The Effectiveness of Art Therapy on Children and Adolescents with ASD: A Systematic Review of RCTs

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects social interaction, communication, and behavior. Traditional interventions such as Applied Behavior Analysis and sensory integration therapy often lack a person-centered approach. Art therapy offers a creative and holistic alternative for supporting children and adolescents with ASD. Objectives: This study systematically reviewed and evaluated the effectiveness, modalities, formats, and methodological quality of randomized controlled trials (RCTs) involving art therapy interventions for children and adolescents with ASD. Methods: A systematic search of eight databases identified 12 RCTs involving art therapy for children and adolescents with ASD. Intervention outcomes, formats, and methodological rigor were assessed through this systematic review. Methodological rigor was assessed using the Cochrane ROB 2.0 tool, and the Delphi list with four additional items. Results: Art therapy showed promise in reducing ASD symptoms and stress-related symptoms, and in improving social communication, motor skills, language, and neurodevelopment. Most studies had limitations, including small sample sizes, short durations, a high risk of bias, and low methodological quality. Conclusions: Although existing studies suggest that art therapy may benefit children and adolescents with ASD, further rigorously designed studies are required to establish its efficacy and inform evidence-based practice.