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Utilization Patterns of Conventional and Complementary/Alternative Treatments in Children with Autism Spectrum Disorders and Developmental Disabilities in a Population-Based Study

Akins, Roger S. DO*,†,‡; Krakowiak, Paula PhD†,§; Angkustsiri, Kathleen MD*,†; Hertz-Picciotto, Irva PhD; Hansen, Robin L. MD*,†

Journal of Developmental & Behavioral Pediatrics: January 2014 - Volume 35 - Issue 1 - p 1–10
doi: 10.1097/DBP.0000000000000013
Original Article

Objective: To compare the utilization of conventional treatments and utilization of complementary and alternative medicine in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD).

Methods: Participants were 578 children who were part of an ongoing population-based, case-control study of 2- to 5-year olds with ASD, DD, and the general population. Parents completed an interview on past and current services.

Results: Four hundred fifty-three children with ASD and 125 DD children were included. ASD families received more hours of conventional services compared with DD families (17.8 vs 11; p < .001). The use of psychotropic medications was low in both groups (approximately 3%). Overall, complementary and alternative medicine (CAM) use was not significantly different in ASD (39%) versus DD (30%). Hispanic families in both groups used CAM less often than non-Hispanic families. Variables such as level of function, immunization status, and the presence of an identified neurogenetic disorder were not predictive of CAM use. A higher level of parental education was associated with an increased CAM use in ASD and DD. Families who used >20 hours per week of conventional services were more likely to use CAM, including potentially unsafe or disproven CAM. Underimmunized children were marginally more likely to use CAM but not more likely to have received potentially unsafe or disproven CAM.

Conclusion: Use of CAM is common in families of young children with neurodevelopmental disorders, and it is predicted by higher parental education and non-Hispanic ethnicity but not developmental characteristics. Further research should address how health care providers can support families in making decisions about CAM use.

*Department of Pediatrics, School of Medicine, University of California, Davis, CA;

MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, University of California, Davis, CA;

Department of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, VA;

§Divisions of Epidemiology and Environmental and Occupational Health, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA.

Address for reprints: Robin L. Hansen, MD, MIND Institute, Department of Pediatrics, University of California, Davis, 2825 50th Street, Sacramento, CA 95817; e-mail:

Supported by the National Institute of Environmental Health Sciences (R01 ES015359, P01 ES11269), the U.S. Environmental Protection Agency through the Science to Achieve Results (STAR) program (R833292 and R829388), and the UC Davis MIND Institute, University of California, Davis.

Disclosure: The authors declare no conflict of interest.

R. S. Akins is a Navy Physician; however, the views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government. K. Angkustsiri participates in clinical trials for fragile X syndrome and autism spectrum disorders funded by Novartis, Roche, Seaside Therapeutics, and Forest Laboratories.

Received June , 2013

Accepted September , 2013

© 2014 by Lippincott Williams & Wilkins