HBOT Therapy and Autism: The Good, The Bad & The Ugly

Annie Tanasugarn, PhDc, BCBA CEO/AUTHOR, The Autism Analyst
"Autism Awareness simply means to acknowledge that Autism exists; Acceptance is to acknowledge its value."
My first introduction to hyperbaric chambers came years ago when working with a client during HBOT treatment. I even got to sit in the chamber, and it was very cool experiencing HBOT therapy used for children with ASD.
What is a Hyperbaric Chamber?
Hyperbaric chambers are pressurized small compartments for individual use, or pressurized large rooms which can accommodate several people at once. These chambers have oxygen-rich air and include up to 100% concentrated oxygen, depending on the type of chamber. Chambers include both small, take-home variety which includes a hood for the head and a small generator attachment to produce the concentrated air. The in-clinic chambers can be steel or an acrylic material and include small portal windows to see out.
HBOT Therapy
Existing research supports the use hyperbaric chambers for the treatment of acute medical symptoms. Hyperbaric Oxygen Therapy (HBOT) has been used to help eliminate critical medical conditions such as decompression sickness (“the bends” associated with deep sea diving), embolisms, severe anemia, gangrene, tissue infections and carbon monoxide poisoning. More recently, studies have included the use of hyperbaric chambers in helping reduce some symptoms associated with Autism with a mixed bag of results on its efficacy and validity.
The Good
According to some existing literature, HBOT therapy may support decreased maladaptive behaviors, and increased prosocial behaviors. Positive behaviors reported can include:
Increase in initiating conversation: Often clients need material prompt for independently asking questions or initiating conversations such as (a piece of paper prompting client for social cues to ask a question/make statement). After 8 weeks of HBOT therapy, it was reported as a client engaging more independently throughout session icluding initiating questions and engaging in conversation.
Less aggression: Prior to HBOT therapy, ABA therapists and parents may report high incidences of aggression, (ex: 3-8 aggresions per hour). After the HBOT therapy, data may suggest a decrease in aggression (ex: 1-4 aggressions per hour).
Longer Duration of Task Engagement: Increasing independent engagement on tasks (ex: goal to 5-minute) to a 10-minute independent goal was reported after HBOT therapy.
Eye Contact: One hallmark of ASD is limited, or no eye contact, especially during communication. It has been reported that eye contact increased in duration after exposure to HBOT therapy.
The Bad
Expensive: HBOT therapy may not be covered by insurance companies. Thus, parents and caregivers may spend hundreds per HBOT session, often with a series of sessions.
No Scientific Validation for Use with Autism: Currently, while there is a decent amount of research on children with ASD and HBOT therapy, HBOT therapy currently has no scientific validation for treatment. The only scientifically validated treatment for Autism is Applied Behavior Analysis (ABA) therapy.
Results Differ: When the treatment itself stops, behavior may return to pretreatment levels.
The Ugly
Controversial: HBOT therapy is concentrated oxygen – of up to 100% pure – being pumped into a small, contained hood and chamber. This can’t be bad for you, right? Wrong. Complications from this type of treatment may include middle ear bruising, eardrum rupture, dizziness, seizures or temporary vision disturbances. Since the chambers themselves may be small, they may only comfortably accommodate a small child or average size adult. Individuals entering the chamber must be able to comfortably fit through the the opening. Communication with staff and personnel may be limited. Individuals with claustrophobia may find these chambers uncomfortable. Children with ASD or other special needs may also have a difficult time entering and exiting them which may lead to injury.
The Verdict
Parents and caregivers should weigh the pros and cons of HBOT therapy to see if it is a good match for your child, your family, and your pocket book.
References
Ghanizadeh, A. (2012). Hyperbaric oxygen therapy for treatment of children with autism: A systematic review of randomized trials. Medical Gas Research, 2, 2-6.
Mayo Clinic. (2014). Tests and procedures: Hyperbaric oxygen therapy.
Satulkchit, T., Ladish, C., & Goldman, R. D. (2017). Hyperbaric oxygen therapy for children with autism spectrum disorder. Canadian Family Physicians, 63(6), 446-448.

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