Placebo effects in children with autism spectrum disorder

Placebo responses are frequently observed in research studies and clinical contexts, yet there is limited knowledge about the placebo effect among children with neurodevelopmental disorders. Here, we review the placebo effect in autism spectrum disorder (ASD). Placebo responses are widely evident in ASD clinical trials and could partly operate via so-called placebo-by-proxy, whereby caregivers or clinicians indirectly shape patient outcomes. Understanding the role of placebo effects in ASD may help discern genuine treatment effects from contextual factors in clinical trials. The much less studied nocebo effect, or negative placebo, might contribute to the experience of side effects in ASD treatments but empirical data is missing. Better knowledge about placebo and nocebo mechanisms may contribute to the development of more effective research designs, such as three-armed designs that account for natural history, and improved treatments for ASD symptoms. At a clinical level, deeper knowledge about placebo and nocebo effects may optimize the delivery of care for individuals with ASD in the future.

Automated summary

Placebo responses are frequently observed in research studies and clinical contexts, yet there is limited knowledge about the placebo effect among children with neurodevelopmental disorders. In this review, the authors discuss the placebo effect in autism spectrum disorder (ASD) and how it can be influenced by caregivers or clinicians indirectly shaping patient outcomes. Understanding placebo effects in ASD may help differentiate genuine treatment effects from contextual factors in clinical trials and improve research designs and treatments for ASD symptoms. Furthermore, deeper knowledge about placebo and nocebo effects may optimize care delivery for individuals with ASD in the future.