Autism and Hyperbaric Oxygen Therapy: Unmasking the 'Snake Oil' Claims
The US Food and Drug Administration has published a warning for parents to beware of false or misleading claims about HBOT for treating autism.
I know a family who purchased a hyperbaric oxygen chamber for their home to treat their son with autism.
It was expensive. A cheap one costs about $10,000, and some go as high as $40,000. Desperate parents are easily swayed into purchasing the more expensive models.
They did their research, which meant they went to Google and absorbed the various snake oil sales pitches. When they saw doctors who touted scientific studies backing their dubious claims, they were convinced the therapy had promise.
It did nothing.
At first, the imagined improvements strengthened their belief that they had found the cure. Their son’s health appeared better; they noticed more eye contact, and they believed he was on the mend.
Confirmation bias works that way.
They told their friends and other parents about their great discovery and their hopes for a “cure” to their son’s autism.
However, when they asked the specialists and therapists who worked with their son regularly about his progress, none reported any significant change.
After a few months, their enthusiasm waned, and they began questioning whether or not this was a cure.
They maintained their belief that the procedure improved his health for many more months, mostly as a way of rationalizing they made the right decision in purchasing the hyperbaric oxygen chamber and putting their son in it daily.
However, the objective reality was ultimately undeniable.
They purchased the chamber to cure their son. They kept it because they believed it improved his health. When they finally accepted that it made no difference, they were shattered.
They were heartbroken for two reasons.
One, they believed erroneously that they could transform their non-neurotypical son into what they wanted him to be. Their dreams of a perfect son were revealed as illusions.
Two, they were embarrassed because they told so many people, and convinced other parents of the efficacy of a treatment that turned out to be snake oil.
They certainly were not alone. It’s a trap nearly every special needs parent falls into, me included.
Hyperbaric oxygen therapy
Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a condition sometimes caused by surfacing too quickly when scuba diving.
According to the Mayo Clinic, other conditions treated with hyperbaric oxygen therapy include:
Serious infections.
Bubbles of air in blood vessels.
Wounds that may not heal because of diabetes or radiation injury.
Notice that curing autism is missing from this list.
In a hyperbaric oxygen therapy chamber, the air pressure is increased 2 to 3 times higher than normal air pressure. Under these conditions, your lungs can gather much more oxygen than would be possible by breathing pure oxygen at normal air pressure.
This extra oxygen helps fight bacteria. It also triggers the release of substances called growth factors and stem cells, which promote healing.
Studies of hyperbaric oxygen therapy as a treatment for autism
A study from 2009 makes bold claims about helping autism, Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial.
After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved"…
Sounds great, doesn’t it?
These snake oil salespeople promote this study.
Unfortunately, this old study hasn’t been able to be replicated by anyone else. Further, follow-up studies in 2016 and 2017 reach the opposite conclusions.
Hyperbaric oxygen therapy for people with autism spectrum disorder (ASD)
Key results
We found a single, small study of 60 children that evaluated high‐pressure oxygen therapy for ASD.
There was no evidence that high‐pressure oxygen therapy improved social interaction, behavioral problems, speech or language communication, or mental function in children with ASD. However, children who received high‐pressure (hyperbaric) oxygen therapy showed an increased occurrence of ear barotrauma events when compared with those in the control group.
[In other words, it hurt them.]
Quality of the evidence
The quality of the evidence is low. Evidence is insufficient to confirm that high‐pressure oxygen is an effective treatment for individuals with ASD.
Hyperbaric oxygen therapy for children with autism spectrum disorder
Recommendation
Hyperbaric oxygen therapy has been approved for treating specific conditions such as decompression sickness. The current absence of conclusive evidence for treatment of autism symptoms has not supported its endorsement for use in treating ASD by the Food and Drug Administration. Further, the Food and Drug Administration has published a warning for parents to beware of false or misleading claims about HBOT for treating autism.21
Conclusion
Currently, there is insufficient evidence to support use of HBOT to treat children with ASD, and its use as a form of treatment is not recommended. More research might reveal specific groups of children who might benefit from such treatment.
In short, hyperbaric oxygen therapy is snake oil.
Snake Oil Sales Tactics
Snake oil treatments rely on the mistrust of consensus opinions. However, they do rely on expert testimony, an interesting dichotomy.
For example, the consensus opinion is that hyperbaric oxygen therapy is snake oil. However, some doctors claim it is not.
Of course, the snake oil peddlers also claim it’s great, making dubious claims.
How HBOT Helps Autistic Patients
HBOT has been used as an alternative autism treatment, and it has shown positive results. [No. It has not.]
Even Autism Parenting Magazine gets in on the snake oils sales support.
The bottom line
Multiple studies show that hyperbaric oxygen therapy can help to alleviate the symptoms of autism in children and adults. Clinically supervised use of the therapy can potentially improve their cognitive abilities, communication behavior, and fine motor skills by increasing oxygenation circulation and reducing inflammation. However, the evidence supporting the efficiency of HBOT is mixed and anecdotal.
Notice how they contradict themselves in the paragraph above. They claim there are multiple studies and clinically supervised uses that show improvements, which is not true, but they follow with the accurate statement that the evidence is mixed and anecdotal, which means there is no real evidence.
If you are a desperate parent, you will ignore the disclaimer and latch on to the idea that the therapy works—confirmation bias at work.
With so many sources of plausible-sounding bullshit, it’s very difficult to sort fact from sales fiction, which is exactly how the snake oil sales pitch works.
Common Sense
If you are still considering hyperbaric oxygen therapy, you’ve probably convinced yourself that your child is unique, and they may be the one who does respond.
Before you waste tens of thousands of dollars on a submarine torpedo, ask yourself a few questions. Why hasn’t the 2009 study been replicated since? Wouldn’t a truly effective treatment for autism spark a great deal of follow-up research? Why have subsequent studies shown no results? If it were effective even for a small number of children, that would be reflected in the results.
Ask yourself what you expect from the therapy. Are you throwing a “Hail Mary” hoping for a “cure?” If so, I fear you are setting yourself up for a major disappointment.
