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: Overall ratings: Overall ratings:
Posey et al. Guanfacine (.25-9 mg • Treated at the
CGI severity, mean CGI, n (%):
2004
daily in divided doses Autism/PDD Clinic at the ± SD:
19 (23.8) subjects
Country: Mean daily dose: 2.6 ± James Whitcomb Riley Inattention: 4.58 ± considered
US
1.7 mg
Hospital for Children 0.68
responders based
Practice
setting:
Academic
Intervention
Mean duration of
treatment: 334 ± 374
days, range 7-1776 days
N=70 (age range, 3-11
years, mean daily dose =
• Diagnosis of PDD by
DSM-IV
• History of guanfacine
treatment within the
clinic
Hyperactivity: 4.75 ± on “much
0.9
improved” or “very
Impulsivity: 4.61 ± much improved”
0.73
CGI global
Aggression/self- improvement item
injury: 4.54 ± 0.95
setting:
Clinic
Enrollment
2 mg)
N=10 (age range, 13-18
Exclusion criteria:
See inclusion criteria
Anxiety/worry: 4 ±
0.59
Irritability: 4.65 ±
CGI Global
Improvement
score, mean ±
period:
October 1997 to
April 2001
Funding:
years, mean daily dose=
3.4 mg)
Dosing frequency:
Age, mean/yrs ± SD
(range):
G1: 7.7 ±3.5 (3-18)
0.66
Insomnia: 4.04 ±
0.82
Repetitive
SD:
Responders: 1.9 ±
0.2
Non-responders:
National Alliance N=2 (once daily)
for Research in N=48 (twice daily)
Schizophrenia and N=29 (three times daily)
Depression, N=1 (four times daily)
Daniel X.
Freedman Assessments:
Psychiatric Conducted by 2 board-
Mental age:
NR
Gender:
G1:
M, n (%): 70 (87)
F, n (%): 10 (13)
behaviors: 3.67 ±
0.78
Tics: 3.83 ± 0.75
Social impairment:
4.05 ± 0.87
Language: 4.23 ±
1.04
3.6 ± 0.6
Improvement in
CGI Severity
score, mean ±
SD:
4.25 ± 0.91
Fellowship, NIMH, certified child and
and Department of adolescent psychiatrists;
Housing and CGI
Race/ethnicity:
NR
Overall:
4.83 ±0.71
T = 6.5 (P <
0.0001)
Urban
development
Author industry
Groups:
G1: Guanfacine
SES:
Maternal education: NR
Medical: mean ±
SD:
SBP:109.6 ± 13.8
CGI severity,
mean ± SD (%)
improvement, n/N
relationship
disclosures: Co-interventions held
Household income: NR DBP: 65.7 ± 10.9
Heart rate: 95.7 ±
subjects showing
improvement:
NR
Design:
Retrospective
stable during treatment: Diagnostic approach:
NR
In-study
15.8
Inattention: 3.91 ±
0.87 (21.10),
16/76
case series Frequency of contact
during study:
NR
Diagnostic tool/method:
DSM-IV criteria clinical
Hyperactivity:
3.92 ± 1.05 (26.7),
20/75
Diagnostic category, n
Impulsivity: 4.07 ±
Concomitant therapies,
n (%):
Overall: 44(55)
Atypical antipsychotics:
16 (20%)
SSRIs: 13 (16%)
(%):
G1:
Autistic disorder: 46 (56)
Asperger’s disorder: 6 (8)
PDD-NOS: 28 (35)
0.9 (17.4), 12/69
Aggression/selfinjury:
4.13 ± 1.03
(14.5), 10/69
Anxiety/worry:
3.64 ± 0.72 (11.1),
Stimulants: 9 (11%)
4/36
Non-SSRI
Irritability: 4.06 ±
antidepressants: 8 (10%)
0.92 (16.9), 13/77
Mood stabilizers: 8 (10%)
Insomnia: 3.22 ±
Conventional
0.99 (27.5), 14/51
antipsychotics: 3 (4%)
Repetitive
behaviors: 3.59 ±
N at enrollment:
0.74 (0), 0/54
G1: 80
Tics: 2.33 ± 0.82
(50), 3/6
C-339