Acupuncture for Children with Autism Spectrum Disorders: A Systematic Review of Randomized Clinical Trials

Abstract

This study aimed to assess the effectiveness of acupuncture as a treatment for autism spectrum disorders (ASD). We searched the literature using 15 databases. Eleven randomized clinical trials (RCTs) met our inclusion criteria. Most had significant methodological weaknesses. The studies’ statistical and clinical heterogeneity prevented us from conducting a meta-analysis. Two RCTs found that acupuncture plus conventional language therapy was superior to sham acupuncture plus conventional therapy. Two other RCTs found that acupuncture produced significant effects compared with conventional language therapy or complex interventions. Three RCTs suggested that acupuncture plus conventional therapies had beneficial effects compared with conventional therapy alone. Four more RCTs reported that subjects who received acupuncture experienced significant effects compared with subjects who were waitlisted or received no treatment. The results of these studies provide mixed evidence of acupuncture’s effectiveness as a treatment for ASD symptoms.

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References

  1. Allam, H., Eidine, N. G., & Helmy, G. (2008). Scalp acupuncture effect on language development in children with autism: A pilot study. Journal of Alternative and Complementary Medicine, 14(2), 109–114.

    Article  Google Scholar 

  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental diorders (4th Edn., Text Revision ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  3. Chan, A. S., Cheung, M. C., Sze, S. L., & Leung, W. W. (2009). Seven-star needle stimulation improves language and social interaction of children with autistic spectrum disorders. American Journal of Chinese Medicine, 37(3), 495–504.

    PubMed  Article  Google Scholar 

  4. Cheuk, D. K. L., Wong, V., & Chen, W. X. (2011). Acupuncture for autistic spectrum disorder. Cochrane Database of Systematic Reviews, CD007849.

  5. Day, S. J., & Altman, D. G. (2000). Statistics notes: Blinding in clinical trials and other studies. BMJ, 321(7259), 504.

    PubMed  Article  Google Scholar 

  6. Druss, B. G., & Rosenheck, R. A. (2000). Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States. Archives of General Psychiatry, 57(7), 708–714.

    PubMed  Article  Google Scholar 

  7. Egger, M., & Smith, G. D. (1998). Bias in location and selection of studies. BMJ, 316(7124), 61–66.

    PubMed  Article  Google Scholar 

  8. Ernst, E. (2006). Acupuncture–a critical analysis. Journal of Internal Medicine, 259(2), 125–137.

    PubMed  Article  Google Scholar 

  9. Ernst, E., & Lee, M. S. (2008). A trial design that generates only ‘‘positive’’ results. Journal of Postgraduate Medicine, 54(3), 214–216.

    PubMed  Article  Google Scholar 

  10. Ernst, E., Lee, M. S., & Choi, T. Y. (2010). Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews. Pain, 152, 755–764.

    Article  Google Scholar 

  11. Ernst, E., & Pittler, M. H. (1997). Alternative therapy bias. Nature, 385(6616), 480.

    PubMed  Article  Google Scholar 

  12. Ernst, E., Pittler, M. H., Wider, B., & Boddy, K. (2007). Acupuncture: Its evidence-base is changing. American Journal of Chinese Medicine, 35(1), 21–25.

    PubMed  Article  Google Scholar 

  13. Hanson, E., Kalish, L. A., Bunce, E., Curtis, C., McDaniel, S., Ware, J., et al. (2007). Use of complementary and alternative medicine among children diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(4), 628–636.

    PubMed  Article  Google Scholar 

  14. Higgins, J. P. T., Altman, D. G., & Sterne, J. A. C. (2011). Chapter 8: Assessing risk of bias in included studies. In J. P. T. Higgins & S. Green (Eds.), Version 5.1.0 (updated March 2011). The cochrane collaboration, 2011. Available from www.cochrane-handbook.org.

  15. Levy, S. E., & Hyman, S. L. (2008). Complementary and alternative medicine treatments for children with autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North America, 17(4), 803–820, ix.

    Google Scholar 

  16. Liu, G., & Yuan, L. X. (2007). Clinical observe of acupuncture treat autism. Chinese Archives of Traditional Chinese Medicine, 25(12), 2497–2498.

    Google Scholar 

  17. Moore, A., Edwards, J., Barden, J., & McQuay, H. (2003). Bandolier’s little book of pain. Oxford: Oxford University.

    Google Scholar 

  18. Ospina, M. B., Krebs Seida, J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., et al. (2008). Behavioural and developmental interventions for autism spectrum disorder: A clinical systematic review. PLoS One, 3(11), e3755.

    PubMed  Article  Google Scholar 

  19. Parr, J. (2010). Autism. Clinical Evidence, 01, 311.

    Google Scholar 

  20. Pittler, M. H., Abbot, N. C., Harkness, E. F., & Ernst, E. (2000). Location bias in controlled clinical trials of complementary/alternative therapies. Journal of Clinical Epidemiology, 53(5), 485–489.

    PubMed  Article  Google Scholar 

  21. Rothstein, H. R., Sutton, A. J., & Borenstein, M. (2005). Publication bias in meta-analysis. In H. R. Rothstein, A. J. Sutton, & M. Borenstein (Eds.), Publication bias in meta-analysis. Chichester, West Sussex: Wiley.

    Google Scholar 

  22. Schulz, K., Altman, D., Moher, D., & the CONSORT Group. (2010). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. BMC Medicine, 8((1), 18.

    PubMed  Article  Google Scholar 

  23. Schulz, K. F., Chalmers, I., Hayes, R. J., & Altman, D. G. (1995). Empirical evidence of bias, dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 273(5), 408–412.

    PubMed  Article  Google Scholar 

  24. Unutzer, J., Klap, R., Sturm, R., Young, A. S., Marmon, T., Shatkin, J., et al. (2000). Mental disorders and the use of alternative medicine: Results from a national survey. American Journal of Psychiatry, 157(11), 1851–1857.

    PubMed  Article  Google Scholar 

  25. Vickers, A., Goyal, N., Harland, R., & Rees, R. (1998). Do certain countries produce only positive results? A systematic review of controlled trials. Controlled Clinical Trials, 19(2), 159–166.

    PubMed  Article  Google Scholar 

  26. Wang, C., Shang, S., & Wei, X. H. (2006). The influence of electroacupuncture plus behavior therapy on social adaptive behavior ability in autism children. Shanghai Journal of Acupuncture and Moxibustion, 25(12), 19–20.

    Google Scholar 

  27. Wong, C. L. (2008). Acupuncture and autism spectrum disorders-an assessor blinded randomized controlled trial. Hong Kong, China: University of Hong Kong.

    Google Scholar 

  28. Wong, V. C. N. (2009a). Use of complementary and alternative medicine (CAM) in autism spectrum disorder (ASD): Comparison of Chinese and western culture (Part A). Journal of Autism and Developmental Disorders, 39(3), 454–463.

    PubMed  Article  Google Scholar 

  29. Wong, V. C. N. (2009b). Use of complementary and alternative medicine (CAM) inautismspectrum disorder (ASD): Comparison of chinese and western culture (Part A). Journal of Autism and Developmental Disorders, 39(3), 454–463.

    PubMed  Article  Google Scholar 

  30. Wong, V. C. N., & Chen, W. X. (2010). Randomized controlled trial of electro-acupuncture for autism spectrum disorder. Alternative Medicine Review, 15(2), 136–146.

    PubMed  Google Scholar 

  31. Wong, H. H. L., & Smith, R. G. (2006). Patterns of complementary and alternative medical therapy use in children diagnosed withautismspectrum disorders. Journal of Autism and Developmental Disorders, 36(7), 901–909.

    PubMed  Article  Google Scholar 

  32. Wong, V. C. N., & Sun, J. G. (2002). Research on tongue acupuncture in children with autism. Brain and Development, 24, 319–320.

    Article  Google Scholar 

  33. Wong, V. C. N., & Sun, J. G. (2007). Randomized controlled trial of using tongue acupuncture versus no acupunccture in children with autism sepctrum disorder. Journal of Alternative and Complementary Medicine, 13(8), 880.

    Google Scholar 

  34. Wong, V. C. N., & Sun, J. G. (2010). Randomized controlled trial of acupuncture versus sham acupuncture in autism spectrum disorder. Journal of Alternative and Complementary Medicine, 16(5), 545–553.

    Article  Google Scholar 

  35. Yan, Y. F., Wei, Y. Y., Chen, Y. H., & Chen, M. M. (2007). Effect of acupuncture on rehabilitation training of child’s autism. Zhongguo Zhen Jiu, 27(7), 503–505.

    PubMed  Google Scholar 

  36. Yuan, Q., Chai, T., Lang, J., Wang, R. C., & Wu, Z. F. (2007). Effect of acupuncture for autismin children: An observation of 40 cases. Journal of Guangzhou University of Traditional Chinese Medicine, 24(3), 208–211.

    Google Scholar 

  37. Zimmer, M., Molloy, C. A., Hollander, E., & Anagnostou, E. (2007). Complementary and alternative therapies for autism. In E. Hollander & E. Anaqnostou (Eds.), Clinical manual for the treatment of autism (pp. 259–288). Arlington, VA, USA: American Psychiatric Publishing.

    Google Scholar 

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Acknowledgments

Myeong Soo Lee and Tae-Young Choi were supported by KIOM (K11111).

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Correspondence to Myeong Soo Lee.

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Lee, M.S., Choi, T., Shin, B. et al. Acupuncture for Children with Autism Spectrum Disorders: A Systematic Review of Randomized Clinical Trials. J Autism Dev Disord 42, 1671–1683 (2012). https://doi.org/10.1007/s10803-011-1409-4

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Keywords

  • Acupuncture
  • Complementary medicine
  • Autism spectrum disorders
  • Effectiveness
  • Systematic review