Therapies for Children With Autism Spectrum Disorders

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Table 37. Interventions/outcomes with insufficient strength of evidence by outcomes assessed Intervention Adaptive behavior Adverse events/ harms Anger Anxiety ASDs symptom severity Challenging behavior 114 Hyperactivity/ inattention Allied health, Auditory integration � � � � Allied health, Music therapy � Allied health, PECS/RPMT � Allied health, Sensory integration � Allied health, Other � � � � Behavioral, CBT (commonly associated conditions) Behavioral, ESDM Behavioral, Imitation (play-/interaction- based) Behavioral, Joint attention/symbolic play (play- /interaction-based) Behavioral, Other— Neurofeedback Behavioral, Other— Sleep Behavioral, Parent & teacher training (commonly associated conditions) Behavioral, Parent training (early intensive behavioral) IQ/cognitive Joint attention Language/ communication � � � � � � � � � � � � Motor/sensory Repetitive behavior Sleep � � � Social skills/ social behaviors � � � �
Table 37. Interventions/outcomes with insufficient strength of evidence by outcomes assessed (continued) Intervention Behavioral, Parent training (early intensive behavioral) Behavioral, Parentfocused (play- /interaction-based) Behavioral, Relationshipfocused (play- /interaction-based) Behavioral, Social skills CAM, Acupuncture Adaptive behavior Adverse events/ harms Anger Anxiety ASDs symptom severity Challenging behavior � 115 Hyperactivity/ inattention IQ/cognitive Joint attention Language/ communication Motor/sensory Repetitive behavior Sleep Social skills/ social behaviors � � � � � � � CAM, Massage � � � Educational, Broadbased � � � Educational, Computer-based � Educational, TEACCH Medical, � � Antipsychotics (Cyproheptadine+H aloperidol) � � Medical, Dietary & other � � � � Medical, Guanfacine � � Medical, SRIs (all) � � � Medical, Stimulants � � CAM=complementary and alternative medicine; CBT=cognitive behavioral therapy; ESDM=Early Start Denver Model; PECS=Picture Exchange Communication System; RPMT= Responsive Education and Prelinguistic Milieu Teaching SRI=serotonin reuptake inhibitor; TEACCH=Treatment and Education of Autistic and Communication related handicapped CHildren KQ2. Modifiers of Treatment Outcomes Understanding the degree to which child characteristics (i.e., specific ASDs related difficulties and skills), treatment factors (e.g., type, duration, intensity), and systems (e.g., family, community) influence response to treatments could improve targeting of treatments to the appropriate children and circumstances. However, with rare exceptions, 259,260,287 few studies are designed or powered to allow analysis of heterogeneous effects. Although we sought studies of treatment modifiers, only one included study 259,260 actually demonstrated true treatment modifiers based upon appropriate study design and statistical analysis. One other study 287 was
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Comparative Effectiveness Review Nu
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This report is based on research co
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Acknowledgments We are indebted to
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Therapies for Children With Autism
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Dietary and Other Medical Intervent
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Figures Figure A. Analytic framewor
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Table A. Description of interventio
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Analytic Framework Figure A. Analyt
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Strength of evidence. The degree of
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epetitive behavior showed improveme
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subgroups of children, although the
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We encourage investigators to provi
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9. Remington B, Hastings RP, Kovsho
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46. Green J, Charman T, McConachie
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82. Reaven JA, Blakeley-Smith A, Ni
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120. Masi G, Cosenza A, Mucci M, et
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157. Evangeliou A, Vlachonikolis I,
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Introduction Need for Evidence for
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Interventions intended primarily to
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Table 1. Description of behavioral
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Serotonin reuptake inhibitors. Sero
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Table 3. Description of medical and
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Table 4. Description of allied heal
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Key Questions and Analytic Framewor
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Chapter 4 discusses the results in
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Methods This chapter documents proc
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• Did not present aggregated resu
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Additional behavioral interventions
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1. Did the study employ a group des
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Scoring: Studies minimally had to h
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These ratings of applicability do n
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Figure 2. Disposition of articles a
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• ABA-based approaches including
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education, children in the intensiv
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abilities. This finding is further
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Table 10. Outcomes of early intensi
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forecast behavior; perspective taki
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interaction with peers; outcome mea
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hyperactivity, inattention, challen
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Table 12. Outcomes of RCTs assessin
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Schedule for Affective Disorders an
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SCAS-P=Spence Child Anxiety Scale-P
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Summary of the literature. Jarusiew
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Table 14. Overview of educational s
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on the Ankara Developmental Screeni
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Checklist scores decreased by 8.4 f
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Table 15. Outcomes of studies asses
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evaluated the effects of risperidon
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Page 101 and 102: Serotonin Reuptake Inhibitors SRIs
Page 103 and 104: One prospective case series of esci
Page 105 and 106: Most participants were recruited fr
Page 107 and 108: Dietary and Other Medical Intervent
Page 109 and 110: Summary of the literature-other int
Page 111 and 112: withdrew after the first six weeks;
Page 113 and 114: therefore described separately belo
Page 115 and 116: addressed, 85 typically involves on
Page 117 and 118: In the second paper, 89 treatment s
Page 119 and 120: Table 25. Overview of CAM studies a
Page 121 and 122: Teacher and Parent Scales, behavior
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Page 125 and 126: Educational Interventions Child cha
Page 127 and 128: showed diminished response to escit
Page 129 and 130: oom as the other assessments, so it
Page 131 and 132: contrast group (n=18) on three meas
Page 133 and 134: and are based on consideration of f
Page 135 and 136: Few studies directly comparing the
Page 137 and 138: Strength of evidence. The strength
Page 139 and 140: While individual studies of CBT and
Page 141 and 142: Table 32. Summary of results of edu
Page 143 and 144: Table 33. Summary of results of med
Page 145 and 146: strength of this reviewed literatur
Page 147: Table 36. Intervention, strength of
Page 151 and 152: gains. 104 Other studies have seen
Page 153 and 154: percent of behavioral studies repor
Page 155 and 156: limited followup, lack of comparati
Page 157 and 158: individual intervention is warrante
Page 159 and 160: selecting participants for their st
Page 161 and 162: studies lacked an arm that consider
Page 163 and 164: 23. Kanner L. Autistic Disturbances
Page 165 and 166: 62. Dosman CF, Drmic IE, Brian JA,
Page 167 and 168: 104. Ben-Itzchak E and Zachor DA. T
Page 169 and 170: 142. Tyminski RF and Moore PJ. The
Page 171 and 172: 177. Aman MG, McDougle CJ, Scahill
Page 173 and 174: 214. Correia CT, Almeida JP, Santos
Page 175 and 176: 252. Akhondzadeh S, Tajdar H, Moham
Page 177 and 178: 290. Dawson G, Rogers S, Munson J,
Page 179 and 180: Acronyms/Abbreviations ABA Applied
Page 181 and 182: Appendix A. Exact Search Strings an
Page 183 and 184: Table A2. PsycINFO search strategie
Page 185 and 186: Therapies for Children with Autism
Page 187 and 188: Therapies for Children with ASD Sys
Page 189 and 190: Appendix C. Evidence Tables Tables
Page 191 and 192: Evidence Table. Therapies for child
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Evidence Table. Therapies for child
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Country: US Practice setting: Clini
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Dunn-Geier et al., 2000 (continued)
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Evidence Table: Therapies for Child
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Appendix D. List of Excluded Studie
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31. Aarsland D, Cummings JL and Lar
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59. Ahearn WH, Clark KM, Gardenier
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89. Allison DB, Basile VC and MacDo
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118. Ando H, Yoshimura I and Wakaba
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146. Atkinson RP, Jenson WR, Rovner
Page 619 and 620:
177. Bakare MO, Agomoh AO, Ebigbo P
Page 621 and 622:
204. Baron-Cohen S, Scott FJ, Allis
Page 623 and 624:
233. Bebko JM, Perry A and Bryson S
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262. Bergmann F, Stepp H, Metzger R
Page 627 and 628:
291. Birkan B, McClannahan LE and K
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319. Boddy F, Rowan EN, Lett D, et
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348. Bouma R and Schweitzer R. The
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376. Broadstock M, Doughty C and Eg
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404. Brudnak MA. Application of gen
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432. Buitelaar JK. Why have drug tr
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460. Butler DE, Nordin IC, L’Ital
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489. Campbell M, Locascio JJ, Choro
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517. Caronna EB, Augustyn M and Zuc
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546. Case-Smith J and Miller H. Occ
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574. Charlop MH, Burgio LD, Iwata B
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602. Cheng CW, Cho SH, Taylor M, et
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631. Cicero FR and Pfadt A. Investi
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662. Collier D and Reid G. A compar
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691. Coskun M, Karakoc S, Kircelli
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718. Cullen LA, Barlow JH and Cushw
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748. Davidovitch M, Holtzman G and
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777. DeLeon IG, Fisher WW and Marhe
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805. Devlin SD, Harber MM. Collabor
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834. Doherty K, Fitzgerald M and Ma
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863. Dudley LL, Johnson C and Barne
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893. Dybvik AC. Autism and the Incl
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924. Elder JH. In-home communicatio
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953. Erickson CA, Posey DJ, Stigler
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979. Faja S, Aylward E, Bernier R,
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1008. Ferri R, Elia M, Agarwal N, e
Page 679 and 680:
1037. Fisher W, Kerbeshian J and Bu
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1066. Fragala-Pinkham M, Haley SM a
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1095. Furneaux B. Keeping the balan
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1124. Garcaa-Villamisar D, Wehman P
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1152. Ghezzi PM. Discrete Trials Te
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1180. Goin-Kochel RP, Myers BJ and
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1210. Gordon R, Handleman JS and Ha
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1239. Grimaldi BL. The central role
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1268. Guptill JT, Booker AB, Gibbs
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1296. Hamdan-Allen G. Brief report:
Page 699 and 700:
1324. Hare DJ, Jones JPR and Paine
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1356. Harrison S and Berry L. Valui
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1386. Heilbrun AB, Jr., Blum N and
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1414. Hetzroni OE and Shalem U. Fro
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1443. Holburn CS. Counter the mistr
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1473. Horner RH, Carr EG, Strain PS
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1504. Hughes C, Soares-Boucaud I, H
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1533. Ijichi S and Ijichi N. Beyond
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1562. James SJ, Cutler P, Melnyk S,
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1591. Johnson CR, Butter EM, Handen
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1619. Joyce PR. The medical model-w
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1647. Karmali I, Greer RD, Nuzzolo-
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1673. Kelly AB, Garnett MS, Attwood
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1702. Kielinen M, Linna SL and Moil
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1731. Klin A, Lin DJ, Gorrindo P, e
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1761. Koegel RL and Frea WD. Treatm
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1790. Kolmen BK, Feldman HM, Handen
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1819. Kratochvil CJ, Findling RL, M
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1846. Lam MK and Rao N. Developing
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1874. Lattimore LP, Parsons MB and
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1903. Lee PC. Verification of a sim
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1932. Lerman DC, Vorndran C, Addiso
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1960. Licciardello CC, Harchik AE a
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1989. Liptak GS, Orlando M, Yinglin
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2015. Lorimer PA, Simpson RL, Myles
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2043. Luiselli JK, Kane A, Treml T,
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2071. MacFarlane JR and Kanaya T. W
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2099. Malone RP, Maislin G, Choudhu
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2127. Marin FZ. CAM versus nucleopl
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2157. Martineau J, Roux S, Adrien J
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2185. Matson JL and Lo Vullo SV. A
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2213. McCabe H. The Importance of P
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2240. McDougle CJ, Holmes JP, Carls
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2267. McHale SM, Olley JG, Marcus L
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2296. Merlo LJ, Lehmkuhl HD, Geffke
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2325. Minderaa RB, Anderson GM, Vol
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2354. Montgomery JM, Duncan CR and
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2385. Morrison RS, Sainato DM, Benc
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2413. Munesue T, Ono Y, Mutoh K, et
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2445. Napolitano DA, Tessing JL, Mc
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2474. Niederhofer H and Pittschiele
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2501. Nwora AJ and Gee BM. A case s
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2530. Olive ML, Lang RB and Davis T
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2559. Owens JA, Rosen CL and Mindel
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2589. Pansegrouw I and Alant E. Com
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2618. Paul C, Williams KE, Riegel K
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2646. Perry R, Nobler MS and Campbe
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2675. Piazza CC, Hagopian LP, Hughe
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2704. Poon L, Partika N and Bolman
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2734. Prizant BM. Speech-language p
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2764. Rapp JT, Vollmer TR, St. Pete
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2792. Reed P, Broomfield L, McHugh
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2819. Remington G, Sloman L, Konsta
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2849. Ringdahl JE, Kitsukawa K, And
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2877. Rogers SJ. Interventions that
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2908. Rossignol DA. Novel and emerg
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2939. Rutter M, Kreppner J, Croft C
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2967. Sandt D. Social Stories for S
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2994. Scanlon K. Art therapy with a
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3023. Schneider CK, Melmed RD, Bars
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3054. Schwartz IS, Sandall SR, Garf
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3085. Shafer MS, Egel AL and Neef N
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3115. Shipley-Benamou R, Lutzker JR
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3143. Siller M and Sigman M. The be
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3173. Smith C, Felce D, Jones E, et
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3202. Snyder A, Bossomaier T and Mi
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3230. Spero MH. The emancipation of
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3259. Stephens CE. Spontaneous imit
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3289. Strambi M, Longini M, Hayek J
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3318. Suzumura K. How an autistic b
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3346. Tager-Flusberg H and Calkins
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3376. Taylor I, O’Reilly M and La
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3407. Thunberg G, Ahlsen E and Sand
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3435. Trembath D, Balandin S, Toghe
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3464. Turner-Brown LM, Perry TD, Di
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3492. Van Der Putt R, Dineen C, Jan
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3522. Vitiello B. Recent NIMH clini
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3553. Walenski M, Mostofsky SH, Gid
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3581. Weber RC and Thorpe J. Teachi
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3610. Wheeler JJ, Baggett BA, Fox J
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3637. Williams B. Mental handicap n
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3669. Wimpory D, Chadwick P and Nas
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3698. Worth S and Reynolds S. The A
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3728. Young JM, Krantz PJ, McClanna
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3759. Zuddas A, Di Martino A, Mugli
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Appendix F. Approach to Categorizin
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APPENDIX G. Discussion of Recent Sy
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one a casein free regime. Diets wer
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outcome data as Type 6, defined as
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Yes—no disclosures to make G7 Bai
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Table G1. Characteristics of recent
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Random assignment Appropriate compa
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Study Group design Random assignmen
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APPENDIX I. Applicability Summary T
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Social skills (continued) Domain De
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