Ayurvedic Interventions for Autism Spectrum Disorder in Children: A Critical Narrative Review of Clinical Evidence, Mechanisms, Safety, and Research Priorities

Abstract

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition for which early developmental, behavioral, educational, communication, and family-centred interventions remain the foundation of care. Objective: To critically synthesize the Ayurvedic conceptual framework, clinical evidence, proposed mechanisms, and safety considerations for oral medicines and procedure-based interventions used in children with ASD. Methods: A structured narrative search of PubMed/MEDLINE, Google Scholar, AYUSH Research Portal, and relevant Ayurveda journals was considered through August 2026 using terms related to autism, Ayurveda, Panchakarma, Bacopa monnieri, Centella asiatica, Withania somnifera, Acorus calamus, Brahmi ghrita, Nasya, Basti, Abhyanga, and Shirodhara. Human evidence was prioritized; preclinical and indirect evidence was used only to discuss biological plausibility. Results: Direct clinical evidence for specifically Ayurvedic interventions in pediatric ASD is sparse and consists mainly of small uncontrolled studies, case reports, and protocols. Bacopa-related preparations have the most developed mechanistic rationale, involving antioxidant, anti-inflammatory, synaptic, and glutamatergic pathways, but ASD-specific human efficacy is unconfirmed. Evidence for other Medhya drugs, medicated ghee, and Panchakarma procedures is largely indirect. Conclusion: Individualized Ayurveda may be studied as an adjunct for co-occurring problems such as sleep disturbance, gastrointestinal symptoms, anxiety, and dysregulation, but it cannot presently be described as disease-modifying or a replacement for established developmental care. Future trials require standardized products, treatment manuals, validated core and functional outcomes, adverse-event monitoring, and long-term follow-up.