This week Biomed central published a double-blind placebo study of the effectiveness of hyperbaric treatment for autism. The study was published in Biomed, which is an open access journal, so readers are invited to read the entire study here. In sum, the authors randomly assigned 62 children (52 boys, 10 girls) between the ages of 2 to 7 to either a hyperbaric treatment condition or a control condition. The treatment involved 40 1-hour sessions for 4 weeks (2 sessions per day 5 times per week). After the study, all participants in the control group were offered the opportunity to receive 40 hyperbaric treatment sessions.
The authors found that hyperbaric treatment resulted in significant improvements in overall functioning, receptive language, social interaction, and eye contact. These findings were affected by the age of the child, in that children over the age of 5 showed more improvement to the treatment than children under 5. In addition, the treatment did not seem to work for children with an initial ADOS score above 50th percentile. The authors then argue that the treatment is most effective with children with more severe autism (ADOS score below the 50th percentile).
In general, the study design was strong. The authors made great efforts to make sure that the two treatment conditions were nearly identical. That is, kids in the control condition were exposed to procedures that mimic the real hyperbaric treatment (being inside the chamber, etc). Thus, it is very unlikely that the results observed were due to a placebo effect. The study also moves in the right direction by presenting evidence for the efficacy of treatments that are usually considered controversial or untested. We need more research on alternative treatment interventions that will help us determine which interventions are actually effective.
UPDATE: Please make sure you read the comments below for additional discussion on other limitations of this study.
Despite the merits of the study, I know that many people will have concerns about the authors’ conflict of interest. I quote directly from the article’s conflict of interest statement (initials refer to each author):
DAR, LWR, SS, CS, AU, JN, EMM, and EAM treat individuals with hyperbaric treatment in their clinical practices and derive revenue from hyperbaric treatment. DAR, LWR, and EAM had previously received research funding from the International Hyperbarics Association for an earlier study of hyperbaric treatment in autism . EAM has also received hyperbaric chambers and financial support (unrelated to this study) from OxyHealth LLC for remodeling the Rimland Center, a center for mentoring clinicians interested in learning how to care for children with autism spectrum disorders. The remaining authors (SL, GH, and BG) declare that they have no competing interests.
Often research is published by authors who have conflict of interest (receiving consulting payments from a drug company for example), but it is unusual for the majority of authors of a study to have direct conflict of interests. The authors are probably aware of this, so I am surprised that the authors did not include as collaborators any academic researchers with permanent research appointments at a research university. Having a reputable university team serve as umbrella for this study would have greatly appease readers who will have concerns about the conflict of interest involved.
UPDATE: Please read the comments for additional discussion on several issues related to the limitations of this study. I’m most concerned about the authors’ apparent misrepresentation of previous studies on HBOT treatment in cerebral palsy (I’m not sure how this made it through the reviewers at BMC).
Rossignol, D., Rossignol, L., Smith, S., Schneider, C., Logerquist, S., Usman, A., Neubrander, J., Madren, E., Hintz, G., Grushkin, B., & Mumper, E. (2009). Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial BMC Pediatrics, 9 (1) DOI: 10.1186/1471-2431-9-21
- All Posts (279)
- Bullying (1)
- Child Psychology (250)
- Editorials (7)
- How To Guide (7)
- Parenting (53)
- All Posts (279)