Systematic Review: Distribution of Age and Intervention Modalities in Therapeutic Clinical Trials for Autism Spectrum Disorder.
Alan S Lewis, Gerrit Ian van Schalkwyk
PMID 30815774WHAT IT FOUND
Adults with autism were far less likely than children to be in therapeutic trials: 184 of 218 studies had mean ages under 18, and 92% of participants were under 18.
Adult trials more often tested medication than behavior.
Key findings
01184 of 218 trials enrolled participants with a mean age under 18, and 92% of all participants were under 18.
02Trials of people under 18 were more often behavioral and less often pharmacological than trials of people 18 or older.
03Functional and physiological/neurocognitive outcomes were more common in adult trials, while core or related symptom outcomes were more common in trials of younger people.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review did not assess study quality or risk of bias, so it describes what was studied, not how reliable the individual trials were. It included only published English studies found through PubMed and the Cochrane Controlled Register of Trials from 2013 to 2017, so unpublished or non-English trials could change the counts. It did not calculate effect sizes or combine treatment effects, so it cannot say whether any intervention worked better for children or adults. Five studies did not report a mean or median age, so age was estimated from the midpoint of the reported age range. Functional outcomes may overlap with core ASD symptom outcomes, especially when language and communication are measured, so outcome categories are approximations.
The easy way to misread this
Do not read this as evidence that adult autism treatments do not work or that behavioral therapy should be avoided in adults. It counted how many trials enrolled adults and what they tested; it did not test whether any treatment was effective.