Can Autism Be Reversed? A Published Case Study
At Food for the Brain, we are committed to exploring the factors that influence brain development, cognitive function and mental wellbeing throughout life. While much of our work today focuses on protecting brain health as we age, we also support research and education on children’s brain development through initiatives such as Smart Kids & Teens.
The question of whether autism can be reversed remains one of the most debated topics in developmental medicine. In this guest article, Simon Martin examines a published case study describing two children with autism spectrum disorder who experienced substantial improvements following a comprehensive programme of nutritional, lifestyle and therapeutic interventions. As a single case study, its findings cannot be generalised to all children with autism, but they raise important questions about the potential role of nutrition, metabolism and environmental factors in influencing symptoms and development, and highlight areas where further research is warranted.
Autism: “reversed” in twins with personalised nutrition, supplements and therapeutic approaches
By Simon Martin – this article was originally shared by IHCAN – shared and edited with permission.
It’s “kind of a miracle”, says one of the paediatricians consulted in a newly-published case study, as twin girls recover – one, so completely it’s as if she never had autism.
Research charity Documenting Hope, has published a case study detailing the reversal of severe Autism Spectrum Disorder symptoms in fraternal female twin toddlers.
Diagnosed at 20 months with severe (Level 3) ASD and requiring substantial support, the twins exhibited limited communication, repetitive behaviours, and significant gastrointestinal issues. Realising that conventional approaches were unlikely to help, the parents assembled an intervention focusing on environmental and lifestyle factors.
In a paper published in the journal Personalised Medicine by a multi-disciplinary team, Dr Chris D’Adamo PhD, (who will be speaking at our Smart Kids & Teens Event in 2025) the charity’s Scientific Director and Principal Investigator and Director of the Centre for Integrative Medicine at the University of Maryland School of Medicine, and his colleagues reported the following stunning results:
“Both twins showed dramatic improvements on the Autism Treatment Evaluation Checklist (ATEC) . The ATEC measures the effectiveness of autism treatment by assessing communication, social skills, sensory awareness and more. Autism Treatment Evaluation Checklist (ATEC) scores dropped from 76 to 32 and 43 to 4 (scores below 43 indicate neurotypical), respectively, with stability over six months. The progress of Twin P, whose score dropped to 4 from March 2022 to October 2023, was described as “a kind of miracle” by one of the paediatricians. Dr D’Adamo told the Telegraph, “This twin’s functions are comparable to those who have never had an autism diagnosis”.
Twin L, who had more severe autism at 20 months, scoring 76 initially, reduced this to 32 a year and a half later. D’Adamo said she “improved dramatically, but not quite as much”.
They also highlighted “the clear environmental and lifestyle influences on ASD that these findings help establish, building upon previous studies revealing the comparatively greater impact of these types of factors than genetics”.
D’Adamo and colleagues do not use the word “cure” in their report, but say the symptoms are unlikely to come back; “Because autism is a developmental condition, one can safely say that once they have overcome the developmental aspects of autism and returned to a typical developmental trajectory, they are very unlikely to exhibit the common symptoms of autism again. Symptoms that could return might be more along the lines of things like anxiety, gastrointestinal issues and sensory issues, but not necessarily the behavioural aspects of autism”.
The team from the University of Maryland and Hope concluded:
“This case revealed a reversal of the Level 3 Autism Spectrum Disorder diagnoses among toddler twin girls that was achieved primarily through environmental and lifestyle modifications over a two-year period. The twins’ dramatic improvements and diagnosis reversal have persisted for over six months with no signs of regression”.
“What’s more”, says Documenting Hope, “we have learned from the parents that the twins’ ATEC scores have continued to drop below those that were originally published in this paper. This is very exciting news for this family and for the promise of symptom reversal in autism as a viable clinical outcome”.
This is not the first report of a reversal/cure of autism, but certainly the first case where researchers have documented treatment initiated and led by parents. The published paper includes a review of the literature, in which D’Adamo and colleagues detail the many “alternative” approaches that have succeeded, but have been ignored by orthodox medicine, even when published, possibly due to lack of blinding, which is challenging for such interventions. Additionally, they say, a degree of expectation bias is possible and more studies are needed for conclusive results regarding any such interventions, particularly in light of both the diversity of possible causes of ASD and the presentation of symptoms.
The nutritional, supplements & therapeutic approaches
Citing almost 50 previous studies, the Hope team write: “There are limited FDA-approved pharmacological options at present to treat ASD. Accordingly, there have been a number of non-pharmacological interventions tailored to address the underlying environmental and lifestyle risk factors that have demonstrated promising, though not conclusive, improvements in ASD symptoms“.
These include:
- Dietary interventions such as gluten and casein-free, GAPS (Gut & Psychology / Physiology Syndrome), a specific carbohydrate diet, low glutamate and ketogenic.
- Targeted or personalised dietary supplements such as vitamin D, methylfolate, carnitine, vitamin B12 and other micronutrient supplementation, mitochondrial support, or supplements thought to be relevant to a child’s functional genomic situation.
- Addressing other modifiable lifestyle factors and environmental interventions, such as more time in nature, a reduction in exposure to artificial light, and improving indoor air quality, have demonstrated promise.
- Therapeutic interventions addressing a child’s physical structure and function, such as cranial osteopathy, retained reflex integration, physical therapy, and occupational therapy, have also been associated with improved outcomes among ASD patients.
“While reversal of ASD diagnosis is relatively rare, there have been documented cases in the literature of complete recovery with a multi-modal intervention. One such case achieved reversal of ASD diagnosis through a combination of dietary modifications, probiotics and micronutrient supplementation, and antimicrobials that were personalised to the child’s risk factors, clinical presentation and a variety of laboratory tests”.
The approaches taken for this intervention
The parents gathered support and resources from many places. They worked with an autism parenting coach, utilising the Child Health Inventory for Resilience and Prevention (CHIRP) survey of the Documenting Hope Project, in addition to resources at Epidemic Answers. They also used Applied Behaviour Analysis (ABA, which is typically recommended for new ASD diagnoses – find out more here) and speech therapy with the twins. Additionally, the twins’ parents implemented a rigorous diet and nutrition intervention around the time of diagnosis.
First to go was glutamate – aka MSG – following the principles of the Reduced Excitatory Inflammatory Diet (REID – references can be found here ) developed by PhD biochemist Dr Katherine Reid. Dr Reid is a mother of a daughter “no longer considered on the autism spectrum, which is managed 100% through diet”.
Dr Reid is also the author of Fat, Stressed, and Sick: MSG, Processed Food, and America’s Health. She says: “The Reduced Excitatory Inflammatory Diet (REID) is a food lifestyle focused on reducing excitatory and inhibitory signalling imbalances (ie improving neurotransmitter balance) and reducing inflammation through a balanced whole food approach. Some of the most prevalent excitatory and inflammatory foods are gluten, casein (a class of proteins found in dairy), soy, corn (to a lesser extent) and ready-to-eat or commercially processed foods with various food additives, particularly those containing free glutamate and aspartate. These foods can be problematic because of their high concentration of unbound/free glutamate (glutamic acid). Unbound or free glutamate (aka MSG) is most commonly found in processed foods as a food additive or created as a by-product of commercial food manufacturing processes”. The book is available in our Food for the Brain bookstore: here.
The parents put the girls on a strictly gluten-free, casein-free diet that was low in sugar and had no exposure to artificial colours, dyes, or ultra-processed foods. They emphasised organic, unprocessed, freshly prepared, and home-cooked food from local sources when possible.
The twins took a number of dietary supplements, including omega-3 fatty acids, a multivitamin, vitamin D, carnitine and 5-methyltetrahydrofolate, plus individualised homoeopathic remedies. They also used lab tests and genomic information to select nutritional supplements based on the twins’ DNA.
There were some common findings, such as impaired serotonin metabolism and a recommendation that the girls be fed a diet rich in tryptophan to upregulate serotonin production, as well as consume foods rich in vitamins B12, B6 and folate. Both twins had several genetic variants associated with a higher risk of systemic inflammation.
The mother was advised to feed the children foods that are high in betaine and choline, as well as to supplement with Lion’s mane and resolvins (found in fatty fish). However, each girl also had unique needs. P had variants that suggested an increased need for vitamin D. L had several variants associated with neuroinflammation, oxidative stress and compromised detoxification. Advice was provided to support glutathione production.
Both girls had the most sessions of any intervention with an occupational therapist who focused on the specialised technique of neuro-sensory motor reflex integration developed by Dr Svetlana Masgutova, PhD.
Eventually the parents’ research led them to check their home for air quality, mould and moisture.
In October of 2022, they brought in a Building Biology Environmental Consultant. The consultant tested the home’s indoor air quality, evaluated possible signs of moisture intrusion, and identified other potential sources of toxicants. Air tests for mould were reported to be “very clean”. However, thermal imaging and moisture metre readings suggested the family was encouraged to further evaluate several areas of the home, which suggested water damage. A window in the twins’ bedroom was one area needing more evaluation.
Both girls were seen by a cranial osteopath. The family decided to pursue osteopathic care for L and not for P. L visited an osteopath at regular intervals in 2023 and saw notable benefits.
Outcomes
Twin L’s ATEC (Autism Treatment Evaluation Checklist) scores improved dramatically, from 76 in March 2022 to 32 in October 2023, and then remained relatively stable at 34 in March 2024. Twin P’s ATEC scores also improved dramatically, from 43 in March 2022 to 4 in October 2023, remaining stable at 4 in March 2024.
“In addition to the twins’ improved ATEC scores, numerous other behavioural and social improvements were noted after the implementation of the interventions”, the paper reports. Both L and P’s eye contact, language, and attention had all improved noticeably by autumn 2022. “This was accompanied by participation in a toddler play group three days per week and ultimately attending pre-school three days per week in Fall 2023″.
Conclusions & future progress
The University of Maryland team give full credit to the parents’ commitment and drive in achieving these results for their twins. They also acknowledge that this level of complex and sustained treatment may be impossible for many families to take on.
“For instance, the cost of the healthy lifestyle modifications and out-of-pocket costs of care of the numerous practitioners and laboratory assessments in this case would be financially prohibitive to many families. Access to healthy foods and the types of practitioners contributing to this therapeutic approach may also be limited for many families”.
However, they conclude: “It has become increasingly clear that ASD treatment is not one-size-fits-all, and that personalised, multi-modality treatment approaches to help address the total load of stressors are likely required to achieve optimal outcomes”.
This case study does not suggest that all autism has the same underlying causes, nor that every autistic individual requires treatment or wishes to change who they are. Autism is a broad spectrum, and experiences vary considerably from person to person. As a single published case study, its findings cannot be generalised. However, it highlights the possibility that, for some children with complex medical and nutritional needs, identifying and addressing underlying biological factors may contribute to meaningful improvements in health, functioning, communication and quality of life. Further research is needed to determine which approaches may be beneficial, for whom, and under what circumstances.
Through initiatives such as Smart Kids & Teens, alongside our wider work in dementia prevention and lifelong brain health, Food for the Brain continues to explore the evidence on how nutrition and lifestyle may support optimal brain function at every stage of life.
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Other resources:
- Want to read more about Autism? Read our ‘Is Autism Genetic?’
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