State of the Evidence and Strength of Recommendations for Interventions Used by Physical Therapists in Children and Adolescents with Autism: An Overview of Systematic Reviews

AIMS: To evaluate the evidence and strength of recommendations for interventions used by physical therapists for children and adolescents with autism spectrum disorder (ASD). METHOD: An overview of systematic reviews was conducted following the Preferred Reporting Items for Overviews of Reviews of Healthcare Interventions statement. Systematic reviews evaluating interventions used by physical therapists for this population were included. Outcomes were categorized according to the ICF framework. Risk of bias was assessed using the Risk of Bias in Systematic Reviews tool. Quality of evidence and strength of recommendations were evaluated using GRADE and translated into a traffic-light system (green, yellow, or red). A patient and public involvement group, including parents and individuals with ASD, contributed to recommendation evaluation. RESULTS: Nine reviews, including 53 studies and 1016 participants, identified 11 interventions used by physical therapists. Most studies reported positive effects, mainly on body functions and activities, although evidence quality ranged from very low to low. Most interventions received conditional "yellow light" recommendations, whereas task-specific motor training for gross motor function received a strong "green light" recommendation. CONCLUSION: Interventions used by physical therapists may benefit children and adolescents with ASD, but evidence remains overall limited and is of low or very low quality.