PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Low-quality studies on early interventions for autism dominate the field, says researchers

Low-quality studies on early interventions for autism dominate the field, says researchers
2023-11-20
(Press-News.org) CHAPEL HILL, N.C. – The Centers for Disease Control and Prevention report that autism is becoming more common in young children. In an effort to improve the challenges young autistic children face as part of their early development, researchers have focused on developing and evaluating nonpharmaceutical interventions that can be provided in early childhood.

Micheal Sandbank, PhD, an assistant professor in the Department of Health Sciences at the UNC School of Medicine, is an expert on the research supporting these early interventions, which informs clinical practice across the United States. A new comprehensive meta-analysis, led by Sandbank, shows that many low-quality studies dominate the field, and ultimately dictate intervention recommendations and patient outcomes.

The results were published in the British Medical Journal.

“What our study shows is really that the evidence is poor for a lot of interventions and that we have not done a very good job of monitoring for potential adverse effects or harms,” said Sandbank. “We, as pediatricians or therapists, need to be clearer with families about what that landscape of evidence looks like and then also be clear that these interventions might have negative impacts that we just don't know about.”

A Fractured Landscape

Early intensive behavioral intervention is the “gold standard” for early autism care in the United States. The adult-led, highly structured intervention provides young autistic children with one-on-one support for 20-40 hours per week.

Some clinicians claim it is too intense, and prefer to promote more developmentally-informed interventions, which are often provided at lower intensities and can be easily embedded in the daily family routines. However, not everyone agrees.

“There's really a lot of different interventions that are available to this population, but the researchers studying them don’t agree with one another,” said Sandbank. “As a result, there's a fractured landscape both of what is offered and how researchers feel about what is the best support for the children and their caregivers.”

A Change-Up in Study Approaches

Clinicians choose interventions for their patients based on outcomes from the most up-to-date research studies.

Several different types of studies can be used to evaluate the efficacy of a particular intervention. Often, these studies compare a group of participants who have received the intervention to participants who did not receive the intervention. Sometimes, participants are assigned to each group randomly through a randomized controlled trial. Other times, the participants are assigned to each group based on non-random factors through a quasi-experimental study.

In autism research, quasi-experimental studies have given way to randomized-controlled trials. Randomized-controlled trials can offer more accurate findings because random assignment reduces the influence of other factors that may skew the outcomes. However, a plethora of quasi-experimental studies still exist in the field and inform clinical practice.

The research team’s meta-analysis, which searched all recent scientific literature and compared study methods and results for different types of interventions, found that the number of studies, including randomized controlled trials, had doubled in just four years.

However, even though randomized controlled trials are increasing, other problematic study methods are prevalent. Sandbank and her colleagues found that even when they considered evidence from randomized controlled trials alone, many of the studies had not adequately controlled for two important risks of bias: placebo-by-proxy and detection bias.

Eliminating Biases and Improving Accuracy

Researchers strive to carefully design studies so that the answers they provide are as accurate as possible. There are cases, though, where aspects of study design threaten the accuracy of results and can make interventions appear more effective than they are.

When scientists measure outcomes through caregiver report, placebo-by-proxy bias may occur. This happens when caregivers subconsciously report better outcomes because they know their child is receiving an intervention that they believe to be effective. Even when scientists directly measure outcomes themselves, they may subconsciously overestimate the effect of the intervention if they are aware of which group each participant is assigned to, a type of bias known as detection bias.

Sandbank and her colleagues found that when they only considered the best evidence that adequately guarded against all of these risks, few of the most popular interventions had support from the best evidence.

“However, this does not mean that these interventions are not effective,” said Sandbank. “What we need are more rigorous studies of the types of interventions that are offered to children and families, so that we can really understand both their positive and negative effects.”

In the meantime, clinicians struggling to choose the best support for their patients can simply be more transparent about current evidence and remove absolute phrasing when presenting interventions to autistic children and their caregivers. Sandbank finds this to be especially important for supporting caregiver decision-making and their own mental health.

“Just as children can thrive with certain interventions, they can have adverse reactions, too,” said Sandbank. “There are families that have very negative experiences, but they are not quick to let go of an intervention approach that is not working for them because they have been told that it is supported by incontrovertible evidence. That can cause a lot of self-doubt and self-blame.”


About UNC School of Medicine

The UNC School of Medicine (SOM) is the state’s largest medical school, graduating more than 180 new physicians each year. It is consistently ranked among the top medical schools in the US, including 5th overall for primary care by US News & World Report, and 6th for research among public universities. More than half of the school’s 1,700 faculty members served as principal investigators on active research awards in 2021. Two UNC SOM faculty members have earned Nobel Prize awards.

# # # #

END


[Attachments] See images for this press release:
Low-quality studies on early interventions for autism dominate the field, says researchers Low-quality studies on early interventions for autism dominate the field, says researchers 2 Low-quality studies on early interventions for autism dominate the field, says researchers 3

ELSE PRESS RELEASES FROM THIS DATE:

Study finds possible early predictor of successful transcranial magnetic stimulation therapy for major depression

2023-11-20
A new study from UCLA Health researchers demonstrates that a novel treatment is effective in most patients with major depressive symptoms even after multiple failed courses of antidepressant medication. The treatment, repetitive transcranial magnetic stimulation (rTMS), may work even more rapidly than past findings have suggested, starting to alleviate symptoms as quickly as one week. Researchers from the Neuromodulation Division of UCLA’s Semel Institute analyzed the outcomes of hundreds of patients treated at UCLA Health from 2009 to 2022 with rTMS therapy, which uses magnetic fields to effectively “rewire” ...

Trend report: High blood pressure increasing in low-income adults; diabetes and obesity on the rise in higher-income adults

2023-11-20
Embargoed for release until 5:00 p.m. ET on Monday 20 November 2023 Annals of Internal Medicine Tip Sheet @Annalsofim Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent. ---------------------------- 1. ...

More than 1,100 physicians, health care professionals, and scientists boycott medical journal

2023-11-20
WASHINGTON, D.C. — More than 1,100 experts have joined the Physicians Committee for Responsible Medicine in boycotting the medical journal Nutrients until it stops publishing egregious animal experiments that could have been ethically conducted in humans. The boycott, which also applies to Nutrients’ publisher, MDPI, comes after repeated requests to the journal’s editors asking them to institute sound editorial practices. A letter sent to those editors today, Nov. 20, 2023, says “As a community of scientists and health care professionals, we have ...

Urban environmental exposures drive increased breast cancer incidence

2023-11-20
DURHAM, N.C. – A Duke Health analysis of breast cancer in North Carolina showed that the state’s urban counties had higher overall incidences of disease than rural counties, especially at early stages upon diagnosis.   The findings, appearing in the journal Scientific Reports, serve as a national template for assessing the impact of poor environmental quality across different stages of breast cancer, which is marked by highly diverse origins and mechanisms for spreading. North Carolina serves as a good model; it has a diverse population ...

C-sections in Mexico increase with obesity level and health care specialization

2023-11-20
URBANA, Ill. — Cesarean section (C-section) procedures have increased dramatically around the world in the recent decades. Overweight and obesity rates, common risk factors for pregnancy outcomes and for C-sections, are also on the rise — creating a major health issue in low- and middle-income countries. A new study from the University of Illinois Urbana-Champaign investigates how high obesity levels lead to hospital specializations that affect the frequency of C-sections in Mexico. “Of course, obesity is a medical factor for C-sections; however, when we started this project we did not believe it to be the ...

New machine learning technique 30% better at predicting cancer cure rates

New machine learning technique 30% better at predicting cancer cure rates
2023-11-20
With the rapid development in computing power over the past few decades, machine-learning (ML) techniques have become popular in medical settings as a way to predict survival rates and life expectancies among patients diagnosed with diseases such as cancer, heart disease, stroke, and, more recently, COVID-19. Such statistical modeling helps patients and caregivers balance treatment that offers the highest chance of a cure while minimizing the consequences of potential side effects. A professor and his doctoral student at The University of Texas at Arlington have published a new model of predicting survival from ...

Potential therapeutic target found to combat tuberculosis, a disrupted NAD(H) homeostasis

Potential therapeutic target found to combat tuberculosis, a disrupted NAD(H) homeostasis
2023-11-20
BIRMINGHAM, Ala. – It has been uncertain how Mycobacterium tuberculosis deflects the immune response in humans, though evidence has pointed to host immunometabolism — the intrinsic link between metabolism in immune cells and their immune function. The pathogen M. tuberculosis is known to disrupt a metabolic pathway called glycolysis in infected myeloid cells, which include macrophages, through an unclear mechanism. A more accurate understanding of this pathogenic mechanism could provide a target against the bacterium that caused 1.6 million deaths in 2021, along with 10 million new cases of tuberculosis every year. Now a study published ...

Global Neuroanatomy Network (GNN): Creating a new resource for neuro educators

2023-11-20
In a leap forward for neuroanatomy education, the Global Neuroanatomy Network (GNN) is about to launch, creating a new, accessible, peer-reviewed collection of resources for instructors around the world. Developed as a response to the challenges faced in transitioning neuroanatomy education to an online format during the pandemic, the GNN represents a collaborative effort by educators globally. The initiative began as a conversation on social media, recognizing the need for better resources and support for teaching neuroanatomy online. As educators ...

New research demonstrates more effective method for measuring impact of scientific publications

2023-11-20
Newly published research reexamines the evaluation of scientific findings, proposing a network-based methodology for contextualizing a publication’s impact. This new method, which is laid out in an article co-authored by Alex Gates, an assistant professor with the University of Virginia’s School of Data Science, will allow the scientific community to more fairly measure the impact of interdisciplinary scientific discoveries across different fields and time periods. The article was published ...

UCSB scientists will eliminate bottlenecks to breakthroughs with a newly acquired synthetic biology robotics system

2023-11-20
Researchers in UC Santa Barbara’s newly designated Biological Engineering (BioE) Department have received a significant boost from the U.S. Army, which awarded the university a $9.85 million grant to design and purchase state-of-the-art equipment that project leader Michelle O’Malley, a professor of chemical engineering and biological engineering, says “allows UCSB scientists to do things that we never thought were possible.” The funding, awarded through the Department of Defense’s Defense University Research ...

LAST 30 PRESS RELEASES:

Bioinformatics approach could help optimize soldiers’ training for improved readiness and recovery

Earth scientists describe a new kind of volcanic eruption

Warmer wetter climate predicted to bring societal and ecological impact to the Tibetan Plateau

Feeding infants peanut products protects against allergy into adolescence

Who will like beetle skewers? What Europeans think about alternative protein food

ETRI wins ‘iF Design Award’ for mobile collaborative robot

Combating carbon footprint: novel reactor system converts carbon dioxide into usable fuel

Investigating the origin of circatidal rhythms in freshwater snails

Altering cellular interactions around amyloid plaques may offer novel Alzheimer’s treatment strategies

Brain damage reveals part of the brain necessary for helping others

Surprising properties of elastic turbulence discovered

Study assesses cancer-related care at US hospitals predominantly serving minority populations compared with non-minority serving hospitals

First in-human investigator-initiated clinical trial to launch for refractory prostate cancer patients: Novel alpha therapy targets prostate-specific membrane antigen

Will generative AI change the way universities communicate?

Artificial Intelligence could help cure loneliness, says expert

Echidnapus identified from an ‘Age of Monotremes’

Semaglutide may protect kidney function in individuals with overweight or obesity and cardiovascular disease

New technique detects novel biomarkers for kidney diseases with nephrotic syndrome

Political elites take advantage of anti-partisan protests to disrupt politics

Tiny target discovered on RNA to short-circuit inflammation, UC Santa Cruz researchers find

Charge your laptop in a minute? Supercapacitors can help; new research offers clues

Scientists discover CO2 and CO ices in outskirts of solar system

Theory and experiment combine to shine a new light on proton spin

PKMYT1, a potential ‘Achilles heel’ of treatment resistant ER+ breast cancers with the poorest prognosis

PH-binding motifs as a platform for drug design: Lessons from protease-activated receptors (PARs)

Virginia Tech researcher creates new tool to move tiny bioparticles

On repeat: Biologists observe recurring evolutionary changes, over time, in stick insects

Understanding a broken heart

Genetic cause of rare childhood immune disorders discovered

With wobbling stars, astronomers gauge mass of 126 exoplanets and find 15 new ones

[Press-News.org] Low-quality studies on early interventions for autism dominate the field, says researchers