Treatment Of Autism

With Mild Hyperbaric Oxygen Therapy (mHBOT)

Written by David Rovetti, DC

Autism cases have skyrocketed in the past decade and it is now the third most prominent development condition of children today. Autism is a neurodevelopmental disorder characterized by impaired communication and social interaction. It may also be accompanied by cognitive impairment and sometimes epilepsy. Its cause remains unknown, although there is some evidence that genetic, environmental, and immunological factors may all play a role.

The physiological changes that typically occur with children with autism have been studied quite extensively. Among other things, three characteristics have been noted in children with autism:

  1. Cerebral hypoperfusion/hypoxia. Inflammation of the blood vesicles in and around the brain is most likely the cause of decreased blood flow and oxygen to key areas of the brain.
  2. Neuroinflammation. A 2005 study showed an active inflammatory process in the brain, specifically the cerebral cortex, white matter, and the cerebellum of patients with autism.
  3. Gastro-Intestinal inflammation. Enlarged lymph nodes and intestinal ulcers are common findings.

As a side note, it has been theorized that some of the behaviors associated with autism such as head-banging and irritability fits could be a direct response to inflammation in the brain or gut.

Mild Hyperbaric Oxygen Therapy (mHBOT) is the application of concentrated oxygen (usually 95-100 percent pure oxygen) while in a chamber that is pressurized. The result is a dramatic increase of oxygen in all the fluids of the body—not just the red blood cells, but the plasma, lymph and cerebral spinal fluid.

Perhaps the most dramatic physiological phenomena of this increased oxygen is a significant anti-inflammatory reaction. Simply put, HBOT reduces, if not completely stops, inflammation anywhere in the body. The three traits listed above, common in all children with autism, are inflammatory conditions.

A recent study by Dan Rossignol, MD sponsored by the International Hyperbaric Association looked at the C – reactive protein in the blood, which is an indicator of inflammation in the body.  Immediately after hyperbaric oxygen therapy, the C – reactive protein decreased significantly. This study also looked at various behavior and cognitive traits. They found improvement after 20 sessions in subject’s lethargy, motivation, mannerisms, sensory awareness, speech and cognition.

HBOT is not a cure. However, many experts have noted that HBOT supports greater and faster improvements with ancillary behavioral therapies like the Applied Behavior Analysis (ABA) and Lovaas learning programs for children with autism.

An Internet search of “HBOT and Autism” will yield hundreds of testimonials of the benefits and successes of hyperbaric oxygen therapy for the treatment of Autism.

  1. University of California, Davis. Medical Investigation of Neurodevelopmental Disorders – MIND Institute.
  2. Wilcox, I et al. Neuropsychobiology. 2002: 45: 81-86.
  3. Vargas, DL. Annals of Neurology. 2005: 57: 933.
  4. Rossignol, D. Medical Hypotheses. 2006: 68(5): 931-1190.

How mild hyperbaric oxygen therapy works and why it is good for our children

Julie A. Buckley, MD, FAAP

Physicists figured out years ago that a gas under pressure is more likely to dissolve into liquid—in mild hyperbaric oxygen therapy, the gas is oxygen and the liquid is blood. But under pressure, oxygen doesn't only hook up to red blood cells (the "traditional" way oxygen is delivered to tissues), it also dis-solves into the plasma. When that plasma circulates near dor-mant or injured tissue such as an encephalopathic brain, a bruised muscle, a sprained tendon, or a surgical wound, the oxygen in the plasma can and does dissolve further into the damaged area than the oxygen that's attached to the red blood cell in that "traditional" delivery system.

When hyperbaric therapy was first used, higher pressures of 2-4 ATA (absolute atmospheres) of pressure and 100% oxygen were used. The world of hyperbaric medicine is learning that lower pressures (1.3 ATA in the portable chambers approved by the FDA for use in the home, 1.3-1.5 ATA in larger hospital and clinic based chambers) and less oxygen (often 21 to 40% FiO2) seem to have excellent effect on multiple systems of our bodies. In particular, lower pressure appears to be more benefi-cial for the injured brain than higher pressure.

We can look to apparent healing of the brain by monitoring its perfusion and activity. We can also monitor behaviors, re-sponse to stimuli (sensory function) and motor skills. Monitor-ing of cerebral brain flow can be done with a Brain SPECT (Single Photo Emission Computed Tomography) scan. SPECT scans before and after 40 sessions of mild hyperbaric oxygen therapy (MHBOT) have shown dramatic improvements in cere-bral brain flow that is sustained over time. In addition, three recent small studies conducted independently at three different centers showed significant improvement in behavior ratings scales with mild hyperbaric therapy. This would seem to corre-late with the improved cerebral brain flow that has already been documented. These results will need larger studies and ongoing research but initial findings are very promising.

In addition to impacting cerebral brain flow in injured brains, lower pressure hyperbaric therapy has been shown to positively impact natural killer cell function and thus, immune function. It has also been found to be of benefit in inflammatory conditions and has facilitated improvement in gut disease such as Crohn's and ulcerative colitis. MHBOT has been shown to increase glutathione levels by 15% for at least 24 hours after therapy in previous studies. These areas are all of interest for parents of children with Autism Spectrum Disorders (ASD) as they are often impaired in their children.

One question that has not yet been answered is the endpoint for mild hyperbaric therapy. Families continue to report signifi-cant improvement with many more than 40 sessions. The abil-ity, with a chamber approved for use at home by the FDA, to safely continue daily therapy at home is potentially of tremen-dous value to families involved in multiple hours of therapy and time out of the home on a daily basis. To be able to use a valu-able tool before school or after dinner facilitates family life for those able to purchase a chamber for their children.

That being said, a family should consider initial therapy in a clinical setting. It is important that the child and the family be-come comfortable with the use of the equipment, the process of "clearing" the ears, and the maintenance of the chamber. Most importantly, habituating an ASD child to the chamber and the therapy process is probably best initiated with the assistance of experienced professionals. In addition, witnessing some benefit prior to making a significant purchase is a good idea. Our ex-perience has shown, however, that after 10 to 20 sessions in an office setting, most families can achieve a level of comfort that allows them to successfully operate a mild hyperbaric chamber in the home. Families of children with ASD are often well versed in extensive research and independent function with medical therapies.

Opportunities for healing in the home setting where a family can function as a unit are few and far between in the world of ASD. A therapy that appears to be of value to the vast majority of children is similarly rare. Mild hyperbaric oxygen therapy appears to be both. Ongoing research will help to explain with greater precision how exactly MHBOT improves the health and well being of our children. The anecdotal reports from parents of significant improvement are being borne out by SPECT scans and behavioral ratings scales. We appear to have a sig-nificant addition to the tool box used in recovering our children.