Comparative effects of non-pharmacological intervention categories on cognitive domains in children with autism spectrum disorder: A systematic review and network meta-analysis of randomized controlled trials.
Miao Zheng, Shuning Liu, Yan Wei et al.
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In 30 seconds
This systematic review and network meta-analysis compared non-pharmacological intervention categories for cognitive outcomes in children with autism spectrum disorder, drawing on randomized controlled trials. Thirty-five reports involving 1694 children contributed to quantitative synthesis. Across interventions, cognitive outcomes improved by a moderate amount (standardized mean difference = 0.54, 95% confidence interval 0.36-0.71); significant benefits were reported for working memory and social-emotional cognition. Only social-emotional cognition had a sufficiently connected network for category comparisons, where social-behavioral and technology- and robot-assisted interventions showed the clearest benefits relative to active controls. Confidence in most estimates was low or very low.
Key findings
- Overall cognitive outcomes improved with non-pharmacological interventions (standardized mean difference = 0.54, 95% confidence interval 0.36-0.71).
- Working memory improved (0.61, 0.09-1.13), as did social-emotional cognition (0.47, 0.30-0.65).
- For social-emotional cognition, social-behavioral and technology- and robot-assisted interventions showed the clearest benefits relative to active controls.
- Networks for attention, working memory, and comprehensive executive function were sparse or disconnected; confidence was low or very low for most estimates.
Why it matters
The findings suggest that cognitive effects may differ by domain, so an overall estimate may not describe likely benefits for a particular outcome. The limited connected evidence for comparing intervention categories and low confidence in most estimates also mean that apparent differences between approaches should be interpreted cautiously. Better head-to-head trials with standardized outcomes could clarify which interventions benefit which cognitive domains.
What to keep in mind
Evidence networks were sparse or disconnected for several domains, and confidence was low or very low for most estimates.