Uhms Position Paper the Treatment of Autism Spectrum Disorder with Hyperbaric Oxygen Therapy

It has been proposed that low pressure/ low oxygen concentration hyperbaric treatment can improve the clinical manifestations of autism. Several case series and a randomized trial have all supported this position despite little physiological or biological evidence of a likely mechanism. The available comparative data suggest widespread improvements in physician assessed Clinical Global Impression (CGI) score, parental Aberrant Behavior Checklist (ABC) score and parental Autism Treatment Evaluation Checklist (ATEC) scores in several dimensions. There has been considerable controversy about the validity and interpretation of these scores as reported in the randomized trial. Given the nature and epidemiology of this group of conditions, there is a strong case for further trials to be done in this area. Any future trials would need to be well planned, appropriately powered and include several relevant treatment arms. The UHMS highly recommends the inclusion of functional neuroimaging in any future investigations. These clinical efforts should be combined with efforts to elucidate the basic mechanisms by which mild hyperbaric therapy might exert a therapeutic effect. At this time, however, we cannot recommend the routine treatment of ASD with HBO2T.