BackgroundThe needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children’s progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact.ObjectivesTo examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents.MethodsThe MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers.ResultsThe conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains ‘Impairments’, ‘Activity Level Indicators’, ‘Participation’, and ‘Family Measures’. In review 1, 10,154 papers were sifted – 3091 by full text – and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed tools was combined with information about their accessibility and presentation. Twelve tools were identified as having the strongest supporting evidence, the majority measuring autism characteristics and problem behaviour. The patchy evidence and limited scope of outcomes measured mean these tools do not constitute a ‘recommended battery’ for use. In particular, there is little evidence that the identified tools would be good at detecting change in intervention studies. The obvious gaps in available outcome measurement include well-being and participation outcomes for children, and family quality-of-life outcomes, domains particularly valued by our informants (young people with ASD and parents).ConclusionsThis is the first systematic review of the quality and appropriateness of tools designed to monitor progress and outcomes of young children with ASD. Although it was not possible to recommend fully robust tools at this stage, the review consolidates what is known about the field and will act as a benchmark for future developments. With input from parents and other stakeholders, recommendations are made about priority targets for research.Future workPriorities include development of a tool to measure child quality of life in ASD, and validation of a potential primary outcome tool for trials of early social communication intervention.Study registrationThis study is registered as PROSPERO CRD42012002223.FundingThe National Institute for Health Research Health Technology Assessment programme.

There is considerable debate regarding the most appropriate and effective ways of supporting the learning of children and young people on the autism spectrum. This international review provides a synthesis of empirical research and expert evidence (dated 2002-2008) to identify best practice in educational provision for these children. Five bibliographic databases were systematically searched using clearly defined keywords, and abstracts assessed according to explicit inclusion and exclusion criteria; 92 research papers that focused on children and young people were included. Expert evidence was drawn from policy documents and government strategies, or research reports, from the UK and Ireland. Findings show that there is insufficiently strong evidence regarding the effectiveness of one type of intervention approach compared with another. A range of educational provision should be maintained in order to cater appropriately for a wide diversity of needs. Interventions most often researched were those involving intensive behavioural techniques and some studies showed these can be successful in teaching specific skills to some children. There was limited evidence regarding the needs of older children as well as consideration of educational provision more widely, including the effects of type of setting (as distinct from a specific type of intervention or learning approach). More research is needed on other types of educational interventions currently used by parents and in schools as well as greater collaboration between researchers and practitioners to establish what works best for children and young people on the autism spectrum.

Evaluation of interventions for children with autism spectrum disorder (ASD) is hampered by the multitude of outcomes measured and tools used. Measurement in research with young children tends to focus on core impairments in ASD. We conducted a systematic review of qualitative studies of what matters to parents. Parent advisory groups completed structured activities to explore their perceptions of the relative importance of a wide range of outcome constructs. Their highest ranked outcomes impacted directly on everyday life and functioning (anxiety, distress, hypersensitivity, sleep problems, happiness, relationships with brothers and sisters, and parent stress). Collaboration between professionals, researchers and parents/carers is required to determine an agreed core set of outcomes to use across evaluation research.Electronic supplementary materialThe online version of this article (doi:10.1007/s10803-017-3282-2) contains supplementary material, which is available to authorized users.

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Relatively little is known about the effect of adult interactive style on children's communication. The aim of this study, written by Lila Kossyvaki, Glenys Jones and Karen Guldberg, all from the University of Birmingham, was to explore the effects of adult interactive style on children's spontaneous communication. The study used an action research methodology. Six children aged between four and five years with autism and three members of staff participated. Each child was video recorded for a total of two hours across four activities. The staff, in collaboration with the researcher, developed and put into practice an Adult Interactive Style Intervention (AISI) intended to promote spontaneous communication. Two months later each child was recorded for two hours across the same activities with staff using AISI. Cohen's d effect size was calculated to measure the differences pre‐ and post‐intervention. The increase in total initiations post‐intervention for all six children was significant. The findings suggest that attention should be paid to adult style when developing communication in children with autism.

Previous research has demonstrated that the way adults interact with children with autism can have a great impact on their spontaneous communication. However, to date, few studies have focused on modifying adults' behaviour and even fewer have been conducted in school settings which actively involve teaching staff in designing the intervention. The aims of this study were twofold: (1) to explore the extent to which staff were able to build on their good practice and alter their interactive style and (2) to then assess the effects of this change on children's communication. The study used an action research methodology and involved three members of staff and six children with autism. The staff and the researcher developed an Adult Interactive Style Intervention (AISI) in partnership. This was based on two theoretical models of child development and disability. Data were collected pre-and postintervention and at follow-up (12 months after the end of the main study) to measure change. The results showed that staff considerably increased the number of times they used AISI principles postintervention and that this change had a significant impact on the children's spontaneous communication. All three staff took an active participatory role in the study which was considered a very positive and empowering experience.