1. Study Children with Autism Spectrum Disorders Using Symptom Differentiation of Traditional Chinese Medicine (TCM) CL Wong and VCN Wong Department of Paediatrics and Adolescent Medicine, the University of Hong Kong

2. Presentation Outline Prevalence of Autism Spectrum Disorders (ASD) Our research - objectives - method - findings 2 cases

3. Epidemiology 1960s- “ classical autism ” - 4/10 000 1985- “ ASD ” - 62.6/10 000 in UK 71/10 000 in Sweden 61/10 000(3-10yr) in USA 2000- “ ASD ” - 60/10 000 Male:Female 4.3(mean) 46. Fombonne E. Epidemiology of pervasive developmental disorders. Trends in Evidence-Based Neuropsychiatry 2003;5(1):29–36. Merrick J et al.Trends in autism. Int J Adolesc Med Health.

4. Epidemiology 2006- autism- 1.8 million cases in China (13.9/10 000) >10 000 cases in Shanghai (6.2/10 000) prevalence in China is largely unknown SHanghai Daily News reported in China View - www.chinaview.cn 2005-11-29 viewed April 2006 "Epidemiologic Research on Autism in China" 2006 U.S. National Institutes of Health"Epidemiologic Research on Autism in China"

5. Previous research Diagnosis TCM symptom differentiation Patients too irritated during acupuncture

6. Objectives TCM symptom differentiation of ASD TCM treatment for ASD Minimal acupuncture points

7. Method Diagnosis by paediatricians, neurologists, autism specific assessment teams CARS, ADOS Symptom differentiation by TCM practitioner Videos and photos

8. Subjects DKCH & QMH paediatric neurology clinic n=19+ Autism/ Autism Spectrum Disorders (ASD)/ Asperger’s Syndrome

9. Results Patients can appear as a combination of problems TypeManifestationN Phlegm obstruction Problem with speech and communication, poor social interaction, obsessive behavior, poor eye contact 19 Obstruction of Liver Qi Emotional problems12 Qi Deficiency (Kidney, Spleen) Congenital problem, developmental delay

10. Tongue

15. Case 1 M/ 20y Autism, MR, Epilepsy No meaningful single word Difficulty in protruding his tongue Poor imitation Placid Seldom appears temper tantrums TCM: Phlegm obstruction

16. Tongue

23. Acupuncture points DU15 啞門 HT5 通裏 Jin’s 3 Needling 舌三針 Chiu’s Head scalp acupuncture 焦氏頭 皮針－言語二、三區

24. Case 2 M/ 11y Asperger Sx, Oromotor dyspraxia, Obesity Normal IQ, read a lot of book Unwilling to communicate verbally Poor articulation Poor eye contact Difficulty in protruding and moving his tongue Poor temper, special fear to sand Deep slippery pluse TCM: Phlegm obstruction

25. Tongue

28. Acupuncture points Jin’s 3 Needling 舌三針

29. Future research More cases Duration of effect Course of treatment Extent of improvement Different acupuncture point Well designed clinical trial