Weitlauf Amy S, Sathe Nila, McPheeters Melissa L, Warren Zachary E
Departments of Pediatrics, and
Department of Health Policy, Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee.
Pediatrics. 2017 Jun;139(6). doi: 10.1542/peds.2017-0347.
Sensory challenges are common among children with autism spectrum disorder (ASD).
To evaluate the effectiveness and safety of interventions targeting sensory challenges in ASD.
Databases, including Medline and PsycINFO.
Two investigators independently screened studies against predetermined criteria.
One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE), or confidence in the estimate of effects.
Twenty-four studies, including 20 randomized controlled trials (RCTs), were included. Only 3 studies had low risk of bias. Populations, interventions, and outcomes varied. Limited, short-term studies reported potential positive effects of several approaches in discrete skill domains. Specifically, sensory integration-based approaches improved sensory and motor skills-related measures (low SOE). Environmental enrichment improved nonverbal cognitive skills (low SOE). Studies of auditory integration-based approaches did not improve language (low SOE). Massage improved symptom severity and sensory challenges in studies with likely overlapping participants (low SOE). Music therapy studies evaluated different protocols and outcomes, precluding synthesis (insufficient SOE). Some positive effects were reported for other approaches, but findings were inconsistent (insufficient SOE).
Studies were small and short-term, and few fully categorized populations.
Some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor.
感觉统合失调在自闭症谱系障碍（ASD）儿童中很常见。
评估针对ASD感觉统合失调的干预措施的有效性和安全性。
包括Medline和PsycINFO在内的数据库。
两名研究人员根据预定标准独立筛选研究。
一名研究人员提取数据，由另一名研究人员审核。研究人员独立评估偏倚风险和证据强度（SOE），或对效应估计的置信度。
纳入了24项研究，包括20项随机对照试验（RCT）。只有3项研究的偏倚风险较低。研究对象、干预措施和结果各不相同。有限的短期研究报告了几种方法在离散技能领域的潜在积极效果。具体而言，基于感觉统合的方法改善了与感觉和运动技能相关的指标（证据强度低）。环境丰富化改善了非语言认知技能（证据强度低）。基于听觉统合的方法的研究并未改善语言能力（证据强度低）。在可能存在重叠参与者的研究中，按摩改善了症状严重程度和感觉统合失调（证据强度低）。音乐治疗研究评估了不同的方案和结果，无法进行综合分析（证据不足）。其他方法也报告了一些积极效果，但结果不一致（证据不足）。
研究规模小且为期短期，很少有对研究对象进行充分分类的。
一些干预措施可能会在短期（<6个月）内使与感觉统合和ASD症状严重程度相关的结果得到适度改善；证据基础薄弱，效果的持续性尚不清楚。尽管一些疗法可能有前景，但在方法学严谨性方面仍有很大的改进需求。
