24 September 2009
By Shobhan Singh
Mumbai, India
Can a dose of oxygen and good amount of money treat autism? Jaslok Hospital on Peddar Road has triggered a debate of sorts by offering the hyperbaric oxygen therapy (HBOT) for autistic children, dividing the city’s medical community and parents in the process.
The hospital has been using HBOT – a process to deliver oxygen to patients at a high pressure in a sealed chamber – for treating various conditions such as gangrene and stroke. But many are sceptical that it will click for autism, a developmental disorder that affects 1 in every 150 children (mainly boys). Autism, for one, doesn’t have a single known cause. For another, the treatment costs Rs 1 lakh even at subsidised rates.
Dr Shoaib Padaria, in–charge of the HBOT centre at Jaslok Hospital, said, “We have autistic children who underwent HBOT sessions and gained. Research has proved HBOT is helpful in treating autism.”
A US study published in January 2009 said children aged two to seven who underwent 40 hours of treatment showed improvement in eye contact, sensory and cognitive awareness, social interaction, receptive language and overall functioning.
Consider the case of 10–year–old Asmit (name changed), who attends a special school for autistic children. Asmit’s attention span has improved since he underwent the 40 sessions, believes his mother Aruna (name changed). “But HBOT should be given after properly assessing if the child suffered oxygen deprivation at birth,” said Aruna.
Doctors remain sceptical. Dr Vrajesh Udani, a paediatric neurologist with Hinduja Hospital said, “A study of HBOT on cerebral palsy did not show any difference between controls and subjects. The autism study did show some differences but it must be, at present, considered experimental as only one study has shown this. More studies need to be done before it can be recommended.” He added the therapy is extremely expensive and one should be careful before recommending it.
Jaslok Hospital offers the therapy at Rs 6,000 per session, with a complete course approximately at Rs 1.5 lakh. Apollo Hospital in Delhi has been offering HBOT therapy at Rs 1,800 a session, with a 40–session course for Rs 72,000.
Some parents, too, are apprehensive. The primary concern indeed is cost, given the uncertainty it entails and also the fact that other treatment such as occupational and behavioural therapy cannot be discontinued. “HBOT therapy is expensive and largely unproven. And there is just one hospital in the city which offers it. We do not even have doctors trained for HBOT therapies who can monitor the whole process,” said Chitra Iyer, president, Foundation For Autism (FFA).
But HBOT has its firm believers. Manish Lad, mother of seven–year–old autistic Akhil, and founder director of an NGO called Akhil Autism Foundation, said, “HBOT must be considered for autistic kids. But parents have to understand temporary healing regressions and actual regressions.” She added parents have to follow the hierarchy of diet, nutrition support, anti–fungal treatment, antiviral, chelation and HBOT.
Hyperbaric oxygen therapy (HBOT)
- The treatment involves breathing pure oxygen in a sealed chamber whose pressure is 1.5 to 3 times the normal atmospheric pressure.
- It can be done in single–person chambers or chambers that can hold over a dozen people.
- The increased pressure allows more oxygen to reach the body’s cells, thereby contributing to the healing process.
- There is no evidence to suggest HBOT cures cancer, but the US FDA has approved it to treat decompression sickness, gangrene, brain abcess and injuries in which tissues are not getting enough oxygen.
- The lack of randomised clinical studies makes it hard to judge the value of HBOT’s claims.
- Side–effects include fatigue, claustrophobia, headache and serious ones like myopia (shortsightedness) lasting for months, sinus damage, ruptured middle ear, and lung damage. In worst cases, oxygen toxicity can result in seizures, fluid in the lungs, and even respiratory failure.
- It’s a developmental disorder diagnosed at birth or the first two–and–a–half years of life.
- Four times more common in boys than girls, it occurs approximately in one of every 150 children.
- Autistic kids are characterised by poor social skills, poor eye contact and by poor co–ordination.
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