MONDAY, Jan. 4, 2010 (HealthDay News) -- A panel of experts says evidence is lacking that placing autistic children on special diets might ease behavioral and other problems.
The team's report, published in the January issue of Pediatrics, does not rule out a connection between behavioral troubles in autistic children and underlying gastrointestinal ills, but it does call for more research into a connection, as well as wider awareness on the part of physicians.
"Evidence-based recommendations are not yet available," wrote the panel of more than 25 experts, funded by a consortium of autism groups such as the Autism Society of America and the Autism Research Institute. In the meantime, the panelists said, "care providers should be aware that problem behavior in patients with autism spectrum disorders may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders."
The issue has been a controversial one, with sporadic reports of special diets helping certain autistic children widely reported by the media. Actress Jenny McCarthy wrote about such diets in her best-seller Louder Than Words, in which she described her struggle to help find effective treatments for her autistic son.
One expert agreed with the panel's findings.
"The really important point is that there simply has not been enough research in this area," said Geraldine Dawson, chief science officer at Autism Speaks, a leading advocacy group for families affected by the condition. "There's been only one randomized clinical trial and that was of 13 children -- it's so small. We simply don't have enough data to either support or not support the use of these diets."
That doesn't mean that parents and physicians should not consider undiagnosed gastrointestinal woes as a potential trigger for behavioral outbursts in children with autism, she added.
"What we do know is that these children do suffer from gastrointestinal problems. These are things like constipation, diarrhea, bloating. And the problem is that they cannot explain their own symptoms," Dawson said. "Many of these children are nonverbal, and even the individuals who have language often can't reflect on their own feelings and talk about their own pain. So what happens is that they start becoming aggressive or throw tantrums, become self-injurious, and people interpret this as the autism rather than realizing that the child actually is experiencing a lot of pain."
However, reports that a particular diet has helped a particular child should not be seen as applicable to autistic children as a whole, the panel of experts stressed. That's because such results "do not address the possibility that there exists a subgroup of individuals who may respond to such diets."
Dawson agreed. "We are always looking for a simple answer -- does it or doesn't it work? But, in fact, in autism it's never simple," she said. "If [a diet] is effective we will probably find that it is only effective for a subgroup of children and we will need to identify which kids it is effective for."
If parents do decide to try out some form of dietary modification for their child, "professional supervision of restricted diets is recommended to prevent nutritional inadequacies," the expert panel said.
Dawson believes that more and better research will be key to helping children over the long term. The first really rigorous trial looking at the usefulness of dietary modification among autistic children is being conducted by a team at the University of Rochester in New York, she said, with results expected sometime soon. And next year, Autism Speaks' own Autism Treatment Network plans to issue its own set of guidelines for the treatment of autism-linked behaviors, including recommendations on diet.
In the meantime, "parents are just left to just sort this out individually because we simply don't have enough data to either say that it's helpful or not," Dawson said.
"For now, the most important thing is for physicians to be very aware that these kids do suffer from these problems and to make sure that they are getting the treatment that they need," she said.
Find out more about autism at the U.S. National Institute of Mental Health.
SOURCES: Geraldine Dawson, Ph.D., chief science officer, Autism Speaks; January 2010 Pediatrics
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