Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Manchester Academic Health Science Centre, Manchester, UK.
J Child Psychol Psychiatry. 2018 Apr;59(4):424-443. doi: 10.1111/jcpp.12892.
There has been recent systematic review of key evidence in psychosocial intervention in autism but little review of biological treatments.
We analyse the current literature from the perspective of intervention and mechanism targets across social and biological development.
The overall quality of trials evidence in autism intervention remains relatively low, despite some recent progress. Many treatments in common use have little or no evidence base. This is very concerning in such an important disorder. A variety of psychosocial interventions can show effect to improve some short-term effects on children's immediate dyadic social interactions, for instance with caregivers. But showing true effectiveness in this developmental disorder requires generalisation of such effects into wider social contexts, on autism symptoms and in long-term progress in development. Only a few interventions so far have begun to show this. A number of early phase interventions on biological targets have shown real promise, but none has yet progressed to larger scale effectiveness trials on behavioural or symptom outcomes.
There has been enough progress in psychosocial intervention research now to be able to begin to identify some evidence-based practice in autism treatment. To consolidate and improve outcomes, the next phase of intervention research needs improved trial design, and an iterative approach building on success. It may also include the testing of potential synergies between promising biological and psychosocial interventions.
最近有系统地综述了自闭症心理社会干预方面的关键证据，但对生物治疗的综述较少。
我们从社会和生物发展的干预和机制目标的角度分析当前的文献。
尽管最近取得了一些进展，但自闭症干预试验证据的整体质量仍然相对较低。许多常用的治疗方法几乎没有或没有证据基础。在这样一个重要的疾病中，这是非常令人担忧的。各种心理社会干预措施可以显示出效果，改善儿童与照顾者等直接人际互动的一些短期效果。但要在这种发育障碍中真正有效，就需要将这些效果推广到更广泛的社会环境中，推广到自闭症症状和长期发展进展中。到目前为止，只有少数干预措施已经开始显示出这一点。一些针对生物靶点的早期干预措施已经显示出真正的希望，但没有一种干预措施在行为或症状结果的更大规模有效性试验中取得进展。
目前心理社会干预研究已经取得了足够的进展，现在可以开始确定一些自闭症治疗的循证实践。为了巩固和改善结果，干预研究的下一阶段需要改进试验设计，并在成功的基础上进行迭代。它还可能包括测试有前途的生物和心理社会干预措施之间的潜在协同作用。
