Acupuncture for children with autism spectrum disorder: A systematic review and meta-analysis.

This research looked at whether acupuncture helps children with autism. They reviewed 38 studies with nearly 3,000 children. Results suggested acupuncture might help improve autism symptoms compared to other treatments. However, most studies had serious quality problems that make the results unreliable. Only one study mentioned side effects, which were mild. While acupuncture appeared safe and possibly helpful, parents should be very cautious about these findings due to poor study quality.

This systematic review and meta-analysis examined acupuncture effectiveness for children with autism spectrum disorder across 38 trials involving 2,862 participants. Results suggested acupuncture groups showed higher clinical effectiveness rates and greater improvements on standardized autism measures (ABC, CARS, ATEC) compared to control groups. However, only one trial had low risk of bias, with 37 trials having high risk of bias. Evidence quality was rated as very low using GRADE criteria.

High heterogeneity existed across studies. Only one study reported adverse events, which were mild. While findings suggest potential benefits, the authors emphasize results should be interpreted cautiously given methodological limitations and poor study quality.

While acupuncture appeared safe and potentially beneficial for autism symptoms, the very low quality of evidence and high risk of bias in included studies means these findings cannot reliably inform clinical practice. Higher quality randomized controlled trials are needed before acupuncture can be recommended as an evidence-based intervention for children with autism.

Only 1 of 38 trials had low risk of bias. Evidence quality rated as very low by GRADE criteria. High heterogeneity across studies (77-90% for outcome measures). Limited adverse event reporting. Results should be interpreted with extreme caution due to methodological flaws.

The aim of this study was to assess the efficiency and safety of acupuncture in core symptomatic improvement of children with autism spectrum disorder (ASD). We searched the following databases: Cochrane Library, PubMed, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Science and Technology Periodical (VIP) and Chinese Biological Medicine (CBM), from 1 January 2012 to 25 September 2022. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Treatment Evaluation Checklist (ATEC) were adopted as outcome indicators. Three reviewers independently assessed the risk of bias (ROB) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)assessment.

Utilizing Review Manager (RevMan) 5.3 and Stata 12.0, data were analyzed. A total of 38 trials were included, and 2862 participants participated in qualitative synthesis and meta-analysis. Only 1 trial was assessed as having a low ROB, and 37 trials were assessed as having an overall high ROB. The quality of evidence for most indicators were considered very low by the GRADE criteria.

The results showed that acupuncture groups might have a higher clinical effective rate than nonacupuncture groups (relative risk [RR] = 1.33,95% confidence interval [CI] = 1.25-1.41; heterogeneity: x2=18.15, P = .64, I2 = 0%). Regarding changes in ABC scores, the acupuncture groups might exhibit greater decrease than nonacupuncture groups (MMD = -6.06, 95%CI = -7.25 to -4.87, P < .00001; heterogeneity: x2 =73.37, P = .03, I2 = 77%). In terms of changes in CARS score, acupuncture group may benefit more than nonacupuncture group (MMD = -3.93, 95%CI = 4.90 to -2.95, P < .00001; heterogeneity: x2=234.47, P < .00001, I2 = 90%). Additionally, in terms of ATEC score, acupuncture groups showed more benefit than nonacupuncture groups (MMD = -10.24, 95%CI = -13.09 to -7.38, P < .00001; heterogeneity: x2=45.74, P = .04, I2 = 85%).

Both subgroup analysis and sensitivity analysis are existing heterogeneity. Only 1 RCT study involved adverse events with mild symptoms that did not interfere with treatment and evaluation. Children with ASD may benefit from acupuncture because of its effectiveness and safety. Nevertheless, given the low quality of the evidence for the assessed outcomes and the high ROB of analyzed trials, the results should be regarded with caution.