**Author details**

Chuen Heung Yau\*, Cheuk Long Ip, Yuk Yin Chau and Ho Cheung Lai School of Chinese Medicine, Hong Kong Baptist University, Hong Kong

\*Address all correspondence to: annyau33@yahoo.com.hk

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**49**

*The Effect of Scalp Acupuncture on Autism: Could This Be a Possible Treatment of Autism?*

autism spectrum disorder. Journal of Autism and Developmental Disorders.

[10] Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice. 2010;**17**(4):281-292

[11] Kodak T, Piazza CC. Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North

[12] Cohen S, Conduit R, Lockley SW, Rajaratnam SM, Cornish KM. The relationship between sleep and behavior in autism spectrum disorder (ASD): A review. Journal of Neurodevelopmental

[13] Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Serotonin hypothesis of autism: Implications for selective serotonin reuptake inhibitor use during pregnancy. Autism Research. 2013;**6**(3):149-168

[14] Lee EJ, Warden S. The effects of acupuncture on serotonin metabolism. European Journal of Integrative Medicine. 2016;**8**(4):355-367

[15] Jia HY, Li Q, Wang D. Scalp Acupuncture Therapy. 1st ed. Beijing, China: People's Medical Publishing

[16] Yuan Q, Ma SL, Zhang JW. Effect of acupuncture on cerebral images in autism children. World Journal of Acupuncture and Moxibustion.

Developmental Cognitive Neuroscience. Cambridge, Mass: MIT Press; 2001

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[17] Nelson CA, Collins ML, MITCogNet. Handbook of

America. 2008;**17**(4):887-905

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*DOI: http://dx.doi.org/10.5772/intechopen.84547*

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[4] Hanson E, Kalish LA, Bunce E, Curtis C, McDaniel S, Ware J, et al. Use of complementary and alternative medicine among children diagnosed with autism spectrum disorder. Journal of Autism and Developmental

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[8] Hoshino Y, Kaneko M, Yashima Y, Kumashiro H, Volkmar FR, Cohen DJ. Clinical features of autistic children with setback course in their infancy. Psychiatry and Clinical Neurosciences.

[9] Samson AC, Phillips JM, Parker KJ, Shah S, Gross JJ, Hardan AY. Emotion dysregulation and the core features of

Medicine. 2003;**9**(5):24-61

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*The Effect of Scalp Acupuncture on Autism: Could This Be a Possible Treatment of Autism? DOI: http://dx.doi.org/10.5772/intechopen.84547*

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CAM complementary and alternative medicine

CSHQ children sleeping habit questionnaire fMRI functional magnetic resonance imaging

CARS childhood autism rating scale

GABA γ-aminobutyric acid WHO World Health Organization

**48**

**Author details**

Chuen Heung Yau\*, Cheuk Long Ip, Yuk Yin Chau and Ho Cheung Lai School of Chinese Medicine, Hong Kong Baptist University, Hong Kong

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*Address all correspondence to: annyau33@yahoo.com.hk

provided the original work is properly cited.

[1] World Health Organization (WHO). Autism Spectrum Disorders: Fact Sheet. 2017. [Accessed: 21 May 2017]

[2] World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva, Switzerland: World Health Organization; 1992

[3] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013

[4] Hanson E, Kalish LA, Bunce E, Curtis C, McDaniel S, Ware J, et al. Use of complementary and alternative medicine among children diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders. 2007;**37**(4):628-636

[5] Cheuk DKL, Wong V, Chen WX. Acupuncture for Autism Spectrum Disorders (ASD) (Review) The Cochrane Collaboration. Hoboken, N.J.: John Wiley and Sons, Ltd; 2011

[6] Kidd P. An approach to the nutritional management of autism. Alternative Therapies in Health and Medicine. 2003;**9**(5):24-61

[7] Ozonoff S, Heung K, Byrd R, Hansen R, Hertz-Picciotto I. The onset of autism: Patterns of symptom emergence in the first years of life. Autism Research. 2008;**1**(6):320-328

[8] Hoshino Y, Kaneko M, Yashima Y, Kumashiro H, Volkmar FR, Cohen DJ. Clinical features of autistic children with setback course in their infancy. Psychiatry and Clinical Neurosciences. 1987;**41**(2):237-245

[9] Samson AC, Phillips JM, Parker KJ, Shah S, Gross JJ, Hardan AY. Emotion dysregulation and the core features of

autism spectrum disorder. Journal of Autism and Developmental Disorders. 2014;**44**(7):1766-1772

[10] Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice. 2010;**17**(4):281-292

[11] Kodak T, Piazza CC. Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North America. 2008;**17**(4):887-905

[12] Cohen S, Conduit R, Lockley SW, Rajaratnam SM, Cornish KM. The relationship between sleep and behavior in autism spectrum disorder (ASD): A review. Journal of Neurodevelopmental Disorders. 2014;**6**(1):44

[13] Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Serotonin hypothesis of autism: Implications for selective serotonin reuptake inhibitor use during pregnancy. Autism Research. 2013;**6**(3):149-168

[14] Lee EJ, Warden S. The effects of acupuncture on serotonin metabolism. European Journal of Integrative Medicine. 2016;**8**(4):355-367

[15] Jia HY, Li Q, Wang D. Scalp Acupuncture Therapy. 1st ed. Beijing, China: People's Medical Publishing House; 1994

[16] Yuan Q, Ma SL, Zhang JW. Effect of acupuncture on cerebral images in autism children. World Journal of Acupuncture and Moxibustion. 2004;**14**(3):3-8

[17] Nelson CA, Collins ML, MITCogNet. Handbook of Developmental Cognitive Neuroscience. Cambridge, Mass: MIT Press; 2001

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[28] Cho ZH, Hwang SC, Wong EK, Son YD, Kang CK, Park TS, et al. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurologica Scandinavica. 2006;**113**(6):370-377

[29] Potegal M. Temporal and frontal lobe initiation and regulation of the top-down escalation of anger and aggression. Behavioural Brain Research. 2012;**231**(2):386-335

[30] Cortesi F, Giannotti F, Ivanenko A, Johnson K. Sleep in children with autistic spectrum disorder. Sleep Medicine. 2010;**11**(7):659-664

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**51**

**Chapter 5**

**Abstract**

microbiome

**1. Introduction**

to identify ASD biomarkers.

Stercobilin: A Putative

*Yong Seok Choi and Giuseppe Fanciulli*

Link between Autism and

Gastrointestinal Distress?

*Christopher L. Pennington, Heather L. Rudolph,* 

*Troy D. Wood, Amber Flynn Charlebois, Emily R. Sekera,* 

Despite the increasing prevalence for its diagnosis in children, there are no clinical biomarkers of autism spectrum disorders (ASD). Herein a research journey is described that began by seeking evidence for the opioid excess theory of autism using mass spectrometry methods to screen human urine specimens and has evolved into the discovery of promising murine fecal biomarkers for ASD. Our results are consistent with an emerging body of evidence that shows that intestinal microflora from ASD subjects can be distinguished from controls, suggesting that metabolite differences due to the action of intestinal microbes may provide a means

**Keywords:** autism, biomarkers, stercobilin, mass spectrometry, metabolomics,

Autism spectrum disorders (ASD) represent a group of neurobehavioral disorders first reported by Dr. Leo Kanner [1] which are characterized by impairments in social interactions, deficits in communications skills, repetitive behaviors, and other stereotypical behavioral patterns [2]. High rates of diagnosis in the United States (up to 1 in 59 children) [3] exemplify the seriousness of ASD as a medical concern. There is great interest in identifying potential ASD biomarkers, as the evidence indicates that early diagnosis and intervention leads to improved long-term outcomes for individuals with ASD [4, 5]. While considerable effort has been dedicated toward discovering potential genetic factors associated with ASD, it is becoming increasingly clear that genetic factors alone are insufficient to explain overall ASD etiology [6]. Combined, these factors have inhibited the development of a grand unified theory (GUT) for autism [7] (note: the irony that gut microbiota may be an important factor contributing to a GUT of ASD is not lost upon the authors).

While a GUT for ASD may be unrealistic because of heterogeneity in causation and severity, increasing attention has been devoted toward identifying potential metabolic molecular markers of ASD. One approach has been to consider conditions that are comorbid with ASD, in particular, gastrointestinal distress, which is a
