Larissa Lyra1, Luiz Eduardo Rizzo1, Camila Sá Sunahara1, Daniela Vianna Pachito2, Carolina de Oliveira Cruz Latorraca3, Ana Luiza Cabrera Martimbianco4, Rachel Riera5. 1. Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil. 2. MD, MSc. Neurologist; Postgraduate Student, Evidence-Based Health Program, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil; and Assistant Researcher at Cochrane Brazil, São Paulo (SP), Brazil. 3. Psychologist. Postgraduate Student, Evidence-Based Health Program, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 4. MSc, PhD. Physiotherapist and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 5. MD, MSc, PhD. Rheumatologist and Adjunct Professor, Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp); and Assistant Coordinator, Cochrane Brazil, São Paulo (SP), Brazil.
Abstract
CONTEXT AND OBJECTIVE: : 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. DESIGN AND SETTING: : Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: : We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: : 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. CONCLUSION: : 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.
CONTEXT AND OBJECTIVE: : 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. DESIGN AND SETTING: : Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: : We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: : 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. CONCLUSION: : 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.
Authors: Frederick R Carrick; Guido Pagnacco; Ahmed Hankir; Mahera Abdulrahman; Rashid Zaman; Emily R Kalambaheti; Derek A Barton; Paul E Link; Elena Oggero Journal: Front Neurol Date: 2018-07-05 Impact factor: 4.003
Authors: Scott A Davis; Kirsten Howard; Alan R Ellis; Daniel E Jonas; Timothy S Carey; Joseph P Morrissey; Kathleen C Thomas Journal: Health Expect Date: 2022-06-08 Impact factor: 3.318