Allam 2008.

Methods	Design: parallel groups Randomization method: according to randomization tables Method of allocation concealment: group assignment in sealed envelope Blinding: outcome assessor (language therapist) was blinded Stratification: not used
Participants	Inclusion criteria: age 4‐7 years and fulfilled DSM‐IV and ADI‐R criteria and CARS score >=30 Exclusion criteria: no Number of participants (intervention:control): 10:10 Number of males (intervention:control): 7:5 Age: overall mean 5.5 years (SD 1.22 years), range 4‐7 years Specific diagnosis/diagnostic subtypes: information not available Comorbidities: information not available Duration of autism: information not available Previous treatment: information not available
Interventions	Intervention group: scalp acupuncture + language therapy Scalp acupuncture at 8 acupoints: Du 20, 26, GV 17, 3 temple needles, and Yamamoto YNSA 2 points: cerebrum and aphasia points. Needles (0.3 x 30mm, disposable, single‐use stainless steel) were inserted to a depth of 1/2 to 1 cm until qi was achieved. Rapid manual stimulation was applied upon insertion and removal of needles. Needles were retained in place for 20 minutes each session, twice weekly for 2 months followed by a period of 2 weeks' rest. This cycle was repeated through the 9 months (total number of 50 acupuncture sessions) Language therapy was individualized and aimed at improving attention, receptive and verbal abilities Control group: language therapy alone (same as intervention group)
Outcomes	Arabic Language Test
Notes	No dropouts Duration of follow‐up: 9 months Acupuncture paradigm: medical acupuncture paradigm, scalp acupuncture Training or qualification of acupuncture therapist: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Sequence generation according to randomization tables
Allocation concealment (selection bias)	Low risk	Group assignment in sealed envelope
Blinding (performance bias and detection bias) All outcomes	Low risk	Outcome assessor was blinded. Although acupuncture therapist was likely not blinded, he was not involved in the care of participants otherwise or in outcome assessment. Therefore this is unlikely to introduce bias. Unblinding of autistic children is also considered unlikely to introduce bias
Incomplete outcome data (attrition bias) All outcomes	Low risk	Outcome data were complete
Selective reporting (reporting bias)	Low risk	All outcomes were reported
Other bias	Unclear risk	Baseline characteristics were not described for treatment groups and it is unclear whether the intervention and the control group were comparable. No placebo or sham control was used and hence there might be placebo effect