A network meta-analysis of the effects of different rehabilitation intervention strategies on executive function in children and adolescents
- Forfatter(e)
- Li, L., Wang, C., Wang, Z., Wang, Y., Xiao, Q.
- År
- 2025
- Tidsskrift
- European Journal of Pediatrics
- Volum
- 184
- Sider
- 637
- Kategori(er)
- Autismespekter Kognisjon (hukommelse, oppmerksomhet og eksekutive funksjoner)
- Tiltakstype(r)
- Kognitiv atferdsterapi, atferdsterapi og kognitiv terapiHabilitering/rehabilitering (inkl. fysioterapi)Fysisk aktivitet
- Abstract
This network meta-analysis aimed to assess and compare the effectiveness of different non-pharmacological interventions for executive function in children and adolescents with autism spectrum disorder (ASD). This network meta-analysis followed PRISMA guidelines and searched multiple databases until 1 May 2025. Studies were selected based on PICOS criteria, including RCTs on ASD and executive function. The risk of bias was assessed via the Revised Cochrane risk-of-bias tool. The certainty of the evidence was appraised via the confidence in the network meta-analysis framework. Network meta-analysis was statistically assessed via STATA 17.0. The surface under the cumulative ranking was used to estimate the rankings among different interventions. A total of 23 RCTs involving 1004 children and adolescents with ASD were included. This study showed that exercise intervention had relatively strong advantages in improving overall executive function and inhibitory control, and also had certain effects on cognitive flexibility and working memory in children and adolescents with ASD. Cognitive-behavioral intervention performs better in terms of working memory. Cognitive-behavioral intervention and executive function task training also demonstrated positive effects on executive function rehabilitation.
CONCLUSION
This study indicates that different rehabilitation methods have a significant impact on overall executive function and its various dimensions. In clinical practice, exercise, cognitive-behavioral intervention, and executive function task training are actively recommended. However, the effectiveness of combining different intervention strategies or using novel AI rehabilitation tools for executive function rehabilitation remains to be explored in randomized controlled trials with larger sample sizes.
TRIAL REGISTRATION
PROSPERO (CRD42025641698).
WHAT IS KNOWN
* In intervention strategies for autism, improving executive function plays a crucial role in enhancing patients' quality of life and social adaptability. Although various interventions have achieved some success, their effects on executive function differ.
WHAT IS NEW
* There is still a lack of sufficient scientific evidence on the comparative advantages and complementary effects of different intervention strategies. Therefore, it is important to conduct a systematic review of the effects of different rehabilitation intervention strategies on the improvement of executive function in autism, especially using a network meta-analysis.