Therapies for Children With Autism Spectrum Disorders

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Evidence Table. Therapies for children with ASD (continued) Study Inclusion/ Exclusion Baseline Description Intervention Criteria/ Population Measures Outcomes Author: Intervention: Inclusion criteria: Overall ratings: Overall ratings: Dawson et al., Early Start Denver Model: • Age < 30 months at ADOS severity ADOS severity 2010 20 hrs/week of ESDM, intake score, mean ± SD: score, 2 years, Country: US Practice setting: parent training, parent delivery for ≥ 5 hrs/week of ESDM, community services chosen by • Met criteria for autistic disorder on the Toddler Autism Diagnostic Interview G1: 7.2 ± 1.7 G2: 6.9 ± 1.7 G1/G2: P = 0.557 Social skills: mean ± SD: G1: 7.0 ± 1.9 G2: 7.3 ± 1.8 G1/G2: P = 0.422 Academic parents • Met ADOS criteria for VABS socialization Diagnostic cate- Intervention Assess-and-monitor: autism or ASD score, mean ± SD: gory, 2 years, n: setting: Families given resource • Clinical diagnosis based G1: 73.8 ± 7.7 Autism: Home manuals, intervention on DSM-IV criteria using G2: 72.4 ± 9.4 G1: 16 Enrollment recommendations, and all available information G1/G2: P = 0.594 G2: 20 period: referrals for intervention at • Resides within 30 IQ or Early PDD-NOS: NR baseline and 2 follow-up minutes of the University Learning G1: 8 Funding: assessments of Washington Composite Score: G2: 1 NIH Duration: • Willingness to participate MSEL scale score, Social skills: Author industry 2 years in ≥ 2 year intervention mean ± SD: VABS sociali- relationship Frequency: Exclusion criteria: Early-learning zation score, disclosures: 2 hour sessions, twice per • Neurodevelopmental composite: 2 years, mean ± 2 of 8 day, 5 days/week disorder of known G1: 61.0 ± 9.2 SD: Early Start Denver Assessments: G2: 59.4 ± 8.6 G1: 69.2 ± 11.6 etiology (such as fragile Model for Young ADI-R; ADOS; MSEL (fine G1/G2: P = 0.530 G2: 63.1 ± 9.3 x syndrome) Children with motor, visual reception, Receptive language: G1/G2: P = 0.263 • Significant sensory or Autism (royalties) expressive language and G1: 21.1 ± 4.7 IQ or Early motor impairment Design: receptive language G2: 21.2 ± 3.8 Learning • Major physical problems RCT scales); VABS; RBS G1/G2: P = 0.920 Composite such as a chronic Yearly assessments Expressive Score: serious health condition conducted by University language: MSEL scale of Washington examiners • Seizures at time of entry G1: 24.5 ± 7.2 score, 2 years, blind to group status for • Use of psychoactive G2: 26.0 ± 8.6 mean ± SD: both groups (G1 & G2) medications G1/G2: P = 0.492 Early-learning and by community • History of a serious head Visual reception: composite: providers (G2) injury and/or neurologic G1: 33.2 ± 11.0 G1: 78.6 ± 24.2 Groups: disease G2: 30.8 ± 8.9 G2: 66.3 ± 15.3 G1: Early Start Denver • Alcohol or drug exposure G1/G2: P = 0.406 G1/G2: P = 0.044 Model during the prenatal VABS communi- Receptive G2: assess-and-monitor period cation score, mean language: Provider: • Ratio IQ below 35 as ± SD: G1: 40.0 ± 16.3 • Bachelor’s level measured by mean age G1: 68.4 ± 7.6 G2: 31.5 ± 10.6 therapists supervised equivalence score/ G2: 69.6 ± 7.3 G1/G2: P = 0.048 by PhD level clinician chronological age on the G1/G2: P = 0.577 Expressive with consultation from visual reception and fine Repetitive language: Clinical psychologist motor subscales of the Behavior: G1: 36.6 ± 13.6 Speech-language MSEL RBS total score, G2: 30.0 ± 9.2 pathologist Age, months ± SD: mean ± SD: G1/G2: P = 0.033 Developmental G1: 23.9 ± 4.0 G1: 15.2 ± 10.8 Visual reception: behavioral pediatrician G2: 23.1 ± 3.9 G2: 21.5 ± 19.2 G1: 41.0 ± 17.9 Occupational therapist G1/G2: P = 0.490 G1/G2: P = 0.171 G2: 34.5 ± 13.0 Measure of treatment Mental age: G1/G2: P = 0.433 fidelity reported: NR Yes Gender, male-to-female ratio: 3.5:1 Dawson et al., Co-interventions held Race/ethnicity, %: Adaptive behavior: Communication/l 2010 stable during treatment: Asian: 12.5 VABS adaptive anguage: (continued) Yes White: 72.9 behavior composite VABS communi- Concomitant therapies: Latino: 12.5 score, mean ± SD: cation score, C-4
Evidence Table. Therapies for children with ASD (continued) Study Inclusion/ Exclusion Baseline Description Intervention Criteria/ Population Measures Outcomes NR Multiracial: 14.6 G1: 69.5 ± 5.7 2 years, mean ± N at enrollment: SES: G2: 69.9 ± 7.3 SD: G1: 24 Maternal education: NR G1/G2: P = 0.844 G1: 82.1 ± 21.8 G2: 24 Household income: NR VABS daily living G2: 69.4 ± 15.8 N at follow-up (%): Diagnostic approach: skills score, mean ± G1/G2: P = 0.015 Year one: Referral and confirmed in SD: Repetitive G1: 24 (100) study G1: 87.3 ± 11.4 behavior: G2: 23 (96) Diagnostic tool/method: G2: 86.8 ± 10.0 RBS total score, 2 Year two: Toddler Autism Diagnostic G1/G2: P = 0.381 years, mean ± G1: 24 (100) Interview, ADOS, DSM-IV Motor skills: SD: G2: 21 (88) Diagnostic category, n: MSEL fine motor G1: 16.7 ± 13.1 Autism: score, mean ± SD: G2: 22.0 ± 16.3 G1: 21 G1: 33.9 ± 11.9 G1/G2: P = 0.545 G2: 18 G2: 30.6 ± 10.7 PDD-NOS: G1/G2: P = 0.318 Adaptive G1: 3 VABS motor skills behavior: G2: 6 score, mean ± SD: VABS adaptive Other characteristics: G1: 70.9 ± 6.2 behavior com- NR G2: 72.5 ± 6.5 posite score, 2 G1/G2: P = 0.862 years, mean ± SD: G1: 68.7 ± 15.9 G2: 59.1 ± 8.8 G1/G2: P = 0.011 VABS daily living skills score, 2 years, mean ± SD: G1: 64.7 ± 12.4 G2: 58.0 ± 8.1 G1/G2: P = 0.013 Motor skills: MSEL fine motor score, 2 years, mean ± SD: G1: 33.5 ± 12.2 G2: 28.5 ± 9.5 G1/G2: P = 0.503 VABS motor skills score, 2 years, mean ± SD: G1: 77.4 ± 19.8 G2: 64.1 ± 12.3 G1/G2: P = 0.009 Dawson et al., Harms: 2010 NR (continued) Modifiers: NR Author: Intervention: Inclusion criteria: Frankel et al., Children’s Friendship • Satisfied ADOS-G and 2010 Training: children were ADI-R criteria for ASD Country: US Practice setting: Academic Intervention integrated into classes • Currently attending a 2 being conducted by the UCLA Children’s Friendship Program, with no more than 4 children with ASD admitted to any nd through 5 th Social skills: Social Skills: Loneliness scale Loneliness scale score, mean ± SD: score, mean ± G1: 34.3 ± 12.3 grade regular G2: 37.8 ± 14.3 classroom for most of (n=32) the school day without a Loneliness scale “shadow” or other score, follow-up closely supervising adult group, mean ± SD: SD: G1: 31.4 ± 8.5 G2: 38.9 ± 13.3 (n=32) G1/G2: P < 0.025 Loneliness scale C-5
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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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that this somnolence improved over
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Table 17. Outcomes of RCTs of antip
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Serotonin Reuptake Inhibitors SRIs
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One prospective case series of esci
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Most participants were recruited fr
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Dietary and Other Medical Intervent
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Summary of the literature-other int
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withdrew after the first six weeks;
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therefore described separately belo
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addressed, 85 typically involves on
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In the second paper, 89 treatment s
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Table 25. Overview of CAM studies a
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Teacher and Parent Scales, behavior
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Because of the potentially increase
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Educational Interventions Child cha
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showed diminished response to escit
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oom as the other assessments, so it
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contrast group (n=18) on three meas
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and are based on consideration of f
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Few studies directly comparing the
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Strength of evidence. The strength
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While individual studies of CBT and
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Page 153 and 154: percent of behavioral studies repor
Page 155 and 156: limited followup, lack of comparati
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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: Evidence Table. Therapies for child
Page 195 and 196: 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
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177. Bakare MO, Agomoh AO, Ebigbo P
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204. Baron-Cohen S, Scott FJ, Allis
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233. Bebko JM, Perry A and Bryson S
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262. Bergmann F, Stepp H, Metzger R
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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
Page 633 and 634:
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
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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:
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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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Therapies for Children With Autism Spectrum Disorders

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