BACKGROUND- Children with Autism Spectrum Disorder (ASD) demonstrate a physiological imbalance between free radicals, resulting from oxidative stress, and antioxidants. Oxidative stress is linked to the pathogenesis of this neurocognitive disorder. The objectives of this pilot feasibility study: 1) to examine the effect of consumption of high concentration antioxidant cacao on behavior of children as perceived by the child’s teacher and 2) as perceived by the child’s parent. METHODS- This clinical trial was a prospective experimental study. Participants consumed 8 squares (or 16 grams) per day of the dark chocolate which had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant concentration was 8,320 μmoles / 100 grams. The two main behavioral measures were the Aberrant Behavior Checklist- 2nd Edition (ABC-2) and the Autism Spectrum Rating Scale (ASRS) which were completed by the child’s teacher at baseline and end of week four; and by the child’s parent at baseline, week two, and week four. RESULTS- Twelve teachers and children with ASD (9 males, 3 females, mean age of 10.9 ±3.9 years) participated in this study. Teachers noted significant improvements on the Autism Spectrum Rating Scales of Social/Communication (p=0.03,
η2=0.79), Unusual Behaviors (p=0.02, η2=0.70), and Self-Regulation (p=0.04, η2=0.59). No significant changes were noted on any of the Aberrant Behavior Checklist-2 subscales (p>.05). For the second study, sixteen parents and children with ASD participated in the study (12 males, 4 females, aged 4 to 17 years). Parent reports showed significant improvements on the ABC-2 subscales of Irritability (p= .03, η2 = 0.25), Social Withdrawal (p=.01, η2 = 0.29), Stereotypic Behavior (p=.05, η2 = 0.13), Hyperactivity/Noncompliance (p=.04, η2 = 0.20), and Inappropriate Speech (p=.05, η2 = 0.16). Significant improvements were noted on the ASRS scales of Social/Communication (p=.04, η2 = 0.25), Unusual Behaviors (p=.003, η2 = 0.20), Self-Regulation (p=0.02, η2=0.32), and Total Scores (p<.001, η2=0.54). CONCLUSION- Results from this study support the therapeutic benefit of antioxidants in improving social communication, unusual behaviors, and self-regulation behaviors of children with ASD. Further robust randomized controlled trials are necessary to elaborate the validity of these finding.
","abstract_html":"<p>BACKGROUND- Children with Autism Spectrum Disorder (ASD) demonstrate a physiological imbalance between free radicals, resulting from oxidative stress, and antioxidants. Oxidative stress is linked to the pathogenesis of this neurocognitive disorder. The objectives of this pilot feasibility study: 1) to examine the effect of consumption of high concentration antioxidant cacao on behavior of children as perceived by the child’s teacher and 2) as perceived by the child’s parent. METHODS- This clinical trial was a prospective experimental study. Participants consumed 8 squares (or 16 grams) per day of the dark chocolate which had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant concentration was 8,320 μmoles / 100 grams. The two main behavioral measures were the Aberrant Behavior Checklist- 2nd Edition (ABC-2) and the Autism Spectrum Rating Scale (ASRS) which were completed by the child’s teacher at baseline and end of week four; and by the child’s parent at baseline, week two, and week four. RESULTS- Twelve teachers and children with ASD (9 males, 3 females, mean age of 10.9 ±3.9 years) participated in this study. Teachers noted significant improvements on the Autism Spectrum Rating Scales of Social/Communication (p=0.03, </p> <p>η2=0.79), Unusual Behaviors (p=0.02, η2=0.70), and Self-Regulation (p=0.04, η2=0.59). No significant changes were noted on any of the Aberrant Behavior Checklist-2 subscales (p>.05). For the second study, sixteen parents and children with ASD participated in the study (12 males, 4 females, aged 4 to 17 years). Parent reports showed significant improvements on the ABC-2 subscales of Irritability (p= .03, η2 = 0.25), Social Withdrawal (p=.01, η2 = 0.29), Stereotypic Behavior (p=.05, η2 = 0.13), Hyperactivity/Noncompliance (p=.04, η2 = 0.20), and Inappropriate Speech (p=.05, η2 = 0.16). Significant improvements were noted on the ASRS scales of Social/Communication (p=.04, η2 = 0.25), Unusual Behaviors (p=.003, η2 = 0.20), Self-Regulation (p=0.02, η2=0.32), and Total Scores (p<.001, η2=0.54). CONCLUSION- Results from this study support the therapeutic benefit of antioxidants in improving social communication, unusual behaviors, and self-regulation behaviors of children with ASD. Further robust randomized controlled trials are necessary to elaborate the validity of these finding.</p>","abstract_has_math":false,"creators":["Sadek, Amy"],"institution":null,"degree_name":"Doctor of Philosophy (PhD)","degree_level":"Dissertation","degree_discipline":"Rehabilitation Sciences","degree_department":null,"school":null,"contributors":["Berk, Lee S.","Daher, Noha S.","Mainess, Karen","Randall, Kiti Freier"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2018,"date_issued":"2018-06-01T07:00:00Z","date_published":"2018-06-01T07:00:00Z","updated_at":"2026-07-24T02:52:52Z","subjects":["Medicine and Health Sciences","Rehabilitation and Therapy","Antioxidants -- Physiology; Cacao -- Physiology; Child; Autistic Disorder; Autism in Children","Autism Spectrum Disorder; Free Radicals; Oxidative Stress; Neurocognitive Disorder"],"languages":["English"],"rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarsrepository.llu.edu/etd/522","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Berk, Lee S.","Daher, Noha S.","Mainess, Karen","Randall, Kiti Freier"]},{"key":"dc:creator","label":"Author","values":["Sadek, Amy"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Rehabilitation Sciences"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy (PhD)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Medicine and Health Sciences","Rehabilitation and Therapy","Antioxidants -- Physiology; Cacao -- Physiology; Child; Autistic Disorder; Autism in Children","Autism Spectrum Disorder; Free Radicals; Oxidative Stress; Neurocognitive Disorder"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarsrepository.llu.edu/etd/522"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["BACKGROUND- Children with Autism Spectrum Disorder (ASD) demonstrate a physiological imbalance between free radicals, resulting from oxidative stress, and antioxidants. Oxidative stress is linked to the pathogenesis of this neurocognitive disorder. The objectives of this pilot feasibility study: 1) to examine the effect of consumption of high concentration antioxidant cacao on behavior of children as perceived by the child’s teacher and 2) as perceived by the child’s parent. METHODS- This clinical trial was a prospective experimental study. Participants consumed 8 squares (or 16 grams) per day of the dark chocolate which had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant concentration was 8,320 μmoles / 100 grams. The two main behavioral measures were the Aberrant Behavior Checklist- 2nd Edition (ABC-2) and the Autism Spectrum Rating Scale (ASRS) which were completed by the child’s teacher at baseline and end of week four; and by the child’s parent at baseline, week two, and week four. RESULTS- Twelve teachers and children with ASD (9 males, 3 females, mean age of 10.9 ±3.9 years) participated in this study. Teachers noted significant improvements on the Autism Spectrum Rating Scales of Social/Communication (p=0.03,
η2=0.79), Unusual Behaviors (p=0.02, η2=0.70), and Self-Regulation (p=0.04, η2=0.59). No significant changes were noted on any of the Aberrant Behavior Checklist-2 subscales (p>.05). For the second study, sixteen parents and children with ASD participated in the study (12 males, 4 females, aged 4 to 17 years). Parent reports showed significant improvements on the ABC-2 subscales of Irritability (p= .03, η2 = 0.25), Social Withdrawal (p=.01, η2 = 0.29), Stereotypic Behavior (p=.05, η2 = 0.13), Hyperactivity/Noncompliance (p=.04, η2 = 0.20), and Inappropriate Speech (p=.05, η2 = 0.16). Significant improvements were noted on the ASRS scales of Social/Communication (p=.04, η2 = 0.25), Unusual Behaviors (p=.003, η2 = 0.20), Self-Regulation (p=0.02, η2=0.32), and Total Scores (p<.001, η2=0.54). CONCLUSION- Results from this study support the therapeutic benefit of antioxidants in improving social communication, unusual behaviors, and self-regulation behaviors of children with ASD. Further robust randomized controlled trials are necessary to elaborate the validity of these finding.
"]},{"key":"dc:title","label":"Title","values":["Effect of High Antioxidant Cacao Consumption on Behaviors in Children with Autism Spectrum Disorder"]}]}],"canonical_facts":{"dc:contributor":["Berk, Lee S.","Daher, Noha S.","Mainess, Karen","Randall, Kiti Freier"],"dc:creator":["Sadek, Amy"],"dc:description.abstract":["BACKGROUND- Children with Autism Spectrum Disorder (ASD) demonstrate a physiological imbalance between free radicals, resulting from oxidative stress, and antioxidants. Oxidative stress is linked to the pathogenesis of this neurocognitive disorder. The objectives of this pilot feasibility study: 1) to examine the effect of consumption of high concentration antioxidant cacao on behavior of children as perceived by the child’s teacher and 2) as perceived by the child’s parent. METHODS- This clinical trial was a prospective experimental study. Participants consumed 8 squares (or 16 grams) per day of the dark chocolate which had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant concentration was 8,320 μmoles / 100 grams. The two main behavioral measures were the Aberrant Behavior Checklist- 2nd Edition (ABC-2) and the Autism Spectrum Rating Scale (ASRS) which were completed by the child’s teacher at baseline and end of week four; and by the child’s parent at baseline, week two, and week four. RESULTS- Twelve teachers and children with ASD (9 males, 3 females, mean age of 10.9 ±3.9 years) participated in this study. Teachers noted significant improvements on the Autism Spectrum Rating Scales of Social/Communication (p=0.03,
η2=0.79), Unusual Behaviors (p=0.02, η2=0.70), and Self-Regulation (p=0.04, η2=0.59). No significant changes were noted on any of the Aberrant Behavior Checklist-2 subscales (p>.05). For the second study, sixteen parents and children with ASD participated in the study (12 males, 4 females, aged 4 to 17 years). Parent reports showed significant improvements on the ABC-2 subscales of Irritability (p= .03, η2 = 0.25), Social Withdrawal (p=.01, η2 = 0.29), Stereotypic Behavior (p=.05, η2 = 0.13), Hyperactivity/Noncompliance (p=.04, η2 = 0.20), and Inappropriate Speech (p=.05, η2 = 0.16). Significant improvements were noted on the ASRS scales of Social/Communication (p=.04, η2 = 0.25), Unusual Behaviors (p=.003, η2 = 0.20), Self-Regulation (p=0.02, η2=0.32), and Total Scores (p<.001, η2=0.54). CONCLUSION- Results from this study support the therapeutic benefit of antioxidants in improving social communication, unusual behaviors, and self-regulation behaviors of children with ASD. Further robust randomized controlled trials are necessary to elaborate the validity of these finding.
"],"dc:identifier":["https://scholarsrepository.llu.edu/etd/522"],"dc:language":["English"],"dc:rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"dc:subject":["Medicine and Health Sciences","Rehabilitation and Therapy","Antioxidants -- Physiology; Cacao -- Physiology; Child; Autistic Disorder; Autism in Children","Autism Spectrum Disorder; Free Radicals; Oxidative Stress; Neurocognitive Disorder"],"dc:title":["Effect of High Antioxidant Cacao Consumption on Behaviors in Children with Autism Spectrum Disorder"],"thesis:degree_discipline":["Rehabilitation Sciences"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Philosophy (PhD)"]},"updated_at":"2026-07-24T02:52:52Z"}