Given the severe and chronic problems associated with Autism Spectrum Disorders (ASD) and the limitations of available treatments, there exists a large public health need for additional interventions. As more parents are inquiring about complementary and alternative treatments (CATs), both parents and practitioners require up-to-date information about them and whether and how to integrate them into treatment. After presenting data on CAT usage patterns for ASD, we review 13 ingestible (i.e., orally administered) and 6 noningestible (i.e., externally administered) CATs for ASD. For each CAT we briefly describe its definition; rationale for use; current research support, limitations, and future directions; safety issues; and whether we currently recommend, not recommend, or find it acceptable for the treatment of ASD. We conclude this paper with recommendations for future research and ten clinical recommendations for practitioners. 1. Background and Significance Many treatments (Txs) have been proposed for Autism Spectrum Disorders (ASD) with the most effective being combined Tx involving specialized and supportive educational programming, communication training (e.g., speech/language therapy), social skills support, and behavioral intervention [1, 2]. Occupational and physical therapy also may promote progress by addressing comorbid difficulties of motor coordination and sensory deficits [3]. Behavior modification (e.g., applied behavior analysis [ABA]) has the most empirical support for a single Tx, with documented improvements in language, social, play, and academic skills, and reduction in severe behavioral problems [4]. However, behavioral Txs are time and staff intensive, requiring up to 30–40 hours of Tx per week for several years by trained staff working directly with the child and typically focusing on one or a few behaviors at a time. Risperidone (Risperdal) and aripiprazole (Abilify) are the only FDA-approved medications for ASD, and they are approved only for the Tx of irritability in 5–16 year olds with ASD. No medications are currently established to treat ASD core symptoms. “Off-label” medications are often prescribed for cooccurring behaviors such as inattention, impulsivity/hyperactivity, sleep problems, repetitive/perseverative behaviors, anxiety, mood, agitation, aggression, and disruptive and self-injurious behaviors but may have significant side effects [5]. Survey research has estimated the utilization of psychotropic medication for youth with ASD as high as 47% [6], but there is ongoing debate about the role of such agents [7].
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