Auricular therapy as adjunctive treatment for pediatric attention deficit hyperactivity disorder: a scoping review

Up to now, attention deficit hyperactivity disorder (ADHD), a prevalent neurodevelopmental disorder in children, remains controversial efficiency of auricular therapy as an adjunctive treatment. Our study aims to synthesize the current evidence from RCTs and NRCTs by conducting qualitative description and quantitative synthesis, in order to draw a further conclusion for ADHD clinical practice.

A total of 7 databases were searched from inception to July 15, 2025. Afterwards, both randomized and non-randomized controlled trials were included, where clinical outcomes were not restricted. After screening eligible studies, risk of bias was assessed using the Cochrane ROB2 and ROBINS-I tools respectively. Then, the characteristics of included studies were tabulated and meta-analyses was conducted.

A total of 21 studies involving 2,270 participants were included. From our main findings, adjunctive auricular therapy could significantly improve scores of Conners' Parent Rating Scale, Hamilton Anxiety Scale and Hamilton Depression Rating Scale (all P < 0.05), and enhance quality of life questionnaire score (P < 0.05). And a non-significant trend toward higher overall efficacy rate was observed (P > 0.05), while no serious adverse events were reported. Whereas, the risk of bias in included studies was assessed as low-and-moderate-certainty evidence.

This work indicates promising effects of auricular therapy in alleviating ADHD-related symptoms among children with long-term interventions, but current evidence is still insufficient to support a 100% positive conclusion due to several limitations. And future studies with rigorously designed pragmatic randomized controlled trials should be encouraged, under real world settings.