Therapies for Children With Autism Spectrum Disorders

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Evidence Table. Therapies for children with ASD (continued) Study Description Intervention Green et al. 2010 (continued) Green et al. 2010 (continued) Concomitant therapies, n (%): Contact time with other treatment professionals, mean hours ± SD: G1: 9.5 ± 16.3 G2: 9.8 ± 12.9 Group-based autism psychoeducation, n (%): G1: 28 (38) G2: 34 (49) Communication-focused interventions, n (%): G1: 27 (36) G2: 23 (33) Early intensive behavioral intervention, n: G1: 1 G2: 0 Son-Rise therapy, n: G1: 1 G2: 0 Portage, n: G1: 10 G2: 10 Special educational needs setting, n (%): G1: 30 (41) G2: 24 (34) Education setting with specific provisions for ASD, n (%): G1: 8 (11) G2: 10 (14) Speech & language therapy: Mean hrs ± SD: G1: 9.5 ± 16.3 /case G2: 9.8 ± 12.9 /case N at enrollment: G1: 77 G2: 75 N at follow-up: G1: 74 G2: 72 Inclusion/ Exclusion Criteria/ Population SES: Education (one parent with qualifications after age 16 years), n (%): G1: 65 (84) G2: 47 (63) Household income: NR SES (dichotomized as at least one parent in professional or administrative occupation versus all others), n (%): G1: 51 (66) G2: 44 (59) Diagnostic approach: In Study Diagnostic tool/method: • Social and communication domains of the ADOS-G • Two of three domains of the ADI-R Diagnostic category, n (%): Core autism: 152 (100) Other characteristics: NR C-12 Baseline Measures Outcomes G2: 24.4 ± 18.5 Parent-child interaction: shared attention time, mean % ± SD: G1: 65.3 ± 22.0 G2: 67.0 ± 21.9 ADI-R, mean (range): Reciprocal social interaction: G1: 17.9 (9–25) G2: 18.2 (8–26) Restricted, repetitive, and stereotyped patterns: G1: 5.2 (0–10) G2: 5.6 (0–10) Non-verbal communication: G1: 10.7 (3–14) G2: 11.0 (3–14) Verbal communication: G1 (n=22): 15.7 (9– 21) G2 (n=25): 15.7 (10–23) ADOS-G, mean (range): Module 1 (at most single words) (G1: n=60; G2: n=57) Communication: G1: 6.3 (4–8) G2: 6.1 (4–8) Reciprocal social interaction: G1: 10.9 (7–14) G2: 10.8 (7–14) Module 2 (phrase speech) (G1: n=17; G2: n=18) Communication: G1: 6.6 (5–9) G2: 6.7 (5–9) Reciprocal social interaction: G1: 9.1 (6–12) Parent-child interaction: parental synchrony, mean % ± SD: G1: 51.3 ± 19.6 G2: 32.6 ± 14.0 Change from baseline, mean % ± SD: G1: 19.5 ± 21.3 G2: 1.4 ± 15.3 Parent-child interaction: child initiations, mean % ± SD: G1: 34.9 ± 19.7 G2: 26.0 ± 17.5 Change from baseline, mean % ± SD: G1: 11.9 ± 25.6 G2: 1.6 ± 21.4 Parent-child interaction: shared attention time, mean % ± SD: G1: 64.0 ± 25.7 G2: 55.6 ± 25.7 Change from baseline, mean % (SD): G1: -1.4 ± 23.7 G2: -11.4 ± 28.4 Analysis adjusted for center, age group, sex, verbal ability, nonverbal ability, socioeconomic status, and education qualifications were 2.28 (95% CI 0.17 – 4.39) for CSBS-DP social composite scores; Communication/ language: ADOS-G
Evidence Table. Therapies for children with ASD (continued) Study Description Intervention Green et al. 2010 (continued) Inclusion/ Exclusion Criteria/ Population C-13 Baseline Measures Outcomes G2: 9.7 (6–14) communication domain, mean Module 1 and 2 (SD): restricted and G1: 6.6 (3.3) repetitive behavior: G2: 6.7 (3.2) G1: 3.7 (0–6) Change from G2: 3.7 (1–6) baseline, mean (SD): G1: -2.3 (2.6) G2: -1.9 (2.4) Parent-rated Communication and Symbolic Behavior Scales Development Profile (CSBS-DP), mean ± SD: G1: 29.5 ± 7.1 G2: 28.3 ± 8.8 Parent-rated MacArthur Communicative Development Inventory (MCDI), mean ± SD: Receptive raw score: G1: 159.5 ± 114.4 G2: 162.0 ± 122.4 Expressive raw score: G1: 93.5 ± 114.8 G2: 111.1 ± 128.6 PLS receptive raw scores, mean (SD) G1: 21.5 (13.0) G2: 20.3 (12.8) Change from baseline, mean (SD): G1: 6.0 (6.7) G2: 5.3 (5.9) PLS expressive raw scores G1: 20.0 (11.2) G2: 20.0 (11.3) Change from baseline, mean (SD): G1: 5.1 (5.6) G2: 4.9 (5.2) Parent-rated CSBS-DP, mean (SD): G1: 34.0 (8.2) G2: 30.8 (8.3) Change from baseline, mean (SD): G1: 4.6 (7.0) G2: 2.5 (6.0) Parent-rated MCDI receptive raw score, mean (SD): G1: 233.7 (129.6) G2: 209.0 (131.3) Change from baseline, mean (SD): G1: 74.2 (66.9) G2: 47.0 (68.2) Parent-rated MCDI expressive raw score, mean
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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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Table 32. Summary of results of edu
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Table 33. Summary of results of med
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strength of this reviewed literatur
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Table 36. Intervention, strength of
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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
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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
Page 199: 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
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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
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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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