Autistic people are at high risk of mental health problems, self-injury and suicidality. However, no studies have explored autistic peoples’ experiences of treatment and support for these difficult...

https://journals.sagepub.com/doi/pdf/10.1177/1362361318816053

'People Like Me Don't Get Support': Autistic Adults' Experiences of Support and Treatment for Mental Health Difficulties, Self-Injury and Suicidality.

Objective We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions. Data sources We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013. Methods We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies. Results We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness. Conclusions A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update

Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.

http://journals.sagepub.com/doi/pdf/10.1177/1362361316646559

Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review

Little information is available about autism spectrum disorder services in the Kingdom of Saudi Arabia. A sample of 205 parents completed an online survey about the use of autism spectrum disorder services for their children. The results revealed that on average, children began services by 3.3 years. Most parents reported utilizing non-medical treatments followed by biomedical treatments and cultural and religious treatment. The age at the initiation of services and the type of treatments used differed by parent’s income, educational attainment, the extent of knowledge about autism spectrum disorders, and geographic location. Some child characteristics also influenced the use of services. The disparities in service utilization in Saudi Arabia point to the need to develop policy and interventions that can mitigate the paucity of services for children with autism spectrum disorders. More research is needed to better understand service use and the decision-making processes that underlie treatment selection b...

Services for children with autism in the Kingdom of Saudi Arabia

Background
Early intervention (EI) can improve a range of outcomes for families of children with developmental disabilities. However, research indicates the level of access does not always match the level of need. To address disparities, it is essential to identify factors influencing access.

Method
We propose a framework where access to EI is conceptualised as a process that includes three main phases. A narrative review examined potential barriers, facilitators and modifiers of access for each phase.

Results
The process of access to EI includes the following: 1) recognition of need, 2) identification or diagnosis and 3) EI provision or receipt. Several factors affecting access to EI for each phase were identified, related to the family, services, the intersection between family and services, and the context.

Conclusion
A broad range of factors appear to influence the process of access to EI for this population. Our framework can be used in future research investigating access. Broad implications for policy, practice and future research to improve access to EI are discussed.

Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review

Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, Journal of Autism and Developmental Disorders, 32: 447–461, 2002). The purpose of this study was to examine the types of treatments in current use by families of children with ASD. In addition, parents’ perceptions of improvement in their child’s functioning were explored. Through an online survey, a sample of 970 parents of ASD children reported on the treatments currently in use, those discontinued, and reasons for discontinuation. Results indicate that most families adopt multiple treatment approaches. Parents were most likely to discontinue non-evidence based treatments when they did not see improvement in their child’s functioning.

Treatments for autism: Parental choices and perceptions of change

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Treatments for autism: Parental choices and perceptions of change