SLPCase SeriesJournal of autism and developmental disorders2024

Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis.

Joshua R Smith, Corey E Hopkins, Jiangmei Xiong and 3 others

PMID 36528758

WHAT IT FOUND

In 32 patients with autism or intellectual disability, retrospective chart review showed 94% improved after ECT.

Most had catatonia. No significant adverse events were reported. This describes outcomes in a small group receiving multiple treatments, not proof of efficacy.

Key findings

01Thirty of thirty-two patients (94%) showed clinical improvement on the Clinical Global Impressions-Improvement scale after ECT.

02The two patients who did not respond were both diagnosed with seronegative autoimmune encephalitis and had catatonia.

03No significant adverse events were reported in this retrospective analysis.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study is a retrospective case series with no control group, so it cannot prove that ECT caused the improvement. The sample size is small (32 patients) and heterogeneous in diagnosis and symptom presentation. Clinical response was measured using a retrospective review of notes using the CGI-I, not a prospective, blinded assessment. Many patients received concurrent medications (antipsychotics, mood stabilizers, benzodiazepines), making it impossible to separate the effect of ECT from medication changes. The study was conducted at a single site, limiting generalizability. Two non-responders had autoimmune encephalitis, suggesting a specific medical etiology that may differ from primary psychiatric catatonia.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not interpret the 94% improvement rate as evidence that ECT is an effective treatment for autism or intellectual disability in general. The study lacked a control group, relied on retrospective chart reviews for outcomes, and involved patients receiving multiple concurrent treatments, so the specific contribution of ECT cannot be isolated.

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