Summary: A sweeping review of 248 meta-analyses on complementary and alternative medicines (CAIMs) for autism found no strong evidence to support their use. Researchers assessed 19 types of interventions, from music therapy to probiotics, but results were generally unreliable and safety evaluations were scarce.
With up to 90% of autistic people trying such treatments at some point, experts warn that families should not rely on isolated, low-quality studies. The study also introduced a new online platform to help users navigate the available evidence.
Key Facts
- Scale of Review: 248 meta-analyses and 200 trials with over 10,000 participants were examined.
- Weak Evidence: Most complementary and alternative treatments showed unreliable or poor-quality results.
- Safety Gap: Less than half of the reviewed treatments included safety or tolerability data.
Source: University of Southampton
The most comprehensive quantitative review of research into complementary and alternative treatments for autism has found no strong evidence to support their use, and that the safety of these treatments was rarely assessed.
A new study from Paris Nanterre University, Paris Cité University and the University of Southampton, published today [28 August] in Nature Human Behaviour, assessed 248 meta-analyses, including 200 clinical trials involving over 10,000 participants.
Researchers were investigating the efficacy and safety of complementary, alternative and integrative medicines (CAIMs) to treat autism.
They looked at 19 types of treatment, including animal-assisted interventions, acupuncture, herbal medicine, music therapy, probiotics and Vitamin D.
The team also created an online platform to make it easier for people to see the evidence they generated on different CAIMS.
Autistic people can find it hard to communicate, understand how people think or feel, be overwhelmed by sensory information, become anxious in unfamiliar surroundings and carry out repetitive behaviours.
All of this can interfere with their quality of life, and up to 90% report having used CAIMs at least once in their lifetime.
“Many parents of autistic children, as well as autistic adults, turn to complementary and alternative medicines hoping they may help without unwanted side effects,” says Professor Richard Delorme, Head of the Child and Adolescent Psychiatry Unit at Robert Debré Hospital in Paris.
“However, it is necessary to carefully consider evidence from rigorous randomised trials before concluding that these treatments should be tried.”
Researchers carried out an umbrella review – a type of study that pulls together evidence to give an overall ‘big picture’ summary.
Dr. Corentin Gosling, Associate Professor at the Paris Nanterre University and first author of the study, explains: “Rather than looking at individual trials, we reviewed all the available meta-analyses, which are a compilation of many trials. This allowed us to evaluate the full body of evidence across different treatments.
“Importantly, we also developed a free and easy-to-use online platform, which we will continue to test. Ultimately, we hope this tool will support autistic people and practitioners in choosing together the best treatment.”
While some treatments showed potential, most studies were supported by weak or poor-quality evidence, so the effects are not reliable. Concerningly, safety assessments were missing for most treatments, with less than half of CAIMs having had any evaluation of the acceptability, tolerability or adverse events.
Professor Samuele Cortese, NIHR Research Professor at the University of Southampton and co-senior author, concluded: “This study shows that when people want to know whether a treatment is effective, they shouldn’t just look at one single study.
“It’s essential to consider all the available evidence and how good that evidence is. Drawing conclusions from one low-quality study can be misleading.”
The online platform is available at: https://ebiact-database.com
Funding: The research was funded by Agence Nationale de la Recherche (ANR).
COI Statement
S.C. has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Central Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian AADHD Alliance Resource, the British Association of Psychopharmacology, Healthcare Convention and CCM Group team for educational activity on ADHD, and has received honoraria from Medice. M.S. received honoraria/has been a consultant for Angelini, AbbVie, Boehringer Angelheim, Lundbeck and Otsuka. The other authors declare no competing interests.
About this Autism research news
Author: Steven Williams
Source: University of Southampton
Contact: Steven Williams – University of Southampton
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Complementary, alternative and integrative medicine for autism: an umbrella review and online platform” by Richard Delorme et al. Nature Human Behavior
Abstract
Complementary, alternative and integrative medicine for autism: an umbrella review and online platform
The use of complementary, alternative and integrative medicine (CAIM) is highly prevalent among autistic individuals, with up to 90% reporting having used CAIM at least once in their lifetime. However, the evidence base for the effects of CAIM for autism remains uncertain.
Here, to fill this gap, we conducted an umbrella review of meta-analyses exploring the effects of CAIM in autism across the lifespan and developed a web platform to disseminate the generated results.
Five databases were searched (up to 31 December 2023) for systematic reviews with meta-analyses exploring the effects of CAIM in autism. Independent pairs of investigators identified eligible papers and extracted relevant data.
Included meta-analyses were reestimated using a consistent statistical approach, and their methodological quality was assessed with AMSTAR-2. The certainty of evidence generated by each meta-analysis was appraised using an algorithmic version of the GRADE framework.
This process led to the identification of 53 meta-analytic reports, enabling us to conduct 248 meta-analyses exploring the effects of 19 CAIMs in autism.
We found no high-quality evidence to support the efficacy of any CAIM for core or associated symptoms of autism. Although several CAIMs showed promising results, they were supported by very low-quality evidence.
The safety of CAIMs has rarely been evaluated, making it a crucial area for future research.
To support evidence-based consideration of CAIM interventions for autism, we developed an interactive platform that facilitates access to and interpretation of the present results (https://ebiact-database.com).
