The primary purpose of this Web site is to provide parents, teachers, clinicians, researchers, and any other interested people with the best available evidence regarding the diagnosis and treatment of autism spectrum disorders, with the focus on early detection and interventions.

Goal 1

To present a broad array of accessible and easy-to-understand information that is evidence based, unbiased, comprehensive, and easily translated into clinical and policy implications. This goal will be achieved by meeting the following objectives.

Objectives:

• providing monthly summaries of evidence-based research from around the world and how the findings can be turned into practice, and
• hosting and moderating an Internet discussion group so that parents and others can post questions, discuss issues, and take part in on-line polls that will be used to generate further topics for discussion and possibly to inform future research.

Goal 2

To find out what it is our readers want to know and how they want to acquire that knowledge.

Objectives:

• conducting on-line surveys to help CAIRN understand who is using the site and what is required to enhance the site’s format, design, and content to meet consumer needs.

Goal 3

To maintain the currency of the Web site and to reduce the likelihood that any work in progress will be missed.

Objective:

• Researchers and experts will commit to visiting this site to provide updates on their work or about ongoing studies in their own areas of expertise.

To achieve the stated goals and objectives, the Web site will be structured using the 12 common criteria used in the evaluation of medical Web sites that were identified by Kim, Eng, Deering and Maxfield (1999, p. 648) To view the Web sites included in the study, go to Evaluation Tools. The categories they identified and a description of how each which will be used to aid in the development of the CAIRN Web site can be found by going to Web site criteria.

Procedures

The Research Study Abstracts

How Articles Will be Selected

The procedures we will use to select and abstract journal articles are based on those developed by the journal Evidence-Based Medicine, and used by Evidence-Based Mental Health, of which journal Dr. Peter Szatmari is an editor. Unlike these two journals, which cover a broad range of health conditions, we will be focusing strictly on autism spectrum disorders.

We are focusing on studies that meet three criteria:

1. They are methodologically rigorous
2. They are new studies
3. They are clinically relevant.

For intervention studies, we will consider studies that use any of the following methodologies:

1. systematic reviews of randomized controlled trials,
2. single randomized controlled trials,
3. controlled clinical trials, and
4. single case studies using an ABA design

For diagnostic studies, we will consider those using DSM-IV and ICD-10 criteria as the "gold standard" comparison and a blinded comparison group.

For studies of prognosis, we will consider those using inception cohorts.

For studies of etiology, we will use

1. randomized controlled trials
2. quasi-randomized controlled trials
3. non-randomized controlled trials
4. cohort studies with case by case matching or statistical adjustment to create comparable groups
5. nested case control studies

Types of Patients:

Children with autism spectrum disorders as described in the DSM-IV and ICD-10.

Types of Interventions:

Early intervention programs, whether behaviour therapies or pharmacological treatment, including head-to-head studies. Each type of intervention will form a separate category and each will be addressed separately

Criteria for selection of articles for abstracting:

Studies of treatment must meet these criteria:

• Original or review articles
• English language
• About humans

• About topics that are important to those living with or working with children with autism and related conditions

• Random allocation of participants to comparison groups
• Follow up (end point assessment) of at last 80% of those entering the investigation
• Outcome measures of known or probable clinical importance
• Analysis consistent with study design.

For details, please see Additional criteria

Search Strategy

We will conduct OVID searches of MEDLINE, CINAHL, PsycINFO, HealthSTAR, Cochrane Controlled Trials Register, DARE, Cochrane Database of Systematic Reviews and ERIC.

Search terms can include the following, depending on the database used:

MeSH heading = autistic disorder, combined with:
early intervention OR diagnosis OR screening OR treatment OR therapy OR causation

Pertinent journals will be hand searched for relevant articles.

Format of Abstracts of Intervention Studies

The summaries, or abstracts, will use a consistent format using the headings described by Haynes, et al. (1990), and thus will consist of

Objective:

Design:

Setting:

Funding Source:

Patients or Other Participants:

Intervention(s):

Main Outcome Measure(s):

Results:

Conclusions:

For heading definitions please see Structured Abstract Headings Definitions

References

Haynes, R. B., Mulrow, C.D., Huth, E.J. Altman, D.G., Gardner, M.J. (1990).

More informative abstracts revisited. Annals of Internal Medicine, Vol. 113, No. 1: 69-76.

Purpose and Procedure. (2000). Evidence-Based Mental Health, Vol. 3, Feb.: 2.