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Question clinique
Do mobile device applications improve symptoms in children with autism spectrum disorders?
L’Essentiel
We are in the early days of the evaluation of mobile device applications (apps) for managing children with autism spectrum disorder (ASD). The limited data suggest the apps may offer something worthwhile, but we can't be certain of that yet. 1a
Référence
Plan de l'etude: Meta-analysis (randomized controlled trials)
Financement: Self-funded or unfunded
Cadre: Outpatient (any)
Sommaire
These authors searched multiple databases and clinical trials registries for randomized trials of interactive mobile device apps used for managing patients with clinically diagnosed ASD. Two authors independently evaluated studies for inclusion, as well as assessed the risk of bias of the included studies. They identified 7 small studies (sample sizes: 25 - 75 children). The median age of the included children ranged from 3 years to 10 years. The control interventions included delayed introduction of the app, usual care, and other behavioral care (for example, classroom interventions). Four of the 7 trials were at high risk of bias. The apps targeted a range of domains: communication, social skills, visual and motor skills, imitation, anxiety, and challenging behaviors. Only 3 studies used the same assessment subscales. Despite these limitations, the authors chose to pool the results. After pooling the data, only 2 of the subscales (the visual and fine motor subscales of the Mullen Scales of Early Learning), which were assessed in only 2 studies, showed improvement with the use of the mobile device apps. It is unclear if the magnitude of these differences are clinically meaningful. The authors report no significant heterogeneity in the pooled data and they found no evidence of publication bias.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI