD patients. According to the review by Medavarapu, et al. (2019), SSRIs were found to be effective in young children with autism as seen in a double-blind two-way crossover trial.
The main limitation is that ASD therapy with SSRIs differs in results across every child. Additionally, it is not possible to firmly choose one SSRI over another to treat any symptom associated with autism.
According to the review by Medavarapu, et al. (2019), methylphenidate is said to improve symptoms in autism such as hyperactivity, inattention, and impulsivity. The limitation to this treatment is that positive results are lower among children on the autism spectrum, but higher in children with attention deficit hyperactivity disorder (ADHD).
Some side effects include decreased appetite, tics, irritability, stomach pain or discomfort, and increased heart rate. It is difficult to confirm whether this stimulant is an effective treatment as more research still needs to be conducted on the treatment in relation to its efficacy in ASD.
- Alpha-adrenergic agonists
An agonist is a chemical which binds to a receptor, activating the receptor and therefore causes a biological response (receptor activator). The alpha-2-adrenergic agonists are sometimes used to treat symptoms of hyperactivity, impulsivity, and inattention. The two types of such agonists include guanfacine and clonidine. The review by Medavarapu, et al. (2019) states that findings from double-blind placebo-controlled trials using clonidine discovered it to be effective in reducing hyperactivity, irritability, stereotypy, outbursts, etc.
Despite the volume of studies, more research needs to be conducted within the autism population to determine the dose of administration that is required to deliver the desired response (known as the dose-response relationship).
New autism treatment findings
Research has uncovered a link at the 16p11.2 chromosomal region related to autism. Genetics studies have discovered that deletion at this region has been found to be related to autism spectrum disorder (ASD). The Boston Children’s Hospital research team have developed a new way to study the effects of this deletion in human neurons which could potentially unlock new data on the cause of some autism-related symptoms.
The chromosomal region encompasses 29 genes, and according to the Boston’s Children’s Hospital researchers, it’s been discovered that deletion in the 16p11.2 region occurs among people who lack a small amount of DNA on copy of chromosome 16 (for contextual understanding, chromosomes should always occur in pairs). In short, in an effort to understand what happens in the brain cells of individuals with deletions or additions at the 16p11.2 gene region, researchers have focused their studies on the dopaminergic neurons which are found to be implicated in autistic individuals. The study is said to use two drugs that are FDA approved believed to treat the symptom of irritability in autism and act on the dopaminergic system.
Fun fact: the dopaminergic neurons are the neurons that use the neurotransmitter dopamine to transmit information between nerve cells. Dopamine is what makes us feel pleasure.
The current research is being conducted by Mustafa Sahin, MD, PhD, Director of the Rosamund Stone Zander Translational Neuroscience Center and the Translational Research Program, and Christopher Walsh, MD, PhD, Chief of the Division of Genetics and Genomics. According to McCarthy (2021), Dr. Walsh was among the researchers who first discovered the association between 16p11.2 and ASD in 2008.
There are several biological treatments that are believed to aid in relieving symptoms of autism. It is important to note that these treatments are not intended to “cure” autism, and the idea of a “cure” for ASD is not supported or endorsed by Autism Parenting Magazine.
Due to the rise in autism diagnosis and parents seeking more answers to understand the cause of their children’s autism, studies on autism pathophysiology and treatment can help ease these uncertainties. In addition, with better understanding of research findings comes better decision-making in terms of which forms of treatments or interventions are effective for autism symptoms. It is always advised to consult with your child’s medical doctor regarding any form of medical treatment prior to application.
DeFilippis, M., & Wagner, K. D. (2016). Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacology bulletin, 46(2), 18–41.
McCarthy, A. (2021). New technique yields potential treatment for a common cause of autism, https://answers.childrenshospital.org/autism-gene-treatment/
Medavarapu, S., Marella, L. L., Sangem, A., & Kairam, R. (2019). Where is the Evidence? A Narrative Literature Review of the Treatment Modalities for Autism Spectrum Disorders. Cureus, 11(1), e3901. https://doi.org/10.7759/cureus.3901
Sundberg, M., Pinson, H., Smith, R. S., Winden, K. D., Venugopal, P., Tai, D., Gusella, J. F., Talkowski, M. E., Walsh, C. A., Tegmark, M., & Sahin, M. (2021). 16p11.2 deletion is associated with hyperactivation of human iPSC-derived dopaminergic neuron networks and is rescued by RHOA inhibition in vitro. Nature communications, 12(1), 2897. https://doi.org/10.1038/s41467-021-23113-z
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