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: Salt et al., 2002 Individualized treatment Country: focusing on social, Scotland UK Practice setting: Specialty treatment center Intervention setting: Clinic Enrollment period: NR Funding: NHS Author industry relationship disclosures: NR Design: Non-RCT communicative, play, and adaptive behaviors; 8 hours every two weeks for 11 months Parent training component focusing on behavior management and teaching new skills Assessments: All occurred pre- and post-treatment Parent reports: Standardized stress measure and satisfaction questionnaire Clinician conducted: Bayley Scales of Infant Development – 2 nd ed; British Picture Vocabulary Scale; VABS; PVCS; MCDI; Symbolic Play Test – 2 nd ed; ESCS; PSI – 3 rd Inclusion criteria: Social skills: Social skills: • Preschool age range VABS score, mean VABS • Accessible geographical ± SD: socialization location Socialization: score, mean ± • Diagnosis of Autism G1: 51.83 ± 1.9 SD: • Children not excluded on G2: 55.0 ± 3.39 G1: 54.08 ± 2.91 the basis of Symbolic play test G2: 52.8 ± 2.95 developmental delay score, mean ± SD: P < 0.05 Exclusion criteria: G1: 2.27 ± 3.5 ESCS symbolic • See inclusion criteria G2: 12.8 ± 4.82 play test score, Age, months ± SD: Communication/ mean ± SD: G1: 42.36 ± 7.16 language: G1: 6.91 ± 5.94 G2: 37.67 ± 3.08 VABS G2: 19.6 ± 3.78 Mental age, months ± SD: Communication: P = NS G1: 17 ± 5.51 G1: 51.17 ± 2.79 ESCS joint G2: 20.83 ± 2.32 G2: 54.8 ± 3.11 attention score, Gender, n (%): MCDI, mean ± SD: mean ± SD: Male: Words understood: G1: 9.11 ± 5.58 G1: 11 (92) G1: 62.55 ± 44.68 G2: 4.6 ± 2.97 G2: 3 (60) G2: 55.6 ± 42.75 P < 0.05 Female: Words produced: ESCS request G1: 1 (8) G1: 4.73 ± 7.46 behavior score, G2: 2 (40) G2: 11.6 ± 15.08 mean ± SD: Race/ethnicity, n (%): PVCS imitation G1: 10.33 ± 6.96 White: 16 (94) score, mean ± SD: G2: 6.2 ± 2.77 ed. Middle eastern: 1 (6) G1: 1.92 ± 2.15 P = NS (P < 0.06) Groups: SES: G2: 1.6 ± 0.55 ESCS social G1: (SCA) intervention NR ESCS score, mean interaction score, G2: Control/other Diagnostic approach: ± SD: mean ± SD: intervention Referral Joint attention: G1: 5.22 ± 2.73 Diagnostic tool/method: G1: 5.44 ± 3.17 G2: 3.2 ± 0.84 Duration (mean ± SD): ICD-10 (WHO, 1993) G2: 6.0 ± 3.39 P < 0.05 Non-SCA intervention diagnosis of childhood Requesting Communication/ (hrs/fortnight): autism behavior: language: Nursery: Diagnostic category, n G1: 3.67 ± 2.12 VABS communi- G1: 27.58 ± 13.32 (%): G2: 6.6 ± 5.59 cation score, G2: 38.7 ± 19.45 Autism: 17 (100) Social interaction: mean ± SD: Other 1:1 therapy: Other characteristics, IQ G1: 3.33 ± 2.0 G1: 46.17 ± 15.07 G1: 2.79 ± 9.06 (MA/CA) x 100, mean ± G2: 4.2 ± 2.86 G2: 50.6 ± 1.82 G2: 2.2 ± 2.28 SD: Adaptive behavior: P = NS G1: 39.43 ± 13.47 VABS Composite MCDI, words Provider: G2: 55.67 ± 6.59 score: understood, mean • Therapists including G1: 49.5 ± 3.75 ± SD: nursery nurses, G2: 54.6 ± 4.83 G1: 91.18 ± 68.51 teachers, OT, PT, SLT VABS Daily living G2: 79.8 ± 50.16 • Parents skills: P = NS Treatment manual G1: 53.08 ± 6.26 MCDI, words followed: G2: 59.0 ± 3.46 produced, mean ± NR Motor skills: SD: Defined protocol VABS Motor skills: G1: 17.82 ± 40.94 followed: G1: 55.92 ± 11.37 G2: 31.20 ± 22.61 NR G2: 69.8 ± 10.89 P = NS Salt et al., 2002 Measure of treatment PVCS imitation (continued) fidelity reported: score, mean ± Yes SD: Measure of reliability G1: 7.67 ± 5.35 reported: G2: 3.8 ± 0.84 C-382
Evidence Table. Therapies for children with ASD Study Inclusion/Exclusion Description Intervention Yes Co-interventions held stable during treatment: NR Concomitant therapies: NR N at enrollment: G1: 14 G2: 6 N at follow-up: G1: 12 G2: 5 Criteria/Population C-383 Baseline Measures Outcomes P < 0.05 Adaptive behavior: VABS composite score, mean ± SD: G1: 49.33 ± 7.09 G2: 48.6 ± 2.3 P < 0.05 VABS daily living skills score, mean ± SD: G1: 53.67 ± 9.93 G2: 50.8 ± 2.95 P < 0.05 Motor skills: VABS motor skill score, mean ± SD: G1: 55.92 ± 15.06 G2: 55.66 ± 5.32 P < 0.05 Harms: NR Modifiers: NR
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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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Page 519 and 520: Evidence Table. Therapies for child
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Page 599 and 600: Dunn-Geier et al., 2000 (continued)
Page 601 and 602: Evidence Table: Therapies for Child
Page 607 and 608: Appendix D. List of Excluded Studie
Page 609 and 610: 31. Aarsland D, Cummings JL and Lar
Page 611 and 612: 59. Ahearn WH, Clark KM, Gardenier
Page 613 and 614: 89. Allison DB, Basile VC and MacDo
Page 615 and 616: 118. Ando H, Yoshimura I and Wakaba
Page 617 and 618: 146. Atkinson RP, Jenson WR, Rovner
Page 619 and 620: 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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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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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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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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