Evidence-Based Review of Interventions for Autism Used in or of Relevance to Occupational Therapy
American Journal of Occupational Therapy
Case-Smith, J., & Arbesman, M. (2008).
American Journal of Occupational Therapy, 62(4), 416-429.
This systematic review investigates the effects of occupational interventions on cognitive communication outcomes in children and adolescents on the autism spectrum. Although this review examines occupational therapy interventions, highlighted conclusions may involve a speech-language pathologist.
Not stated
1986-2007
Randomized controlled trials; systematic reviews; meta-analyses; nonrandomized clinical trials; cohort studies; before-after design studies; one-group design studies
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Social Stories™ resulted in small positive effects on teaching appropriate social skills behavior to children on the autism spectrum, including eliciting the children's active participation in therapy.
Results indicated modest, positive effects for cognitive-based social skills training, which incorporated simple discrete steps of social skills that are explained, modeled, and practiced.
"Training parents to implement skill-based interventions has mixed evidence for its effectiveness in promoting the child's performance and does not lower parent stress" (p. 423).
The included studies suggested evidence of moderate to strong effects for Early Intensive Behavioral Intervention using discrete trial training.
Group social skills training demonstrated limited improvements in social interaction of adolescent participants.
Studies indicated structured play activities (including cueing, prompting, and reinforcement) to be effective in enhancing the following skills in children on the autism spectrum:<br />
<ul>
<li>turn-taking;</li>
<li>sharing;</li>
<li>communication; and</li>
<li>social interaction</li>
</ul>
"Interventions emphasizing responsive, supportive relationships, and social-emotional development in young children can facilitate the child's social-emotional growth and promote development of pivotal behaviors essential for learning" (p. 420).
The included studies indicated small positive effects for developmental, play-based interventions (e.g., Treatment and Education of Autistic and Communication Handicapped Children [TEACCH]) that emphasize positive affect, nonverbal communication play, social relationships, and classroom structure. These developmental programs that use visual cueing and visual learning were reported to be effective in promoting communication and learning. Although the included studies reported positive effects across developmental domains, results were limited due to the Level II or III studies.
Relationship-based interventions (RBIs) had small but positive effects for improving social-emotional growth in children (p. 419). RBIs that incorporate adult imitation of the child's actions, "implement high levels of positive responsiveness, apply prompting and cueing, facilitate peer interactions, establish environments that support social interaction, and demonstrate positive effects on social engagement in children with ASD" (p. 419).
"Sensory integration intervention appears to enhance the child's ability to modulate behavior and participate in social interaction; however, findings are inconclusive at this time" (p. 418).<br /><br />Results indicated inconclusive evidence to support the effectiveness of auditory training approaches, such as therapeutic listening and auditory integration training.
