The Behavioral Medicine Report

Children who received 40 1-hour sessions of hyperbaric oxygen over 4 weeks realized significant improvements across a number of different outcomes measures, such as receptive language, social interaction, stereotyped behaviors, and hyperactivity. Readers may be somewhat surprised to see a review of hyperbaric oxygen on this website. Obviously, this type of treatment does not fall under the purview of Clinical Health Psychology and Behavioral Medicine; however, the hallmark of health/behavioral medicine psychologists is an interdisciplinary approach to treatment, as well as knowledge of available treatments across disciplines. Hence, I believe it important that psychologists are aware of this new treatment option in hyperbaric therapy. Check the end of this report to download this open access study.

During hyperbaric treatment, patients sit in an enclosed, pressurized chamber that delivers a high level of pure oxygen. The high density of oxygen speeds healing and is thus used with patients who have, for example, surgery wounds, burns, or cancer. Neurological conditions, such as Autism, fetal alcohol syndrome, cerebral palsy, and traumatic brain injury also appear to respond well to treatment (Rossignol et al., 2009).

The current study used a multi-center, randomized, double-blind design to investigate hyperbaric oxygen treatment for children with Autism. Participants included 62 children (mean age 4.92 with a range of 2-7 years) from 6 hyperbaric centers. Children were randomly assigned to an experimental group to receive 40 1-hour treatments in a high pressure environment with 24% oxygen, or to a control group with a slightly pressurized room with 21% oxygen. The Clinical Global Impression Scale (CGI), Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC) were the primary outcome measures. Please see the article for a good overview of these scales.

Researchers reported the following statistically significant improvements for children the experimental group (versus controls) after 40 sessions:

Symptom improvement on the physician CGI:

• improved overall functioning (p=0.0008)
• improved receptive language (p<0.0001)
• improved social interaction (p=0.0473)
• improved eye contact (p=0.0102)
• 80% of children were rated as “improved” (versus 38% of controls) (p=0.0024)
• 30% of children were rated as “very much improved” or “much improved” (versus 8% for controls) (p=0.0471)

Symptom improvement on the parental CGI:

• improved overall functioning (p=0.0336)
• improved receptive language (p=0.0168)
• increased eye contact (p=0.0322)

Symptom improvements on the ABC:

• total Score (p<0.03)
• decreased irritability (p<0.03)
• decreased stereotypy (p<0.03)
• decreased hyperactivity (p<0.03)
• improved speech (p<0.03)

Symptom improvement on the ATEC:

• improved sensory/cognitive awareness (p=0.0367)

The researchers noted that a low incident of side effects, a low participant attrition rate, and that children 5 and older and those with less severe forms of Autism exhibited the largest treatment gains.

I hope that the researcher extend the study to include a long term follow up to see if treatment gains persist over time. I am also interested to learn how researchers coaxed children with Autism to sit in enclosed capsules for an hour or longer.

On another note, the placebo effect has been discussed many times on this website. The current study provides a great example of the strength of the placebo effect and why scientists must compare treatments to placebo conditions. Why do I say this? Notice the statistic above that stated, “80% of children were rated as “improved” (versus 38% of controls).” This means that nearly 40% of children who received a placebo treatment demonstrated improvements! The belief that you will improve is powerful “medicine!”

Download the the original study here.

Reference:
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(21).

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