Eye Contact, Appetite, and Vomiting Improved in Children With Autism Spectrum Disorder After Visceral Osteopathic Technique

Bramanti-Castellarin I, Patel VB, Drysdale IP. Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT) [published online January 13, 2016]. J Bodyw Mov Ther. doi:10.1016/j.jbmt.2016.01.001.

In a novel research approach, researchers in the United Kingdom assessed the application of visceral osteopathic technique (VOT) to children aged between 3½ and 8 years who had a diagnosis of autism spectrum disorder (ASD) and whose medical records included significant gastrointestinal dysfunction. Forty-nine children met inclusion criteria of ASD and gastrointestinal symptoms, including abdominal distention or pain, constipation, chronic diarrhea, and foul-smelling stools or flatulence. Parental approval was required for participation.

The trial used a single-patient design, and each patient acted as his or her own control using pre- and posttreatment repeated measures. This design is particularly appropriate for the ASD population because separate homogeneous groups of patients with ASD are virtually impossible to assemble as a result of the vast array of ASD presentations.

The modified standardized Autism Research Institute/Secretin Outcomes Survey Form was used to assess social behavior, ritual, and repetitive activities; digestive symptoms; and general symptoms. Parents filled out the forms 4 times during the 6-week control period; 4 times during the 6-week treatment period (weekly treatment sessions); and 1 time during the posttreatment period at week 18. At each treatment session, any changes in health status, changes in the patient’s diet or medication, and any infections were assessed to confirm the safety of continuing in the study.

The intervention was administered using standard VOT procedures to the ileocecal valve, mobilization of the duodenum, mobilization of the ligament of Treiz, mobilization of the pancreas, and sigmoid colon technique.

The main effects analysis for ritual and repetitive activities, digestive signs, and general signs were not significant. However, there were significant subscale differences before and after VOT for less vomiting (P<.001), improved appetite (P=.039), and improved eye contact (P=.035).

The authors cite limitations of no randomization and participant self-referral by the parents. The authors also suggest a possible gut-brain axis mechanism of action in which worsening of behavior symptoms may be a result of inflammatory gut reactions mediated by immunologic signals. As a source for such speculation, the authors cited the osteopathic research of Hodge et al.^1,2

This article demonstrates a possible benefit of osteopathic intervention in this special needs population and thus warrants additional investigation.