S H Ameis1,2,3, C Kassee1, P Corbett-Dick4, L Cole4, S Dadhwal1, M-C Lai1,2,3, J Veenstra-VanderWeele5, C U Correll6,7,8. 1. Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada. 2. Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada. 3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 4. Division of Developmental and Behavioural Pediatrics, University of Rochester School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA. 5. New York Presbyterian Hospital Center for Autism and the Developing Brain, New York State Psychiatric Institute, Columbia University, New York, NY, USA. 6. The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA. 7. Hofstra Northwell School of Medicine, Hempstead, NY, USA. 8. Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
Abstract
OBJECTIVE: Evidence-based guidance of clinical decision-making for the management of Autism Spectrum Disorder (ASD) is lacking, particularly for co-occurring psychiatric symptoms. This review evaluates treatment evidence for six common symptom targets in children/adolescents with ASD and provides a resource to facilitate application of the evidence to clinical practice. METHOD: A systematic search identified randomized controlled trials (RCTs) and high-quality systematic reviews published between 2007 and 2016, focused on: social interaction/communication impairment, stereotypic/repetitive behaviours, irritability/agitation, attention-deficit/hyperactivity disorder symptoms, mood or anxiety symptoms, and sleep difficulties. We then completed qualitative evaluation of high-quality systematic reviews/meta-analyses and quantitative evaluation of recently published RCTs not covered by prior comprehensive systematic reviews. RESULTS: Recently published RCTs focused on social interaction and communication impairment (trials = 32) using psychosocial interventions. Interventions for irritability/agitation (trials = 16) were mainly pharmacological. Few RCTs focused on other symptom targets (trials = 2-5/target). Integration of these results with our qualitative review indicated that few established treatment modalities exist, and available evidence is limited by small studies with high risk of bias. CONCLUSION: Given the current evidence-base, treatment targets must be clearly defined, and a systematic approach to intervention trials in children/adolescents with ASD must be undertaken with careful consideration of the limitations of safety/efficacy data.
OBJECTIVE: Evidence-based guidance of clinical decision-making for the management of Autism Spectrum Disorder (ASD) is lacking, particularly for co-occurring psychiatric symptoms. This review evaluates treatment evidence for six common symptom targets in children/adolescents with ASD and provides a resource to facilitate application of the evidence to clinical practice. METHOD: A systematic search identified randomized controlled trials (RCTs) and high-quality systematic reviews published between 2007 and 2016, focused on: social interaction/communication impairment, stereotypic/repetitive behaviours, irritability/agitation, attention-deficit/hyperactivity disorder symptoms, mood or anxiety symptoms, and sleep difficulties. We then completed qualitative evaluation of high-quality systematic reviews/meta-analyses and quantitative evaluation of recently published RCTs not covered by prior comprehensive systematic reviews. RESULTS: Recently published RCTs focused on social interaction and communication impairment (trials = 32) using psychosocial interventions. Interventions for irritability/agitation (trials = 16) were mainly pharmacological. Few RCTs focused on other symptom targets (trials = 2-5/target). Integration of these results with our qualitative review indicated that few established treatment modalities exist, and available evidence is limited by small studies with high risk of bias. CONCLUSION: Given the current evidence-base, treatment targets must be clearly defined, and a systematic approach to intervention trials in children/adolescents with ASD must be undertaken with careful consideration of the limitations of safety/efficacy data.
Authors: Eric Fombonne; Lisa A Croen; Joanna E Bulkley; Alexandra M Varga; Yihe G Daida; Brigit A Hatch; John F Dickerson; Frances L Lynch Journal: J Dev Behav Pediatr Date: 2021-10-21 Impact factor: 2.988
Authors: Colin Hawco; Laagishan Yoganathan; Aristotle N Voineskos; Rachael Lyon; Thomas Tan; Zafiris J Daskalakis; Daniel M Blumberger; Paul E Croarkin; Meng-Chuan Lai; Peter Szatmari; Stephanie H Ameis Journal: Neuroimage Clin Date: 2020-04-23 Impact factor: 4.881
Authors: Jordan Wickstrom; Kristin Dell'Armo; Emma Salzman; Jessica L Hooker; Abigail Delehanty; Somer Bishop; Marc J Tassé; Amy M Wetherby; Antonia M H Piergies; Diane Damiano; Alexandra Rauch; Audrey Thurm Journal: Arch Rehabil Res Clin Transl Date: 2021-07-22