非药物干预类别对自闭症谱系障碍儿童认知领域影响的比较：随机对照试验的系统综述与网络荟萃分析。
完整摘要 · 中文译文
本系统综述与网络荟萃分析旨在比较非药物干预类别对孤独症谱系障碍儿童注意力、工作记忆、综合执行功能和社会情绪认知的影响。检索了五个数据库，纳入2005年1月至2026年4月12日发表的随机对照试验。采用标准化均数差及95%置信区间进行随机效应配对荟萃分析和频率学派网络荟萃分析。分别使用Cochrane偏倚风险2工具和CINeMA评估偏倚风险和网络估计的置信度。36篇报告符合纳入标准，其中35篇报告涉及1694名儿童纳入定量合成。非药物干预对认知结局产生了具有统计学意义的中等程度总体改善（标准化均数差=0.54，95%置信区间0.36-0.71），对工作记忆（0.61，0.09-1.13）和社会情绪认知（0.47，0.30-0.65）具有显著获益。社会情绪认知是唯一具有足够连接网络以进行干预类别间比较的领域；社会行为干预以及技术和机器人辅助干预相对于主动对照显示出最明显的获益。注意力、工作记忆和综合执行功能的证据网络稀疏或不连通。部分社会情绪认知比较的置信度为中等，但大多数估计的置信度为低或极低。非药物 干预措施可能改善自闭症谱系障碍儿童的某些特定认知结局，但效应似乎具有领域特异性。仍需开展样本量更充足、采用标准化结局指标的头对头试验。
完整摘要 · 英文原文
This systematic review and network meta-analysis aimed to compare the effects of non-pharmacological intervention categories on attention, working memory, comprehensive executive function, and social-emotional cognition in children with autism spectrum disorder. Five databases were searched for randomized controlled trials published from January 2005-12 April 2026. Random-effects pairwise meta-analyses and frequentist network meta-analyses were conducted using standardized mean differences with 95% confidence intervals. Risk of bias and confidence in network estimates were assessed using the Cochrane Risk of Bias 2 tool and CINeMA, respectively. Thirty-six reports met the eligibility criteria, and 35 reports involving 1694 children contributed to the quantitative synthesis. Non-pharmacological interventions produced a statistically significant moderate overall improvement in cognitive outcomes (standardized mean difference = 0.54, 95% confidence interval 0.36-0.71), with significant benefits for working memory (0.61, 0.09-1.13) and social-emotional cognition (0.47, 0.30-0.65). Social-emotional cognition was the only domain with a sufficiently connected network for comparisons across intervention categories; social-behavioral and technology- and robot-assisted interventions showed the clearest benefits relative to active controls. Evidence networks for attention, working memory, and comprehensive executive function were sparse or disconnected. Confidence was moderate for selected social-emotional cognition comparisons but low or very low for most estimates. Non-pharmacological interventions may improve selected cognitive outcomes in children with autism spectrum disorder, but effects appear domain specific. More adequately powered head-to-head trials using standardized outcomes are needed.