Research on effective interventions for autism spectrum disorder (ASD) has historically been focused on Western populations and little is known in China. This literature review sought to determine the current state of ASD intervention research in mainland China, with respect to the evidence-based practice (EBP) movement in the treatment of ASD. A methodical search process of refereed articles yielded 33 studies from 2003 through August 2018 meeting the selection criteria for inclusion and analysis. The majority of articles (76%) used either a true EBP or an idiosyncratic behavior intervention package (IBIP) including at least one EBP to treat ASD. The total number of articles, and the number of articles testing IBIPs, has risen sharply in the past few years. Of studies testing true EBPs, the most popular EBP (n = 3) was parent-implemented intervention. All studies, regardless of the type of intervention, only included children or young adolescents. Although more definitive conclusions cannot be drawn without a meta-analysis of the literature, parent-implemented intervention of established interventions for ASD appears to be a promising route for mainland China until resources are more sufficient throughout the country, as these can be both evidence-based and culturally competent. Future research should include a meta-analysis of interventions for ASD in mainland China, as well as more rigorous testing of true EBPs and IBIPs that truly meet the needs of autistic individuals in China.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Baron-Cohen, S. (2019). The concept of neurodiversity is dividing the autism community. Scientific American: Observations. Retrieved from https://blogs.scientificamerican.com/observations/the-concept-of-neurodiversity-is-dividing-the-autism-community/. Accessed 3 May 2019
Cao, H., Shan, W., Xu, Y., & Xu, R. (2013). Eastern sandplay as a safe container for a combined intervention for a child with Asperger syndrome: a case study. The Arts in Psychotherapy, 40(1), 134–142. https://doi.org/10.1016/j.aip.2012.12.008.
Chen, J. M., Zhang, J. S., & Li, X. R. (2003). Gètǐ huà xùnliàn duì 30 lì értóng gūdú zhèng zhìliáo de guānchá. [Individual training for children with autism.]. Zhōngguó xīnlǐ wèishēng zázhì [Chinese Journal of Mental Health], 17(2), 130–132.
Chen, L., Tao, H. M., Li, H., Shao, Z., Yao, L., & Liao, L. J. (2010). Yīnyuè zhìliáo gānyù zì bì zhèng értóng línchuáng xiàoguǒ de shízhèng yánjiū. [Empirical study of clinical effect of music therapy on children with autism]. Chóngqìng yīxué [Chongqing Medical], 39(18), 2481–2485. https://doi.org/10.3969/j.issn.1671-8348.2010.18.042.
Clark, E., & Zhou, Z. (2005). Autism in China: from acupuncture to applied behavior analysis. Psychology in the Schools, 42(3), 285–295. https://doi.org/10.1002/pits.20079.
Dai, X., & Ma, T. H. (2008). Gǎnjué tǒnghé xùnliàn duì zì bì zhèng értóng pínghéng nénglì yǔ yùndòng nénglì de yǐngxiǎng. [The effect of sensory integration training on balance and exercise abilities of children with autism.]. Zhōngguó kāngfù yīxué zázhì [Chinese Journal of Rehabilitation Medicine], 23(5), 436–437.
Du, L., Shan, L., Wang, B., Li, H., Xu, Z., Staal, W. G., & Jia, F. (2015). A pilot study on the combination of applied behavior analysis and bumetanide treatment for children with autism. Journal of Child and Adolescent Psychopharmacology, 25(7), 585–588. https://doi.org/10.1089/cap.2015.0045.
Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcín, C., et al. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179. https://doi.org/10.1002/aur.239.
French, L., & Kennedy, E. M. (2018). Annual research review: early intervention for infants and young children with, or at-risk of, autism spectrum disorder: a systematic review. Journal of Child Psychology and Psychiatry, 59(4), 444–456. https://doi.org/10.1111/jcpp.12828.
Gong, Q., Zhang, F. L., Chen, S. M., Hu, L. Q., Liu, F., Cui, R. H., & He, L. (2009). Tīngjué tǒnghé xùnliàn duì er tóng gūdú zhèng de liáoxiào pínggū. [Evaluation of the effect of auditory integration training on children with autism.]. Běijīng dàxué xuébào (yīxué bǎn) [Journal of Peking University (Medical Sciences)], 41(4), 426–431.
Guo, M., Zhu, J., Yang, T., Lai, X., Liu, X., Liu, J., et al. (2018). Vitamin A improves the symptoms of autism spectrum disorders and decreases 5-hydroxytryptamine (5-HT): a pilot study. Brain Research Bulletin, 137, 35–40. https://doi.org/10.1016/j.brainresbull.2017.11.001.
Hu, X., Zheng, Q., & Lee, G. T. (2018). Using peer-mediated LEGO® play intervention to improve social interactions for Chinese children with autism in an inclusive setting. Journal of Autism and Developmental Disorders, 48(7), 2444–2457.
Jia, F., Wang, B., Shan, L., Xu, Z., Staal, W. G., & Du, L. (2015). Core symptoms of autism improved after vitamin D supplementation. Pediatrics, 135(1), 196–198. https://doi.org/10.1542/peds.2014-2121.
Khan, N. Z., Gallo, L. A., Arghir, A., Budisteanu, B., Budisteanu, M., Dobrescu, I., et al. (2012). Autism and the grand challenges in global mental health. Autism Research, 5(3), 156–159. https://doi.org/10.1002/aur.1239.
Kuang, G. F., He, L. N., Xin, X. Y., Heng, Z. Y., & Chen, Y. Y. (2004). Zònghé liáofǎ zhìliáo értóng gūdú zhèng de liáoxiào. [Comprehensive therapy for children with autism]. Zhōngguó xīnlǐ wèishēng zázhì [Chinese Journal of Mental Health], 18(9), 607–609.
Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. Lancet, 383(9920), 896–910. https://doi.org/10.1016/S0140-6736(13)61539-1.
Lee, G. T., Chen, J., Xu, S., Feng, H., & Guo, Z. (2018a). Effects of self-monitoring intervention on independent completion of a daily living skill for children with autism spectrum disorders in China. Child and Family Behavior Therapy, 40(2), 148–165. https://doi.org/10.1080/07317107.2018.1477352.
Lee, G. T., Xu, S., Feng, H., Lee, G. K., Jin, S., Li, D., & Zhu, S. (2018b). An emotional skills intervention for elementary children with autism in China: a pilot study. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 1–20. https://doi.org/10.1007/s10942-018-0295-5.
Lee, G. T., Feng, H., Xu, S., & Jin, S. J. (2019). Increasing “object-substitution” symbolic play in young children with autism spectrum disorders. Behavior Modification, 43(1), 82–114. https://doi.org/10.1177/0145445517739276.
Li, Q., Lü, Y. T., Huan, Y., Liu, M., Ge, R. C., Chen, X. Y., et al. (2012). Rén qí xuè dāngè hé xìbāo yízhí qiánhòu zì bì zhèng huàn er nǎojǐyè zhōng xìbāo shēngzhǎng yīnzǐ de biǎodá. [Changes in cellular growth factor levels in cerebrospinal fluid of autism patients before and after human umbilical cord blood mononuclear cell transplantation.]. Zhōngguó zǔzhī gōngchéng yánjiū [Chinese Journal of Tissue and Engineering Research], 16(23), 4367–4370. https://doi.org/10.3969/j.issn.1673-8225.2012.23.035.
Li, J., Wang, D., Guo, Z., & Li, K. (2015). Using psychodrama to relieve social barriers in an autistic child: a case study and literature review. International Journal of Nursing Sciences, 2(4), 402–407. https://doi.org/10.1016/j.ijnss.2015.08.008.
Li, H. B., Li, J. W., Ma, C. Y., & Shang, Q. (2017). Yīnyuè duì er tóng gūdú zhèng kāngfù zhìliáo de yǐngxiǎng fēnxī [The effect of music on rehabilitation of children with autism.]. Shèqū yīxué zázhì [Journal of Community Medicine], 15(3), 60–61.
Liu, J., Liu, X., Xiong, X. Q., Yang, T., Cui, T., Hou, N. L., et al. (2017). Effect of vitamin A supplementation on gut microbiota in children with autism spectrum disorders-a pilot study. BMC Microbiology, 17(1), 204. https://doi.org/10.1186/s12866-017-1096-1.
Ma, R. L., Yuan, Q., & Qi, R. (2006). Zhēn cì pèihé xíngwéi gānyù liáofǎ duì er tóng bái bì zhèng xíngwéi de yǐngxiǎng. [Effect of acupuncture combined behavior intervention on children with autism.]. Zhōngguó zhōng xīyī jiéhé zázhì [Chinese Journal of Integrated Traditional and Western Medicine], 26(5), 419–422.
Matson, J. L., Wilkins, J., & Gonzalez, M. (2008). Early identification and diagnosis in autism spectrum disorders in young children and infants: how early is too early? Research in Autism Spectrum Disorders, 2(1), 75–84. https://doi.org/10.1016/j.rasd.2007.03.002.
National Bureau of Statistics of China. (2016). China Statistical Yearbook. China Statistics Press.
Naughton, B. J. (2007). The Chinese economy: transitions and growth. MIT Press.
Ou, J. J., Shi, L. J., Xun, G. L., Chen, C., Wu, R. R., Luo, X. R., et al. (2015). Employment and financial burden of families with preschool children diagnosed with autism spectrum disorders in urban China: results from a descriptive study. BMC Psychiatry, 15(1), 3. https://doi.org/10.1186/s12888-015-0382-4.
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598 https://doi.org/10.1016/S0140-6736(18)31612-X.
Shan, L., Wang, B., Hu, X. L., & Jia, F. Y. (2016). Correlating single nucleotide polymorphisms in vitamin D metabolism-related genes to autism susceptibility and vitamin D treatment: study protocol of a non-randomized parallel-cohort controlled trial. Asia Pacific Journal of Clinical Trials: Nervous System Diseases, 1(1), 31. https://doi.org/10.4103/2455-7765.173011.
Sun, X., Allison, C., Auyeung, B., Baron-Cohen, S., & Brayne, C. (2013a). A review of healthcare service and education provision of autism spectrum condition in mainland China. Research in Developmental Disabilities, 34(1), 469–479. https://doi.org/10.1016/j.ridd.2012.08.013.
Sun, X., Allison, C., Matthews, F. E., Sharp, S. J., Auyeung, B., Baron-Cohen, S., & Brayne, C. (2013b). Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Molecular Autism, 4(1), 7. https://doi.org/10.1186/2040-2392-4-7.
Sun, C., Zou, M., Zhao, D., Xia, W., & Wu, L. (2016). Efficacy of folic acid supplementation in autistic children participating in structured teaching: an open-label trial. Nutrients, 8(6), 337. https://doi.org/10.3390/nu8060337.
Tang, Q., Zhang, C. Y., Wang, Y., Xiang, D. L., & Zhang, Y. (2013). Tóu xué cóng cì jiéhé kāngfù xùnliàn zhìliáo zhōng dù értóng zì bì zhèng de línchuáng guānchá. [Clinical observations of scalp acupuncture combined with rehabilitation training for treatment of moderate autism in children.]. Zhōngguó kāngfù yīxué zázhì [Chinese Journal of Rehabilitation Medicine], 28(3), 251–253. https://doi.org/10.3969/j.issn.1001-1242.2013.03.013.
Tang, T. Y., Falzarano, M., & Morreale, P. A. (2017). Assessment of the utility of gesture-based applications for the engagement of Chinese children with autism. Universal Access in the Information Society, 17(2), 275–290.
Wan, Y., Hu, Q., Li, T., Jiang, L., Du, Y., Feng, L., et al. (2013). Prevalence of autism spectrum disorders among children in China: a systematic review. Shanghai Archives of Psychiatry, 25(2), 70–80.
Wang, L., & Wang, F. (2014). Értóng gūdú zhèng zǎoqí gānyù xiàoguǒ jí yǐngxiǎng yīnsù yánjiū. [Effect of early intervention on children with autism and its influencing factors.]. Jīngshén yīxué zázhì [Journal of Psychiatry], 27(5), 350–352. https://doi.org/10.3969/j.issn.1009-7201.2014.05.010.
Wang, F., Lu, L., Wang, S. B., Zhang, L., Ng, C. H., Ungvari, G. S., et al. (2018). The prevalence of autism spectrum disorders in China: a comprehensive meta-analysis. International Journal of Biological Sciences, 14(7), 717–725.
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., et al. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z.
Xiong, N. N., Ji, C. Y., Bo, H. L., Wang, X. Q., Shi, J. L., Chen, Y. H., et al. (2010). Gūdú zhèng értóng línchuáng zhèngzhuàng jí mǔqīn xīnlǐ zhuàngkuàng de yìngyòng xíngwéi fēnxī gānyù xiàoguǒ [The effectiveness analysis of applied behavior analysis intervention on clinical symptoms of children with autism and psychological condition of their mothers]. Zhōngguó kāngfù yīxué zázhì [Chinese Journal of Rehabilitation Medicine], 25(10), 970–973.
Xu, M. Y., Huang, X. Y., Lu, Y., Xu, X. C., Tang, Y., & Lu, P. J. (2010). Túpiàn yǔ yīnyuè gǎishàn gūdú zhèng értóng zhùyì lì yǔ qíngxù de tànsuǒ xìng fēnxī. [Explorative analysis on the effects of pictures and music on the attention and emotion in autistic children.]. Zhōngguó xīnlǐ wèishēng zázhì [Chinese Journal of Mental Health], 24(9), 696–710.
Xu, S., Wang, J., Lee, G. T., & Luke, N. (2017). Using self-monitoring with guided goal setting to increase academic engagement for a student with autism in an inclusive classroom in China. The Journal of Special Education, 51(2), 106–114. https://doi.org/10.1177/0022466916679980.
Xu, Y., Yang, J., Yao, J., Chen, J., Zhuang, X., Wang, W., et al. (2018). A pilot study of a culturally adapted early intervention for young children with autism spectrum disorders in China. Journal of Early Intervention, 40(1), 52–68. https://doi.org/10.1177/1053815117748408.
Yan, Y., Liu, C., Ye, L., & Liu, Y. (2018). Using animated vehicles with real emotional faces to improve emotion recognition in Chinese children with autism spectrum disorder. PLoS One, 13(7). https://doi.org/10.1371/journal.pone.0200375.
Zhang, R., Jia, M. X., Zhang, J. S., Xu, X. J., Shou, X. J., Zhang, X. T., et al. (2012). Transcutaneous electrical acupoint stimulation in children with autism and its impact on plasma levels of arginine-vasopressin and oxytocin: a prospective single-blinded controlled study. Research in Developmental Disabilities, 33(4), 1136–1146. https://doi.org/10.1016/j.ridd.2012.02.001.
Zhang, Y.H., Han, S.W., & Wang, L.F. (2013). Tīngjué tǒnghé xùnliàn duì er tóng gūdú zhèng de jìnqí liáoxiào jí kāngfù xiàoguǒ píngjià. [Short-term efficacy and rehabilitation evaluation of auditory integration training in the treatment of autistic children]. Zhōngguó yīyào dǎobào [China Medical Herald].
Zhao, Z. Q., Jia, S. W., Hu, S., & Sun, W. (2014). Evaluating the effectiveness of electro-acupuncture as a treatment for childhood autism using single photon emission computed tomography. Chinese Journal of Integrative Medicine, 20(1), 19–23. https://doi.org/10.1007/s11655-014-1680-2.
Zhao, N. X., Gao, F., Jiao, W. T., Zhang, N. B., Yan, B. C., Fan, Y. N., et al. (2015). Tóu diàn zhēn jiéhé tèshū jiàoyù duì gūdú zhèng huàn er yìcháng xíngwéi gānyù de línchuáng yánjiū. [Clinical study of the intervention on abnormal behavior in the children with autism treated with head electroacupuncture and special education.], Shìjiè zhōng xīyī jiéhé zázhì [World Journal of Integrated Traditional and Western Medicine]., 10(8), 1104–1106. https://doi.org/10.13935/j.cnki.sjzx.150822.
Zhou, B., Xu, Q., Li, H., Zhang, Y., Wang, Y., Rogers, S. J., & Xu, X. (2018). Effects of parent-implemented Early Start Denver Model intervention on Chinese toddlers with autism spectrum disorder: A non-randomized controlled trial. Autism Research, 11(4), 654–666. https://doi.org/10.1002/aur.1917.
Zou, B., Ke, X. Y., Hong, S. S., Hang, Y. Y., Chen, Y. Z., Chen, X. J., & Wang, M. J. (2008). Jiāzhǎng yìngyòng huíhé shì jiàoxué fǎ xùnliàn gūdú zhàng'ài értóng de liáoxiào yánjiū. [Analysis on the efficiency of discrete trial teaching for autistic children used by parents.]. Zhōngguó xīnlǐ wèishēng zázhì [Chinese Journal of Mental Health], 22(9), 634–636.
This research was supported by grants from the Humanities and Social Sciences Youth Foundation of the Ministry of Education of China (13YJCZH167) and the Fundamental Research Funds for the Central Universities, Nankai University (Z1A2205599) to the correspondence author.
Conflict of Interest
The authors declare that they have no conflict of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Sullivan, O.A., Wang, C. Autism Spectrum Disorder Interventions in Mainland China: a Systematic Review. Rev J Autism Dev Disord 7, 263–277 (2020). https://doi.org/10.1007/s40489-019-00191-w
- Autism spectrum disorder
- Mainland China
- Evidence-based practice