10 year studies important findings for autism

[Guest guest]

3 autism studies published in the AAP journal examined data from 2000-2010

found;

1. Medications have minimal benefits not worth the severe side effects " even in

short term use " !! (thank you for finally validating what was already

obvious!!!) This includes a list of drugs -one that just came up on this group

I have to find.

2. Secretin -no benefits at all with side effects- not worth side effects, time

and money.

3. While early intervention proved important-there were variable benefits in

all types from ABA to play based. So ABA may not necessarily be the most

appropriate for autism after all! More research is needed. Parent based home

therapy also stressed as supplemental to the professional therapies no matter

what program.

Below are the 3 abstracts and a link to this AAP page.

Selected Abstracts

Returned: 3 citations and abstracts. Click on down arrow or scroll to see

abstracts.

Zachary Warren, L. McPheeters, Nila Sathe, H. Foss-,

Glasser, and Veenstra-VanderWeele

A Systematic Review of Early Intensive Intervention for Autism Spectrum

Disorders

Pediatrics 0: peds.2011-0426v1-20110426.

L. McPheeters, Zachary Warren, Nila Sathe, L. Bruzek, Shanthi

Krishnaswami, N. Jerome, and Veenstra-VanderWeele

A Systematic Review of Medical Treatments for Children With Autism Spectrum

Disorders

Pediatrics 0: peds.2011-0427v1-20110427.

Shanthi Krishnaswami, L. McPheeters, and Veenstra-VanderWeele

A Systematic Review of Secretin for Children With Autism Spectrum Disorders

Pediatrics 0: peds.2011-0428v1-20110428.

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Abstract 1 of 3

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Review Articles

A Systematic Review of Early Intensive Intervention for Autism Spectrum

Disorders

Zachary Warren, PhDa,b, L. McPheeters, PhD, MPHc,d, Nila Sathe, MA,

MLISc, H. Foss-, MAe, Glasser, BAc,

Veenstra-VanderWeele, MDb,f,g

aDepartments of Psychiatry and Pediatrics,

bVanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum

Disorders,

cVanderbilt Evidence-Based Practice Center, Institute for Medicine and Public

Health, and

dDepartment of Obstetrics and Gynecology, Vanderbilt Medical Center,

eDepartment of Psychology and Human Development, and

fDepartments of Psychiatry, Pediatrics, and Pharmacology,

gCenter for Molecular Neuroscience, Vanderbilt University, Nashville, Tennessee

Context Early intensive behavioral and developmental interventions for young

children with autism spectrum disorders (ASDs) may enhance developmental

outcomes.

Objective To systematically review evidence regarding such interventions for

children aged 12 and younger with ASDs.

Methods We searched Medline, PsycINFO, and ERIC (Education Resources Information

Center) from 2000 to May 2010. Two reviewers independently assessed studies

against predetermined inclusion/exclusion criteria. Two reviewers independently

extracted data regarding participant and intervention characteristics,

assessment techniques, and outcomes and assigned overall quality and

strength-of-evidence ratings using predetermined criteria.

Results Thirty-four unique studies met inclusion criteria. Seventeen studies

were case series; 2 were randomized controlled trials. We rated 1 study as good

quality, 10 as fair quality, and 23 as poor quality. The strength of the

evidence overall ranged from insufficient to low. Studies of University of

California Los Angeles/Lovaas–based interventions and variants reported

clinically significant gains in language and cognitive skills in some children,

as did 1 randomized controlled trial of an early intensive developmental

intervention approach (the Early Start Denver Model). Specific parent-training

approaches yielded gains in short-term language function and some challenging

behaviors. Data suggest that subgroups of children displayed more prominent

gains across studies, but participant characteristics associated with greater

gains are not well understood.

Conclusions Studies of Lovaas-based approaches and early intensive behavioral

intervention variants and the Early Start Denver Model resulted in some

improvements in cognitive performance, language skills, and adaptive behavior

skills in some young children with ASDs, although the literature is limited by

methodologic concerns.

Key Words: autism spectrum disorders • early intervention • behavioral

intervention

Abbreviations: ASD = autism spectrum disorder • AHRQ = Agency for Healthcare

Research and Quality • ADOS = Autism Diagnostic Observation Schedule • UCLA =

University of California Los Angeles • EIBI = early intensive behavioral

intervention • SOE = strength of the available evidence • RCT = randomized

controlled trial • ESDM = Early Start Denver Model

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Accepted Mar 1, 2011.

[Reprint (PDF) Version of Warren et al.]

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Abstract 2 of 3

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Review Articles

A Systematic Review of Medical Treatments for Children With Autism Spectrum

Disorders

L. McPheeters, PhD, MPHa,b, Zachary Warren, PhDc,d, Nila Sathe, MA,

MLISa, L. Bruzek, PhDa, Shanthi Krishnaswami, MBBS, MPHa, N.

Jerome, MLIS, MPHe, Veenstra-VanderWeele, MDd,f,g

aVanderbilt Evidence-Based Practice Center, Institute for Medicine and Public

Health; and

bDepartment of Obstetrics and Gynecology, Vanderbilt University Medical Center;

cDepartments of Psychiatry and Pediatrics;

dVanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum

Disorders;

fDepartments of Psychiatry, Pediatrics, and Pharmacology,

gCenter for Molecular Neuroscience; and

eEskind Biomedical Library and Department of Biomedical Informatics, Vanderbilt

University, Nashville, Tennessee

Context As many as 1 in every 110 children in the United States has an autism

spectrum disorder (ASD). Many medical treatments for ASDs have been proposed and

studied, but there is currently no consensus regarding which interventions are

most effective.

Objective To systematically review evidence regarding medical treatments for

children aged 12 years and younger with ASDs.

Methods We searched the Medline, PsycInfo, and ERIC (Education Resources

Information Center) databases from 2000 to May 2010, regulatory data for

approved medications, and reference lists of included articles. Two reviewers

independently assessed each study against predetermined inclusion/exclusion

criteria. Studies of secretin were not included in this review. Two reviewers

independently extracted data regarding participant and intervention

characteristics, assessment techniques, and outcomes and assigned overall

quality and strength-of-evidence ratings on the basis of predetermined criteria.

Results Evidence supports the benefit of risperidone and aripiprazole for

challenging and repetitive behaviors in children with ASDs. Evidence also

supports significant adverse effects of these medications. Insufficient strength

of evidence is present to evaluate the benefits or adverse effects for any other

medical treatments for ASDs, including serotonin-reuptake inhibitors and

stimulant medications.

Conclusions Although many children with ASDs are currently treated with medical

interventions, strikingly little evidence exists to support benefit for most

treatments. Risperidone and aripiprazole have shown benefit for challenging and

repetitive behaviors, but associated adverse effects limit their use to patients

with severe impairment or risk of injury.

Key Words: autism spectrum disorders • antipsychotics • risperidone •

aripiprazole • serotonin-reuptake inhibitors • citalopram • fluoxetine •

psychostimulants

Abbreviations: ASD = autism spectrum disorder • SRI = serotonin-reuptake

inhibitor • RCT = randomized controlled trial • RUPP = Research Units on

Pediatric Psychopharmacology • ABC-C = Aberrant Behavior Checklist Community

Version • ABC-C-I = ABC-C irritability/agitation/crying subscale • ABC-C-H =

ABC-C hyperactivity/noncompliance subscale • ABC-C-S = ABC-C stereotypy subscale

• CY-BOCS = Children's Yale-Brown Obsessive Compulsive Scale

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Accepted Mar 1, 2011.

[Reprint (PDF) Version of McPheeters et al.]

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Abstract 3 of 3

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Review Articles

A Systematic Review of Secretin for Children With Autism Spectrum Disorders

Shanthi Krishnaswami, MBBS, MPHa, L. McPheeters, PhD, MPHa,b,

Veenstra-VanderWeele, MDc,d,e

aVanderbilt Evidence-Based Practice Center, Institute for Medicine and Public

Health, and

bDepartment of Obstetrics and Gynecology, Vanderbilt Medical Center,

cDepartments of Psychiatry, Pediatrics, and Pharmacology,

dCenter for Molecular Neuroscience, and

eVanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum

Disorders, Vanderbilt University, Nashville, Tennessee

Context As many as 1 in every 110 children in the United States has an autism

spectrum disorder (ASD). Secretin is 1 of many medical treatments studied for

treating the symptoms of ASDs, but there is currently no consensus regarding

which interventions are most effective.

Objective To systematically review evidence regarding the use of secretin in

children with ASDs who are aged 12 years and younger.

Methods We searched the Medline, PsycINFO, and ERIC (Education Resources

Information Center) databases from 2000 to May 2010 and reference lists of

included articles. Two reviewers independently assessed each study against

predetermined inclusion/exclusion criteria. Two reviewers independently

extracted data regarding participant and intervention characteristics,

assessment techniques, and outcomes and assigned overall quality and

strength-of-evidence ratings on the basis of predetermined criteria.

Results Evidence from 7 randomized controlled trials supports a lack of

effectiveness of secretin for the treatment of ASD symptoms including language

and communication impairment, symptom severity, and cognitive and social skill

deficits. No studies have resulted in significantly greater improvements in

measures of language, cognition, or autistic symptoms when compared with

placebo; study authors who reported improvement over time did so equally for

both the intervention and placebo groups.

Conclusions Secretin has been studied extensively in multiple randomized

controlled trials, and there is clear evidence that it lacks benefit. The

studies of secretin included in this review uniformly point to a lack of

significant impact of secretin in the treatment of ASD symptoms. Given the high

strength of evidence for a lack of effectiveness, secretin as a treatment

approach for ASDs warrants no further study.

Key Words: autism spectrum disorders • secretin

Abbreviations: ASD = autism spectrum disorder

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Accepted Mar 2, 2011.

http://pediatrics.aappublications.org/cgi/gca?gca=peds.2011-0426v1 & gca=peds.2011\

-0427v1 & gca=peds.2011-0428v1 & sendit=Get+All+Checked+Abstract%28s%29

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