Question 5-What is valued in current practice? What is under-considered, and may be valuable, to current practice paradigms?

The CAM that is most valued in current practice is diet; specifically gluten and casein free diets. As with most new ideas regarding CAM’s, putting your autistic child on a gluten/casein free diet was controversial just a decade ago. Now, we can find gluten/casein free foods in our regular supermarkets. Families used to have to go to specialty stores to get the food for their autistic child.
Proponents of the gluten-free diet say that many children with autism have gastrointestinal difficulties that make it hard for them to digest certain grains properly. The most studied theory is that eating gluten leads to high levels of protein by-products in some children with autism. These by-products may then affect behavior like a drug would. Specifically, these children could reduce their desire for social interaction, block pain messages, and increase confusion. If gluten is taken out of the diet, the idea is that this will reduce the level of protein by-products and behavior will improve as a result (2-4).
These by-products are much more common in the urine of children with autism than in children without autism. Some scientists have concluded that they are leaking from the intestines into the blood of these children (2, 5). Many research studies report that children with autism often have gastrointestinal problems, including intestinal leakage (5). The argument is that, if gluteomorphine (the protein by-products) is being absorbed into the general circulation in children with autism, then it could affect behavior (2-5). There have been many studies on autism and gluten free and casein free diets and there are conflicting results. The current thinking is that there is at least some evidence showing that a gluten-free diet, when combined with a casein-free diet, can help improve the behavior of some children with autism. Although the casein-free diet combined with a gluten-free diet is popular, there is little evidence to support or refute this intervention and reviewers have determined that meaningful conclusions cannot be drawn from the existing literature (3, 4).
References:

1) Murch, S. 2005. "Diet, Immunity, and Autistic Spectrum Disorders." J Pediatr. 146(5):582-584.
2) Reichelt, K.L., and A.M. Knivsberg. 2003. "Can the Pathophysiology of Autism be Explained by the Nature of the Discovered Urine Peptides?" Nutr.Neurosci. 6(1):19-28.
3) Christison, G.W., and K. Ivany. 2006. "Elimination Diets in Autism Spectrum Disorders: Any Wheat Amidst the Chaff?" J Dev Behav Pediatr. 27(2 Suppl):S162-S171.
4) Millward, C., et al. 2004. "Gluten- and Casein-Free Diets for Autistic Spectrum Disorder." Cochrane.Database.Syst.Rev. (2):CD003498.
5) Horvath K, P.J. 2002. "Autism and Gastrointestinal Symptoms." Curr Gastroenterol Rep. 4(3):251-258.
6) Elchaar, G.M., et al. 2006. "Efficacy and Safety of Naltrexone Use in Pediatric Patients with Autistic Disorder." Ann.Pharmacother. 40(6):1086-1095.

It is difficult to say what is underused and may be valuable to current practice paradigms since all CAMs have not been scientifically proven to improve children with autism. In my opinion, CAMs such as traditional Chinese medicine have been underused. Practices that unblock the Qi (energy) such as acupressure and shiatsu should be considered more. They all have minimal or mild side effects and they all promote the flow of energy for the body to heal itself. I believe that Chinese medicine coupled with the correct diet will enhance the traditional treatments of education and ABA.