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 Lilly (5) NR Education of parent or Daily living: G1: 0.03 ± 0.29 McNeil (2) Frequency of contact primary caregiver, n (%): G1: 40.8 ± 21.0 G2: 0.34 ± 0.41 Novartis (1) during study: High school or less: G2: 34.0 ± 15.6 G1/G2: P = NS Noven (1) Weekly during RCT, G1: 9 (18) Medical: (ES = 0.81) Pediamed (1) monthly thereafter G2: 13 (25) CYBOCS score, Post-extension Pfizer (4) Concomitant therapies: Trade school or college: mean ± SD:^ phase: Shire (2) NR G1: 33 (67) G1: 15.51 ± 2.73 G1: 0.10 ± 0.36 Sigma Tau (1) N at RCT enrollment: G2: 31 (60) G2: 15.18 ± 3.88 VABS communi- Targacept (1) G1: 49 Advanced degree: BMI, CDC standard cation, standard Wyeth (1) G2: 52 G1: 7 (14) score, mean ± SD: score, post- 7 of 17§ N at start of 8 week G2: 8 (15) G1: 0.4 ± 1.4 extension phase, Bristol-Myers extension trial: Annual household income, G2: 0.7 ± 1.3 mean change ± Squibb (6) G1: 46 n (%): SARS score, mean ± SD:º Forest (3) < $20,000: SD: G1: 1.63 ± 8.91 Jannssen (4) G1: 5/48 (10) G1: 0.27 ± 0.70 (n=48) Johnson and G2: 8/51 (16) G2: 0.54 ± 1.60 G1/BL: P = NS Johnson (1) $20,001-$40,000: AIMS score, mean ± (ES = 0.11) Lilly (4) G1: 12/48 (25) SD: Repetitive McNeil (3) G2: 16/51 (31) G1: 0.36 ± 0.99 behavior: Neuropharm (3) $40,001-$60,000: G2: 0.23 ± 1.02 ABC stereotypy Novartis (2) G1: 10/48 (21) Sleep time, mean score, mean ± SD: Organon (1) G2: 7/51 (15) hours/day: Post-RCT:‡ Pfizer (1) > $60,000: G1: 9.66 G1: 5.8 ± 4.6 Shire (3) G1: 21/48 (44) G2: 9.42 G2: 7.3 ± 4.8 Supernus (2) G2: 20/51 (39) Serum prolactin, G1/G2: P < 0.001 UCB (1) Diagnostic approach: mean ng/mL ± SD:ª (ES = 0.8) Wyeth (1) In Study G1: 9.3 ± 7.5 (n=42) (ES = 1.2) Diagnostic tool/method: G2: 9.3 ± 7.6 (n=36) Diagnosis corroborated by Motor skills: ADI-R, administered by a Purdue pegboard, clinician with special training and systematic review to ensure reliability mean ± SD:§ Aman et al., 2005 Diagnostic category: Dominant hand Problem McDougle et al., See inclusion criteria insert: behavior: 2005^ CGI-S, RCT population, n G1: 32.76 ± 17.4 ABC irritability Arnold et al., (%) (n=17) score, post-RCT, 2003† Moderate: G2: 24.08 ± 10.5 mean ± SD:‡ RUPP, 2002‡ G1: 9/49 (18) (n=13) G1: 11.3 ± 7.4 Williams et al, G2: 9/49 (18) Nondominant hand G2: 21.9 ± 9.5 2006º Marked: insert: G1/G2: P < 0.001 Anderson et al., G1: 27/49 (55) G1: 26.82 ± 18.4 ABC lethargy/ 2007ª G2: 28/49 (57) (n=17) social withdrawal Aman et al., 2008§ Severe: G2: 22.38 ± 9.9 score, mean ± SD: Martin et al., G1: 12/49 (24) (n=13) Post-RCT:‡ 2004¥ G2: 12/49 (24) Dominant hand G1: 8.9 ± 6.4 (continued) Extreme: drops: G2: 12.0 ± 8.3 G1: 1/49 (2) G1: 2.35 ± 1.9 G1/G2: P = 0.03 Design: G2: 0 (n=17) (ES = 0.4) Randomized trial Other characteristics, n G2: 2.77 ± 2.4 ABC hyperactivity with open label (%): (n=13) score, mean ± SD: continuation phase Educational placement of Nondominant hand Post-RCT:‡ child, RCT population: drops: G1: 17.0 ± 9.7 Regular class: G1: 3.24 ± 3.0 G2: 27.6 ± 10.6 G1: 5/47 (11) (n=17) G1/G2: P < 0.001 G2: 3/50 (6) G2: 2.31 ± 2.4 (ES = 1.0) Special education program: (n=13) ABC inappropriate C-118
Evidence Table. Therapies for children with ASD (continued) Study Inclusion/ Exclusion Baseline Description Intervention Criteria/ Population Measures Outcomes G1: 42/47 (89) Both hands inserts: speech score, G2: 46/50 (92) G1: 59.59 ± 35.3 mean ± SD: Residential school: (n=17) Post-RCT:‡ G1: 0 G2: 46.46 ± 19.5 G1: 3.0 ± 3.1 G2: 1/50 (2) (n=13) G2: 5.9 ± 3.8 Current anticonvulsant Both hands drops: G1/G2: P = 0.03 treatment, RCT population: G1: 5.59 ± 4.0 (ES = 0.3) G1: 2/49 (4) (n=17) VABS maladap- G2: 2/49 (4) G2: 5.08 ± 4.3 tive behavior Previous medication, RCT (n=13) score, part 1, population: Sensory: mean ± SD:^ None: RLRS score, mean ± Post-RCT: G1: 8/41 (20) SD:^ G1: 14.89 ± 5.93 G2: 10/35 (29) Sensory motor G2: 22.97 ± 5.99 Antipsychotic agent: behaviors: G1/G2: P < 0.001 G1: 4/41 (10) G1: 1.00 ± 0.52 (ES = 1.17) G2: 1/35 (3) G2: 0.93 ± 0.58 Post-extension SSRI: Sensory responses: phase: G1: 6/41 (15) G1: 1.13 ± 0.53 G1: 16.55 ± 6.87 G2: 10/35 (29) G2: 1.21 ± 0.53 VABS maladap- Stimulant: tive behavior G1: 14/41 (34) score, part 2, G2: 7/35 (20) mean ± SD:^ Alpha-2 adrenergic agonist: Post-RCT: G1: 9/41 (22) G1: 5.45 ± 3.25 G2: 7/35 (20) G2: 7.30 ± 3.45 Child living at home with at G1/G2: P = 0.02 least 1 parent, RCT population: 92 (91) (ES = 0.49) Aman et al., 2005 Educational/ Post-extension McDougle et al., cognitive/ phase: 2005^ academic G1: 5.04 ± 3.20 Arnold et al., attainment: VABS maladap- 2003† Cancellation task, tive behavior total RUPP, 2002‡ mean ± SD:§ score, mean ± Williams et al, Correct detections: SD:^ 2006º G1: 126.75 ± 46.9 Post-RCT: Anderson et al., (n=12) G1: 20.34 ± 7.93 2007ª G2: 110.71 ± 56.3 G2: 30.27 ± 8.87 Aman et al., 2008§ (n=7) G1/G2: P < 0.001 Martin et al., Commissions: (ES = 1.03) 2004¥ G1: 6.50 ± 22.2 Post-extension (continued) (n=12) phase: G2: 2.29 ± 4.3 (n=7) G1: 21.60 ± 9.50 Omissions: Target symptom G1: 11.75 ± 22.6 ratings (lower (n=12) scores better) G2: 19.00 ± 20.3 post-RCT, mean ± (n=7) SD:† Analogue classroom G1: 2.8 ± 1.16 task, mean ± SD:§ (n=44) Number attempted: G2: 4.5 ± 1.28 G1: 22.88 ± 14.7 (n=43) (n=8) G1/G2: P < 0.001 G2: 31.63 ± 11.0 (ES = 1.39) (n=8) Adaptive Number correct: behavior: C-119
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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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individual intervention is warrante
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selecting participants for their st
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studies lacked an arm that consider
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23. Kanner L. Autistic Disturbances
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62. Dosman CF, Drmic IE, Brian JA,
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104. Ben-Itzchak E and Zachor DA. T
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142. Tyminski RF and Moore PJ. The
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177. Aman MG, McDougle CJ, Scahill
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214. Correia CT, Almeida JP, Santos
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252. Akhondzadeh S, Tajdar H, Moham
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290. Dawson G, Rogers S, Munson J,
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Acronyms/Abbreviations ABA Applied
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Appendix A. Exact Search Strings an
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Table A2. PsycINFO search strategie
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Therapies for Children with Autism
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Therapies for Children with ASD Sys
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Appendix C. Evidence Tables Tables
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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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546. Case-Smith J and Miller H. Occ
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748. Davidovitch M, Holtzman G and
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805. Devlin SD, Harber MM. Collabor
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863. Dudley LL, Johnson C and Barne
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924. Elder JH. In-home communicatio
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1324. Hare DJ, Jones JPR and Paine
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1989. Liptak GS, Orlando M, Yinglin
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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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