Autism spectrum disorder (ASD) and Asperger’s syndrome

Autism, also called “autism spectrum disorder” (ASD), is a neurodevelopmental disorder characterized by difficulties socializing and communicating, processing and understanding external stimuli, and repetitive behaviors. Asperger’s syndrome is also an ASD. Approximately 1 in 36 children in the US have autism, with 4 in 100 boys and 1 in 100 girls diagnosed.

Technically, there is no treatment for autism, and many people feel that autism is a difference in how an individual’s brain works (“neurodivergence”) as opposed to a medical condition. There are, however, prescription medications and various therapies available for managing the side effects of autism, such as mood and behavioral concerns.

Endocannabinoid system (ECS) dysregulation and lower circulating endocannabinoid levels are characteristics of autism. Medical cannabis may help manage some of the symptoms of autism and medication side effects.

Autism causes

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with no single known cause. However, a combination of genetic, environmental, and possibly epigenetic factors is thought to contribute to its development. Factors include:

• Genetic variations: Mutations or changes in certain genes may increase the likelihood of autism. This includes fragile X syndrome (FXS).
• Environmental influences: Prenatal factors such as maternal infections, exposure to toxins, or complications during pregnancy could play a role
• Brain development abnormalities: Differences in brain connectivity and structure, particularly in regions involved in communication and sensory processing
• Gut and immune system dysregulation: Children with autism experience gastrointestinal (GI) inflammation and shifts in their gut microbiota, as well as reduced immune system regulation

Autism symptoms & health effects

ASD manifests through a broad range of symptoms that vary in severity. Common symptoms include:

• Social communication challenges: Difficulty with eye contact, understanding social cues, or engaging in reciprocal conversations
• Repetitive behaviors: Engaging in repetitive motions or speech, such as hand-flapping or echolalia
• Sensory sensitivities: Hypersensitivity or hyposensitivity to sensory input like sound, light, or textures
• Health-related effects:
  • Gastrointestinal issues: Such as constipation or irritable bowel syndrome (IBS)
  • Sleep disorders: Difficulty falling or staying asleep
  • Mental health challenges: Increased risk of anxiety, depression, and attention-deficit hyperactivity disorder (ADHD)

Autism can cause sensory processing difficulties as it alters how nerve cells and synapses connect and organize. Evidence suggests that those with autism are more likely to experience synesthesia, implying an extreme sensitivity to light, taste, touch, and sound, and a “crossing” or “joining” of the senses.

Autism diagnosis

Diagnosing ASD involves a combination of observational assessments and developmental screenings. The diagnostic process often includes:

• Developmental screenings: Regular screenings during pediatric checkups to identify early signs of developmental delays
• Comprehensive diagnostic evaluations: Conducted by specialists using tools like the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R)
• Criteria from DSM-5: The Diagnostic and Statistical Manual of Mental Disorders outlines specific criteria for diagnosing ASD

Early diagnosis and intervention are crucial for better long-term outcomes.

Autism prognosis

The prognosis for individuals with ASD varies widely, depending on the severity of symptoms, the presence of co-occurring conditions, and the timing and type of interventions. Key considerations include:

• Lifelong condition: Autism is a lifelong condition, but symptoms can improve with therapy and support
• Independence levels: Some individuals live independently, while others require ongoing support
• Quality of life (QoL): Tailored interventions, supportive environments, and understanding social networks can significantly improve quality of life

Depending on the severity of autism and other comorbidities, autism can lead to a reduction in life expectancy.

Autism treatments

Medications, psychiatric therapies, and various behavioral and dietary interventions may be prescribed and recommended for those with autism.

First-line treatments

• Behavioral interventions: Applied Behavior Analysis (ABA) and other therapies designed to improve communication, social skills, and behavior
• Speech and occupational therapy (OT): Addressing language development and motor skills
• Educational support: Individualized education programs (IEPs) tailored to the child’s needs

Other treatments

• Medication: Prescriptions like risperidone or aripiprazole may help manage irritability or aggression
• Dietary interventions: Some patients experiment with gluten-free or casein-free (dairy-free) diets, though evidence of effectiveness is limited

Adjunctive therapy & alternative treatments

• Sensory integration therapy: Helps manage sensory processing challenges
• Social skills training: Improves the ability to navigate social situations
• Mindfulness and relaxation techniques: Beneficial for reducing anxiety

Medical cannabis for autism

Emerging evidence suggests medical cannabis, particularly CBD-rich formulations, may help manage certain symptoms of autism, including:

• Anxiety and aggression: Cannabidiol (CBD) has shown promise in reducing anxiety and irritability
• Seizure control: Particularly relevant for individuals with co-occurring epilepsy
• Improved sleep: Some anecdotal reports suggest better sleep quality

Cannabis and autism:

1. Cannabis could help regulate synapse signaling in those with autism, including those with ASD from fragile X syndrome. Mutations of the protein neuroligin-3 found in those with autism can interfere with endocannabinoid signaling in the brain.
2. CBD may modulate the immune system, which is dysregulated in autism.
3. Cannabinoids like THC and CBD may help reduce the reliance on antidepressants, antipsychotics, and stimulants.
4. Phytocannabinoids (plant cannabinoids) may help improve mood and reduce anxiety.

Cannabinoid ratios:

• THC:CBD 1:20
• THC:CBD 1:1
• THC:CBD 5:1

Effective administration:

• Routes of administration: Sublingual tinctures and edibles
• Specialized products: Hope 1 and Hope 2 tinctures (1:1 and 5:1 THC:CBD ratios)

Additional information for patients

• Support groups: Connecting with local or online autism support networks can provide valuable resources and emotional support
• Advocacy organizations: Groups like Autism Speaks or the Autism Society offer educational materials and community programs
• Caregiver education: Training for caregivers to implement effective strategies at home

Autism FAQs

Can autism be cured? 

There is no cure for autism, but therapies and interventions can help manage symptoms effectively.

Is medical cannabis safe for children with autism?

Medical cannabis should be used under the guidance of a healthcare provider, with a focus on CBD-dominant products to reduce the risk of psychoactive effects. However, in some instances, higher THC ratios may be required, although this may be preferred for older patients who are less sensitive to THC’s side effects.

Are there any risks associated with medical cannabis for autism? 

Potential risks include drowsiness, changes in appetite, and possible interactions with other medications. Always consult a healthcare professional for advice on dosage, administration route, and contraindications with other medications.

How early can autism be diagnosed?

Autism can often be reliably diagnosed by the age of two, though signs may appear earlier.

Is Asperger’s syndrome on the autism spectrum?

While some differentiate between autism and Asperger’s syndrome, the latter is now considered part of the autism spectrum. In the past, Asperger’s syndrome was often a term used to describe someone with “high-functioning” or “mild” autism.

Terms like high-functioning and low-functioning autism are now falling out of use as signs and quality-of-life issues often overlap.

Resources

• Data and Statistics on Autism Spectrum Disorder: https://www.cdc.gov/autism/data-research/index.html
• Autism Spectrum Disorder on Fragile X Syndrome: Cooccurring Conditions and Current Treatment: https://pmc.ncbi.nlm.nih.gov/articles/PMC5619699/
• Gut-Brain Connections in Autism: https://hms.harvard.edu/news/gut-brain-connection-autism
• Immune Dysregulation in Autism Spectrum Disorder: What Do We Know about It?: https://pmc.ncbi.nlm.nih.gov/articles/PMC8955336/ 
• Mortality in Individuals with Autism Spectrum Disorder: Predictors over a 20-Year Period: https://pmc.ncbi.nlm.nih.gov/articles/PMC6713622/
• Terpene-Enriched CBD oil for treating autism-derived symptoms unresponsive to pure CBD: Case report: https://pmc.ncbi.nlm.nih.gov/articles/PMC9649447/
• A pediatric patient with autism spectrum disorder and epilepsy using cannabinoid extracts as complementary therapy: a case report: https://pmc.ncbi.nlm.nih.gov/articles/PMC7507278/
• A Placebo-Controlled Trial of Cannabinoid Treatment for Disruptive Behavior in Children and Adolescents with Autism Spectrum Disorder: Effects on Sleep Parameters as Measured by the CSHQ: https://pmc.ncbi.nlm.nih.gov/articles/PMC9312464/
• Endocannabinoid Signal Dysregulation in Autism Spectrum Disorders: A Correlation Link between Inflammatory State and Neuro-Immune Alterations: https://pmc.ncbi.nlm.nih.gov/articles/PMC5535916/
• CBD-enriched cannabis for autism spectrum disorder: an experience of a single center in Turkey and reviews of the literature: https://pmc.ncbi.nlm.nih.gov/articles/PMC8675523/
• Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders: https://pmc.ncbi.nlm.nih.gov/articles/PMC7699613/
• Role of the endocannabinoid system in fragile X syndrome: potential mechanisms for benefit from cannabidiol treatment: https://pmc.ncbi.nlm.nih.gov/articles/PMC9830713/

Please note that the information in this article does not constitute medical advice.

Get your medical marijuana card

Select State

Get started