Context: An approach for improving brain lymphatic flow in autism through lymphatic drainage massage that is a strategy successfully utilized in a variety of neurological conditions where lymph coming from the brain finds obstacles at the level of deep cervical nodes.

Methods: After obtaining written informed assent, children with autism spectrum disorder who fulfilled the inclusion criteria was recruited and enrolled in the study. The total sample size was 100 children with autism spectrum disorder. Study subjects was assigned randomly to either experimental arm (n=50) or control arm (n=50). All 100 subjects were interviewed before intervention by assessing background variables. Stereotyped behavior was assessed by using Gilliam Autism Rating Scale 3 – Subscale Stereotype behavior. Experimental arm received larger dose of manual lymphatic drainage on daily basis. The massage performed using a novel, petroleum free, cosmetic cream endowed with specific rheological and sensory properties. The researcher operates the massage with both hands, gently stroking the surface of the neck on the sides of the trachea with open palms and extended fingers. The subject was asked to overextend the neck tilting the head as far back as possible to perform the massage. Counterfactually Control arm received smaller dose of manual lymphatic drainage on alternative days. This massage was given either on daily basis or alternative days for the period of 1 month. Posttest was conducted by using the same assessment techniques in experimental arm & control arm.

Results: The computed odds ratio between manual lymphatic drainage and stereotyped behavior among cases and controls showed statistical significance.   

Keywords: Manual lymphatic drainage, Stereotyped behavior, Autism spectrum disorder, Dose response analysis