A small study of 31 children between the ages of 18 months and 38 months showed positive changes in autism spectrum disorder assessment scores after three months of daily omega supplementation.
The Centers for Disease Control and Prevention (CDC) estimates one in 42 boys and one in 189 girls are affected by autism spectrum disorder (ASD). Early intervention programs have demonstrated positive results in children with ASD, improving cognitive ability and social skills in kids as young as 18 months old. However, waiting lists for behavioral programs can hinder timely intervention.
"The waiting times for evaluation for ASD and then getting into behavioral therapies can be years long," says Sarah Keim, Ph.D., and principal investigator at the Center for Biobehavioral Health in The Research Institute at Nationwide Children's Hospital in Columbus, Ohio.
In 2011, Keim and her colleague Barbara Gracious, M.D., and principal investigator at the Center for Innovations in Pediatric Practice at Nationwide Children's, applied for and received local funding for autism-related research. The duo applied research Keim had seen regarding omega fatty acids improving cognitive development in infants.
"I realized we could apply this same nutritional supplement intervention to [the ASD] population," Keim says. "We were honored to be awarded that grant be able to do this project."
Recruiting for the trial
The trial focused on a small segment of the pediatric population: children who were born at least 11 weeks premature and were showing early signs of autism.
"Other studies have focused on older kids who have autism," Keim says. "We wanted to do our intervention early because we felt like we might have the best hope of being able to see some improvement."
The brain is still actively growing in those early developmental years, and children who are born premature have a higher risk of developing ASD. The idea was that intervening earlier—when Keim describes the brain as still "malleable"—would create greater, lasting change for kids affected by ASD.
Keim's team screened 500 kids between the ages of 18 and 38 months old, all of whom were previously patients in Nationwide Children's Neonatal Intensive Care Unit (NICU). The average age for diagnosis of ASD in the United States is about 4 years old, introducing a unique patient population as the focal point of the study.
Parents were given a survey used to screen kids for autism by identifying key signs of ASD that could be easily observed in the home. The survey inquired about the child's social and language skills and learning development.
Thirty-one kids were chosen for the study that would last three months.
Once screened, participants were started on the trial within a couple of months. Half of the group took a placebo, while the other have took an omega fatty acid blend daily, delivered as lemon-flavored oil. To maintain reliability of results, families were not aware of whether they had the placebo or the omega supplement.
The blend in the administered oil features omega-3 fatty acid, which is popular among adults and children for its variety of health benefits, and an omega-6 fatty acid called borage oil that is rich in gamma-Linolenic acid (GLA).
Twenty-eight of the 31 kids participating in the study had comprehensive outcome data. After the three months, results indicated greater positive change in the group taking the omega supplement. Measured using the Brief Infant Toddler Social Emotional Assessment ASD scale, patients taking the omega supplement experienced a 2.1-point difference when compared to the patients on the canola oil placebo.
"We think that there's something interesting about GLA that may help individuals whose metabolic pathways for how they process these fatty acids are not quite as efficient as they should be or aren't working quite right," Keim says. "We think the GLA comes in and interacts with the other fatty acids in such a way that the brain can use the omega-3 fatty acids more effectively."
What it could mean for parents and children
Due to the lengthy waiting process getting into behavioral therapy programs after a diagnosis, incorporating an omega fatty acid supplement can help in the interim as patients wait to get into a program.
"I'm not going to argue that these supplements take the place of those therapies or are as effective," Keim says. "Those therapy programs have a lot of evidence behind them and are still really important. But, if a family is waiting to get into one of those programs and this helps their child, it seems like [incorporating an omega supplement] could make a lot of sense as something they could do while they're waiting."
The next phase
Last fall, Keim and Gracious received a grant from the National Center on Complementary and Integrative Health, a branch of the National Institutes of Health (NIH), to start trying omega fatty acid supplementation on a broader group of kids.
The next group will include 2 to 6 year olds who have already received a clinical diagnosis of ASD. The research team will be approaching potential candidates through the child development center at Nationwide Children's. Keim and Gracious are hoping to start the next trial in the spring of 2018. If the results prove positive, they will be conducting another trial with a larger group of kids.
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