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: Inclusion criteria: Commonly Commonly Chalfant et al., Intervention: • Met criteria for an anxiety occurring occurring co- 2007 CBT based on “cool kids” Disorder beyond their comoribidities: morbidities: (Lyneham, Abbott, ASD symptoms. Child Report: Child Report: Country: Wignall, & Rapee, 2003) • Children with frequent , Children’s Automatic Children’s Australia consisted of recognition of irrational fears and Thoughts Scale Automatic Practice anxious feelings and reactions to anxiety, avoidant behaviors (internalizing), mean Thoughts Scale ± SD: (internalizing), setting: cognitive restructuring Exclusion criteria: G1: 43.82 ± 22.91 mean ± SD: Academic Intervention setting: Clinic Enrollment period: NR Funding: NR strategies, coping self- • Intellectual delay talk, exposure to feared • Physical disability stimuli, and relapse • Currently taking anti- prevention; 2-hr weekly anxiety or anti- sessions for 9 weeks, and depressant medication three monthly booster • Those presenting with sessions totaling 12 marked externalizing sessions difficulties (e.g. Conduct Disorder or Oppositional Groups: Defiant Disorder) or G1: CBT whose parents were G2: Wait-list control experiencing acute marital breakdown Provider: G2: 54.58 ± 14.8 G1: 10.39 ± 5.56 G2: 51 ± 11.87 Revised Children’s Manifest Anxiety Revised Scale, mean ± SD: Children’s G1: 15.86 ± 3.33 Manifest Anxiety G2: 17.58 ± 4.10 Scale, mean ± SD: Spence Children’s G1: 4.93 ± 2.55 Anxiety Scale, mean G2: 16.74 ± 4.63 ± SD: G1: 43.57 ± 12.74 Spence Children’s G2: 42.26 ± 8.53 Anxiety Scale, mean ± SD: • Clinical psychologist G1: 13.79 ± 10.96 G2: 41.37 ± 9.09 Author industry relationship disclosures: NR Design: RCT Chalfant et al., 2007 (continued) Assessment: Multi-modal and multiperson assessment Self report: RCMAS, SCAS, CATS Parent-report: SCAS, SDQ Teacher report: SDQ Measure of treatment fidelity reported: No Co-interventions held stable during treatment: NR Concomitant therapies: NR N at enrollment: G1: 32 G2: 19 N at follow-up: G1: 28 G2: 19 Age, mean/years ± SD: G1 and G2 combined: 10.8 ± 1.35 Range: 8-13 years Mental age: NR Gender: G1 and G2 combined M, n (%): 35 (74) F, n (%): 12 (26) Race/ethnicity: NR SES: Maternal education: NR Household income: NR Diagnostic approach: In Study (method): Independent diagnosis; confirmed during baseline Referral (method): Community health centers, mental health professionals, medical practitioners, and parents Diagnostic tool / method: Diagnosed by pediatrician, C-196 Children’s Automatic Thoughts Scale (hostile intent), mean ± SD: G1: 14.75 ± 8.61 G2: 11.21 ± 5.67 Parent Report: Spence Children’s Anxiety Scale – Parent report, mean ± SD: G1: 44.96 ± 13.7 G2: 46.79 ± 10.95 Strengths and difficulties questionnaire – Parent report (emotional) , mean ± SD: G1: 7.25 ± 1.88 G2: 7.37 ± 2.48 Strengths and difficulties questionnaire – Parent report (externalizing) , mean ± SD: G1: 6.96 ± 4.29 G2: 5.95 ± 5.23 Teacher report: Strengths and Children’s Automatic Thoughts Scale (hostile intent), mean ± SD: G1: 9.54 ± 5.64 G2: 11.37 ± 5.25 Parent Report: Spence Children’s Anxiety Scale – Parent report, mean ± SD: G1: 13.96 ± 5.11 G2: 44.16 ± 9.04 Strengths and difficulties questionnaire – Parent report (emotional) , mean ± SD: G1: 2.75 ± 1.38 G2: 8.21 ± 1.03 Strengths and difficulties
Evidence Table. Therapies for children with ASD Study Inclusion/Exclusion Description Intervention Criteria/Population Psychiatrists or psychologists Diagnostic category, n (%): G1 and G2 combined Chalfant et al., 2007 (continued) High Functioning Autistic Disorder: 13 (28) Asperger’s Disorder: 34 (72) Other characteristics, n (%): G1 and G2 combined SAD: 8 (17) GAD: 14 (30) SP: 20 (43) SpP: 3 (6) PD: 2 (4) ADHD: 13 (28) G1, %: SAD: 18 GAD: 32 SP: 43 SpP: 4 PD: 4 G2, %: SAD: 16 GAD: 26 SP: 42 SpP: 11 PD: 5 C-197 Baseline Measures Outcomes difficulties questionnaire – questionnaire – Parent report Teacher report (externalizing) , (emotional) , mean ± mean ± SD: SD: G1: 3.82 ± 3.12 G1: 5.61± 1.99 G2: 6.32 ± 2.14 G2: 6.32 ± 4.92 Teacher report: Strengths and Strengths and difficulties difficulties questionnaire – questionnaire – Teacher report Teacher report (externalizing) , (emotional) , mean ± SD: mean ± SD: G1: 5.79 ± 4.52 G1: 2.39 ± 1.45 G2: 4.79 ± 4.65 G2: 6.89 ± 1.82 Number of anxiety disorder diagnoses between G1 & G2 at pre- treatment: G1 vs. G2 NS, P>0.05 No significant difference elicited between G1 & G2 for any of the child/parent or teacher reported measures (P > 0.05) Strengths and difficulties questionnaire – Teacher report (externalizing) , mean ± SD: G1: 2.75 ± 2.32 G2: 4.89 ± 4.58 Comparisons: Number of anxiety disorder diagnoses between G1 & G2 at pre-post treatment: Time effect: F=73.66 P < 0.001 Time X group: F=63.79 P < 0.001 Within G1 Pre vs. post F=10.41 P < 0.01 Within G2 Pre vs. Post P > 0.05 Within Post trt G1 vs. G2 t=5.07 P < 0.01 Child report measures:
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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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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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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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