Interventions for Children on the Autism Spectrum: A Synthesis of Research Evidence
Whitehouse, A., Varcin, K., et al. (2020).
Brisbane (Australia): Autism CRC, 1-503.
This umbrella review investigates non-pharmacological interventions in children on the autism spectrum. Only interventions within the speech-language pathologist's scope of practice will be discussed in the Conclusions section below. Specific details about the included articles are available elsewhere in the Evidence Maps. See the Associated Article section below for the citations.
Autism CRC (Australia)
The data in this umbrella review are included in other documents in the Evidence Maps, some of which can found in the Associated Article section below. For the full list of included studies, please see Appendix M of the <a href="https://www.autismcrc.com.au/interventions-evidence">AutismCRC report</a>.
2010 to July 15, 2020
Systematic reviews
58
<div>Overall, technology-based interventions demonstrated mixed effects across communication-related outcomes. Apps were reported to have no effect on improving social-communication, communication, and expressive/receptive language skills. Low-quality evidence indicated that computer-based instruction had a positive effect on social communication.</div>
<div>Results demonstrated that the Picture Exchange Communication System (PECS) had a positive effect on social-communication, no effect on expressive language, and an inconsistent effect on general outcomes.</div>
<div>Results indicated that systematic reviews of assorted behavioral interventions (e.g., discrete trial training, early intensive behavioral intervention, functional communication training) generally had positive effects on the following skills in children on the autism spectrum:</div>
<ul>
<li>social-communication;</li>
<li>communication;</li>
<li>expressive language; and</li>
<li>cognition.</li>
</ul>
<div>The results, however, were limited due to the moderate to low quality of the reviewed studies.</div>
<div>Systematic reviews of moderate-quality evidence investigating assorted developmental interventions were reported to have a positive effect on social-communication and no effect on communication; however, high-quality evidence indicated that developmental interventions can improve caregiver communication and interaction strategies.</div>
<div>Results suggested that individual and group interventions both demonstrated positive effects on child and family outcomes.</div>
<div>Although limited due to low quality evidence, findings indicated naturalistic teaching strategies to have a positive effect on social-communication, communication, cognition, play, and academic skills. Findings suggested Developmental Individual-Difference Relationship-Based (DIR)/Floortime to have a positive effect on social-communication, but no effect was demonstrated for communication and other general outcomes.</div>
<div>Low-quality evidence indicated that language training (production) had a positive effect on communication outcomes and language training (production and understanding) had an inconsistent effect on children on the autism spectrum.</div>
<div>Low-quality evidence reported that discrete trial training had positive effects on social-communication, communication, cognitive, play, and academic skills in children on the autism spectrum. Moderate-quality evidence reported that early intensive behavioral intervention had positive effects on social-communication, communication, expressive language, receptive language, cognitive, and academic skills in children on the autism spectrum.</div>
<div>Although limited to one included systematic review, social skills training was reported to have positive effects on improving social-communication, communication, and play skills. Results indicated that social cognition and Social Thinking interventions had no effects on outcomes.</div>
<div>Early Start Denver Model (EDSM) and Pivotal Response Treatment were reported to demonstrate mixed effects across social-communication, communication, and receptive/expressive language outcomes in children on the autism spectrum. Moderate-quality evidence supported the use of EDSM to improve caregiver communication and interaction strategies.</div>
<div>Moderate-quality evidence indicated that TEACCH had no effect on improving social-communication skills. Low-quality evidence indicated that structured teaching had inconsistent effects on children on the autism spectrum.</div>
<div>Findings demonstrated that sensory-based intervention, such as auditory integration training, had no effect on communication outcomes in children on the autism spectrum.</div>
<div>"The few [systematic reviews] SRs that examined telepractice reported a positive intervention effect on select child outcomes, and a positive effect on a number of caregiver outcomes. No SR reported a comparison of intervention effects between telepractice and face-to-face delivery" (p. 96).</div>
<div>Results indicated that systematic reviews of moderate-quality studies investigating assorted naturalistic developmental behavioral interventions had a positive effect on social-communication, communication, expressive language, receptive language, and play skills in children on the autism spectrum.</div>
<div>Findings demonstrated that the amount of intervention did not influence intervention effects on social-communication and communication skills.</div>
<div>Parent-mediated, peer-mediated, and clinician-provided interventions were reported to have positive effects on child outcomes. "Active caregiver involvement in intervention was reported to have a similar, and at times greater, intervention effect on child outcomes than those delivered by clinicians or educators alone" (p. 96).</div>
<div>Augmentative and alternative communication was reported to have a positive effect on communication skills, but the effect on social-communication skills was inconclusive.</div>
