OBJECTIVES: To determine role of folinic acid in improving the adaptive skills and language impairment in autism spectrum disorder (ASD) among children aged 3-14 years. METHODS: This open label randomized controlled trial was conducted at the Out-patient Department of Pediatric Neurology, The Children Hospital & The Institute of Child Health Multan, Pakistan from October-2020 to March-2021. A total of 44 (22 in each group) children of both genders, aged 3-14 years with diagnosis of ASD were included. Children receiving folinic acid (dose of 2mg/kg/day in two divide doses) and behavioral therapy were assigned to Group-A while Group-B received only behavioral therapy. Primary outcome measures were improvement of language and adaptive skills while secondary outcome measures were stereotype movements, verbal communication, hyperactivity, peer relationship and inattention were these parameters measured at baseline, 6-weeks and 12-weeks (final outcome) intervals. RESULTS: Of 44 children, 34 (77.3%) were males. Mean age was 4.28±1.57 years. At baseline, outcome measures scores in between both study groups had no statistically significant difference (p>0.05). Regarding final outcome, among children in Group-A, primary outcome measures as gross motor development age (51.41±16.29 months vs. 39.23±51.41 months, p=0.002), self-help (48.64±13.68 months vs. 37.45±6.82 months, p=0.001) and language (18.68±6.34 months vs. 15.15±5.22 months, p=0.050) scores improved significantly when compared to Group-B. Regarding secondary outcome, stereotype movements improved significantly in Group-A in comparison to Group-B (4.68±2.01 vs. 5.64±0.06, p=0.038). CONCLUSION: Folinic acid along with behavioral therapy helped improving language and adaptive skills in children with ASD when compared to behavioral therapy alone.

Fawad Saleem
Children's hospital
Pakistan

Faisal Zafar
Children's hospital
Pakistan

Naveed Anjum
Children's hospital
Pakistan