Parents of children diagnosed with Autism Spectrum Disorder (ASD) tend to opt for alternative intervention for their children , for example, the use of gluten- and casein-free diets, which they perceived as safe, to improve the cognitive-behavioral function of their children with ASD. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay The primary purpose of this essay is to discuss the most recent advances in gluten-free research and the evidence that argues for or against the use of gluten-free and casein-free diets, particularly for children diagnosed with ASD. It also critically explored the strategies used, challenges faced, and emotional impact felt by people following a gluten-free diet, as documented in previous research studies. A systematic review of research articles published from 1970 to date indicated that most studies of children with ASD who follow a gluten-free diet were tested mostly in randomized controlled trials, with small sample sizes. Therefore, there is a lack of validity and strong scientific evidence to conclude the effectiveness of adopting a gluten-free diet as a form of intervention. Future, larger-scale research is recommended (O'Shea, Arendt, & Gallaghar, 2014; Zarkadas, Dubois, McIsacc, Cantin, Rashid, Roberts, La Vieille, Godefroy, & Pulido, 2013; Mari-Bauset, Zazpe, Mari-Sanchis , Llopis-Gonzalez and Morales-Suarez-Varela, 2014). Description and definition Autism spectrum disorders (ASD) have been on the rise over the past 30 years and are becoming prevalent, affecting 1 in 68 people in the United States. It is a very complex disorder with multiple causes and various therapeutic approaches to treat only the symptoms, as autism is not curable. Children with autism are characterized by a spectrum of neurodevelopmental disorders that manifest from early childhood. They include persistent deficits in social communication and social interaction, as well as restricted and repetitive patterns of behavior, interests, or activities, such as stereotyped or repetitive speech, motor movements, or fixated interest in certain objects or tasks. Various genetic, environmental and immunological factors could also affect several systems, including the cognitive-behavioral function of the person with ASD. In previous epidemiological studies of prenatal development, metabolic and nutritional factors have been identified as one of the risks contributing to autism in newborns (Matelski and Van de Water, 2016). The “opioid excess theory” may better explain “gluten and casein intolerance” in people diagnosed with ASD. According to Lange, Hauser & Reissmann (2015), when gluten (from wheat) and casein (from dairy) are consumed in the body, they are metabolized to “gluteomorphine” and “casomorphine”. These “peptides” then bind to “opiate receptors” in the “central nervous system” and mimic the effects of “opiate drugs.” During digestion, “opioid peptides” are formed, which then lead to increased activity in the “endogenous opioid system” and results in the symptoms of autism. Therefore, a diet low in gluten and casein is thought to improve the cognitive-behavioral function of individuals with ASD (Lange, Hauser, & Reissmann, 2015, np). Children diagnosed with autism also havetend to suffer from comorbid conditions that cause gastrointestinal symptoms and affect their concentration and attention span. Previous research studies have also associated gluten intolerance with ASD and indicated the relationship between ASD and celiac disease, an autoimmune disease that causes gastrointestinal syndrome (Lange, Hauser, & Reissmann, 2015; Jackson , Eaton, Cascella, Fasano and Kelly, 2012, pp. 95-96). Definition of intervention to improve quality of life The goal of choosing a non-invasive intervention or therapy is to improve the quality of life. life of the sick. A gluten-free diet (GFD) tends to be the preferred intervention for parents of children with ASD because it is not a form of medication that is non-evasive in nature, compared to another form of therapy , such as stem cell therapy. , GFD is widely used by people with celiac disease and by parents whose children have been diagnosed with ASD to improve their children's quality of life. However, due to misinformation circulating online or bad advice from unqualified sources regarding the benefits or harms of GFD, it is legitimate to examine the accuracies or inaccuracies, facts and fiction of the use of the GFD, as a form of intervention. With the growing popularity of parents putting their children on GFD, believing it to be a safe intervention to alleviate their children's autistic symptoms, this could have significant implications for them (Reilly, 2016). A recent survey in the United Kingdom indicated that 80% of parents of children with autism spectrum disorder tend to use some form of dietary intervention for their child, of which 29% of parents have subjected their child to a gluten-free and casein-free diet (GFCFD). When examining the effects of using the GFCFD on their children, 20-29% of parents reported significant improvements in cognitive-behavioral function. The results also suggest that a gluten-free and casein-free diet helps alleviate comorbid problems such as gastrointestinal symptoms and improve concentration and attention span in these children. Although parents in studies have reported positive effects of GFCFD on their children, most scientific evaluations have failed to confirm its therapeutic effects. Using parents as informants about their children's autistic symptoms may be a biased source of information. Perhaps, in future case studies, we will need to include clinicians as informants and evaluators of effects, to introduce standardized testing procedures and observation parameters. It will then complement the measurements and provide a more complete picture of the dietary effects of GFCFD on children with ASD (Lange, Hauser & Reissmann, 2015). There may be some gaps in parents' use of GFCFD on their children that need to be addressed. For example, some parents may decide to place their child on GFCFD without testing their child for celiac disease or consulting a dietitian. Some children with celiac disease may be asymptomatic early on and therefore may not have been diagnosed. Additionally, there is not adequate information on the health and social consequences of putting a child on GFCFD online or in books to allow parents to make an informed choice (Reilly, 2016). Research studies behind the intervention and evaluations According to Lange et al. (2015), GFCFD trials evaluating the effects of a GFCFD on autistic symptoms have thus far been questionable and inconclusive. The authors havealso mentioned that research studies examining the effectiveness of a GFCFD in the treatment of autism are seriously flawed and that the therapeutic value of this diet appears weak and limited. A systematic review of research articles published from 1970 to date also indicated that most research studies conducted on children with ASD placed on a gluten-free diet were mostly tested in randomized controlled trials. and with a small sample. Therefore, it lacks validity and reliability and is unable to provide solid scientific evidence to conclude the effectiveness of adopting a gluten-free diet as a form of intervention. Recent research studies have indicated that gluten sensitivity (GS) is a disease distinct from celiac disease. This new discovery gave rise to new understanding and knowledge of the disease. Celiac disease and GS can present with various neurological and psychiatric comorbidities. However, in people with GS, the main symptoms are extraintestinal problems. People with celiac disease have been found to have villous atrophy or antibodies in their body cells, unlike those with GS who do not have the antibodies. Therefore, if GS is left untreated, it can lead to psychiatric and neurological manifestations in individuals with ASD (Jackson et al., 2012). Jackson et al. (2012) also cited a few research studies indicating an increased risk of ASD in children with a “maternal history of rheumatoid arthritis,” “celiac disease,” and “irritable bowel syndrome.” Another study used a control group to make a comparison. People with ASD and their family members have been found to have a high percentage of people with “abnormal intestinal permeability” compared to the group without ASD. Another control group study of the GFCFD used on ASD patients found “improved intestinal permeability” compared to patients on a non-GFCFD. As most research studies tend to focus on the use of GFCFD rather than its elimination in individuals with ASD, it is difficult to determine whether there are additional beneficial effects if a non-GFCFD is used (p. 95). The beneficial effects of a GFCFD on autistic symptoms have so far been contradictory and remain questionable to date and there is insufficient data to support its benefits (Mari-Bauset, et al., 2014; Gaesser & Angadi, 2012, p. 1330). . In fact, recent evidence suggests that a gluten-free diet may reduce beneficial gut bacteria in the intestines. Other reports also indicate that obese patients tend to gain even more weight after being put on a gluten-free diet. This could be due to better absorption of nutrients or healing of the intestinal lining following a gluten-free diet (Gaesser & Angadi, 2012). This could result in obese children with ASD gaining more weight if they used a gluten-free diet as a form of intervention. Reilly (2016) asserted that there is insufficient evidence to support the health benefits of a gluten-free diet. On the contrary, a gluten-free diet can have negative effects if it is not prescribed or approved by a registered dietitian or physician. Gluten-free packaged foods also tend to be higher in sugar and fat than gluten-free foods. Excessive consumption of sugar and fats can increase the risk of obesity. New evidenceshow that a strict gluten-free diet based on rice flour and without other varieties of gluten-free products can lead to toxicity due to "arsenic", present in an inorganic form in most gluten-free rice-based products . A gluten-free diet can also lead to vitamin B, folate, and iron deficiencies. It is therefore a myth to think that a gluten-free diet is a healthier choice (Reilly, 2016, pp. 206-207). A recent research study was conducted by Hyman, Stewart, Foley, Cain, Peck, Morris, Wang, and Smith (2016), on the safety and effectiveness of the gluten-free/casein-free (GFCF) diet on a group of 14 children. (aged 3 to 5 years) with autism. They were placed on the GFCF diet for 4 to 6 weeks and followed by a 12-week placebo-controlled challenge study while continuing the diet, with a 12-week follow-up. Children received weekly snacks containing gluten, casein, gluten and casein, or placebo, during nutritional counseling dietary challenges. Results indicated that the GFCF diet was safe and well tolerated. However, the limitation of this study was that it was not able to track significant effects on physiological functioning, behavioral problems, or autism symptoms. Due to the small sample size, the results should be interpreted with caution and should be replicated on a larger scale to validate the results. The scientific community has always tried to find alternative means of intervention. To date, no pharmacological treatment is available for patients with gluten intolerance. Placing patients on a strict gluten-free diet throughout their life appears to be the only safe solution, even if it is not yet conclusive as to its effectiveness. A research study was conducted by Caputo, Marilena, Stefania & Esposito (2010) on the use of enzymes as additives or processing aids in the food biotechnology industry to detoxify gluten. The recent development of “enzyme therapy” is a new alternative intervention focused on inactivation of immunogenic gluten epitopes and administered orally to patients. For people with ASD, this could be a new hope and a new strategy to relieve their autistic symptoms and improve their cognitive-behavioral functions. People undergoing this treatment receive doses of “Flavobacterium meningosepticum”, “Sphingomonas capsulate” and “Myxococcus Xanthus”. These enzymes are thought to help "degrade proline-containing peptides" that are otherwise resistant to degradation by "proteases" in the gastrointestinal tract. A lifelong gluten-free diet may not be easy to maintain and has a negative impact on food quality. life. It is also expensive to stick to a gluten-free diet, whereas a gluten-free diet is commonly available and less expensive to maintain (Caputo, Marilena, Stefania & Esposito, 2010, pp.4-5; Zarkadas, et al. al., 2013). A systematic review of the medical literature relating to GFCFD was conducted by Mari-Bauset et al. (2014). Researchers tracked databases dating back from the 1970s to September 2013 of published research articles or written reports on the use of GFCFD in children with ASD as an intervention. The systematic review assessed the findings and reported that none of the identified studies provided conclusive evidence for the effectiveness of GFCFD as an intervention for ASD, as they were poorly validated. The studies are mostly tested on randomized controlled trials, with a small sample and therefore cannot be conclusive or..