Autism spectrum disorder (ASD) is one the most disabling developmental disorders, imposing an extremely high economic burden. Obtaining as accurate prevalence estimates as possible is crucial to guide governments in planning policies for identification and intervention for individuals with ASD and their relatives. The precision of prevalence estimates can be heightened by summative analyses of the data collected around the world. To that end, we conducted a three-level mixed-effects meta-analysis. A systematic search of the Web of Science, PubMed, EMBASE, and PsycINFO databases from 2000 up to 13 July 2020 was performed, and reference lists of previous reviews and existing databases of prevalence studies were screened. Overall, 79 studies were included in the analysis of ASD and 59–in the analysis of previously existing relevant diagnoses: 30 for Autistic Disorder (AD), 15 for Asperger Syndrome (AS), and 14 for Atypical Autism (AA) and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS); these research reports covered the period from 1994 to 2019. Pooled prevalence estimates were 0.72% (95% CI = 0.61–0.85) for ASD, 0.25% (95% CI = 0.18–0.33) for AD, 0.13% (95% CI = 0.07–0.20) for AS, and 0.18% (95% CI = 0.10–0.28) for the combined group of AA and PDD-NOS. Estimates were higher (1) for the studies that used records-review surveillance rather than other designs; (2) in North America compared with other geographical regions; and (3) in high-income compared with lower-income countries. The highest prevalence estimates were registered in the USA. There was an increase in autism prevalence estimates over time. The prevalence was also significantly higher for children aged between 6 and 12 years compared to children under the age of 5 and over the age of 13 years.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019131525, identifier CRD42019131525.
Complementary and alternative therapy (CAT) methods for children with autism spectrum disorders (ASD) are widespread in European countries and the Russian Federation; however, their efficacy and safety is not routinely considered by parents and clinicians when recommended or used. The current narrative review presents the most widely known CAT interventions for children with ASD synthesizing data from meta-analyses, systematic reviews, and randomized controlled trials obtained from the PubMed database based on the safety-efficacy model. We have found that, of the reviewed CATs, only the melatonin intervention can be considered safe and effective for children with ASD with comorbid sleep problems. The methods that were classified as safe but had inconclusive efficacy are recommended to be implemented only when they do not interfere with front line treatment for ASD, Applied Behavior Analysis (ABA). Methods with the lack of current evidence for the efficacy such as auditory integration therapies, bioacoustic correction, sensory integration therapy, micropolarization, animal assisted therapy, and dietary interventions should not be recommended as alternative treatments and can only be used as complimentary to ABA-based interventions. We advise against the use of chelation, hyperbaric oxygen therapy, and holding therapy due their documented harmful psychological and physical effects. When considering CAT for ASD we recommend parents and clinicians use the criteria suggested by Lofthouse and colleagues [59]: only the therapies that are safe, easy, cheap, and sensible can be recommended and used, as opposed to therapies that are risky, unrealistic, difficult, or expensive that should not be recommended or utilized.
Difficulties in language development are common hallmarks of different neuro-developmental disorders. Early diagnosis is a crucial factor for proper early interventions and better prognosis. Currently, there is a severe shortage of standardized instruments for assessing potential language disorders in Russia. To address this gap, we analyzed the psychometric properties of the Russian version of the Preschool Language Scale, 5th edition (RPLS-5). The sample consisted of 473 children aged 3 to 96 months (Mean=32.64, SD=19.79), including 224 typically developing (TD) children and 240 at-risk (AR) children. To assess the reliability of the Russian version of the PLS-5, we used both Classical Test Theory (CTT) and Item Response Theory (IRT). The results indicated the high reliability of the RPLS-5 based on both types of analyses. According to the results of IRT analysis, the difficulty of items ranged from very easy to very difficult, and with few exceptions, the difficulty parameters consistently increased for each subsequent item, reflecting the hierarchical organization of the test. The discrimination parameters ranged from high to perfect. In general, IRT demonstrated that the RPLS-5 is reliable for low-to-high levels of language abilities.
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