Therapies for Children With Autism Spectrum Disorders

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Evidence Table. Therapies for children with ASD Study Inclusion/Exclusion Baseline Description Intervention Criteria/Population Measures Outcomes Author: Intervention: Inclusion criteria: Social Skills: Social skills: Bauminger et al., Group-centered social • Diagnosis of ASD from Specific Specific 2007 multimodal Cognitive prior assessment by companionship companionship Country: Behavioral-Ecological licensed psychologists behaviors, behaviors, mean Israel intervention: within using DSM-IV mean ± SD: ± SD: Practice teacher-led small groups Exclusion criteria: Mutual planning: Mutual planning: setting: Academic of peers that included 2 • See inclusion criteria typical peers and between Age, months ± SD: G1: 1.69 ± 0.73 Cooperation: G1: 2.19 ± 0.84 G1/BL: P < 0.01 Intervention 1 and 3 high functioning G1a: 105.4 ± 7.24 G1: 2.08 ± 1.16 Cooperation: setting: children with ASD. The G1b: 110.78 ± 15.06 Eye contact: G1: 3.58 ± 1.39 School research coordinator Mental age: G1: 2.50 ± 0.76 G1/BL: P < 0.001 Enrollment period: supported each teacher once monthly. Verbal IQ, mean ± SD: G1a: 104.09 ± 14.28 Negotiation: G1: 1.15 ± 0.36 Eye contact: G1: 2.65 ± 1.12 NR Duration: 7 months G1b: 110.62 ± 14.44 Sharing: G1/BL: P = NS Funding: Group lesson included G1a/G1b: P = NS G1: 2.00 ± 0.93 Negotiation: Israel Foundation Trustees teaching process to set “definitions and rules” for PIQ, mean ± SD: G1a: 109.73 ± 9.12 Positive interaction, social behaviors, G1: 1.23 ± 0.65 G1/BL: P = NS Author industry participants and practice G1b: 116.92 ± 16.44 mean ± SD: Sharing: relationship process that allowed G1a/G1b: P = NS Group: G1: 2.58 ± 1.20 disclosures: NR rehearsal of learned skills Full IQ, mean ± SD: Social skills training G1a: 108.09 ± 8.62 G1a: 8.27 ± 10.01 G1b: 9.86 ± 8.82 G1/BL: P < 0.05 Positive inter- Design: consisted of 50 lessons G1b: 115.08 ± 13.68 G1a/G1b: P = NS action, social Retrospective focusing on group G1a/G1b: P = NS Dydactic: behaviors, mean case series behavior and practicing Gender, n: G1a: 25.45 ± 23.98 ± SD: Note: See related study behavior, covering: • Instruction in prere- Male: G1a: 10 G1b: 34.86 ± 27.73 G1a/G1b: P = NS Group: G1a: 4.36 ± 6.75 with 11 quisite concepts for G1b: 14 Low-level inter- G1b: 14.26 ± overlapping group involvement Female: action, social 16.48 participants, Bauminger et al., 2007{#422} • Affective education G1a: 1 focusing mainly on G1b: 1 higher processes of Race/ethnicity: emotional under- NR standing SES: • Group conversation Maternal education: NR skills Household income: NR • Cooperative skills Diagnostic approach: • Double message issues Referred from prior Assessments: assessment by Observed direct and psychologists, diagnosis indirect treatment effects verified In Study on social cognitive Diagnostic tool/method: capabilities, children’s DSM-IV, ADI-R change in overt cooper- Diagnostic category, n: ative skills within and High functioning autism: outside the group. All G1a: 7 measures administered G1b: 10 once before and once Aspergers: after treatment. G1a: 4 Groups: G1b: 5 G1: individual intervention Ga: original group Gb: newly recruited behaviors, mean ± Dydactic: SD: G1a: 29.45 ± 9.67 Group: G1b: 27.73 ± G1a: 14.09 ± 7.1 18.01 G1b: 10.73 ± 8.14 Low-level inter- G1a/G1b: P = NS action, social Dydactic: behaviors, mean G1a: 15.36 ± 10.26 ± SD: G1b: 21.00 ± 15.40 Group: G1a/G1b: P = NS G1a: 14.36 ± 4.41 Negative interaction, G1b: 11.86 ± 7.33 social behaviors, Dyadic: mean ± SD: G1a: 11.09 ± 5.50 Group: G1b: 14.86 ± G1a: 0.91 ± 1.22 10.02 G1b: 0.6 ± 1.12 Negative inter- G1a/G1b: P = NS action, social Dydactic: behaviors, mean G1a: 5.09 ± 5.32 ± SD: G1b: 2.26 ± 2.21 Group: G1a/G1b: P = NS G1a: 1 ± 1.34 G1b: 0.87 ± 1.41 Bauminger et al., Provider: Other characteristics: Problem solving Dydactic: 2007 (continued) Special education teacher ADI social score, mean ± initiation behavior, G1a: 6.09 ± 4.82 Measure of treatment SD: mean ± SD: G1b: 2.46 ± 3.90 fidelity reported: G1a: 17.45 ± 3.90 G1a: 4.72 ± 2.41 ANOVA: social NR G1b: 17.64 ± 3.62 G1b: 4.33 ± 2.52 behavior type C-182
Evidence Table. Therapies for children with ASD Study Inclusion/Exclusion Baseline Description Intervention Criteria/Population Measures Outcomes Co-interventions held G1a/G1b: P = NS Number of social (group/didactic; stable during treatment: ADI communication score, solutions, mean ± P < 0.001), group NR mean ± SD: SD: (newly recruited/ Concomitant therapies: G1a: 13.27 ± 4.88 G1a: 55.71 ± 17.80 original; P < 0.05) NR G1b: 13.71 ± 4.28 G1b: 47.25 ± 17.74 Problem solving N at enrollment: G1a/G1b: P = NS TOM strange initiation behavior, G1a: 11 ADI behavior score, mean stories, mean ± SD: mean ± SD: G1b: 15 ± SD: Comprehension: G1a: 6.54 ± 4.03 N at follow-up: G1a: 5.00 ± 1.34 G1a: 4.45 ± 1.03 G1b: 5.80 ± 2.33 G1a: 11 G1b: 5.79 ± 1.52 G1b: 4.13 ± 0.91 G1/BL: P < 0.01 G1b: 15 G1a/G1b: P = NS Justification: Number of social G1a: 3.63 ± 2.46 solutions, mean ± G1b: 4.2 ± 3.02 SD: Executive function, G1a: 58.60 ± mean ± SD: 23.74 Number of sorts G1b: 59.32 ± performed: 13.99 G1a: 9.18 ± 2.18 G1/BL: P < 0.05 G1b: 8.13 ± 4.27 TOM strange Strategies stories, mean ± generated: SD: G1a: 9.18 ± 2.52 Comprehension: G1b: 8 ± 4.05 G1a: 4.09 ± 1.37 Strategies G1b: 4.26 ± 0.45 recognized: G1/BL: P = NS G1a: 9 ± 3.13 Justification: G1b: 7.40 ± 3.92 G1a: 4.18 ± 2.35 Emotional G1b: 5.40 ± 2.35 understanding: G1/BL: P < 0.01 Recognition of Executive func- emotion, mean ± tion, mean ± SD: SD: Number of sorts Basic: performed: G1a: 10.90 ± 1.86 G1a: 10.45 ± 2.84 G1b: 11.60 ± 2.16 G1b: 9.46 ± 2.94 Complex: G1/BL: P < 0.001 G1a: 11.18 ± 2.08 Strategies G1b: 10.46 ± 3.22 generated: Relevancy of expla- G1a: 10.63 ± 2.84 nation, mean ± SD: G1b: 9.46 ± 2.92 Basic: G1/BL: P < 0.05 G1a: 6.90 ± 1.04 Strategies G1b: 6.53 ± 1.76 recognized: Complex: G1a: 10.27 ± 3.19 G1a: 7.00 ± 0.77 G1b: 7.80 ± 2.47 G1b: 6.33 ± 1.45 G1/BL: P < 0.05 Bauminger et al., Definition accuracy, Emotional 2007 (continued) mean ± SD: understanding: Basic: Recognition of G1a: 1.09 ± 1.51 emotion, mean ± G1b: 1.06 ± 1.33 SD: Complex: Basic: G1a: 2.36 ± 2.01 G1a: 13.81 ± 2.27 G1b: 2.80 ± 2.56 G1b: 12.66 ± 2.59 Overall: G1/BL: P = 0.056 G1a: 3.45 ± 3.41 Complex: G1b: 3.86 ± 3.64 G1a: 12.27 ± 2.10 C-183
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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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489. Campbell M, Locascio JJ, Choro
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546. Case-Smith J and Miller H. Occ
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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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863. Dudley LL, Johnson C and Barne
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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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1095. Furneaux B. Keeping the balan
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1124. Garcaa-Villamisar D, Wehman P
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1210. Gordon R, Handleman JS and Ha
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1324. Hare DJ, Jones JPR and Paine
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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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