Autism & Acupuncture

abstracted & translated by

Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)
As far as I am aware, relatively little has been published to date on Chinese medicine and
autism in the Chinese journal literature. However, this condition is a growing concern to Western
parents and practitioners. As someone who has high-functioning Aspergers syndrome (a mild
form of autism), I also have a personal interest in this condition. Therefore, I was happy to find
recently an article by Yuan Qing et al. titled, Clinical Research on Acupuncture and the Various
Clinical Symptoms of Pediatric Autism. This article appeared on pages 83-85 of issue #3, 2009
of Xin Zhong Yi (New Chinese Medicine). The five authors of this study are all from Guangzhou
and work either in the Acupuncture-moxibustion & Tuina College or the Basic Medicine College of
Guangzhou University of Chinese Medicine & Pharmacology. A summary of this article is
presented below.
Cohort description:
This study was a two-wing comparison study with a total of 202 cases of pediatric autism
enrolled. These 202 cases were randomly divided into a treatment group and a comparison
group. In the treatment group, there were 118 cases, 98 males and 20 females, with a median
age of 6.025 2.179 years. In the comparison group, there were 84 cases, 75 males and nine
females, with a median age of 5.157 1.992 years. Therefore, in terms of sex and age, these
two groups were deemed statistically comparable for the purposes of this study (P > 0.05).
Diagnostic criteria were based on the American Psychiatric Associations Diagnostic & Statistical
Manual of Mental Disorders - IV (DSM-IV). Patients with Aspergers syndrome, Hellers
syndrome, and Retts syndrome as well as children suffering from depression were excluded
from this study. In terms of Chinese medical pattern discrimination, four patterns were
identified: 1) liver depression qi stagnation, 2) heart-liver fire effulgence, 3) phlegm misting the
orifices of the heart, and 4) kidney essence depletion and vacuity. The key manifestations of
liver depression qi stagnation were depression, unhappiness, and unsociability. The key
manifestations of heart-liver fire effulgence were impetuosity, agitation, and irritability, raving or
confused speech, and inability to sleep at night. The key manifestations of phlegm misting the
orifices of the heart were a dull affect, torpid intelligence, talking to oneself, and drooling from
the corners of the mouth. The key symptoms of kidney essence depletion and vacuity were
retarded development, short, small stature, wilting, limp bones, muscles, and flesh, and slow
closing of the fontanelles.
In terms of severity of the condition, the Childhood Autism Rating Scale (CARS) was used. A
score of 30-35 points indicated a light or mild condition, a score of 36-41 points indicated a
moderate condition, and a score of 42 points or higher indicated a heavy or severe condition.
Treatment method:
All members of the treatment group were treated with acupuncture. The main points consisted
of several named groups of points:
Si Shen Zhen (Four Spirits Needles): A.k.a. Si Shen Cong (M-HN-1), the four points located 1.5
inches in front, behind, and to the left and right of Bai Hui (GV 20)
Ding Shen Zhen (Stabilizing the Spirit Needles): 5 inches above each of Yin Tang (M-HN-3) and
Yang Bai (GB 14)
Nie San Zhen (Temporal Three Needles): 2 inches perpendicularly above the apex of the ear and
1 inch in front and back of that on the same level; three points in toto
Nie Shan San Zhen (Temporal Above Three Needles): 3 inches perpendicularly above the apex
of the ear and 1 inch in front and back of that on the same level; three points in toto

Nao San Zhen (Brain Three Needles): Nao Hu (GV 17), both Nao Kong (GB 19)
Zhi San Zhen (Intelligence Three Needles): Shen Ting (GV 24), both Ben Shen (GB 13)
Xing Shen Zhen (Arousing the Spirit Needles): Ren Zhong (GV 26), Shao Shang (LU 11), Yin Bai
(Sp 1)
Shou Zhi Zhen (Hand Intelligence Needles): Nei Guan (Per 6), Shen Men (Ht 7), Lao Gong (Per
8)
Zu Zhi Zhen (Foot Intelligence Needles): Yong Quan (Ki 1), Quan Zhong (extra-channel point.
Draw a line from the tip of the second toe to the midpoint of the posterior edge of the heel. This
point is located 0.5 inches posterior to the midpoint of this line), Quan Zhong Nei (extra-channel
point. May be located midway between Quan Zhong and Yong Quan. However, I was not able to
find any source for this point for a conclusive identification.)
She San Zhen (Tongue three Needles): Shang Lian Quan (M-HN-21) and 1 inch to the left and
right of that, three points in toto
Thirty-five gauge one-inch Hua Tuo brand fine needles were used with twisting and rotating
hand technique. Si Shen Zhen were needled transversely to the front, back, and side to side to
a depth of 0.5-0.8 inches. Nie San Zhen and Nei Shang San Zhen were needled transversely
downward to a depth of 0.5-0.8 inches. Zhi San Zhen were needled transversely to the rear to a
depth of 0.5-0.8 inches. Ding Shen Zhen and Nao San Zhen were needed transversely
downward to a depth of 0.5-0.8 inches. Xing Shen Zhen were each needled perpendicularly to a
depth of 0.2-0.3 inches. All these needles were manipulated and removed without retention. Nei
Guan within Shou Zhi Zhen was needled perpendicularly to a depth of 0.5-0.8 inches, Shen Men
was needled perpendicularly to a depth of 0.3 inches, and Lao Gong was needled through to He
Gu (KI 4) to a depth of 0.5 inches. Yong Quan within Zu Zhi Zhen was needled towards Tai
Chong (Liv 3) to a depth of 0.5-0.8 inches. Quan Zhong and Quan Zhong Nei were both needled
perpendicularly to a depth of 0.5 inches. Shen San Zhen were needled perpendicularly towards
the root of the tongue to a depth of 0.5-0.8 inches.
In addition, the following points were added based on pattern discrimination:
Liver depression qi stagnation: He Gu (LI 4) and Tai Chong (Liv 3)
Heart-liver fire effulgence: Shao Fu (Ht 8) and (Xing Jian (Liv 2)
Phlegm misting the orifices of the heart: Feng Long (St 40) and Da Ling (Per 7)
Kidney essence depletion and vacuity: Tai Xi (Ki 3)
He Gu, Tai Chong, Shao Fu, Xing Jian, Feng Long, and Da Ling were all needled using draining
method, while Tai Xi was needled using supplementing method. All these needles were
manipulated using lifting and thrusting draining and supplementing hand technique. All these
needles were retained for 45 minutes and stimulated once every 5-10 minutes. Treatment was
given once each morning six days per week for four months.
All members of the comparison group were treated with behavioral training in terms of
cognition, speech, fine motor skills, gross motor skills, interpersonal ability, and self-care ability.
They also received sensory integration training. (Sensory integration is the capacity of an
individual to receive, process, and make sense of information provided by the senses. Sensory
integration training is designed to provide various sensory experiences to help the person with
autism spectrum disorder elicit a more adaptive response to sensory challenges. In other words,
how to cope with his or her sensory problems and sensitivities.)
Study outcomes:
Total median CARS scores were compared before and after treatment in both groups. The
following table shows these scores.

Group

Number

Before treatment

After treatment

Treatment

118

44.70 6.12

34.63 5.63

Comparison

84

47.07 7.52

41.29 7.70

As the reader can see, mean CARS scores were markedly lower in both groups after treatment
(P < 0.01). In addition, CARS scores for specific areas of function were compared in both groups
before and after treatment. In nine out of 14 of these areas, the treatment group experienced
markedly better reduction in CARS scores than did the comparison group (P < 0.001). These
areas included interpersonal relationships, emotional responses, visual responses, auditory
responses, anxiety responses, verbal communication skills, cognitive function, and overall
impression.
Discussion:
The authors of this study do not discuss pediatric autism from the point of view of Chinese
medicine. However, this study does suggest that acupuncture can help improve the function of
children with autism. Unfortunately, the treatment regime is intense and I doubt whether
Western patients and their children could adhere to it in terms of time, money, and discomfort.