scholarly journals A Systematic Review and Meta-Analysis of Moderate-to-Vigorous Physical Activity Levels in Children and Adolescents With and Without ASD in Inclusive Schools

2021 ◽  
Vol 9 ◽  
Author(s):  
Ru Li ◽  
Xiao Liang ◽  
Yujuan Zhou ◽  
Zhanbing Ren
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Children And Adolescents ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Vigorous Physical Activity ◽  
Autism Spectrum ◽  
Relational Model ◽  
Inclusive Schools ◽  
Adolescents With Asd

Background: The health benefits of physical activity (PA) participation are well-documented. Little was known about the PA levels of students with autism spectrum disorder (ASD) and their typically developing (TD) peers in inclusive schools. This study aimed to synthesize available studies examining PA levels of children and adolescents with and without ASD and its associated factors that affected their PA participation during inclusive schools applying the social–relational model of disability (SRMD).Methods: Eight databases were searched including CINAHL Complete, SPORTDiscus with Full Text, PubMed, Embase, Web of Science, Eric, APA PsycINFO, and Scopus from inception through May 2021 to identify related studies. Two researchers independently screened studies, assessed methodological quality, and summarized relevant data. The McMaster Critical Reviewer Form for quantitative studies was used to evaluate the methodological quality of the included articles.Results: A total of seven articles were included in this systematic review. Overall, meta-analysis results indicated that children and adolescents with ASD had a moderately decreased PA levels compared with their TD peers [SMD = −0.585, 95% CI (−0.774, −0.425), p < 0.01]. Individual-, social-, and environmental-level factors that influence PA levels in children and adolescents with ASD were identified from the perspective of SRMD.Conclusion: This review indicates that children and adolescents with ASD have lower PA levels than their TD peers in inclusive schools and multilevel factors affect their PA.

scholarly journals Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gian Loreto D’Alò ◽  
◽  
Franco De Crescenzo ◽  
Laura Amato ◽  
Fabio Cruciani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Grey Literature ◽  
Indirect Evidence ◽  
Autism Spectrum ◽  
National Guidelines ◽  
Adolescents With Autism ◽  
Adolescents With Asd

Abstract Background It is unclear whether the administration of antipsychotics to children and adolescents with autism spectrum disorders (ASD) is acceptable, equitable, and feasible. Methods We performed a systematic review to support a multidisciplinary panel in formulating a recommendation on antipsychotics, for the development of the Italian national guidelines for the management of ASD. A comprehensive search strategy was performed to find data related to intervention acceptability, health equity, and implementation feasibility. We used quantitative data from randomized controlled trials to perform a meta-analysis assessing the acceptability and tolerability of antipsychotics, and we estimated the certainty of the effect according to the GRADE approach. We extracted data from systematic reviews, primary studies, and grey literature, and we assessed the risk of bias and methodological quality of the published studies. Results Antipsychotics were acceptable (dropouts due to any cause: RR 0.61, 95% CI 0.48–0.78, moderate certainty of evidence) and well tolerated (dropouts due to adverse events: RR 0.99, 95% CI 0.55–1.79, low certainty of evidence) by children and adolescents with ASD. Parents and clinicians did not raise significant issues concerning acceptability. We did not find studies reporting evidence of reduced equity for antipsychotics in disadvantaged subgroups of children and adolescents with ASD. Workloads, cost barriers, and inadequate monitoring of metabolic adverse events were indirect evidence of concerns for feasibility. Conclusion Antipsychotics in children and adolescents with ASD were likely acceptable and possibly feasible. We did not find evidence of concern for equity.

scholarly journals Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review.

2020 ◽  
Author(s):  
Gian Loreto D'Alò ◽  
Franco De Crescenzo ◽  
Laura Amato ◽  
Fabio Cruciani ◽  
Marina Davoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Grey Literature ◽  
Indirect Evidence ◽  
Autism Spectrum ◽  
National Guidelines ◽  
Adolescents With Autism ◽  
Adolescents With Asd

Abstract Background: It is unclear whether the administration of antipsychotics to children and adolescents with autism spectrum disorders (ASD) is acceptable, equitable, and feasible. Methods: We performed a systematic review to support a multidisciplinary panel in formulating a recommendation on antipsychotics, for the development of the Italian national guidelines for the management of ASD. A comprehensive search strategy was performed to find data related to intervention acceptability, health equity, and implementation feasibility. We used quantitative data from randomized controlled trials to perform a meta-analysis assessing the acceptability and tolerability of antipsychotics, and we estimated the certainty of the effect according to the GRADE approach. We extracted data from systematic reviews, primary studies, and grey literature, and we assessed the risk of bias and methodological quality of the published studies. Results: Antipsychotics were acceptable (dropouts due to any cause: RR 0.61, 95% CI 0.48-0.78, moderate certainty of evidence) and well tolerated (dropouts due to adverse events: RR 0.99, 95% CI 0.55- 1.79, low certainty of evidence) by children and adolescents with ASD. Parents and clinicians did not raise significant issues concerning acceptability. We did not find studies reporting evidence of reduced equity for antipsychotics in disadvantaged subgroups of children and adolescents with ASD. Workloads, cost barriers, and inadequate monitoring of metabolic adverse events were indirect evidence of concerns for feasibility. Conclusion : Antipsychotics in children and adolescents with ASD were likely acceptable and possibly feasible. We did not find evidence of concern for equity.

scholarly journals Impact of antipsychotics in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Gian Loreto D’Alò ◽  
◽  
Franco De Crescenzo ◽  
Laura Amato ◽  
Fabio Cruciani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Children And Adolescents ◽  
Social Communication ◽  
Meta Analysis ◽  
Health Benefit ◽  
Autism Spectrum ◽  
Global Functioning ◽  
Global Improvement ◽  
Adolescents With Asd

Abstract Background The net health benefit of using antipsychotics in children and adolescents with ASD is unclear. This review was performed to provide the evidence necessary to inform the Italian national guidelines for the management of ASD. Methods We performed a systematic review of randomized controlled trials (RCTs) comparing antipsychotics versus placebo for the treatment of ASD in children and adolescents. For efficacy, acceptability and safety we considered outcomes evaluated by the guideline panel critical and important for decision-making. Continuous outcomes were analyzed by using standardized mean difference (SMD), and dichotomous outcomes by calculating the risk ratio (RR), with their 95% confidence interval (95% CI). Data were analyzed using a random effects model. We used the Cochrane tool to assess risk of bias of included studies. Certainty in the evidence of effects was assessed according to the GRADE approach. Results We included 21 RCTs with 1,309 participants, comparing antipsychotics to placebo. Antipsychotics were found effective on “restricted and repetitive interests and behaviors” (SMD − 0.21, 95% CI − 0.35 to − 0.07, moderate certainty), “hyperactivity, inattention, oppositional, disruptive behavior” (SMD − 0.67, 95% CI − 0.92 to − 0.42, moderate certainty), “social communication, social interaction” (SMD − 0.38, 95% CI − 0.59 to − 0.16, moderate certainty), “emotional dysregulation/irritability” (SMD − 0.71, 95% CI − 0.98 to − 0.43, low certainty), “global functioning, global improvement” (SMD − 0.64, 95% CI − 0.96 to − 0.33, low certainty), “obsessions, compulsions” (SMD − 0.30, 95% CI − 0.55 to − 0.06, moderate certainty). Antipsychotics were not effective on “self-harm” (SMD − 0.14, 95% CI − 0.58 to 0.30, very low certainty), “anxiety” (SMD − 0.38, 95% CI − 0.82 to 0.07, very low certainty). Antipsychotics were more acceptable in terms of dropout due to any cause (RR 0.61, 95% CI 0.48 to 0.78, moderate certainty), but were less safe in terms of patients experiencing adverse events (RR 1.19, 95% CI 1.07 to 1.32, moderate certainty), and serious adverse events (RR 1.07, 95% CI 0.48 to 2.43, low certainty). Conclusions Our systematic review and meta-analysis found antipsychotics for children and adolescents with ASD more efficacious than placebo in reducing stereotypies, hyperactivity, irritability and obsessions, compulsions, and in increasing social communication and global functioning. Antipsychotics were also found to be more acceptable, but less safe than placebo.

scholarly journals Cortisol awakening response in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

2019 ◽  
Vol 22 (3) ◽  
pp. 118-124
Author(s):  
Julie A Hadwin ◽  
Emma Lee ◽  
Robert Kumsta ◽  
Samuele Cortese ◽  
Hanna Kovshoff
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cortisol Awakening Response ◽  
Newcastle Ottawa Scale ◽  
Adolescents With Asd

BackgroundThe cortisol awakening response (CAR) is characterised by an increase in cortisol in the 30 to 60 min after waking. Research has found significant associations between an atypical CAR and symptoms of stress and anxiety in typically developing (TD) children and adolescents. A number of studies have explored the CAR in autism spectrum disorder (ASD), but no evidence synthesis is available to date.Objective and methodsBased on a preregistered protocol (PROSPERO: CRD42017051187), we carried out a systematic review (SR) and meta-analysis (MA) of CAR studies to explore potential significant differences between children and adolescents with ASD and TD controls. Web of Science, PubMed and PsychInfo were searched until January 2019. A random-effects model was used to pool studies and we used the Newcastle-Ottawa scale (NOS) to assess study quality and risk of bias.FindingsThe SR retrieved a total of nine studies, with mixed findings on the comparison of the CAR between children and adolescents with ASD and TD controls. The MA, based on four studies (ASD; n=117 and TD n=118), suggested no differences between the CAR in ASD and TD populations (SMD: −0.21, 95% CI −0.49 to 0.08). In terms of NOS items, no study specified Representativeness of the cases and Non-response rate.Discussion and clinical implicationsGiven the relatively few studies and lack of appropriately matched TD controls, additional research is needed to further understand and recommend the utility of the CAR as a reliable marker to differentiate ASD and TD.

scholarly journals Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies

2021 ◽  
pp. bjsports-2020-103140
Author(s):  
Rodney K Dishman ◽  
Cillian P McDowell ◽  
Matthew Payton Herring
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vigorous Physical Activity ◽  
Prospective Cohort Studies ◽  
Over Time

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.

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