Evidence Review Of Interventions For Autism

Three review articles in the May 2011 issue of Pediatrics (published online April 4) examine the scientific evidence behind medical, behavioral and developmental interventions for autism spectrum disorders (ASD). The studies, funded by the Agency for Healthcare Research and Quality, examined research published between 2000 and May 2010 on ASD interventions for children ages 12 and younger. Researchers found strong evidence for a few treatments, but also a critical need for additional studies to pinpoint specific approaches that are most effective for individual children. 

In "A Systematic Review of Medical Treatments for Children with Autism Spectrum Disorders ," researchers found strikingly little evidence of benefit for most medications used to treat ASDs. Medications that address challenging behavior had the strongest evidence to support their use. The antipsychotic medications risperidone and aripiprazole each have at least two randomized controlled trials that found improvements in challenging behavior, hyperactivity and repetitive behavior. However, both medications also cause significant side effects, including weight gain and sedation, which limit their use to patients with severe impairment. Insufficient evidence is available to judge the potential benefits and adverse effects of all other medications used to treat autism, including serotonin-reuptake inhibitors and stimulant medications. 

In a companion article, "A Systematic Review of Secretin for Children With Autism Spectrum Disorders," researchers examined evidence for treating children with autism with secretin, a gastrointestinal polypeptide used to treat peptic ulcers. Study authors found strong evidence that secretin is not effective for children with ASDs, and that further studies are not warranted. 

The study, "A Systematic Review of Early Intensive Intervention for Autism Spectrum Disorders," examined 34 studies of early intensive behavioral and developmental interventions for young children with ASDs. Gains were seen in studies of intensive interventions emphasizing both specific behavioral (e.g., UCLA/Lovaas approach) and developmental principles (e.g., the Early Start Denver Model). Such interventions resulted in improved cognitive performance, language skills and adaptive behavior skills in some young children with ASDs. However, few research studies were rated of good quality and the existing evidence did not provide strong evidence in favor of any single early intervention approach. Study authors conclude these early intensive intervention approaches have significant potential but need further research to determine which interventions are most likely to benefit specific children. 

Source: 
American Academy of Pediatrics