Non-pharmacological Treatment

  • A review of five RCTs provided some evidence that involvement in social skills groups for children with ASD aged 7 to 12 can improve social competence for some children and adolescents. More research is needed in this area as all studies were conducted in the U.S. with participants of average or above average intelligence.1
  • Research studies were reviewed to determine the evidence for the effectiveness of Early Intensive Behavioural Intervention (EIBI) on functional behaviours and skills in young children with ASD. This review found there is some evidence that EIBI is an effective behavioural treatment for some children with ASD. Unfortunately, the small number of RCTs limits the availability of evidence and the ability to make stronger conclusions.2
  • EIBI has demonstrated a moderate to large effect on non-verbal IQ and adaptive behaviours in young children with ASD.3
  • Gluten and/or casein-free diets have been used as a complementary or alternative therapy to treat individuals with ASD. A systematic review published in 2009 states the  evidence for the efficacy of these diets is poor.4
  • Teaching parents of children with ASD strategies for interacting and managing their child’s behaviour provides an opportunity for early intervention which is found to be useful. A Cochrane review of such approaches found parental interactions did change as intended. It also showed some evidence for improvement in the childrens’ understanding of language and severity of autism characteristics. In the studies included in the review, parents received training either individually or in groups with other parents. The main objective in the majority of studies was to develop the child’s communication skills by teaching parents to be more observant and responsive during their interactions with their child.5
  • The Early Start Denver Model has reported significant gains in cognitive ability and other core deficits in preschool-aged children.6
  • A dose-response relationship was found for intensive behavioural interventions on both language and adaptive skills outcomes. Higher intensity (hours per week, minimum 20 hours) and higher duration (months or years) led to better outcomes.7

Pharmacological Treatment

  • Risperidone, an atypical antipsychotic, has been used to relieve symptoms and improve behaviour in children with ASD. Findings from RCTs indicate risperidone may be useful for symptoms such as irritability, repetitive behaviours, aggression, and hyperactivity.8,9
  • Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used to reduce anxiety and obsessive-compulsive behaviours. A systematic review of nine trials, five of which included only children evaluated four SSRIs and found no evidence to support the use of SSRIs in children with ASD.10
1Reichow, B., Steiner, A.M. & Volkmar, F. Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD008511. DOI: 10.1002/14651858.CD008511.pub2
2Reichow, B., Barton, E.E., Boyd, B.A. & Hume, K. Early intensive behavioural intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD009260. DOI: 10.1002/14651858.CD009260.pub2
3Peters-Scheffer, N., Didden, R., Korzilius, H. & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. DOI: 10.1016/j.rasd.2010.03.011.
4Millward, C., Ferriter, M., Calver, S.J. & Connell-Jones, G.G. Gluten and casein-free diets for autism spectrum disorder. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD003498. DOI: 10.1002/14651858.CD003498.pub3
5Oono, I.P., Honey, E.J., & McConachie, H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2
6Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J. et al. (2010). Randomized controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17-e23.
7Virués-Ortega, J. (2010). Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose-response meta-analysis of multiple outcomes. Clinical Psychology Review, 30(4), 387-399.
8Jesner, O.S., Aref-Adib, M. & Coren, E. Risperidone for autism spectrum disorder. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD005040. DOI:10.1002/14651858.CD005040.pub2
9McPheeters, M.L., Warren, Z., Sathe, N., Bruzek, J.L., Krishnaswami, S., et al. (2011). A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics, 127(5), e1312-e1321.
10Williams, K., Brignell, A., Randall, M., Silove, N. & Hazell, P. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004677. DOI: 10.1002/14651858.CD004677.pub3
**Anagnostou, E., Zwaigenbaum, L., Szatmari, P., Fombonne, E., Fernandez, B.A., et al. (2014). Autism spectrum disorder: Advances in evidence-based practice. Canadian Medical Association Journal, 186(7), 509-519. **need to digest this further