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The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis.

Kreslins A, Robertson AE, Melville C - Child Adolesc Psychiatry Ment Health (2015)

Bottom Line: Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment.However, the results of self-reported outcome measures failed to reach significance.The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland.

ABSTRACT
Anxiety is a common problem in children and adolescents with autism spectrum disorder (ASD). This meta-analysis aimed to systematically evaluate the evidence for the use of psychosocial interventions to manage anxiety in this population. Cognitive behavioural therapy (CBT) was the primary intervention modality studied. A comprehensive systematic search and study selection process was conducted. Separate statistical analyses were carried out for clinician-, parent-, and self-reported outcome measures. Sensitivity analyses were conducted by removing any outlying studies and any studies that did not use a CBT intervention. A subgroup analysis was performed to compare individual and group delivery of treatment. Ten randomised control trials involving a total of 470 participants were included. The overall SMD was d = 1.05 (95 % CI 0.45, 1.65; z = 3.45, p = 0.0006) for clinician- reported outcome measures; d = 1.00 (95%CI 0.21, 1.80; z = 2.47, p = 0.01) for parent-reported outcome measures; and d = 0.65 (95%CI -0.10, 1.07; z = 1.63, p = 0.10) for self-reported outcome measures. Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment. However, the results of self-reported outcome measures failed to reach significance. The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment. The main limitations of this review were the small number of included studies as well as the clinical and methodological variability between studies.

No MeSH data available.


Related in: MedlinePlus

Forest plot of self-reported outcome measures with risk of bias summary
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Fig4: Forest plot of self-reported outcome measures with risk of bias summary

Mentions: Self-reported outcome data from 297 participants (152 in the intervention condition and 145 in the control condition) across seven studies was reported. The overall SMD was d = 0.649 (95 % CI -0.10, 1.07; z = 1.63, p = 0.10) with no significant difference between the experimental and control conditions at post-treatment. There were high levels of heterogeneity across the studies (I2 = 83 %). A forest plot illustrating these results is included as Fig. 4. Once more, the SMD reported by Chalfant et al. [30] was an outlier and removal of this study reduced the overall SMD to 0.14 (95%CI -0.11, 0.39; z = 2.80, p = 0.005). A sensitivity analysis was carried out by removing Schohl et al. [43], the only study that did not use a CBT intervention. This changed the overall SMD to 0.55 (95 % CI -0.16, 1.27; z = 1.51, p = 0.13) and the difference between intervention and control conditions at post-treatment remained insignificant.Fig. 4


The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis.

Kreslins A, Robertson AE, Melville C - Child Adolesc Psychiatry Ment Health (2015)

Forest plot of self-reported outcome measures with risk of bias summary
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4482189&req=5

Fig4: Forest plot of self-reported outcome measures with risk of bias summary
Mentions: Self-reported outcome data from 297 participants (152 in the intervention condition and 145 in the control condition) across seven studies was reported. The overall SMD was d = 0.649 (95 % CI -0.10, 1.07; z = 1.63, p = 0.10) with no significant difference between the experimental and control conditions at post-treatment. There were high levels of heterogeneity across the studies (I2 = 83 %). A forest plot illustrating these results is included as Fig. 4. Once more, the SMD reported by Chalfant et al. [30] was an outlier and removal of this study reduced the overall SMD to 0.14 (95%CI -0.11, 0.39; z = 2.80, p = 0.005). A sensitivity analysis was carried out by removing Schohl et al. [43], the only study that did not use a CBT intervention. This changed the overall SMD to 0.55 (95 % CI -0.16, 1.27; z = 1.51, p = 0.13) and the difference between intervention and control conditions at post-treatment remained insignificant.Fig. 4

Bottom Line: Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment.However, the results of self-reported outcome measures failed to reach significance.The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland.

ABSTRACT
Anxiety is a common problem in children and adolescents with autism spectrum disorder (ASD). This meta-analysis aimed to systematically evaluate the evidence for the use of psychosocial interventions to manage anxiety in this population. Cognitive behavioural therapy (CBT) was the primary intervention modality studied. A comprehensive systematic search and study selection process was conducted. Separate statistical analyses were carried out for clinician-, parent-, and self-reported outcome measures. Sensitivity analyses were conducted by removing any outlying studies and any studies that did not use a CBT intervention. A subgroup analysis was performed to compare individual and group delivery of treatment. Ten randomised control trials involving a total of 470 participants were included. The overall SMD was d = 1.05 (95 % CI 0.45, 1.65; z = 3.45, p = 0.0006) for clinician- reported outcome measures; d = 1.00 (95%CI 0.21, 1.80; z = 2.47, p = 0.01) for parent-reported outcome measures; and d = 0.65 (95%CI -0.10, 1.07; z = 1.63, p = 0.10) for self-reported outcome measures. Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment. However, the results of self-reported outcome measures failed to reach significance. The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment. The main limitations of this review were the small number of included studies as well as the clinical and methodological variability between studies.

No MeSH data available.


Related in: MedlinePlus