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OrIgInal research
Improving communication skills in children With
allergy-related autism Using nambudripad’s allergy
elimination Techniques: a Pilot study
Jacob Teitelbaum, MD; Devi S. Nambudripad, MD, PhD, DC, LAc; Yvonne Tyson, MD; Ming Chen, MD; Robert
Prince, MD; Mala M. Moosad, RN, LAc, PhD; Laurie Teitelbaum, MS
abstract
Background: Autism prevalence increased more than 50%
Evaluation Checklist (ARI-ATEC), Childhood Autism Rating between 2002 and 2006. We hypothesized that major con- Scale (CARS), NST, and Allergy Symptom Rating Scale tributors to the development and symptoms of autism include food and nutrient sensitivities. Desensitization to multiple Results: A total of 56 children (NAET, 26 children; control,
allergens forms the basis of the Nambudripad Allergy 30 children) completed the study. After 1 year, the children Elimination Techniques (NAET) treatment for autism. receiving NAET treatments demonstrated significant improve- Subjects and Intervention: Sixty children (2.5-10 years old)
ments in performance compared with the control group, with autism were randomly assigned to treatment or control determined with the ARI-ATEC score (mean decrease: NAET, groups. The treatment group (26 boys and four girls) received 68%; control, 0.8%; P < .0001), CARS (mean improvement: NAET treatments (combining acupressure and kinesiology) NAET, 47%; control, 0.4%; P < .0001), NST (mean improve- for 50 key allergens for 1 year. The nonblinded control group ment: NAET, 66%; control, 0%; P < .0001), and ASRS (total (25 boys and five girls) did not receive any NAET treatments. decrease: NAET, 85%; control, 2%; P < .0001). The NAET Each group was allowed to continue with any other therapies treatment resulted in statistically significant improvements in they had been receiving. Neuromuscular Sensitivity Testing 30 of the 35 symptoms assessed using the ASRS. In the NAET (NST, kinesiology and muscle testing) was used to determine group, 23 of the 30 children returned to regular school classes which substances triggered sensitivity reactions in each child, with healthy, nonautistic peers after treatment, but all of the and NAET acupressure treatments were then used to elimi- children in the control group continued to require special Outcome Measures: Status for each participant was deter-
Conclusions: The NAET treatment is effective and well toler-
mined at the beginning and end of the 1-year study using the ated for children with allergy-related autism. following tools: Autism Research Institute Autism Treatment Trial registration
This trial was registered at ClinicalTrials.gov: Registration #
Autism is an early childhood developmental disorder characterized by difficulties with social interactions and communication and stereotyped patterns of behavior. Autism was present in less than 1% (1/110) of Amer- Jacob Teitelbaum, MD, is the director of the Kona Research Center,
ican 8-year-old children in 2006, having increased in preva- Kona, Hawaii. Devi S. Nambudripad, MD, PhD, DC, LAc, is director for
lence by more than 50% between 2002 to 2006.1 With phar- research, Nambudripad’s Allergy Research Foundation (NARF) Research
maceutical treatment options producing only limited success, Center, Buena Park, California. Yvonne Tyson, MD, is assistant director
there is an urgent need for effective therapies for this debili- for research, NARF. Ming Chen, MD, is a pediatric physician, Synergy
tating disorder. Decreased severity of autism may be noted Integrated Healing Arts, San Gabriel, California. Robert Prince, MD, is an
after treating nutritional, toxin-related, and infectious prob- NAET practitioner at the NAET of Carolina clinic, Charlotte, North Caro-
lems that may be associated with autism, and further research lina. Mala M. Moosad, RN, LAc, PhD, is clinical director, NARF Research
Center. Laurie Teitelbaum, MS, is codirector, Kona Research Center.
Most children with autism exhibit symptoms of food and other sensitivities. In a previous study of 153 autistic children Disclosure: No competing financial interests exist. Some authors are NAET
treated over 5 years, 101 (66%) had clinical symptoms and practitioners, and Devi Nambudripad developed the technique. findings on Neuromuscular Sensitivity Testing (NST)2 that were consistent with the presence of food allergies or sensi-tivities. NST has been described in detail elsewhere2 and looks Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
Teitelbaum, et al—NAET Effective for Autism This article is protected by copyright. To share or copy this article, please visit copyright.com. Use ISSN#10786791. To subscribe, visit imjournal.com
for a drop in muscle strength when the person is holding a clinical observation documented on videotape.
substance he or she is allergic or sensitive to. Muscle weak- 2) Participants had to be between the ages of 2.5 and 10 ness is looked for by having the patient resist when applying downward pressure to an outstretched arm while the patient 3) A history suggestive of food sensitivities had be present. In our experience, allergy/sensitivity symptoms commonly With the Nambudripad Allergy Elimination Technique seen in autistic children include those associated with (NAET), it has been hypothesized that a food sensitivity may gastrointestinal disorders (such as indigestion, abdominal result from an imbalance or reactivity between the energy bloating, foul smelling gas, abdominal pain, constipation, fields of an individual (as described by traditional Chinese and/or diarrhea), skin problems (including rashes and medicine and acupuncture) and of a particular substance or eczema), insomnia, or hyperirritability triggered by eating group of substances. Such imbalances can be identified with or drinking. Patients had at least one of these symptoms.
the application of Neuromuscular Sensitivity Testing (NST).2-4 4) Participants had to have ratings of ≥30 on the Childhood We hypothesized that eliminating detectable sensitivities in Autism Rating Scale (CARS; range of possible scores, 0 autistic children would improve their ability to function. [least impaired] to 60 [most impaired])11,12 and NAET is a noninvasive therapy that combines aspects of 5) a score ≥15 on the Autism Research Institute Diagnostic Oriental medicine, traditional Chinese medicine, nutritional therapy, and applied kinesiology2-6 NAET may cause improved function by desensitizing the individual to foods and environ- Exclusion Criteria
mental toxins such as heavy metals. In affected children, this Potential study participants were excluded if they had a history may improve neurologic function.2-6 The NAET hypothesis2 is of previous major surgery or congenital deformities, malig- supported by unpublished clinical data collected over the past nant tumors, chronic infections such as human immunodefi- 24 years that suggest the NAET approach can substantially ciency virus, or any physically debilitating physical or mental reduce many of the physiological and physical symptoms asso- disorder that is not part of autism such as Down syndrome or ciated with childhood autism.6 This study was undertaken to evaluate the use of NAET treatments in children with autism.
All parents of the participants gave informed consent, and the study was approved by the Nambudripad Allergy MaTerIals anD MeThODs
Research Foundation (NARF) Institutional Review Board and Subjects
The participants in the study were selected from volunteers The study was not blinded because of the difficulties who responded to a study announcement published in the associated with attempting to perform sham acupressure and NAET Newsletter,7 the NAET Web site8 (http://www.NAET.
muscle testing. Therefore, the control group continued to com), local newspapers, local school flyers, and the http:// receive standard care except without NAET. A total of 60 eligible children were randomly assigned to either NAET treatment (n = 30) or control (n = 30) groups. The Inclusion Criteria
children who were accepted into the study were screened for Study participants were included based on five criteria. the presence of allergy symptoms using the Allergy Symptom 1) A previous diagnosis of autism made by their physician: Rating Scale (ASRS) questionnaire.14 This questionnaire Participants also had to satisfy the criteria for the diagnosis examined 35 allergy-related symptoms. Each symptom was of autistic disorder as described in Diagnostic and Statis- scored from 0 to 10, with higher scores indicating greater tical Manual of Mental Disorders, 4th Edition10 based on perceived discomfort. The presence and severity of a suspected Groups of Related Allergens Subjected to Neuromuscular Sensitivity Testinga
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allergy to 50 groups of allergens (Table 1) was determined direct observation by the attending health care professional, using NST (range, 0 to 3; higher scores indicated more severe offers a combination of practicality and research support, and muscle weakness associated with sensitivity to the substance is a commonly used outcome measure in treatment trials.11,12 NST is similar to Muscle Response Testing, which was developed in 1960 by George Goodheart, DC, and has been Randomization
used by chiropractors, kinesiologists, and other holistic The names of all 60 subjects were placed on individual pieces medical practitioners for many years. NST adds a few steps of paper in a bowl. A 5-year-old boy who could not see the to balance the energetic status of the subject before beginning names removed the first 30 name slips, and these subjects were assigned to the treatment group. The remaining 30 subjects The ASRS form asks clients to rate symptoms that may be associated with food and other sensitivities. Each symptom is rated on a scale from 0 to10 (no discomfort, 0; mild discom- Treatment
fort, 1-3; moderate discomfort, 4-6; severe discomfort, 7-10).
Testing began in October 2004. Treatments began in November 2004 and were completed in December 2005. During a period Statistical Analyses
of 1 year, the NAET-treated children received NAET treat- The mean changes in the outcome variables were compared ments twice per week (total, 100 treatments) for 50 basic aller- using an unpaired t-test with a 2-sided α of .05 (Number gens. This treatment has been described elsewhere in detail2-6 Cruncher Statistical System, version 5.03, NCSS, Kaysville, and consists of applying pressure to acupressure points along the spine (from the neck to the sacrum) and on the hands and feet while the patient is holding the allergen. After the acupressure procedure, the participant continues to hold the There were 23 NAET-treated children who improved to the sample for 20 more minutes. Then the participant is tested via extent that they were able to function in regular school classes NST. If the arm continues to be strong on NST in the pres- instead of special education classes. There were four children ence of the allergen, the treatment is said to be satisfactory. in the NAET-treated group who dropped out of the study The participant is sent home with the instruction to avoid the after receiving 25 (range, 20-30) NAET treatments because treated item for the following 25 hours. At the follow-up visit, their families moved out of the area; in the opinions of both the participant is retested for the treated item using NST. The the parents and NAET practitioners, these children had clini- children in the control group received no NAET treatments. In cally meaningful improvements before dropping out. There both groups, parents were instructed to continue any medical were three children who received NAET treatments who did treatments the child was receiving prior to enrollment in the not have clinically and functionally significant improvement, for unknown reasons. Another patient (one girl) improved markedly in most characteristics except for speech, but her Outcome Measures
continued inability to speak despite treatment was caused by The primary outcome measures of the effectiveness of NAET vocal cord dysfunction (she is now otherwise much improved treatments in improving the core features of autism were and doing well in regular school). No adverse reactions to scores on the Autism Research Institute Autism Treatment NAET treatments were observed during the study. Evaluation Checklist (ARI-ATEC).13 The ARI-ATEC consists of None of the children in the control group improved or were able to function in regular school classes. None of the 1) speech/language/communication (range 0-28), control patients dropped out before completion of the study. At the beginning of the study, the two groups did not 3) sensory/cognitive awareness (range 0-36), and exhibit any clinically significant differences (Table 2). After 1 4) health/physical/behavior (range 0-75). year of NAET treatments, there were statistically significant decreases in mean severity scores for all four of the ARI-ATEC The score for each subscale was based on ratings provided subtests: speech/language/communication (mean decrease: by the parent or primary caretaker. For all subscales, greater 82.1%; 95% confidence interval [CI]: 63.4, 100.7); sociability scores were interpreted to reflect greater impairment. (64.7%; 95% CI: 48.2, 80.6); sensory/cognitive awareness The checklist was designed to measure treatment effec- (63.5%; 95% CI: 49.4, 77.5), and health/physical/behavior tiveness in autism. Lacking such a scale, previous researchers (66.0%; 95% CI: 52.8, 79.7), but scores for these subtests did had resorted to using scales such as the CARS, the Gilliam not change in the control group (Table 3). Autism Rating Scale (GARS), or the Autism Behavior Check- After 1 year of NAET treatments, there was a statistically list, which were all designed to diagnose autism and not to significant decrease by 68.4% (95% CI: 57.0, 79.9) in the mean measure treatment effectiveness. Several secondary outcome total of the severity scores for the four subtests, while the mean measures also were evaluated, including CARS,11,12 NST,3,4,15-17 total score did not change in the control group (Table 3). For each of the four ARI-ATEC subtests and the total ARI-ATEC CARS is a validated test combining parent reports and score, the mean improvement in the NAET-treated group Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
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Baseline Characteristics of Autistic Children Selected to Participate in
Nambudripad’s Allergy Elimination Techniques Efficacy Pilot Study
naeT (n = 30)
cOnTrOl (n = 30)
Abbreviations: NAET, Nambudripad’s Allergy Elimination Techniques; ARI-ATEC, Autism Research Institute Autism Treatment Evaluation Checklist; SD, standard deviation.
Change In Autism Research Institute Autism Treatment Evaluation Checklist Rating Scores
After 1 Year of Nambudripad’s Allergy Elimination Techniques Treatment
naeT vs cOnTrOl
arI-aTec subtest
Total score
–47.6 –55.5, –39.7 .0001
Abbreviations: ARI-ATEC, Autism Research Institute Autism Treatment Evaluation Checklist; NAET, Nambudripad’s Allergy Elimination Techniques; CI, confidence interval.
Teitelbaum, et al—NAET Effective for Autism Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
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Change After 1 Year: Childhood Autism Rating Scale, Neuromuscular Sensitivity Testing,
and Allergy Symptom Rating Scale Ratings
naeT vs cOnTrOl
mean 95% cI
Abbreviations: NAET, Nambudripad’s Allergy Elimination Techniques; CI, confidence interval.
was significantly greater than the mean improvement in the disability. It is important to be aware that this may be part of the recovery response. Backache, cough, poor weight gain, Consistent with these findings, 1 year of NAET treat- and seizures were not responsive to NAET treatment (Table ments was associated with a significant mean decrease of 6). Except for cough, all of the individual symptoms that were 47.4% (95% CI: 39.3, 55.2) in the mean CARS score, while associated with average NAET-produced improvements that mean CARS scores did not change significantly in the control exceeded 1 rating point were significantly greater than any group (Table 4). The mean improvement in the NAET-treated improvements in the corresponding symptoms in the children group was significantly greater than the mean improvement in After the conclusion of the study, the children in the Similarly to the findings reported above, 1 year of NAET control group were offered complimentary NAET sessions (as treatments reduced the responses during NST by an average received by the children in the treatment group). of 65.5% (95% CI: 65.5, 69.0), but no reduction was experi-enced by the children in the control group (Table 4). After 1 case rePOrT
year, most NAET-treated children had become desensitized Patient 13 was a 3.5-year-old male autistic child. He was to all of the test allergens (as reflected in the results of NST described as nervous, irritable, paying no attention to his testing). In addition, the NAET-treated children responded surroundings, sometimes aggressive, and pinching peers in to 1 year of treatment with a significant mean 85.0% decrease his “special needs” preschool. He was unable to use two words (95% CI: 79.6, 90.4) in total ASRS scores, while the children in at a time, and his teacher described him as unable to commu- the control group improved only an average of 2.3% (95% CI: nicate verbally. He called almost everyone “Mama.” 1.8, 2.8; Table 4). The mean improvement in the NAET-treated After desensitization to egg mix, he began to speak more group was significantly greater than the mean improvement in and then became very calm after desensitization to the sugar mix. After he received desensitization treatments for approxi- There were no clinically significant differences among the mately ten of the 50 allergen groups, he began speaking in 35 individual baseline ASRS scores (Table 5). After 1 year of short sentences. After 6 months of treatment, he became toilet NAET treatment, 30 of these individual scores were improved trained and qualified to receive speech therapy at school; he had previously been ineligible for this support because of The most marked improvements (more than 5 rating limited speaking ability. His parents felt that he became much points greater than the average improvements exhibited by more normal for his age after being desensitized to diptheria- the children in the control group) were seen in abdominal pertussis-tetanus vaccine. He later told us that he had a “best bloating, attention deficit hyperactivity disorder, anger, autism, fatigue, joint pain, and sinusitis. In contrast, the At completion of the study, his ARI-ATEC rating for the severity of mood swings increased by a statistically significant speech/language/communication subtest decreased from 26 29% in the NAET-treated children. Though the cause of this is to 0, and his total ARI-ATEC score decreased from 84 to 4. This not clear, it is possible that this occurred because of metabolic allowed him to be placed in regular kindergarten after gradua- shifts occurring as part of the process of recovery or occurred tion from preschool. Although he still had some difficulty with as the children improved enough to become aware of their conventional speech, he was doing well and was improved Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
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Baseline Allergy Symptom Rating Scale Scores
naeT (n = 30)
cOnTrOl (n = 30)
allergy symptom rating scale scores
Abbreviations: NAET, Nambudripad’s Allergy Elimination Techniques; SD, standard deviation. enough to be eligible for supportive speech therapy.
23 of the 30 treated children (77%) were able to be included in regular schools. This outcome provides a very encouraging DIscUssIOn
measure of the degree of improvement that can be achieved in Children who received 100 twice-weekly NAET treatments young autistic children during 1 year of NAET treatments. for 50 allergens exhibited highly significant improvements in Limitations of this study include the concern about the the area of speech, language, communication skills, and other evaluation of the effectiveness of acupressure (a key facet of autistic behaviors compared with the subjects in the control NAET therapy) because of the paucity of double-blind, place- group who received conventional care. The children receiving bo-controlled studies of that therapeutic modality. It may NAET treatments also had marked clinical improvement, and be difficult to eliminate the potential confounding effects of Teitelbaum, et al—NAET Effective for Autism Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
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Change After 1 Year Allergy Symptom Rating Scale Symptom Ratings
Mean change
Mean DIfference
P <
–107.9
–105.3
Abbreviations: NAET, Nambudripad’s Allergy Elimination Techniques; CI, confidence interval; NS, not significant (P > .05).
Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011
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applying pressure to an acupuncture point. Similar to studies associates and the statistical team for designing the study, of acupressure, studies using NST also are very difficult to Michael J. Glade, PhD, FACN, CNS (The Nutrition Doctor, perform in a blinded manner. Therefore, conducting placebo- Skokie, Illinois), for statistical analysis, and the NAET practi- controlled studies of NAET is difficult, and a potential placebo tioners who conducted the study. Our sincere appreciation is effect may have occurred because patients and families received also expressed to our dedicated volunteers (examiners, moni- more attention associated with treatment. The marked degree tors, research assistants, volunteer-assistants, and patients) of recovery, however, suggests that a treatment effect beyond a who participated in this study. The study was conducted by the NAR Foundation Research associates at the Pain Clinic Applied kinesiology (muscle testing used in NST), Research Center, Buena Park, California. The study was funded although not yet accepted by many in the conventional by the Teitelbaum Family Foundation and NARF, Buena Park, medical community, has been reported by many kinesiolo- gists, chiropractors, and other health care professionals to NAET research associates participating in this study were be very helpful in assessing the reactivity of an individual to Adam Vigil, DC; Jing Li, MD, LAc, OMD; Iris Prince, RN; Ross a particular substance, and NAET practitioners have found Stark, BSEE, DAc, LAc; James Benjamin, MD; Joyce Benjamin, this technique to be helpful and safe in the identification of RN; Anthony De Siena, DC; Nancy B. Rosen, RN, LAc; Gary candidate substances for desensitization. In addition, NST has Erkfritz, DC; Sue Anderson, DC; Ray Alexander, DC; Roya been reported to produce agreement in interpretation among Nikzad, LAc, PhD; Farangis Tavily, LAc; Michael Liang, LAc; examiners,15 and the results of NST and measured plasma Tom Anderson, DC; Laurie Teitelbaum, MS; Gloria Phillips, concentrations of immunoglobulins G and E following expo- DC; Margaret Owens, ND, MEd; Kris K Nambudripad, BSEE, sure to antigens are significantly correlated.16 LAc, MS; and Mohan K Moosad, LAc, ND.
An additional limitation is that this study was limited to children aged 2.5 to 10 years. The benefits of NAET treatments References
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7. No authors listed. Autistic children wanted for study. NARF Message: The Although the complete NAET program for autism Newsletter of the Nambudripad’s Allergy Research Foundation. July 2003: 6.
requires approximately 75 to 100 office visits over 1 to 2 years, 8. Nambudripad’s Allergy Elimination Techniques Web site. http://www.naet.com/. most children with severe difficulty communicating begin to 9. No authors listed. An autism study using Nambudripad’s food allergy elimination improve after only 15 to 20 treatments. These children usually treatments. ClinicalTrials.gov. http://www.clinicaltrials.gov/ct2/show/NCT002471 56?term=autism+and+naet&rank=2. Accessed December 21, 2011. exhibit increased visual contact, more masterful verbal and 10. American Psychiatric Association. Pervasive developmental disorders. In: Diagnostic nonverbal communication, greater social interaction, and and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 2000:69-70.
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have been treated at the NAET clinic (Buena Park, California) 12. Eaves RC, Milner B. The criterion-related validity of the Childhood Autism Rating over the past 24 years are now leading normal lives and are Scale and the Autism Behavior Checklist. J Abnorm Child Psychol. 1993;21(5):481- attending regular classes in high schools, colleges, and profes- 13. Rimland B, Edelson SM. Autism Treatment Evaluation Checklist (ATEC). Autism sional schools (unpublished data). This study offers hope to Research Institute. http://www.autismeval.com/ari-atec/research.html. Accessed autistic children and their parents for this difficult and devas- 14. Nambudripad DS, Masuda H, Moosad M, et al. NAET® Testing Devices in Detection of Hypersensitivity to Cane Sugar. J NAET Energet Complement Med. 2005:1(3):199- 15. Lawson A, Calderon L. Interexaminer agreement for applied kinesiology manual cOnclUsIOn
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16. Schmitt WH Jr, Leisman G. Correlation of applied kinesiology muscle testing find- NAET treatment provides an effective treatment modality for ings with serum immunoglobulin levels for food allergies. Int J Neurosci.1998;96(3- children with autism to decrease autistic traits and improve 17. Nambudripad DS, Mala Moosad, Nambudripad KK, et al. NST-NAET® Reliability their speech, language, communication skills, social interac- Study. J NAET Energet Complement Med. 2005;1(1):53-68.
tions, sensory and cognitive awareness, and overall physical health and behavior. Acknowledgements
We sincerely want to express our profound gratitude to
Nambudripad’s Allergy Research Foundation (NARF) research
Teitelbaum, et al—NAET Effective for Autism Integrative Medicine • Vol. 10, No. 5 • Oct/Nov 2011

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