Therapies for Children With Autism Spectrum Disorders

Evidence Table. Therapies for children with ASD
Study
Inclusion/Exclusion Baseline
Description Intervention
Criteria/Population Measures Outcomes
Author:
Intervention:
Inclusion criteria: Communication/
Howlin et al., 2007 PECS: 2-day workshop • Formal clinical autism language:
Country:
(13 hours) for teachers diagnosis and meet ADOS language
UK
plus 6 half day school- criteria for autism or impairment score,
Practice
based trainings sessions ASD (ADOS-G) mean ± SD:
setting:
Academic
Intervention
setting:
School
Enrollment
period:
NR
Funding:
NR
Author industry
relationship
disclosures:
None
Design:
RCT, not masked
with expert consultants • Little or no functional G1: 2.7 ± 1.4
over 5 months
language
G2: 3.4 ± 0.8
Assessments:
• No evidence of sensory G3: 2.5 ± 1.5
ADOS-G, BPVT and impairment
G1/G2: P < 0.05
EOWPVT administered • Age 4-11 years G1/G3: P = NS
by researchers in school • Not using PECS beyond G2/G3: P < 0.05
setting
Phase 1
Non-verbal mental
Groups:
• Each class was required
age equivalent/
18 classrooms (from 15
to have a minimum of 3
chronological age x
schools) were random-
children who met the
100, mean ± SD:
ized into 6 classes per
above criteria
G1: 25.9 ± 11.4
group
Exclusion criteria:
G2: 22.7 ± 8.2
G1: immediate treatment
G3: 27.3 ± 10.2
• See inclusion criteria
G2: delayed treatment
Age, months ± SD
ADOS total
(recieved PECS 2 terms
(range):
algorithm scores,
after study entry)
G1: 73.1 ± 15.8
mean ± SD:
G3: no treatment
G1: 16.4 ± 2.7
(47.3-106.3)
Provider:
G2: 86.6 ± 12.7 (62-113.5)
G2: 16.9 ± 2.9
• Teachers trained to G3: 85.6 ± 13.6 (61-122.1)
G3: 15.3 ± 3.2
teach PECS
Mental age:
• PECS consultants NR
Measure of treatment Gender, n (%):
fidelity reported: Male:
No
G1: 21 (81)
Measure of observer G2: 27 (90)
reliability reported: G3: 25 (89)
Yes
Female:
Co-interventions held G1: 5 (19)
stable during treatment: G2: 3 (10)
NR
G3: 3 (11)
Concomitant therapies: Race/ethnicity:
NR
NR
N at enrollment: SES:
G1: 30
Maternal education: NR
G2: 29
Household income: NR
G3: 29
Diagnostic approach:
N at follow-up:* Referral; diagnosis
G1: 25
confirmed in study
G2: 30
Diagnostic tool/method:
G3: 28
ADOS-G
Diagnostic category, n
(%):
Autism: 75 (89)
ASD: 9 (11)
Howlin et al., 2007
(continued)
C-221
Overall ratings:
Rate of initiations,
more likely to be
in higher initiation
rate category,
pre- to posttreatment,
OR
(95% CI):
G1+G2/G3: 2.73
(1.22-6.08)
Rate of initiations,
children moved
up one or more
categories, pre- to
post-treatment,
%:
G1+G2: 51.8
G3: 25.0
No change:
G1+G2: 28.6
G3: 35.7
Moved down one
or more
categories:
G1+G2: 19.6
G3: 39.3
Rate of initiations,
more likely to be
in higher initiation
rate category,
post-treatment to
10 month followup,
OR (95% CI):
G1/G3: 1.08
(0.30-3.90)
Communication/
Language:
Rate of speech,
pre- to posttreatment,
OR
(95% CI):
G1+G2/G3: 1.10
(0.46-2.62)
ADOS-G
communication
scores, pre- to
post-treatment,
OR (95% CI):
G1+G2/G3:
0.52 (0 .24-
1.12)
Other characteristics: NR ADOS-G
reciprocal social
interaction
scores, pre- to
post-treatment,