Qigong in the treatment of children with autism spectrum disorder: A systematic review

Background: Autism spectrum disorder is a condition that affects all races, ethnic and socioeconomic groups. With a high incidence ratio of one in every 68, it has become one of the most discussed psychiatric disorders. For this reason, the need for investigating novel treatments has been emerging. Qigong, a traditional Chinese mind-body technique, has already proven to be able to reduce symptoms of several physical and psychological illnesses. Objective: The purpose of this systematic review is to examine and categorize the current scientific evidence regarding the efficacy of Qigong on children suffering from autism spectrum disorders. Search strategy: A systematic literature search of the electronic scientific databases PubMed, Clinical Trials. gov, BioMed Central, PubMed Central and Google Scholar was performed to identify studies of Qigong in the treatment of children with autism spectrum disorder. Inclusion criteria: This review included randomized controlled trials, replication studies, retrospective studies and observational follow-up studies of Qigong on children with autism spectrum disorder. Case reports and case series were excluded. Data extraction and analysis: Two researchers independently evaluated the methodological quality of all included studies. Any discrepancies were solved by discussion until consensus was achieved. Results: Our literature search identified 157 publications, and 10 additional publications from hand search of references. After duplicate removal, 103 records remained. After the title/abstract screening, 19 publications were obtained for detailed evaluation. After detailed evaluation, 10 studies were included. Seven studies were conducted with small children with 2-6 years old employing Qigong massage, and three studies were conducted with older children aged 7-17 years old applying both Qigong massage (one study) and Neigong (two studies). Conclusion: Studies demonstrated that Qigong has interesting and promising applicability and effect on children with autism spectrum disorder and should be tested further. Despite the need for more rigorous controlled studies, Qigong seems to be able to decrease severity of individual sensory, behavioural, and language components of autism, and improve self-control, sociability, sensory and cognitive awareness as well as healthy-physical behaviour. Besides positive effect on children and adolescents, benefits seem to extend to parents and caregivers as well. However, quality of methodology seems to be insufficient to state that Qigong is an alternative to common behavioural therapies. We suggest that, until more investigation is performed, Qigong may only be used as a complement, or when behavioural therapies are not accessible. (C) 2019 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.