Treatments show some promise in reducing autism behaviors

McPheeters ML. Pediatrics. 2011;127:e1312-e1321.

Some medical and behavioral treatments show promise for reducing certain behaviors in children with autism spectrum disorders, but more research is needed to assess the potential benefits and harms, according to three studies published online in Pediatrics.

Vanderbilt researchers searched Medline, PsycINFO, and Education Resources Information Center (ERIC) databases for data published between 2000 and May 2010 that looked at medical as well as behavioral interventions, including the UCLA/Lovaas approach and Early Start Denver Model.

The comparative effectiveness report, funded by the Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ), found that two commonly used medications — risperidone and aripiprazole (Abilify, Otsuka) — show benefit in reducing some behaviors, including emotional distress, aggression, hyperactivity and self-injury. However, these medicines are associated with significant adverse events, such as rapid weight gain and drowsiness, the researchers said. They added that no medications used for autism spectrum disorders (ASDs) improved social behaviors or communication skills. The report also concluded that secretin, which has been studied extensively, has shown no effectiveness.

Behavioral interventions showed promise for improving some symptoms and behaviors, but their effects varied. For example, early intensive behavioral and developmental interventions seemed to improve cognitive performance, language skills and adaptive behavior in some groups of children, the report found.

Other interventions, which focused on parent training and cognitive behavioral therapy, may be useful for children with ASDs to improve social communication, language use and potentially symptom severity, researchers said.

“Autism spectrum disorders are frustrating and challenging for patients, their families and caregivers,” AHRQ Director Carolyn M. Clancy, MD, said in a press release. “This report will help parents and clinicians understand their options and design a course of treatment that is consistent with their goals and values.”

The researchers were critical of the fact that current studies contain few comparisons of medical interventions with behavioral interventions, as well as combinations of the two, despite the fact that most children undergo multiple treatments at the same time.

Because of these limitations in the available evidence, researchers were not able to compare treatments and interventions to each other. In addition, they said every case of ASD is different, and no one type of treatment is superior.

Disclosure: The researchers report financial support from AHRQ.

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