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Hyperbaric Oxygen Treatment
For Autism Spectrum Disorders

Hyperbaric Oxygen Treatment (HBOT) has been the talk of many autism conferences specifically by Dr. Jerry Kartzinel at a conference in June 2005 as a possible treatment for Autistic Spectrum Disorders.

What is HBOT?

Mild Hyperbaric Therapy is a safe, effective way to get more oxygen into the body at the cellular level by using pressurized air chambers. According to the Laws of Physics, an increase in atmospheric pressure allows for more gas to be dissolved into any given liquid. Oxygen exists as a gas at room temperature, and the human body is made up almost entirely of water. The chambers used at the Hyperbaric Therapy Center use filtered ambient air with an additional oxygen concentrator to safely administer oxygen to the body with many therapeutic benefits. By allowing more oxygen to penetrate otherwise oxygen deficient areas, relief for many common ailments can be sought, because HBOT enables the body to carry out oxygen dependant processes by dissolving oxygen directly into the blood, plasma and cerebrospinal fluids.

Some doctors are still studying the effects of HBOT treatment for children affected with autism and if it helps –

healing the gut and brain inflammation (two that may be separate issues or experienced simultaneously)
blood flow to key areas of the brain
dealing with gut parasites, yeast or bacteria
or if it helps all four areas

Some Personal Notes

My son has completed 40 HBOT outpatient treatments at 1.3 atmospheres for the first five treatments and then moved up to 1.5 atmospheres for the last 35 treatments.

His improvements are in the areas of:

language (pragmatics)
social skills
It appears he is mastering and acquisitioning in his ABA program much more and much faster than ever before. (They are on theory of mind and advanced skills with curriculum helpers for abstract/new concepts at school.)
In addition, his abstract concepts are really picking up (for example: If I say, "Jeff -- tell me a story," he responds with a full on story; 5-10 sentences long with a start "Once upon a time..." and keeps going!)
Overall health has improved as well in his complexion and his body functions (stooling everyday that look more normal than before).

A Few Thoughts To Consider If You Are Pursuing This Treatment

Dr. Jerry Kartzinel and other Defeat Autism Now!(DAN!) doctors recommend 1.3-1.5 atmospheres and 1 hour sessions
It is recommended that your child undergoes a minimum of 40 sessions. Dr. Jerry reports benefits being seen at 2 – 20 sessions. Some children may require up to 80 sessions to see benefits. We did not see any changes in Jeff until the 21 st session.
HBOT costs about $85-$300 per session. If you pre-pay for 20, 40 or more sessions there are discounts that can be arranged. Some HBOT clinics offer bulk session purchase discounts and packages. These need to be discussed with each vendor prior to committed to a service.
Unfortunately, this is not a standard care option for autism so I have not heard of anyone yet who has been reimbursed by their health insurance company.
This medical intervention typically requires a prescription for outpatient services (both soft chambers & hard / 100% oxygen chambers. )
You ALSO require a prescription to buy a unit for in home use.
The most efficacious treatment for hyperbaric oxygen is to do the prescribed number of treatments as close together as possible. It is important to dedicate to the intervention with no long breaks in between treatments. Some examples of treatment schedules are:
1. 40 treatments - Monday through Saturday 4-5pm
2. 40 treatments - Tuesday through Saturday - 8-9am and 6-7pm
3. 80 treatments - Tuesday through Saturday - 8-9am and 6-7pm

Types of HBOT Treatment

This is where treatments vary and providers argue which treatment is best. For the purpose of providing an overview to parents considering this treatment for their child – there are two types of HBOT equipment:

Hard chambers with 100% oxygen (typically provided in an outpatient facility.)
Soft chambers with “concentrated” oxygen (provided by certain Defeat Autism Now!(DAN!) doctors and other providers such as chiropractors and other professionals.)

Many of the DAN! providers are looking to recommend mild hyperbarics at 1.3 to 1.5 atmospheres. The hard chamber providers can provide this low level hyperbaric treatment with 100% oxygen. Hard chambers with 100% oxygen are not approved for home use.

Typically the hard chambers providing 100% oxygen DO NOT ALLOW electronics of any kind in their units for safety reasons. Some providers have wired their units for music or for watching video on DVD with viewing portholes. You will need to inquire if this is available for your child if it is needed. Hard chambers can also treat several children at once in a session so you and your child can go into the chamber with other families.

Many of the soft chambers have been approved for home use and do not use 100% oxygen. These chambers typically use what is defined as an oxygen concentrator. These concentrators filter the air in the room and provide a higher level of oxygenation to the air in the chamber. The percent concentration of the air in the chamber with an oxygen concentrator has been debated to be somewhere between 40-80%. While I realize this is a big difference in the level of concentration of oxygen, I have to keep in mind that here in smoggy Southern California, the air we breathe is about 15-20% oxygen. If available, for soft chambers, a bulk session package such as 300 sessions, can be pre-purchased and then shared among several families, lowering the cost of each session down to about $30/session (instead of the usual $85-$300/session rate).

Please note these are my opinions based on the research I have done and professionals I have spoken to. I highly recommend doing your own research regarding the different units and outpatient services available.

HBOT & Supplements – A Very Important Combination

It is important to note that many doctors recommend HBOT for children on the spectrum IN CONJUNCTION WITH antioxidant supplements. HBOT treatments can cause additional oxidative stress to patients.

Supplements to consider taking while providing HBOT treatments are: Vitamin C, Vitamin E, Coenzyme Q10, glutathione, and selenium. Doses of these supplements are based on the age, weight and testing of the patients. Please see your doctor for additional information and dosing.

Many Defeat Autism Now!Doctors and the International Hyperbaric Association (IHA) recommend the first hyperbaric oxygen treatments occur in patient, with a supervising physician, trained medical staff at 100% oxygen.

Should parents and treating physicians recommend additional hyperbaric treatments utilizing a home unit IHA will refund a partial credit towards the purchase or a unit. The partial credit is available when patients visits an IHA center only.

The IHA member benefit (i.e. if you go to an IHA center and receive in patient HBOT services, you can apply a “credit” to a purchase of a chamber – if you choose to purchase.)

Read updated studies and research information.

For additional providers – please visit www.hbotproviders.com

Please note: I do NOT KNOW if the professionals listed at HBOT PROVIDERS.com have experience with children affected with autism. Please be sure to ask this question. You can also ask your doctor (DAN! doctors, especially) for recommended HBOT providers of good repute.

What Children Are Not Good Candidates For HBOT?

HBOT is a medical procedure. It is recommended that your doctor evaluate the treatment based on the unique needs of the patient, your child, to make a recommendation. HBOT treatment REQUIRES A DOCTORS PRESCRIPTION and should be evaluated uniquely based on a child's needs and potential issues.

Some doctors do NOT recommend HBOT for children with the following issues:

Central nervous system birth trauma (severe). Some children with cerebral palsy, stroke or other birth traumas can greatly benefit from HBOT. This needs to be evaluated on a case by case basis.
Seizures (some variations may be fine for HBOT treatments. This needs to be discussed with your doctor.)
Children with a severe sinus infections or cold should not do hyperbaric oxygen therapy until these symptoms subside. If sinus issues are chronic this needs to be discussed with your doctor.

Buying a Personal/Portable HBOT Unit

There are HBOT units that are FDA approved for home use. These units do not use 100% oxygen like the units in hospitals or out-patient clinics. These units use filtered or concentrated oxygen.

The Hyperbaric Therapy Center in Georgia has generously offered a 5% discount on all chamber purchases made by members of TACA.In addition, a donation will be made to your charity of choice for each sale. Please note, none of these organizations sell HBOT chambers directly. Purchases must be made through the Oxyhealth website or by calling (877) 789-0123 toll free.

For families who are unsure if they wish to obtain HBOT services or buy a unit for in-home use, the Hypebaric Therapy Center offers inexpensive treatments in Georgia for families of special needs children. In addition, any services paid to them for treatment can be applied to a soft Oxyhealth chamber should you desire to purchase one.

Retail price of these units are $20,900 PLUS $300 SHIPPING

Recent Paper on Mild Hyperbaric Oxygen for ASD

J.A. Buckley/Medical Veritas 2 (2005) 647 647 Hypothesis
How Mild Hyperbaric Oxygen Therapy Works and Why It Is Good For Our Children

Julie A. Buckley, MD, FAAP
Pediatric Partners of Ponte Vedra, P.A.
5270 Palm Valley Road
Ponte Vedra Beach, FL 32082 USA
Phone: +1 904 543 1288 Fax: +1 904 543 1289
drbuckley@pppvonline.com
www.pppvonline.com

Physicists figured out years ago that a gas under pressure is more likely to dissolve into liquid—in mild hyperbaric oxygen therapy, the gas is oxygen and the liquid is blood. But under pressure, oxygen doesn't only hook up to red blood cells (the "traditional" way oxygen is delivered to tissues), it also dissolves into the plasma. When that plasma circulates near dormant or injured tissue such as an encephalopathic brain, a bruised muscle, a sprained tendon, or a surgical wound, the oxygen in the plasma can and does dissolve further into the damaged area than the oxygen that's attached to the red blood cell in that "traditional" delivery system. When hyperbaric therapy was first used, higher pressures of 2-4 ATA (absolute atmospheres) of pressure and 100% oxygen were used. The world of hyperbaric medicine is learning that lower pressures (1.3 ATA in the portable chambers approved by the FDA for use in the home, 1.3-1.5 ATA in larger hospital and clinic based chambers) and less oxygen (often 21 to 40% FiO2) seem to have excellent effect on multiple systems of our bodies. In particular, lower pressure appears to be more beneficial for the injured brain than higher pressure.

We can look to apparent healing of the brain by monitoring its perfusion and activity. We can also monitor behaviors, response to stimuli (sensory function) and motor skills. Monitoring of cerebral brain flow can be done with a Brain SPECT (Single Photo Emission Computed Tomography) scan. SPECT scans before and after 40 sessions of mild hyperbaric oxygen therapy (MHBOT) have shown dramatic improvements in cerebral brain flow that is sustained over time. In addition, three recent small studies conducted independently at three different centers showed significant improvement in behavior ratings scales with mild hyperbaric therapy. This would seem to correlate with the improved cerebral brain flow that has already been documented. These results will need larger studies and ongoing research but initial findings are very promising.

In addition to impacting cerebral brain flow in injured brains, lower pressure hyperbaric therapy has been shown to positively impact natural killer cell function and thus, immune function. It has also been found to be of benefit in inflammatory conditions and has facilitated improvement in gut disease such as Crohn's and ulcerative colitis. MHBOT has been shown to increase glutathione levels by 15% for at least 24 hours after therapy in previous studies. These areas are all of interest for parents of children with Autism Spectrum Disorders (ASD) as they are often impaired in their children.

One question that has not yet been answered is the endpoint for mild hyperbaric therapy. Families continue to report significant improvement with many more than 40 sessions. The ability, with a chamber approved for use at home by the FDA, to safely continue daily therapy at home is potentially of tremendous value to families involved in multiple hours of therapy and time out of the home on a daily basis. To be able to use a valuable tool before school or after dinner facilitates family life for those able to purchase a chamber for their children.

That being said, a family should consider initial therapy in a clinical setting. It is important that the child and the family become comfortable with the use of the equipment, the process of "clearing" the ears, and the maintenance of the chamber. Most importantly, habituating an ASD child to the chamber and the therapy process is probably best initiated with the assistance of experienced professionals. In addition, witnessing some benefit prior to making a significant purchase is a good idea. Our experience has shown, however, that after 10 to 20 sessions in an office setting, most families can achieve a level of comfort that allows them to successfully operate a mild hyperbaric chamber in the home. Families of children with ASD are often well versed in extensive research and independent function with medical therapies.

Opportunities for healing in the home setting where a family can function as a unit are few and far between in the world of ASD. A therapy that appears to be of value to the vast majority of children is similarly rare. Mild hyperbaric oxygen therapy appears to be both. Ongoing research will help to explain with greater precision how exactly MHBOT improves the health and well being of our children. The anecdotal reports from parents of significant improvement are being borne out by SPECT scans and behavioral ratings scales. We appear to have a significant addition to the tool box used in recovering our children.
doi: 10.1588/medver.2005.02.00085

Additional studies on HBOT therapy for autism spectrum patients include:

Hyperbaric treatment for children with autism: A multicenter, randomized, double-blind, controlled trial. Rossignol DA, Rossignol LW, Smith S, Schneider C, Logerquist S, Usman A, Neubrander J, Madren EM, Hintz G, Grushkin B, Mumper EA. BMC Pediatr. 2009 Mar 13;9:21. PMID: 19284641 [PubMed - indexed for MEDLINE]
Hyperbaric oxygen therapy in Thai autistic children. Chungpaibulpatana J, Sumpatanarax T, Thadakul N, Chantharatreerat C, Konkaew M, Aroonlimsawas M. J Med Assoc Thai. 2008 Aug;91(8):1232-8. PMID: 18788696 [PubMed - indexed for MEDLINE]
A review of recent reports on autism: 1000 studies published in 2007. Hughes JR. Epilepsy Behav. 2008 Oct;13(3):425-37. Epub 2008 Jul 31. Review. PMID: 18627794 [PubMed - indexed for MEDLINE]
The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study. Rossignol DA, Rossignol LW, James SJ, Melnyk S, Mumper E. BMC Pediatr. 2007 Nov 16;7:36. PMID: 18005455 [PubMed - indexed for MEDLINE]
Hyperbaric oxygen therapy might improve certain pathophysiological findings in autism. Rossignol DA. Med Hypotheses. 2007;68(6):1208-27. Epub 2006 Dec 4. PMID: 17141962 [PubMed - indexed for MEDLINE]

Some Final Words

Biomedical treatment and care should be PART of your intervention plan for a child with autism. In addition to biomedical intervention, please consider one-on-one behavioral intervention including but not limited to: Applied Behavioral Analysis (ABA), , Speech and Occupational theraphy, play skills, and social skills. Additional information on therapy options. Both a biomedical intervention and a behavioral therapy plan are part of a total solution for your child.

Disclaimer: Talk About Curing Autism (TACA) provides general information of interest to the autism community. The information comes from a variety of sources, and TACA does not independently verify any of it. The views expressed herein are not necessarily TACA's . Nothing in this document should be construed as medical advice. Always consult your child's doctor regarding his or her individual needs.

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