Prevalence and Correlates of Use of Complementary and Alternative Medicine in Children with Autism Spectrum Disorder in Europe

Background:  Complementary and alternative medicine (CAM) comprises diverse health care systems, practices, and products not considered to be part of conventional medicine, including potentially unsafe or definitively disproven approaches. Children with ASD are treated with CAM at higher rates than the general population. In US samples, high parental educational level, lower level of functioning and high levels of use of conventional treatment increase the likelihood of CAM use.

Objectives:  To report on prevalence and correlates of use of different categories of CAM among a sample of young children with ASD in Europe. Specifically, the following characteristics in relation to the likelihood of CAM use were examined: child’s age, gender, verbal ability, use of prescription medication, level of use of conventional treatment, parental educational level.

Methods:  Parents of children with ASD < 7 years completed an online survey on use of conventional, pharmacological and CAM treatments. The survey, translated in 19 languages, was distributed via national support associations in 20 countries.

Results:  The survey yielded 1,680 responses. Forty seven percent of parents reported having used one or more CAM approaches in the past 6 months; for these, the total number of different CAM approaches used ranged from 1 to 12 with a mean of 2.15 (SD=1.55; IQR: 1-3). Diets and other supplements were used by 25% of the sample, mind and body practices by 24% and other unconventional approaches by 25%. A minority of parents reported having tried an invasive or potentially harmful approach (2%). Children over 5 years and children with lower verbal ability were more likely to have used CAM. Use of any prescription medication was associated with using any CAM, particularly diets and supplements (two-fold increase).  Concurrent high levels of use of conventional psychosocial interventions were associated with a three-fold increase in use of any CAM; the effect was four-fold for mind-and-body practices. Higher parental educational level also increased the likelihood of CAM use; both of diets and supplements and mind-body practices.

Conclusions:  This was the first study to report on factors associated to use of CAM in a large sample of young children with autism in Europe. The study replicates the findings of high prevalence of CAM use among young children with ASD in non-EU samples. Use of CAM was positively associated with concurrent use of high number of conventional treatment, which is an indication that parents need to be supported in the choice of appropriate treatments early on in the assessment and diagnostic process.