Complementary and Alternative Treatments for Autism Spectrum Disorder: A Comprehensive Review

This review article comprehensively examines complementary and alternative treatment (CAT) approaches for children and adolescents with Autism Spectrum Disorder (ASD). CAT usage rates among individuals with ASD range from 28-95%, with families turning to these methods due to insufficient responses to conventional treatments, concerns about side effects, and the pursuit of "natural" therapies. The article covers biologically-based interventions (gluten-free/casein-free diet, ketogenic diet, omega-3 supplements, vitamins, probiotics, melatonin), mind-body practices (yoga, music therapy, massage), and manipulative therapies (hippotherapy, sensory integration). While melatonin and music therapy demonstrate strong evidence levels, risky and ineffective methods such as chelation therapy and hyperbaric oxygen therapy are not recommended. Evidence for gluten-free/casein-free diet, probiotics, and omega-3 remains inconsistent, requiring individual evaluation. It is critically important for clinicians to maintain non-judgmental, open communication with families and provide evidence-based guidance. CAT applications should be integrated with standard treatments, monitored with concrete goals, and potential risks must be considered. Future controlled studies accounting for phenotypic heterogeneity are needed to determine which CAT strategies are appropriate for whom and under what conditions. Although more than half of parents prefer to discuss CAT options with their child's physician, the perception that physicians lack sufficient knowledge about CAT can lead to reluctance in disclosure.