Abstract
Objectives. We aimed to summarize and critically evaluate the available evidence regarding the efficacy and safety of acupuncture for children with autism spectrum disorder (ASD). Methods. We searched 13 databases for studies published up to December 2016. Randomized controlled trials (RCTs) evaluating the efficacy of acupuncture for children with ASD were included. Outcome measures were the overall scores on scales evaluating the core symptoms of ASD and the scores for each symptom, such as social communication ability and skills, stereotypies, language ability, and cognitive function. Effect sizes were presented as mean differences (MD). Results. Twenty-seven RCTs with 1736 participants were included. Acupuncture complementary to behavioral and educational intervention significantly decreased the overall scores on the Childhood Autism Rating Scale (CARS) (MD −8.10, 95% CI −12.80 to −3.40) and the Autism Behavior Checklist (MD −8.92, 95% CI −11.29 to −6.54); however, it was unclear which of the ASD symptoms improved. Acupuncture as a monotherapy also reduced the overall CARS score. The reported adverse events were acceptable. Conclusions. This review suggests that acupuncture may be effective and safe for pediatric ASD. However, it is not conclusive due to the heterogeneity of the acupuncture treatment methods used in the studies.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an etiology that remains incompletely understood
When acupuncture was added to behavioral and educational interventions (BEI), the meta-analyses showed that reductions of the overall Childhood Autism Rating Scale (CARS) [32, 33, 35, 36, 45], ABC1 [32, 38], and Autism Treatment Evaluation Checklist (ATEC) scores [29, 40, 43] were higher after treatment than for BEI alone (CARS, mean differences (MD) −8.10, 95% CI −12.80 to −3.40, I2 = 98%; ABC1, MD −8.92, 95% CI −11.29 to −6.54, I2 = 51%; ATEC, MD −12.28, 95% CI −14.74 to −9.82, I2 = 33%)
The outcome assessment of our review was summarized in two aspects: improvement of overall symptoms of ASD and improvement in each of the major symptom categories of ASD
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an etiology that remains incompletely understood. The core symptoms of ASD include persistent deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, or activities [1]. The prevalence of ASD as reported in various studies ranges from as low as 1 in 500 to as high as 1 in 50 [2, 3]. Many types of treatments are available for ASD, but none have yet been developed that effectively treat the core symptoms. Conventional treatments for ASD include pharmacological therapy and behavioral and educational interventions (BEI). Risperidone, a commonly used medication for the treatment of maladaptive behaviors in ASD, has adverse effects such as weight gain, fatigue, drowsiness, and tremors [4, 5]. The majorities of high quality BEI require 20 to 40 hours of treatment per week, and take a long time to show benefits [6,7,8]
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