Controlled Evaluation of the Effects of Hyperbaric Oxygen Therapy on the Behavior of 16 Children with Autism Spectrum Disorders

21 Apr

Hyperbaric oxygen treatment (HBOT) has become a big topic in the world of CAM (complementary and alternative medicine) and autism. An upcoming parent convention with a focus on CAM is even sponsored by an HBOT company. A few papers have come out, without much clear evidence of benefit.

A recent paper looks again at HBOT. This paper has a few limitations. Amongst these: there were only 16 participants and, well, I consider papers by Thoughtful House and by Andrew Wakefield in particular to be somewhat problematic.

Here is the abstract:

Controlled evaluation of the effects of hyperbaric oxygen therapy on the behavior of 16 children with autism spectrum disorders.

Jepson B, Granpeesheh D, Tarbox J, Olive ML, Stott C, Braud S, Yoo JH, Wakefield A, Allen MS.

Thoughtful House Center for Children, Austin, TX, USA.
Abstract

Hyperbaric oxygen therapy (HBOT) has been used to treat individuals with autism. However, few studies of its effectiveness have been completed. The current study examined the effects of 40 HBOT sessions at 24% oxygen at 1.3 ATA on 11 topographies of directly observed behavior. Five replications of multiple baselines were completed across a total of 16 participants with autism spectrum disorders. No consistent effects were observed across any group or within any individual participant, demonstrating that HBOT was not an effective treatment for the participants in this study. This study represents the first relatively large-scale controlled study evaluating the effects of HBOT at the level of the individual participant, on a wide array of behaviors.

One problem with HBOT studies in the past is the attempt to use a placebo like therapy. It seems to this observer at least that it would be quite easy to distinguish placebo vs. real HBOT. The current study avoids that. They took data during a baseline period, during the HBOT therapy weeks and a post-HBOT period. They found that there was no benefit.

These findings diverge considerably from those of Rossignol et al. (2009). The current study controls for the potential ‘‘washing out’’ of the effect when group data are averaged (as must be done in a between-groups design) by carefully measuring potential changes in 11 topographies of behavior over time across 16 individuals. If there was a subgroup for which HBOT was effective, it seems likely that at least one such child would have participated in the current study. The lack of an effect for any participant in the current study makes the existence of such a subgroup seem implausible.

The paper concludes:

News programs and community blogs report that many families of children with autism are using HBOT therapy. The cost of such treatment may range up to $150 per hour. Families report using anywhere from 40 to 120 h of HBOT. These hours are in lieu of other therapies such as applied behavior analysis, speech therapy, and occupational therapy and do not include travel time to the medical center where the therapy is provided. Some families purchase the chambers in order to provide therapy in their home. A number of websites focus on renting ($1,395 per month) and selling ($8,495–27,995) chambers to families. Given the financial and time-investment required for HBOT and the conflicting study outcomes to date, we cannot recommend HBOT as a treatment for autism until such time as more conclusive favorable results are demonstrated.

This is consistent with a previous study which included one of the above authors, Randomized trial of hyperbaric oxygen therapy for children with autism, which concluded:

This study found HBOT to have no significant beneficial effect on ASD symptoms. The experimental design of the current study is of a higher rigor than those employed in previous studies which have suggested that HBOT is effective. Further, the dependent measures included were far more comprehensive than those included in previous studies; therefore it is unlikely that an effect was present which was not detected. Based upon the findings of the current study, HBOT delivered at 24% oxygen at 1.3 atmospheric is not recommended for the treatment of ASD symptoms.

Do’C over at the AutismStreet blog has followed the HBOT research pretty closely. Here is his list of articles skeptical about HBOT.

My own view:
HBOT is expensive, time consuming, not effective for treating autism and will continue to be promoted heavily to parents looking for a way to help their children. There is something profoundly wrong with the world of CAM and autism if they don’t move away from therapies like HBOT.

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76 Responses to “Controlled Evaluation of the Effects of Hyperbaric Oxygen Therapy on the Behavior of 16 Children with Autism Spectrum Disorders”

  1. David N. Andrews M. Ed., C. P. S. E. June 20, 2011 at 17:21 #

    steve veloso,

    you’re being a pillock.

    it makes bugger all difference if chemmomo has a completed PhD in chemistry and written a book or if chemmomo has done neither of these things. what matters is what has been said. scientific terms are very tightly defined and you seem to be totally unaware of this, or you are just ignoring it because it is just inconvenient for you to have to take into account.

    you are claiming that oxygen is ‘more like a catalyst’ in the way that it supports combustion. as chemmomo has very clearly explained, with excellent reasoning, oxygen is not a catalyst: it is a reactant.

    i learned all this in grade-school chemistry, where you should have learned it too.

    fact: catalyst – chemical which facilitates a reaction but is not consumed in the reaction. in chemmomo’s example, the oxygen is consumed. it does not remain unaffected by the reaction. ergo is is not ‘more like’ a catalyst. it is a reactant since it is consumed in the reaction. what is so fucking hard for you to get about that?

    “let the readers decide for themselves who is correct and who is not.”

    chemmomo is right. you are wrong. hint: look at chemmomo’s name… this may be linked to some serious interest or expertise in … chemistry! also, the chemistry texts that i have in my library support what chemmomo says, not what you say.

    “I just hope the readers on this page does not agree with your reasoning else they will be wrong when they answer an IQ question of does oxygen supports combustion?”

    i administer IQ tests. i have never seen a question of that sort in any test i have investigated. that question would come up in a chemistry learning assessment test, not in and IQ test. now, i have a BA-equvalence in psychology and a master’s in educational psychology, with course-work and practical assessment of my skills in testing and explaining the results of tests… you want to get into a stupid argument with me on the basis of what you think might be in a generic Psych 101 course? because if you are, you’re already a lost cause.

    now, bugger off and leaeve the science talk to those who can actually do it!

    • Sullivan June 20, 2011 at 19:49 #

      David N. Andrews M. Ed., C. P. S. E.,

      steve veloso’s responses remind me of the old saying: the first step in getting out of the hole is to stop digging. He made an off-the-cuff remark that was simply wrong. Defending it only serves to make him seem less expert, not more.

      “let the readers decide for themselves who is correct and who is not.”

      I didn’t realize I had the power to do otherwise.

      I have no idea what his freshman chem teacher had to say. I know if he/she likened oxygen to a catalyst, he/she was wrong.

  2. David N. Andrews M. Ed., C. P. S. E. June 20, 2011 at 17:34 #

    in comment in moderation, typo:

    laeave -> leave.

  3. David N. Andrews M. Ed., C. P. S. E. June 20, 2011 at 20:28 #

    Sullivan: you’re right. Dunning-Kruger syndrome should be an entry in the new DSM V being worked on now … SV could easily become one of its first diagnosees!

    “I didn’t realize I had the power to do otherwise.”

    Heh … well, it’s not like truth is established by means of a jury system, is it? SV and his sort worry me!

    “I have no idea what his freshman chem teacher had to say. I know if he/she likened oxygen to a catalyst, he/she was wrong.”

    Absolutely. This was a definitional thing, and there it ends, no? SV was wrong. And now looks like a pillock. With ambition that low, maybe SV needs to learn the meaning of the abbreviation: STFU!

    😉

  4. steve veloso June 24, 2011 at 15:57 #

    David N. Andrews: you just showed everybody here the level of education you have. You see, highly educated people do not call other people a pillock or loose your cool and tell other people to STFU! specially on a discussion.
    This is my last post. I cannot argue with someone who argues just for the sake of arguing. If I say the world is round, you will probably say no, it is elliptical. I’m sorry but I cannot go down to your level.

  5. David N. Andrews M. Ed., C. P. S. E. June 24, 2011 at 22:53 #

    steve veloso: “David N. Andrews: you just showed everybody here the level of education you have. You see, highly educated people do not call other people a pillock or loose your cool and tell other people to STFU! specially on a discussion.”

    Actually, highly educated people do call other people ‘pillocks’, and we do tell other people to STFU; we also know whether someone has lost their cool or not – and I haven’t. The level of education I have is beyond sufficient to know that you are a fucking idiot who learns nothing because he just doesn’t fucking want to. You deserve the scorn you get from me. I’ve worked with people whose brains were turned to mush by post-viral encephalitis or whose brains had not developed very much (if at all). They have proper reasons for not having been able to learn a great deal. You – to all intents and purposes – have a fully functioning brain, so you do not have even an excuse to not learn anything. Deal with being a pillock. Because that is exactly what you are.

    And I know very well that all I’m doing is saying what other people here are thinking.

    “This is my last post.”

    Thank fuck for that!

    “I cannot argue with someone who argues just for the sake of arguing.”

    Actually, you cannot argue with someone who knows things far better than you fucking do. There … FTFY.

    “If I say the world is round, you will probably say no, it is elliptical.

    Actually, if you did it was round, you’d be very wrong. The earth is an oblate spheroid… so, yes… in profile, it is actually elliptical.

    “I’m sorry but I cannot go down to your level.”

    You mean you’re sorry that you can’t get up to my level. There… FTFYT.

  6. David N. Andrews M. Ed., C. P. S. E. June 24, 2011 at 22:54 #

    response to the hopefully not visiting steve veloso in moderation… it’s a doozy!

  7. David N. Andrews M. Ed., C. P. S. E. June 25, 2011 at 09:57 #

    typo: “Actually, if you did it was round, you’d be very wrong.” should be… “Actually, if you did say it was round, you’d be very wrong.”

  8. hollow point June 28, 2011 at 10:45 #

    Andrews you are wrong!!!
    “The earth is an oblate spheroid… so, yes… in profile, it is actually elliptical”

    The earth is close to an oblate spheroid, but not specifically an oblate spheroid!

    source: http://en.wikipedia.org/wiki/Earth#Shape

  9. David N. Andrews M. Ed., C. P. S. E. June 28, 2011 at 13:19 #

    hollow point… it’s still> fucking elliptical, you prick!

    Best of it is that HP is too thick to understand the maths that s/he is trying to use against me. For a start, the ‘close to’ issue is because the Earth is not a smooth shape. Then there’s the issue of the mathematical function describing an oblate spheroid

    The flatness of the oblate spheroid is calculated by dividing the minor radius by the major radius, and then subracting the result from 1. This means that, ignoring the roughness of the surface of the Earth (e. g., by ‘averaging out’ the local maxima and minima), the shape of the Earth is in act that of an oblate fucking spheroid.

    Ergo, I was not wrong (contrary to HP’s claim). HP, go and learn some maths. Then come back and talk. Otherwise, get back to bed with your mum. You’re too young to be talking with us big people!

  10. David N. Andrews M. Ed., C. P. S. E. June 28, 2011 at 13:21 #

    comment in moderation. HP is wrong. The reason why HP is wrong is explained in the comment. HP needs to stop being an idiot and learn maths and what the terms actually mean.

  11. アイフォン ケース オリジナル September 16, 2013 at 03:05 #

    iphone 稼ぐ アイフォン ケース オリジナル http://www.jxhgk.com/

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