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 G1a: ± 3 (4-14) Autistic disorder: 6 (67) Communication: 5 ± PDD-NOS: 1 (11) 2 (2-10) Asperger’s: 2 (22) Communication+ G1b: social: 15 ± 4 (7-23) Autistic disorder: 20 (69) Play: 2 ± 1 (0-4) PDD-NOS: 7 (24) Stereotyped Asperger’s: 2 (7) behavior/interests: 3 G1c: Autistic disorder: 8 (42) PDD-NOS: 9 (47) Asperger’s: 2 (11) ± 2 (0-6) Owley et al., 2010 Other characteristics: NR Non-verbal IQ, (continued) mean ± SD (range): G1: 86 ± 34 (21- 146) G1a: 63 ± 34 (21- 103) G1b: 91 ± 33 (25- 140) G1c: 86 ± 34 (21- 146) Author: Pan 2010 Country: Taiwan Practice setting: Intervention: Water exercise swimming program (WESP), 10 weeks, 20 sessions (two sessions/week, 90 minutes each) for improvement of aquatic and social skills Inclusion criteria: • Diagnosis of mild ASD or Asperger syndrome • Age 6- 9 years • Able to follow instructions • Parental commitment to allow participation C-20 Verbal IQ, mean ± SD (range):: G1: 76 ± 35 (11- 141) G1a: 60 ± 36 (11- 114) G1b: 75 ± 34 (14- 141) G1c: 76 ± 35 (11- 141) ABC Irritability scale score, mean ± SD (range):: G1: 21 ± 6 (12-37) G1a: 21 ± 5 (14-30) G1b: 20 ± 6 (12-33) G1c: 21 ± 6 (12-37) ABC Hyperactivity scale score, mean ± SD (range):: G1: 25 ± 11 (4-45) G1a: 22 ± 8 (10-36) G1b: 27 ± 10 (7-45) G1c: 25 ± 11 (4-45) Social skills: SSBS-2, mean ± SD: Peer relations: G1a: 41.50 ± 4.17 G1b: 43.00 ± 4.57 Social competence T2: after 10 weeks of WESP or regular/treatment/ activity T3: after an additional 10 weeks
Evidence Table. Therapies for children with ASD (continued) Study Inclusion/ Exclusion Baseline Description Intervention Criteria/ Population Measures Outcomes University without changing current total: Duration: 21 weeks, with therapy or activity G1a: 42.67 ± 3.02 Adaptive Intervention 10 weeks WESP, 10 Exclusion criteria: G1b: 43.38 ± 4.31 behavior: setting: weeks control, and 1 • Intellectual disability T2: School week transition Adaptive behavior: SBSS-2, mean ± Enrollment Age, mean/yrs ± SD SSBS-2, mean ± SD: period: Assessments: School (range): SD: Self- NR Social Behavior Scales G1a: 7.27 ± 1.25 (5.58- Selfmanagement/com Funding: (SSBS-2) completed by 9.75) management/compli pliance: Grant from classroom teacher G1b: 2 7.20 ± 0.89 (6.08- ance: G1a: 47.13 ± 4.88 National Science Baseline (T1), after 10 8.58) G1a: 44.13 ± 2.17 G1b: 45.13 ± 4.32 Council, Taiwan weeks (T2) and after 20 Mental age, mean/yrs G1b: 44.38 ± 3.74 Design: weeks (T3). Classroom (range): T3: Prospective case teachers were blinded to NR Educational/ SBSS-2, mean ± series children’s treatment Gender, n (%): cognitive/ SD: conditions. M: 16 (100) academic Self- HAAR checklist used to F: 0 (0) attainment: management/com assess aquatic skills SSBS-2, mean ± pliance: Race/ethnicity, n (%): SD: G1a: 46.38 ± 6.57 Groups: Asian: 16 (100) Academic behavior, G1b: 50.75 ± 4.46 G1a: WESP for first 10 mean: weeks followed by 10 SES: G1a: 45.88 ± 2.30 Educational/ weeks regular Maternal education: G1b: 45.25 ± 6.30 cognitive/ treatment/activity NR academic G1b: regular Problem behavior: attainment: treatment/activity for first Household income: SSBS-2, mean ± T2: 10 weeks then WESP for NR SD: SBSS-2, mean ± second 10 weeks Hostile/irritable, SD: mean: Academic G1a: 60.38 ± 5.24 behavior: G1b: 60.75 ± 6.20 G1a: 51.38 ± 2.20* G1b: 48.50 ± 4.21 Pan 2010 (continued) Provider: • 4 research assistants completed WESP training course prior to study and served as swimming instructors Treatment manual followed: Yes Defined protocol followed: Yes Measure of treatment fidelity reported: No Co-interventions held stable during treatment: Yes Concomitant therapies, n (%): Occupational therapy: 6 (37.5) Physical therapy: 2 (12.5) Group therapy: 3 (18.75) All described as residing in urban setting with twoparent household Diagnostic approach: Referral (diagnosis by medical and psychological assessment by physicians in the public hospitals) Diagnostic tool/method: DSM-IV Diagnostic category, n (%): Mild or high-functioning autism: 8 (50) Aspergers: 8 (50) Both groups were split 4/4 for high-functioning autism and asperger syndrome Other characteristics: Height, mean/cm ± SD: G1a: 128.75 ± 7.83 G1b: 124.43 ± 4.04 Weight, mean kg ± SD: C-21 Antisocial/ aggressive, mean: G1a: 52.00 ± 3.30 G1b: 56.00 ± 7.60 Defiant/disruptive: G1a: 59.50 ± 5.15 G1b: 58.63 ± 7.41 Antisocial behavior total: G1a: 58.00 ± 4.17 G1b: 59.38 ± 6.93 Motor skills: HAAR, mean ± SD: HAAR stage 1mental adjustment: G1a: 95 ± 9.26 G1b: 100 ± 0 HAAR stage II-intro to water: G1a: 51.25 ± 15.53 T3: Academic behavior: G1a: 50.38 ± 2.45 G1b: 52.75 ± 4.03 Social skills: T2: SBSS-2, mean ± SD: Peer relations: G1a: 43.88 ± 4.92 G1b: 41.63 ± 5.26 Social competence total: G1a: 46.25 ± 3.99 G1b: 43.88 ± 3.48 T3: SBSS-2, mean ± SD: Peer relations: G1a: 45.50 ± 5.45
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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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Table 37. Interventions/outcomes wi
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gains. 104 Other studies have seen
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percent of behavioral studies repor
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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 207: 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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