A Pilot Study: Parent Perceptions of Behavior Change in Their Child With Autism Spectrum Disorder Following High Antioxidant Cacao Consumption

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Background: Autism spectrum disorder (ASD) is a heterogeneous neurocognitive disorder with primary symptomology related to maladaptive behaviors and communication deficits. Children with ASD tend to have higher free radicals than antioxidants compared with their matched controls. This disequilibrium of oxidative stress has been associated with the pathogenesis of this neurocognitive disorder. The aim of this pilot feasibility study was to examine the effect of high antioxidant cacao consumption on behavior in children with ASD.
Methods: This was a 4-wk repeated measures experimental pilot study of high antioxidant cacao and children with ASD. Participants consumed 8 squares (or 16 g) per day of the dark chocolate that had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant activity was 8320 µmoles TE/100 g). The 2 main behavioral measures, Aberrant Behavior Checklist, 2nd ed (ABC-2) and the Autism Spectrum Rating Scale (ASRS), were completed by the child’s parent at baseline, end of week 2, and end of week 4. 
Results: Seventeen participants were recruited for this study. Follow-up data were available for 16 participants (12 males, 4 females, aged 4 to 17 y). Significant improvements were noted on the ABC-2 subscales of irritability (P = .03, ?2 = 0.25), social withdrawal (P = .01, ?2 = 0.29), stereotypic behavior (P = .05, ?2 = 0.13), hyperactivity/noncompliance (P = .04, ?2 = 0.20), and inappropriate speech (P = .05, ?2 = 0.16). Significant improvements were noted on the ASRS subscales of social/communication (P = .04, ?2 = 0.25), unusual behaviors (P = .003, ?2 = 0.20), self-regulation (P = .02, ?2 = 0.32), and total scores (P < .001, ?2 = 0.54).
Conclusion: Results from this study support previous literature on antioxidant intake as an adjunct therapy to improve behaviors of children with ASD. More robust randomized controlled trials are now necessary to validate and elaborate on these findings.