Autism or Autistic Spectrum Disorder (ASD) is a behaviorally defined, lifelong disorder of the brain. Although it is one of the most common neurodevelopmental disorders in children, its cause is still a mystery, and no cure is currently available. Autism is characterized by deficits in language, social communication and cognition. The basis of the disorder may be neurochemical (serotonin or dopamine neuronal dysfunction), neurobiological (genetic basis), or neuropsychological (dysfunction of complex information processing or theory of mind). Children with autism usually have secondary problems in behavior including aggression, irritability, stereotypies, hyperactivity, negativism, volatile emotions, temper tantrums, short attention span and obsessive-compulsive behavior. Direct and indirect evidence suggests that neurochemical systems might be relevant in understanding the pathogenesis of autism.
 
We are witnessing a worldwide increase in the incidence of autism. Rates of 10-15 per 10,000 used just a few years ago are being replaced with new rates of 40-60 per 10,000 individuals. There has been an increasing trend of autism in Asians and Caucasians recently. Therefore, an urgent need exists for developing new intervention strategies that may be useful for this population.
 
How Traditional Chinese Medicine (TCM) views Autism
In TCM, no such disease called Autism exists. TCM doctors approach health and disease according to the philosophy of Yin-Yang, which encompasses balance and the homeostasis of the universe and the 5 elements (gold, wood, water, fire and soil). They also believe in the phenomenological and empirical observations of Qi, Blood and the 8 Principles. TCM practitioners differentiate syndrome according to 8 principles; Qi and Blood or according to the theory of Zang-Fu organs. The pathogenesis of disease is based on disharmony of Yin and Yang, conflicts between antipathogenic Qi and Pathogenic Qi; or the abnormal descending or ascending Qi. Qi is the life energy that flows through the entire body. The 8 principles involve Exterior/Interior, cold/heat, deficiency/excess, and yin-yang. This philosophy is based on more than 5,000 years of cumulative experience of human physiology and pathophysiology.

The etiology of disease, in TCM concept, can include 6 exogenous factors (wind, cold, summer heat, dampness, dryness, fire) and 7 emotions (joy, anger, melancholy, worry, grief, fear and fright), together with improper diet, overstrain, lack of physical exercise, stagnated blood and phlegm fluid. In the western concept, this may affect the body's immune defense system.
 
A TCM diagnosis has four components: Inspection, auscultation /olfaction, Inquiring, and palpation. For inspection, one looks at the vitality, color, appearance, observe the 5 sense organs (eye, nose, ear, gums, lips/mouth, throat), and observe the tongue. For auscultation, one listens and smells. By inquiring, one asks leading and relevant questions that address heat versus cold, inside versus outside and strong versus weak, and for palpation, one feels the pulse qualitatively (not according to the western methodology) and palpates other parts of the body. Integrating these 4 components with knowledge of zang-fu (the organ system) and jing-luo (the meridian system) helps the TCM doctor make a Syndromal diagnosis and develop a treatment based on TCM methodologies. Treatment choices include herbal medicine, natural medicine, acupuncture, Acu-Tuina or acu-massage.
 
Traditionally in TCM, all children with mental retardation, cerebral palsy, autism, global developmental delay or delayed language development are grouped under the Syndrome of 5-Delays. This Syndrome is based on observed delays in hair growth, teeth eruption, speech, standing and walking. In the TCM concept, brain dysfunction in children is a disequilibrium of body functions. The TCM approach is a holistic approach, firmly rooted in the Yin/Yang theory; disease is viewed within the framework of a Balance of Energy.
 
Acupuncture
Acupuncture has been practiced in Traditional Chinese Medicine (TCM) for over 2,000 years. In 1997, the Food & Drug Administration (FDA) in the USA recognized the legal status of acupuncture as a treatment technique, and since that time several other countries including Canada, the United Kingdom and several in Europe, have also done so. Research studies have now proven the benefits of acupuncture in treating pain and disorders of the brain.
 
Acupuncture uses very thin needles, as thin as a hair on your head which are inserted into targeted points in the body called acupoints. There are more than 400 acupoints in the body, linked through a system of 14 meridians, or pathways. Acupoints are rich in nerve terminals, and when stimulated, result in activation of both the local point and other, more distant points in the body that fall along the same meridian. Their stimulation may result in neural signaling, electromagnetic energy enhancement, neuro-immunomodulatory and neurochemical-hormonal effects.
 
The therapeutic effect of acupuncture depends on the acupoint(s) selected and the type of stimulation used. Body acupuncture, electrical acupuncture, laser acupuncture, and even acupressure have been practiced. Traditional acupoints on the scalp and body (by manipulation and electrical) have been found effective for treating children with brain dysfunction, resulting in improvement in the patient's overall functional abilities.
 
Tongue Acupuncture
Tongue diagnosis is an important part of the clinical diagnostic examination in Traditional Chinese Medicine for a syndromal approach such as autism. The tongue is the only body organ which can be exposed and seen externally. By looking at its color, thickness, dryness, superficial growth, and smell, TCM doctors can determine a treatment based on the eight principles. Moreover, according to TCM, the tongue reflects the condition of the heart, which is the master organ, controlling all the other internal organs. Thus indirectly, the tongue is linked by meridians to all the organs of the body.
 
Tongue Acupuncture (TAC) is an innovative acupuncture technique invented by my team collaborator, Dr. Sun JG from China. It is based on one of the most ancient medical books in China, Wang Di's Internal Medicine, and the idea that the tongue is the intersection site of all 14 meridians in the human body. Dr. Sun discovered that the tongue contains more than 40 acupoints. We hypothesize that there is a Human Map in our tongue, which is connected via rich neural-vascular pathways inside the tongue to different regions of the brain, especially the cerebellum. Neuroimaging with PET and functional MRI has demonstrated the possible role of the cerebellum and other brain region dysfunction with ASD. The cerebellum can be viewed as having its own internal topography, one that is directly linked to the modulation of emotions and social behavior, thought, language and the ability to plan. Is autism part of the system dysfunction of the cerebellum and its connecting pathways?
 
In our research, we had been encouraged by the positive results in two normal subjects in the areas of language and visual processing, after a short course of TAC. We decided to conduct further research to test how TAC might affect the cerebellum [cognition], temporal lobe [language], frontal lobe [executive function and affect] and basal ganglia [ritualistic/stereotypic mannerisms]. This was done through monitoring changes in glucose metabolism, via a PET scan. The use of Brain FDG-PET in the integration of Western-Chinese Medicine is essential to scientifically assess Alternative Medicine strategy for neurobiological diseases from a functional outcome perspective.