Abstract
Autism spectrum disorders (ASDs) include autistic disorder, Asperger's disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.
Highlights
Autism spectrum disorders (ASDs) have an estimated prevalence ranging from 3.3 to 116 children per 10,000 and it is widely accepted that autism affects approximately 1% of children worldwide.[1]
With greater severity of ASDs, activities of daily living are limited and the impairments of ASDs can have an important impact on learning and social functioning that may persist during adulthood.[4]
Acupuncture The review[4] considered randomized controlled trials (RCTs) and quasi-randomized controlled trials and included 10 studies on 390 children aged from 3 to 18 years who presented ASDs and received acupuncture for periods ranging from four weeks to nine months
Summary
Autism spectrum disorders (ASDs) have an estimated prevalence ranging from 3.3 to 116 children per 10,000 and it is widely accepted that autism affects approximately 1% of children worldwide.[1]. ASDs include autistic disorder, Asperger’s disorder and pervasive developmental disorder. Patients with these conditions present deficits in communication, social interaction and cognitive function; problems with feeding; hypo or hypersensitivity; and, sometimes, self-harmful behavior.[3] With greater severity of ASDs, activities of daily living are limited and the impairments of ASDs can have an important impact on learning and social functioning that may persist during adulthood.[4]. Healthcare and social care for people with ASDs is frequently complex, since they are more likely to have mental health comorbidities and suicidal ideation.[5] Assessments need to be multidisciplinary and developmental, and early detection is determinant. Therapeutic interventions need to be personalized, focusing on the specific clinical features presented by each patient.[6]
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