Essential Oils and Aromatherapy: Is There Science Behind That?

Catherine L. McHugh, MA, BCBA, LBA, Stacha C. Leslie, MEd, BCBA, LBA,

and Thomas Zane, PhD, BCBA-D

Department of Applied Behavioral Science, University of Kansas

Is there science behind that Current empirically supported treatments for autism (e.g., applied behavior analysis, speech therapy, etc.) can be expensive and time consuming for individuals with autism and relevant stakeholders (i.e., caregivers). Given this, low-cost and less effortful treatments or procedures may be appealing. One low-cost and low-effort treatment growing in popularity is the use of essential oils and aromatherapy to mitigate the effects of potentially challenging behavior in individuals with autism.

What are essential oils and aromatherapy, and how are they used?

Essential oils are concentrated plant extracts obtained through mechanical pressing or distillation of elements such as leaves, flowers, bark, roots, or fruit (Johns Hopkins Medicine, 2021; National Institute of Environmental Health Sciences [NIH], 2022). Typically, essential oils are inhaled or applied in diluted form to the skin on various areas of the body (NIH, 2020). The alleged primary benefits of essential oils include antimicrobial, antiviral, antibiotic, and anti-inflammatory properties, as well as stress relief, alleviation of symptoms of depression, and reduction in insomnia (Ramsey et al., 2020).

Aromatherapy is the use of essential oils as a complementary health approach and practice. Proponents say that the scent molecules from the essential oils are diffused and inhaled, allowing them to travel through olfactory nerves directly to the brain, impacting the amygdala – the emotional center of the brain (NIH, 2020). Aromatherapy may also be incorporated into massage therapy or into accessories like necklaces and bracelets such that the essential oils can be smelled throughout the day. Aromatherapy shares many alleged benefits of essential oils including pain management, improving sleep quality, alleviating stress and anxiety, and fighting bacteria; the primary distinction is that it is not directly applied to the skin. (NIH, 2020). Often, however, essential oils and/or aromatherapy are used in conjunction with one another to hopefully provide optimal benefits.

How do proponents of essential oils and aromatherapy suggest they may be used for individuals with autism?

According to Tobik (2021), the chemical composition of essential oils can provide psychological, emotional, and physical therapeutic benefits for individuals with autism. Specifically, Tobik provided a list of the ten “best” oils to assist in mitigating challenging behaviors (e.g., anger, anxiety, physical aggression, attention deficit, hyperactivity, sensory overload, sleep issues, and meltdowns) of individuals with autism, along with the oil’s stated function. These oils include frankincense, vetiver, sandalwood, cedarwood, lavender, mandarin, peppermint, ylang-ylang, bergamot, and chamomile. In one example, Tobik suggested frankincense may help individuals with autism and ADHD stay focused and boost their immune systems. Tobik further suggested sandalwood oil may have “relaxing and calming effects” that can be effective for children with autism.

Bloggers on autism support websites also make claims of the supposed benefits of essential oils and aromatherapy practice. For example, Jameson (2018) suggested the application of essential oils like ylang-ylang may be effective in managing emotional outbursts and aggression. Martinez (2021) suggested diffusing essential oils (i.e., aromatherapy) along with mindfulness exercises may help children with autism maintain good, or appropriate, behavior. Further, Ibarra (2019) and Shreya (2022) suggested aromatherapy may decrease stereotypic behaviors occurring in response to overstimulating situations (“sensory overload”; e.g., large crowds, loud noises, etc.). At first glance, these suggestions seem ideal – affordable, less effortful, and effective procedures that are easily accessible. Yes, let’s do it! But wait – is there science behind that?

What the research tells us.

Most, if not all, of the support for the use of these two therapies, has been garnered through caregiver and stakeholder testimonials (caregiver and autism support websites mentioned above) that suggest essential oils and aromatherapy may result in a reduction of challenging behaviors in children with autism. However, few scientific studies have been conducted that directly evaluate the effects of essential oils and validate such claims. For example, Hawkins et al. (2019) evaluated the effects of aromatherapy on medical office-induced anxiety in children with ASD. Within this clinical trial, some participants were exposed to diffused bergamot essential oil while receiving medical treatment. Results showed no significant differences between groups regarding reducing anxiety during medical visits. Additionally, the authors stated that Bergamot oil had the potential to increase anxiety, suggesting potential counter-therapeutic effects.

Another example was Solomons (2005) who evaluated the effects of aromatherapy massage and a sensory exploration activity on increased levels of shared attention (i.e., mutual gaze and joint reference) in four children with autism and severe learning difficulties who engaged in “challenging behaviors” (i.e., extreme anxiety, withdrawal, aggression, ritualistic, and obsessive behaviors, and self-injurious behavior (Solomons, 2005). Bi-weekly aromatherapy treatment sessions were conducted at each child’s nursery school for 10 min. Each session included an aromatherapist (i.e., child’s nursery nurse) diffusing lavender oil while giving the child a lavender oil-infused massage. Sensory exploration activities were provided within the context of the child’s daily nursery school schedule and included music and singing. Experimenters conducted monthly observations and collected responses from pre- and post-treatment parent interviews to observe changes in child behavior across both contexts. Thus, this is more of a case study than an experimental evaluation. Results from experimenter observations showed some change in child responding (i.e., from rare eye contact too often made eye contact) during aromatherapy massages and no change during sensory activities. Similarly, pre- and post-treatment parent interview reports suggested that daily aromatherapy treatments increased their child’s sharing behaviors, and eye contact, expanded their child’s interests in various activities, and reported no change during sensory activities.

These reports should be viewed with caution, however, as there is no way to directly attribute the effects of the massage on increased shared attention behaviors. That is, experimenters did not provide operational definitions for mutual gaze and joint reference, thus the reliability of the reports gathered from the experimenter’s direct observation is unknown. Further, children included in this study reported communicating using pointing, leading an adult to an item, or one-step picture exchanges. Thus, although parents report changes in their child’s behavior, the children were unable to communicate the efficacy or preference for either sensory exploration or massages.

Additional studies have evaluated the use of essential oils and aromatherapy for individuals with autism across communication skills (Kumari et al., 2006), as an aid to mitigate sleep disturbance (Holloway, 2018; Williams, 2006), and most recently, in educational settings (Dolah et al., 2022). However, treatment procedures across these studies either showed no effect or inconclusive results. Williams (2006) used a reversal design (ABABAB) to evaluate the effects of aromatherapy massage on sleep onset, sleep duration, and waking from sleep. Results from this study reported no significant difference between nights when the aromatherapy massage was given and when it was not. Further, Dolah et al. (2022) focused on a literature review and concluded that based on the limited current literature on essential oils and aromatherapy in educational settings more work is required before we can determine if it was effective or not.

What else should we consider?

In addition to the lack of quality research conducted on the effects of essential oils and aromatherapy, we must also consider the risks associated with any non-pharmaceutical intervention. Research conducted on essential oils and their interactions with other bodily processes suggests that some essential oils can be associated with hormone imbalance in young girls (i.e., lavender; Ramsey, 2020), potentially harmful chemical components (e.g., eucalyptol, anethole; De Groot, 2016), risks of stimulating the onset of other conditions in young boys (i.e., lavender and tea tree oils; Henley et al., 2007), various allergic reactions (Johns Hopkins Medicine, 2021) and can be toxic when ingested (Blair, 2020). Further, there seems to be no standard protocol governing exactly how to use these oils. There is no standardization of appropriate dosage (e.g., how many drops should we use and how often?), application (e.g., should I put in on the skin or can it be ingested?), or what oils are good for what ages (e.g., how old does my child need to be?). Thus, given the highly individualized components of essential oils and how they may interact with an individual, all autism providers and relevant stakeholders (i.e., caregivers) are advised to consult medical professionals before their use, if they are used at all.

Final thoughts

Limited empirical research has been conducted on the impact of essential oils on autism symptoms. Although testimonials and one scientific study suggest aromatherapy (i.e., through essential oil-infused massages) may be a preferred activity for individuals, there is insufficient scientific evidence to suggest this as an effective treatment to mitigate potentially challenging behaviors in children with autism. Comprehensive research is needed on both the effectiveness of essential oils and aromatherapy on symptoms of autism and the potential counter-therapeutic effects of its use (Hawkins, 2019). Research must first examine if there is any causal relationship between the use of any particular oil and positive changes in autism symptomology. If there are replicated positive results, then researchers must examine dosage parameters, delivery mechanisms, safety considerations, and the potential maintenance and generalization of effect. As outlined above, further research is required using a controlled technological methodology to determine if essential oils and aromatherapy have any impact on observable behaviors in individuals with autism. Thus, caregivers and clinical professionals would not be advised to recommend the use of essential oils as a scientific treatment for autism at this time.

References

Aromatherapy: Do essential oils really work? (2021, August 8). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/aromatherapy-do-essential-oils-really-work

Blair, C. (2020). Are essential oils save for children? Johns Hopkins All Children’s Hospital. https://www.hopkinsallchildrens.org/ACH-News/General-News/Are-Essential-Oils-Safe-for-Children

Can kids with autism and ADHD benefit from essential oils? Edens Garden. (n.d.). Retrieved January 24, 2023, from https://www.edensgarden.com/blogs/news/can-kids-with-autism-and-adhd-benefit-from-essential-oils

De Groot, A. C., & Schmidt, E. (2016). Essential Oils, part III: Chemical composition. Dermatitis, 27(4), 161–169. https://doi.org/10.1097/der.0000000000000193

Dolah, J., Amreek Singh, A. K., Che Ahmad, A., Mustafa, M., Abdul Majid, A. Z., Azraai, N. Z., & Mohd Bakhir, N. (2022). Review on the effectiveness of aromatherapy oils in the learning of autistic children in an educational setting. Journal of Human Centered Technology, 1(1), 1–9. https://doi.org/10.11113/humentech.v1n1.5

Essential oils and autism: Treating autism with only a drop. Autism Academy. (2021, June 9). Retrieved January 24, 2023, from https://www.aaed.org/essential-oils/essential-oils-and-autism-treating-autism-with-only-a-drop/

Hawkins, J. R., Weatherby, N., Wrye, B., & Ward, K. U. (2019). Bergamot aromatherapy for medical office induced anxiety among children with an autism spectrum disorder: A randomized, controlled, blinded clinical trial. Holistic Nursing Practice, 33(5), 285-294.

Henley, D. V., Lipson, N., Korach, K. S., & Bloch, C. A. (2007). Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine, 356, 479-485. https://doi.org/10.1056/nejmoa064725

Ibarra, M. (2019, June 22). Autism & Essential Oils: A Guide to the best oils for ASD and sensory issues. World Stem Cells Clinic. Retrieved January 24, 2023, from https://worldstemcellsclinic.com/blog/autism-essential-oils-a-guide-to-the-best-oils-for-asd-and-sensory-issues/

Jameson, J. (2018, July 3). Essential oils that can benefit kids with autism & ADHD. Jewel Autism Centre Blog. Retrieved January 24, 2023, from https://jewelautismcentre.com/jewel_blog/essential-oils-that-can-benefit-kids-with-autism-adhd/

Kumari, A., Mansingh, S., Perepa, P. (2006). Effects of aromatherapy on the development of communication skills in children with autism. [Conference paper]. DOI: 10.13140/2.1.4188.0006

Martinez, B. (2021, May 5). Can kids with autism and ADHD benefit from essential oils? (2021, May) Edens Garden. https://www.edensgarden.com/blogs/news/can-kids-with-autism-and-adhd-benefit-from-essential-oils

Ramsey, J. T., Shropshire, B. C., Nagy, T. R., Chambers, K. D., Li, Y., & Korach, K. S. (2020). Essential oils and health. The Yale Journal of Biology and Medicine, 93(2), 291–305.

Solomons, S. (2005). Using aromatherapy massage to increase shared attention behaviours in children with autistic spectrum disorders and severe learning difficulties. British Journal of Special Education, 32(2), 127-137.

Tobik, A. (2021, May 16). Best essential oils for autism and ADHD – the ultimate guide. Autism Parenting Magazine. Retrieved January 24, 2023, from https://www.autismparentingmagazine.com/essential-oils-for-autism-adhd-add/

U.S. Department of Health and Human Services. (n.d.). Essential oils. National Institute of Environmental Health Sciences. Retrieved January 24, 2023, from https://www.niehs.nih.gov/health/topics/agents/essential-oils/index.cfm

Williams, T. I. (2006). Evaluating effects of aromatherapy massage on sleep in children with autism: A pilot study. Evidence-Based Complementary and Alternative Medicine, 3(3), 373–377. https://doi.org/10.1093/ecam/nel017

Citation for this article:

McHugh, C. L., Leslie, S. C., & Zane, T. (2023). Essential oils and aromatherapy: Is there science behind that? Science in Autism Treatment, 20(4).

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