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Scalp acupuncture treatment for children's autism spectrum disorders: A systematic review and meta-analysis
Chang Liu1, Ting Li, Zhijie Wang
1Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
Insights
Scalp acupuncture treatment (SAT) shows promise for improving outcomes in children with autism spectrum disorder (ASD). This meta-analysis found SAT significantly reduced symptom severity and enhanced developmental skills in children with ASD.
Area of Science:
- Neuroscience
- Integrative Medicine
- Developmental Pediatrics
Background:
- Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with no definitive cure.
- Previous research suggests potential benefits of scalp acupuncture treatment (SAT) for children with ASD.
- A systematic evaluation of SAT's efficacy in this population was lacking.
Purpose of the Study:
- To systematically evaluate the efficacy of scalp acupuncture treatment (SAT) in children diagnosed with autism spectrum disorder (ASD).
- To synthesize evidence from randomized controlled trials (RCTs) on SAT for ASD.
Main Methods:
- A systematic literature search was conducted across six major databases (MEDLINE, EMBASE, Cochrane, AMED, CNKI, Wanfang) from inception to September 2018.
- Included studies were randomized controlled trials (RCTs) assessing SAT efficacy in ASD patients.
- Primary outcomes included Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) scores; secondary outcomes were Psychoeducational Profile (Third Edition) (PEP-3) scores. Risk of bias was assessed using the Cochrane risk of bias tool.
Main Results:
- Fourteen trials involving 968 participants were analyzed; 11 were included in the meta-analysis.
- Scalp acupuncture treatment (SAT) significantly reduced CARS scores in children with ASD, both under 3 years (MD = -3.08) and over 3 years (MD = -5.29).
- SAT also significantly decreased ABC scores (MD = -4.70) and improved PEP-3 scores in communication (MD = 3.61), physical ability (MD = 2.00), and behavior (MD = 2.76).
Conclusions:
- Scalp acupuncture treatment (SAT) demonstrates potential as an effective intervention for children with autism spectrum disorder (ASD).
- Further high-quality, well-designed randomized controlled trials are necessary to confirm these findings and guide widespread clinical application.
Background:
Autism spectrum disorder (ASD) is a neurodevelopment disorder without definitive cure. Previous studies have provided evidences for efficacy and safety of scalp acupuncture in children with ASD. However, the efficacy of scalp acupuncture treatment (SAT) in children with ASD has not been evaluated systematically. The objective of this study is to evaluate the efficacy of SAT in children with ASD.
Methods:
Information from 6 databases, including MEDLINE, EMBASE, Cochrane database, AMED, China National Knowledge Infrastructure, and Wanfang Data, were retrieved from the inception of each database from 1980 through September 2018. Randomized controlled trials evaluating the efficacy of SAT for patients with ASD were included. The primary outcome measures were the Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). The secondary outcome measures were Psychoeducational Profile (Third Edition) (PEP-3) scores. Risk of bias assessment and data synthesis were conducted with Review Manager 5.3 software. Methodological quality was assessed with the Cochrane risk of bias tool.
Results:
Fourteen trials with 968 participants were conducted and 11 of the trials were suitable for meta-analysis. Compared with behavioral and educational interventions, SAT significantly decreased the overall CARS scores for children under 3 years old (mean difference (MD) = 3.08, 95% confidence interval (CI) [-3.96, -2.19], P < .001) and above 3 years old (MD = 5.29, 95% CI [-8.53, -2.06], P < .001), ABC scores (MD = 4.70, 95% CI [-6.94, -2.79], P < .001). Furthermore, SAT significantly improved PEP-3 scores in communication (MD = 3.61, 95% CI [2.85, 4.37], P < .001), physical ability (MD = 2.00, 95% CI [1.16, 2.84], P < .001), and behavior (MD = 2.76, 95% CI [1.80, 2.71], P < .001).
Conclusion:
SAT may be an effective treatment for children with ASD. Given the heterogeneity and number of participants, randomized controlled trials of high quality and design are required before widespread application of this therapy.