Therapies for Children With Autism Spectrum Disorders

Evidence Table. Therapies for children with ASD
Study
Description Intervention
Comments: *after controlling for age, IQ and baseline scores
Author:
Vorgraft et al.,
2007
Country:
Israel
Practice
setting:
Academic
Intervention
setting:
Residential and
home
Enrollment
period:
1997 to 1999
Funding:
NR
Author industry
relationship
disclosures:
NR
Design:
Case series,
retropective
Intervention:
Mifne treatment: family
attends a residential
treatment facility for 3
weeks; therapy is
provided together and
separately for each family
member, followed by
intensive home care for
6-18 months, and a
gradual integration into
nursery. Reciprocal play
therapy attempts to
gradually introduce social
interactions to the child by
using the child’s lead.
Assessments:
Assessments by trained
raters of videotapes of
child in home and clinic
(Mifne) settings
CARS, SBRS
Groups:
G1: Mifne treatment
Ga: baseline CARS total
score ≤ 27
Gb: baseline CARS total
score ≥ 28
Provider:
OT, physiotherapists,
psychologists, social
workers, and speech
therapists trained for 1.5
years and accredited
Measure of treatment
fidelity reported:
No
Co-interventions held
stable during treatment:
NR
Concomitant therapies:
NR
N at enrollment:
G1: 23
G1a: 14
G1b: 9
N at follow-up:
G1: 23
Inclusion/Exclusion
Criteria/Population
Inclusion criteria:
• Children with PDD
treated at the Mifne
Institute for whom full
documentation was
available
• DSM-IV diagnosis by
consultant child and
adolescent psychiatrists
• Diagnosis confirmation
by two senior clinicians
on the study team after
chart review
Exclusion criteria:
• See inclusion criteria
Age, months ± SD
(range):
42.8 ± 11.4 (38-49)
Mental age:
NR
Gender, n (%):
Male: 15 (65)
Female: 8 (35)
Race/ethnicity:
NR
SES:
Maternal education: NR
Household income: NR
Diagnostic approach:
In study
Diagnostic tool/method:
Based on DSM-IV
Diagnostic category, n
(%):
Autistic disorder: 14 (61)
PDD-NOS: 9 (39)
Other characteristics, n
(%):
Intellectual impairment:
2 (9)
Specific developmental
language disorder: 1 (4)
C-260
Baseline
Measures Outcomes
G1/6M: P ≤ 0.001
ANOVA: time
(P ≤ 0.001)
Harms:
NR
Modifiers:
NR
Overall ratings:
CARS score, home
video, mean ± SD:
Total:
G1: 27.7 ± 6.1
Emotional response:
G1: 2 ± 0.8
Fearful and nervous
response:
G1: 1.8 ± 0.0
Overall impression:
G1: 2.9 ± 0.7
CARS score, Mifne
video, mean ± SD:
Total:
G1: 29.7 ± 7.1
Emotional response:
G1: 2.4 ± 0.7
Fearful and nervous
response:
G1: 1.6 ± 0.9
Overall impression:
G1: 2.7 ± 0.7
SBRS score, home
video, mean ± SD:
Total:
G1: 46 ± 8.1
Awareness of
others’ emotional
states:
G1: 3.3 ± 0.7
Mutuality:
G1: 3.7 ± 0.5
Overall impression:
G1: 3 ± 0.8
SBRS score, Mifne
video, mean ± SD:
Total:
G1: 48.5 ± 7.9
Awareness of
others’ emotional
states:
G1: 3.5 ± 0.6
Joint positive
emotional
experiences:
G1: 3.4 ± 0.7
Overall ratings:
CARS score,
home video,
mean ± SD:
Total:
G1: 24.5 ± 5.3
G1/BL: P = NS
Emotional
response:
G1: 1.8 ± 0.8
G1/BL: P < 0.05
Fearful and nervous
response:
G1: 1 ± 0.0
G1/BL: P < 0.05
Overall
impression:
G1: 2.5 ± 0.8
G1/BL: P < 0.05
CARS total score,
home video,
mean change ±
SD:
G1a: -0.27 ± 3.6
G1b: 7.56 ± 7.8
G1a/BL: P = NS
G2a/BL: P < 0.05
CARS score,
Mifne video, mean
± SD:
Total:
G1: 26.7 ± 6
G1/BL: P < 0.01
Emotional
response:
G1: 2 ± 0.4
G1/BL: P < 0.05
Fearful and nervous
response:
G1: 1.1 ± 0.3
G1/BL: P < 0.05
Overall
impression:
G1: 1.7 ± 0.5
G1/BL: P < 0.05
CARS total score,
Mifne video, mean
change ± SD: