ISSN: 2322 - 0902 (P)

ISSN: 2322 - 0910 (O)

International Journal of Ayurveda
and Pharma Research
Research Article

AYURVEDIC INTERVENTIONS IN AUTISM SPECTRUM DISORDERS –A CASE SERIES

Lekshmi M K
Department of Kaumarabritya, Government Ayurveda College, Thiruvananthapuram, India.
ABSTRACT
The prevalence of Autism Spectrum Disorder has increased to 1in 68 children. With impaired social
interactions, impaired language and stereotypic movements as the classic triad of the condition, this social
stigma is known to have no satisfactory treatment options till now. Applied behavior analysis(ABA), yoga
therapy , music therapy, nutritional modifications and certain drugs have shown improvements in some
aspects of the disease in various case studies but a significant result has not yet attained. In Ayurveda all
childhood autism cases come under the category of either Vatakaphajaunmada or Vatapaittikaunmada. A
case series was developed with 10 cases having the following characteristics. The diagnosis of all the cases
was done with Childhood Autism Rating Scale (CARS) and the treatment outcome was measured by Autism
Treatment Evaluation Checklist (ATEC). Clinical features of Unmada were also considered for the diagnosis
and assessment of all the cases. The Ayurvedic treatment protocols for the cases selected were according to
Dosha predominance of the condition at that time. All of the children considered for the case series were
receiving speech as well as psycho therapies and appropriate dietary advice and assessment was done after
three months. The change in CARS score was highly significant at 0.05% level (P<0.0005). Also the change in
ATEC and sensory parameters was significant at 1% level (P<0.01). The treatment has significant effect on
sociability (t=2.662, P<0.05) and physical features (t=2.436, p<0.05). Speech development was not
statistically significant. This points towards the necessity of mainstreaming Ayurvedic treatment for autism
spectrum disorders.
KEYWORDS: Autism Spectrum Disorders, Vatakaphajaunmada, Vatapaittikaunmada.
INTRODUCTION
Autistic Spectrum Disorders are a graving language are some of the main clinical features. Their
problem of the present era that has shown an alarming intellectual functioning may vary from mental retardation
increase in the past decade. The prevalence of this to superior intellectual functioning. The augmented mental
condition in the United States is 1 in 68 children1 and in functioning may be evident in areas such as solving
India its incidence rate is calculated as 1 in 90, 666 or 11, complicated puzzles, art, or music and is entitled as
914.2 Though the factors like genetic problems, splinter skills and savant behavior5.
autoimmune conditions and neurological abnormalities Risperidone and aripiprazole are the only FDA-
have been identified as the causes of ASD, no definite approved medications for ASD, and they are approved only
reason is so far identified for the disorder till date. Various for the treatment of irritability in 5–16 year olds with
new theories about the cause of Autistic Spectrum ASD6. No medications are currently established to treat
Disorders have also been developed. Among children ASD core symptoms. Supplemental melatonin has shown
conceived using ART, about 0.8% of those born as promise in treating sleep onset insomnia in children with
singletons (only one baby carried during the pregnancy) autism spectrum disorders (ASD)7. Behavior modification
and about 1.2% of those born as a twin or multiple were therapies like applied behavior analysis (ABA) has the
diagnosed with ASD. Children conceived using ART were most empirical support for a single treatment, with
more likely to be diagnosed with ASD if intracytoplasmic documented improvements in language, social, play, and
sperm injection (ICSI) was used compared to conventional academic skills, and reduction in severe behavioral
in vitro fertilization3. problems 8. However, behavioral treatments are time and
The major clinical features of the condition as per staff intensive, requiring up to 30–40 hours of treatment
DSM V criteria are diminished social interaction, impaired per week for several years by trained staff working
language and restricted repetitive behaviors (RRB). directly with the child and typically focusing on one or a
Children with autism have restricted interpersonal few behaviors at a time. In a study conducted in 30
communication and engagement due to their limitations in subjects diagnosed with ASD in the Developmental Eclectic
creative, playful pretend4. Impaired use of multiple Approach to Language Learning(DEALL) Communication
nonverbal behaviors like eye-to-eye gaze, facial (Com DEALL) units in Bangalore, statistically significant
expression, body postures and gestures, failure to develop increase in all eight developmental domains and
peer relationships, lack of spontaneous seeking to share statistically significant decrease in symptoms as measured
enjoyments, odd prosody or intonation, echolalia, pronoun by the CARS, were seen9. The efficacy of Picture Exchange
reversal, nonsense rhyming and other idiosyncratic Communication System (PECS) as an adjunct treatment to

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 Int. J. Ayur. Pharma Research, 2016;4(12):64-67
behavioral management has also been studied10. Malhotra psychological stress of children in their infancy will have
et al reported experience with psychological intervention an add on effect on the above mentioned causes14.
with parents of autistic children. Their treatment methods MATERIALS AND METHODS
were drawn from Treatment and Education of Autistic and The present study is a case series consisting of 10
related Communication handicapped Children (TEACCH) patients aged between 3 and 8 years selected from the
protocol11. In a study using Integrated Approach to Yoga patients attended the OPD of the Department of
Therapy (IAYT) for two years, it was observed that there Kaumarabhritya, Government Ayurveda College,
were significant improvements in imitation and other Thiruvananthapuram during the period March 2015-
skills, and in behaviour at home and family relationships. March 2016 with complaints of impaired social
The presumed role of mirror neuron activation has been interaction, language and stereotypic movements. The
hypothesized for this effect12. Though all these studies patients were diagnosed as autism spectrum disorders by
have a nominal effect on the management of ASD, none of using the Childhood Autism Rating Scale (CARS)15. Autism
them have been accepted as the exact treatment. The treatment evaluation checklist (ATEC) was used for the
behavior and yoga therapies are very time consuming and assessment of severity of their clinical features in four
difficult to practice in Autistic children. Here comes the aspects like sociability, speech and language, sensory
role of Ayurvedic management of ASD. aspects and physical features16.
Unmada is a term that represents broad classes of Specific treatment protocols were selected for the
mental ailments in Ayurvedic literature that covers Autism management of the patients by considering the clinical
Spectrum Disorders too. Unmada is explained in Ayurveda features of Unmada and the Dosha predominance. Of the
as the derangement in the Manas (mental functioning), selected ten cases, seven children were identified to have
Budhi (application of the acquired knowledge), Samjna Vatakaphajaunmada and the other three had
(perceptions), Jnana (experiences), Smriti (memory), Vatapaittikaunmada. The treatment consisted of two
Bhakti (emotional adhesions), Seela (conditioned weeks of OP management which included Deepana
activities), Cheshta (behavior) and Achara (socio cultural (enhancing digestion and absorption) followed by
activities)13. The clinical features of Autism Spectrum Sadyasnehapana (giving medicated ghee to children in
Disorders merge well with that of Unmada. The major small quantity along with food)17. After that three weeks of
cause for the above, explained in Ayurveda are the IP management including Abhyanga andooshmasweda (oil
Beejadushti (genetic factors) which may have occurred due massage and fomentation), Yogavast i(medicated enema)
to the non-congenial diet and regimen of the parents and Shirodhara (slow pouring of oil on head) was done
before conception or the improper diet and regimen of with concerned medicines for each group. All the patients
mother and psychological stress during pregnancy were then given three weeks of Shirolepa (herbal paste
(Garbhaja) or unknown causes explained as a curse or the application on head) to be done at home and later one
after effects of the unrighteous deeds done in the past month of internal medication only and followed up. The
(Prabhavaja). The non-congenial diet and regimen and patients were assessed before and three months after the
treatment using CARS and ATEC scale.
Table 1: Treatment protocol of patients
S. No. Treatment Medicine Duration
Vatakaphaja Vatapaittika
1 Deepanam Ashtachoorna18 Ashtachoornam 5-15g with honey before food
5 days
2 Sadya Snehapana Kalyanaka ghrita19 Tiktaka ghrita20 15-30 ml twice daily with Peya
and Saindava for 10 days
3 Abhyangamooshmasweda Vatasini tailam21 Ksheerabala tailam22 3 days
4 Yogavasti Pippalyadianuvasana Madhuyashtyadi taila24 8 days
tailam23
5 Shirodhara Vatasinitailam Chandanadi tailam25 7 days
6 Shirolepam Mustatakram, Balasohaladi lepam26 21 days
Rasnadichoornam,
Amalakichoornam
7 Samanachikitsa Manasamitra vatakam27 Manasamitravatakam 1-0-1
Guloochyadi kashayam28 Chandanadi 30 ml twice a day before food
kashayam29
Kalyanakaghrita Tiktakaghrita 10ml twice daily after food
RESULTS
The data on pretest and post test score were collected for various parameters and calculated the mean and SD.
The statistical significance of observed mean difference was tested using paired t test (The details are shown in the Table
2). The change in CARS score was highly significant at 0.05% level (P<0.0005). Also the change in ATEC and sensory
parameters was significant at 1% level (P<0.01). The treatment has significant effect on sociability (t=2.662, P<0.05) and
physical features (t=2.436, p<0.05). But there do not exist any significant effect due to treatment on speech (t=0.873,
P>0.05). The clinical features explained in Unmada like anorexia, excess salivation, and constipation in Vatakaphaja
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 Lekshmi M K. Ayurvedic Interventions in Autism Spectrum Disorders –A Case Series
patients and increased sweating, excess thirst and self-biting in Vatapaittika patients has shown considerable reduction in
clinically notable levels.
Table 2: Data and test of significance (paired t test) on effectiveness of treatment on various study parameters
Variable Test Mean SD t df P
Speech BT 20.50 4.86 0.873 9 0.405
AT 19.40 5.10
Sociability BT 20.10 10.14 2.662 9 0.026
AT 13.70 8.33
Sensory BT 21.60 6.20 5.274 9 0.001
AT 14.80 5.37
Physical BT 16.60 6.93 2.436 9 0.038
AT 12.40 8.78
ATEC BT 78.70 21.49 4.578 9 0.001
AT 60.40 23.57
CARS BT 34.85 7.13 5.401 9 0.000
AT 28.95 7.18
DISCUSSION
The improper diet and regimen in children leads natural progression. The assessments were done after just
to Rasadushti. The main function of rasa being Preenana three months of treatment which is a very short period of
(Preenanamchittapreetihi)30 which can be considered as management when ASD is considered. Further
the general wellbeing of the individual both physically and management will definitely improve the speech and social
mentally. Thus rasa can be considered as all the factors interaction of such children. The Ayurvedic intervention
that help to maintain the homeostasis of the body. Hence will increase the attention and social interaction which will
Rasadushti especially in those who are prone to help the children to engage more in other therapies. Also it
psychologic disturbances (with Heenasatwa) due to is observed clinically that early identification and
hereditary (Sahaja), improper food and stress during Ayurvedic intervention along with speech and behavior
pregnancy (Garbhaja) or other unknown factors therapies will help mild and moderate ASD children to
(Prabhavaja or Poorvajanmakrita karma) leads to Unmada have a normal schooling.
in children. The treatment aims at alleviating the ACKNOWLEDGEMENT
Rasadushti in the body which is present throughout the The author acknowledge Dr. K V Baiju, Assistant
body by Sodhana in the form of Vasthi preceded by Professor, Department of Statistics, Government College
Snehana and Swedana. The functions of cognition , for Women, Thiruvananthapuram and Dr. Rajmohan V,
emotions and sensory perceptions are mainly controlled Assistant Professor, Department of Rasasastra and
by Praanavata. So Shirodhara and Shirolepa are done to Bhaishajya Kalpana, Government Ayurveda College,
enhance the proper functioning of Praanavata. After that Thiruvananthapuram, for their guidance.
Medhya rasayanas are given to improve the speech and
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Cite this article as: *Address for correspondence

Lekshmi M K. Ayurvedic Interventions in Autism Spectrum Disorders –A Dr Lekshmi M K
Case Series. International Journal of Ayurveda and Pharma Research. Department of Kaumarabritya,
2016;4(12):64-67. Government Ayurveda College,
Source of support: Nil, Conflict of interest: None Declared Thiruvananthapuram, India.
Email: lekshmimk@gmail.com

Available online at: http://ijapr.in 67