Medical Therapies for Children with Autism Spectrum Disorder—An Update

Project Summary Title and Description

Title
Medical Therapies for Children with Autism Spectrum Disorder—An Update
Description
This review was conducted to evaluate the comparative effectiveness and safety of medical interventions (defined broadly as interventions involving the administration of external substances to the body or use of external, non-behavioral procedures to treat symptoms of ASD) for children with Autism Spectrum Disorder (ASD). This report is a update on a previous report from 2011.
Attribution
N/A
Authors of Report
N/A
Methodology description
We included comparative studies of medical interventions that included at least 10 children with ASD between 2 and 12 years old. Two investigators independently screened studies and rated risk of bias. We extracted and summarized data qualitatively given significant heterogeneity. We also assessed strength of the evidence (SOE) and considered cumulative data from eligible studies included in our 2011 review of ASD therapies and newly published studies.
PROSPERO
N/A
DOI
10.26300/5xpm-0852
Notes
Data entered retrospectively into SRDR. Outcome data,demographics data, and harms data files have been uploaded.
Funding Source
N/A

Key Questions

1. KQ1: Among children ages 2-12 with ASD, what is the comparative effectiveness (benefits and harms) of medical treatments? a) What are the effects on core symptoms (e.g., deficits in social communication and interaction; restricted, repetitive patterns of behavior, interests, or activities including hyper- or hypo- reactivity to sensory input or unusual interest in sensory aspects of the environment) in the short term (≤6 months)? b) What are the effects on commonly associated symptoms (e.g., motor, medical, mood/anxiety, irritability, and hyperactivity) in the short term (≤6 months)? c) What are the longer-term effects (>6 months) on core symptoms (e.g., social deficits, communication deficits, and repetitive behaviors)? d) What are the longer-term effects (>6 months) on commonly associated symptoms (e.g., motor, medical, mood/anxiety, irritability, and hyperactivity)?
2. KQ2: Among children ages 2-12 with ASD, what are the modifiers of outcome for different medical treatments? a. Is the effectiveness of the therapies reviewed affected by the frequency, duration, intensity, or dose of the intervention? b. Is the effectiveness of the therapies reviewed affected by co-interventions or prior treatment, or the training and/or experience of the individual providing the therapy? c. What characteristics (e.g., age, symptom severity), if any, of the child modify the effectiveness of the therapies reviewed? d. What characteristics, if any, of the family modify the effectiveness of the therapies reviewed?
3. KQ3: What is the time to effect of interventions?
4. KQ4: What is the evidence that effects measured at the end of the treatment phase predict long-term functional outcomes of interventions?
5. KQ5: Is the effectiveness of interventions maintained across environments or contexts (e.g., people, places, materials)?
6. KQ6: What evidence supports specific components of treatment as driving outcomes, either within a single treatment or across treatments?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
A randomized, double-blind comparison of atomoxetine and placebo on response inhibition and interference control in children and adolescents with autism spectrum disorder and comorbid attention-deficit/hyperactivity disorder symptoms.2013
Atomoxetine in autism spectrum disorder: no effects on social functioning; some beneficial effects on stereotyped behaviors, inappropriate speech, and fear of change.2014
A randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorder.2012
Long-term treatment with atomoxetine for attention-deficit/hyperactivity disorder symptoms in children and adolescents with autism spectrum disorder: an open-label extension study.2013
Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial.2006
Positive effects of methylphenidate on hyperactivity are moderated by monoaminergic gene variants in children with autism spectrum disorders.2014
Effects of extended release methylphenidate treatment on ratings of attention-deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms.
Extended-Release Guanfacine for Hyperactivity in Children With Autism Spectrum Disorder.
Comparing Efficacy and Side Effects of Memantine vs. Risperidone in the Treatment of Autistic Disorder.2016
A head-to-head comparison of aripiprazole and risperidone for safety and treating autistic disorders, a randomized double blind clinical trial.2014
Head-to-Head Comparison of Aripiprazole and Risperidone in the Treatment of ADHD Symptoms in Children with Autistic Spectrum Disorder and ADHD: A Pilot, Open-Label, Randomized Controlled Study.2016
Positive effects of methylphenidate on inattention and hyperactivity in pervasive developmental disorders: an analysis of secondary measures.
Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity.2005
Tolerability, Safety, and Benefits of Risperidone in Children and Adolescents with Autism: 21-Month Follow-up After 8-Week Placebo-Controlled Trial.2015
Sensitivity of the modified Children's Yale-Brown Obsessive Compulsive Scale to detect change: Results from two multi-site trials.2016
Brief Report: social disability in autism spectrum disorder: results from Research Units on Pediatric Psychopharmacology (RUPP) Autism Network trials.2013
Moderators, mediators, and other predictors of risperidone response in children with autistic disorder and irritability.2010
Initial severity and efficacy of risperidone in autism: Results from the RUPP trial.2016
Cognitive effects of risperidone in children with autism and irritable behavior.2008
Acute and long-term safety and tolerability of risperidone in children with autism.2005
Risperidone for the core symptom domains of autism: results from the study by the autism network of the research units on pediatric psychopharmacology.2005
Weight and leptin changes among risperidone-treated youths with autism: 6-month prospective data.2004
Risperidone in children with autism and serious behavioral problems.2002
Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials.2003
Risperidone treatment of autistic disorder: longer-term benefits and blinded discontinuation after 6 months.
Risperidone and adaptive behavior in children with autism.2006
Effects of short- and long-term risperidone treatment on prolactin levels in children with autism.2007
Aripiprazole in the treatment of irritability in pediatric patients (aged 6-17 years) with autistic disorder: results from a 52-week, open-label study.2011
Line-item analysis of the Aberrant Behavior Checklist: results from two studies of aripiprazole in the treatment of irritability associated with autistic disorder.2010
Effect of aripiprazole 2 to 15 mg/d on health-related quality of life in the treatment of irritability associated with autistic disorder in children: a post hoc analysis of two controlled trials.2012
Safety and tolerability of aripiprazole for irritability in pediatric patients with autistic disorder: a 52-week, open-label, multicenter study.
Safety and tolerability of aripiprazole in the treatment of irritability associated with autistic disorder in pediatric subjects (6-17 years old):results from a pooled analysis of 2 studies.2011
A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder.2009
Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder.2009
Risperidone dosing in children and adolescents with autistic disorder: a double-blind, placebo-controlled study.2013
An open-label extension study of the safety and efficacy of risperidone in children and adolescents with autistic disorder.
A randomized controlled trial investigating the safety and efficacy of aripiprazole in the long-term maintenance treatment of pediatric patients with irritability associated with autistic disorder.2014
Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders.2004
Risperidone in children with autism: randomized, placebo-controlled, double-blind study.2006
Risperidone versus haloperidol in children and adolescents with AD : a randomized, controlled, double-blind trial.2008
Body mass index change in autism spectrum disorders: comparison of treatment with risperidone and aripiprazole.2014
Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study.2005
Tetrahydrobiopterin as a treatment for autism spectrum disorders: a double-blind, placebo-controlled trial.2013
Tetrahydrobiopterin in the treatment of children with autistic disorder: a double-blind placebo-controlled crossover study.2005
Atomoxetine, Parent Training, and Their Combination in Children With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.2015
A Pilot Study on the Combination of Applied Behavior Analysis and Bumetanide Treatment for Children with Autism.2015
Transplantation of human cord blood mononuclear cells and umbilical cord-derived mesenchymal stem cells in autism.2013
Controlled-release melatonin, singly and combined with cognitive behavioural therapy, for persistent insomnia in children with autism spectrum disorders: a randomized placebo-controlled trial.2012
Efficacy of Folic Acid Supplementation in Autistic Children Participating in Structured Teaching: An Open-Label Trial.2016
The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders.2010
Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial.2016
A randomised, controlled study of dietary intervention in autistic syndromes.2002
Camel Milk as a Potential Therapy as an Antioxidant in Autism Spectrum Disorder (ASD).
Are 'leaky gut' and behavior associated with gluten and dairy containing diet in children with autism spectrum disorders?2015
The Gluten-Free/Casein-Free Diet: A Double-Blind Challenge Trial in Children with Autism.2016
Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder.2015
Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebo-controlled trial.2007
Atomoxetine and Parent Training for Children With Autism and Attention-Deficit/Hyperactivity Disorder: A 24-Week Extension Study.2016
Data mining the ScanBrit study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders: behavioural and psychometric measures of dietary response.2014
Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial.2009
Hyperbaric oxygen in the treatment of childhood autism: a randomised controlled trial.2012
Melatonin versus placebo in children with autism spectrum conditions and severe sleep problems not amenable to behaviour management strategies: a randomised controlled crossover trial.2011
The short-term effects of transcranial direct current stimulation on electroencephalography in children with autism: a randomized crossover controlled trial.2015
Baseline factors predicting placebo response to treatment in children and adolescents with autism spectrum disorders: a multisite randomized clinical trial.2013
Safety and Efficacy of Memantine in Children with Autism: Randomized, Placebo-Controlled Study and Open-Label Extension.2016
Levetiracetam versus placebo in childhood and adolescent autism: a double-blind placebo-controlled study.2006
Placebo-controlled pilot trial of mecamylamine for treatment of autism spectrum disorders.2012
Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders.2010
Efficacy of Low-Dose Buspirone for Restricted and Repetitive Behavior in Young Children with Autism Spectrum Disorder: A Randomized Trial.2016
Nasal oxytocin for social deficits in childhood autism: a randomized controlled trial.2014
A randomised controlled trial of bumetanide in the treatment of autism in children.2012
Double-blind, placebo-controlled study of amantadine hydrochloride in the treatment of children with autistic disorder.2001
Corticosteroid therapy in regressive autism: a retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior.2014
Safety and efficacy of donepezil in children and adolescents with autism: neuropsychological measures.
Effect of anodal transcranial direct current stimulation on autism: a randomized double-blind crossover trial.2014
Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism.2009
A randomized controlled pilot trial of oral N-acetylcysteine in children with autism.
A randomised, double blind, placebo-controlled trial of a fixed dose of N-acetyl cysteine in children with autistic disorder.2016
A pilot randomized controlled trial of omega-3 fatty acids for autism spectrum disorder.2011
Pilot study of the effect of methyl B12 treatment on behavioral and biomarker measures in children with autism.2010
Digestive enzyme supplementation for autism spectrum disorders: a double-blind randomized controlled trial.2010
A Randomized, Placebo-controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders.2015
A randomized, placebo controlled trial of omega-3 fatty acids in the treatment of young children with autism.2015
Internet-based, randomized, controlled trial of omega-3 fatty acids for hyperactivity in autism.2014
Randomized, Placebo-Controlled Trial of Methyl B12 for Children with Autism.
Dietary docosahexaenoic acid supplementation in children with autism.2014
A prospective double-blind, randomized clinical trial of levocarnitine to treat autism spectrum disorders.2011
Minocycline as Adjunctive Treatment to Risperidone in Children with Autistic Disorder: A Randomized, Double-Blind Placebo-Controlled Trial.2016
A randomized double-blind placebo-controlled clinical trial of adjuvant buspirone for irritability in autism.2015
A randomized double blind placebo controlled clinical trial of N-Acetylcysteine added to risperidone for treating autistic disorders.2013
Double-blind, placebo-controlled trial of risperidone plus topiramate in children with autistic disorder.2010
N-acetylcysteine as an adjunctive therapy to risperidone for treatment of irritability in autism: a randomized, double-blind, placebo-controlled clinical trial of efficacy and safety.-- Not Found --
Riluzole as an adjunctive therapy to risperidone for the treatment of irritability in children with autistic disorder: a double-blind, placebo-controlled, randomized trial.2013
Celecoxib as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial.2013
Memantine as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial.2013
Double-blind, placebo-controlled trial of risperidone plus amantadine in children with autism: a 10-week randomized study.-- Not Found --
A double-blind placebo controlled trial of Ginkgo biloba added to risperidone in patients with autistic disorders.2012
A pilot double-blind placebo-controlled trial of pioglitazone as adjunctive treatment to risperidone: Effects on aberrant behavior in children with autism.2015
Galantamine efficacy and tolerability as an augmentative therapy in autistic children: A randomized, double-blind, placebo-controlled trial.2014
Double-blind placebo-controlled trial of pentoxifylline added to risperidone: effects on aberrant behavior in children with autism.2010
A double-blind placebo controlled trial of piracetam added to risperidone in patients with autistic disorder.2008
Positive Effects of Methylphenidate on Social Communication and Self-Regulation in Children with Pervasive Developmental Disorders and Hyperactivity2009
Effect of a Dietary Intervention on Autistic Behavior2003
Effects of gluten free / casein free diet in young children with autism: A pilot study2011
The Gluten-Free, Casein-Free Diet In Autism: Results of A Preliminary Double Blind Clinical Trial2006
The gluten- and casein-free diet and autism: Communication outcomes from a preliminary double-blind clinical trial2007
Randomized trial of hyperbaric oxygen therapy for children with autism2010
Donepezil hydrochloride: A double-blind study in autistic children2003
L-Carnitine supplementation improves the behavioral symptoms in autistic children2013

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