Autism Spectrum Disorder Interventions in Mainland China: A Systematic Review

Background: Research on effective interventions for autism spectrum disorder (ASD) has historically been focused on Western populations.However, research in low- and middle-income countries is severely limited.This issue is particularly relevant given the majority of ASD measures and interventions were developed in high-income countries, with potentially limited relevance to low- and middle-income countries such as China(Elsabbagh et al. 2012).

Objectives: In light of the growing interest in ASD interventions in China, we systematically reviewed the academic literature to identify interventions to support individuals with ASD and their families in mainland China. This literature review seeked to determine the current state of ASD intervention research in mainland China, as well as trends from the past 25 years.

Methods: Using an identical search string, four databases – PubMed, PsycINFO, ScienceDirect, and Web of Science – were methodically searched for peer-reviewed studies conducted in mainland China on ASD interventions from 1995 to August 8^th, 2018. Although 1,012 studies were initially found, reading abstracts from each study yielded 35 potentially suitable papers. After removing duplicates and reading full texts, only 13 English-language articles and nine Chinese-language articles were found to be suitable for inclusion.

Results: Half of included studies (n = 11) were published in 2017 and 2018, indicating a recent surge in research. Participants in all studies were either children or adolescents. The most popular interventions researched included acupoint-based (n= 5) and theory of mind (TOM)-based (n = 5) interventions. Studies demonstrated a spectrum of cultural adaptation of each intervention. All but one study concluded that their interventions were effective in mitigating specific ASD symptoms.

Conclusions: Although there has been a recent surge in research on interventions for ASD in mainland China, future studies must be longer, randomized, and placebo-controlled if possible. Additionally, studies should strive to include larger sample sizes consisting of participants of more diverse geographic and ethnic backgrounds throughout the country. Meanwhile, increased support must be given to teachers, therapeutic specialists, and caregivers of dependents with ASD.