Intervention Effects on Language in Children With Autism: A Project AIM Meta-Analysis

Sandbank, Micheal; Bottema‐Beutel, Kristen; Crowley, Shannon; Cassidy, Margaret; Feldman, Jacob; Canihuante, Marcos; Woynaroski, Tiffany G.

doi:10.1044/2020_jslhr-19-00167

Cited by 60 publications

(87 citation statements)

References 127 publications

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“…Though the logical framework of these theories suggests that children with autism should receive intervention as early as possible to capitalize on periods during which we should expect optimal plasticity, intervention research has not definitively shown that children who receive intervention at younger ages benefit more than those who begin intervention later in life. In fact, several previous meta‐analyses of early interventions for children with autism have found that chronological age at intervention was not a significant moderator of intervention effects on outcomes of interest [Makrygianni & Reed, 2010; Reichow & Wolery, 2009; Sandbank et al, 2020b; Virués‐Ortega, 2010].…”

Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

“…Intervention effects may vary as a function of child language level at the start of intervention. Previous investigations have found that children with higher language level at intervention onset tend to demonstrate larger gains than their counterparts with lower language level [Bono, Daley, & Sigman, 2004; Itzchak & Zachor, 2011; Sandbank, Bottema‐Beutel, Crowley, et al, 2020b]. This may be because children with more advanced language levels have more tools to help them engage in a social dyad with the interventionist administering an NDBI, which is where much (or all) learning is expected to take place.…”

Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

“…Prior meta‐analytic work suggests that caregiver‐implemented interventions can have strong positive effects on language outcomes for children with disabilities [Roberts & Kaiser, 2011]. However, a recent meta‐analysis examining the effect of interventions on language outcomes of children with autism reported that effects of caregiver‐implemented interventions were significantly smaller than those of clinician‐ and combination‐led interventions [Sandbank, Bottema‐Beutel, Crowley, et al, 2020b]. NDBIs are designed to be implemented within a child's natural environment and naturally‐occurring daily routines.…”

Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

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Understanding the Effects of Naturalistic Developmental Behavioral Interventions: A Project AIM Meta‐analysis

et al. 2021

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We examined the quality of evidence supporting the effects of Naturalistic Developmental Behavioral Interventions (NBDIs) for facilitating change in young children with autism. We also investigated whether effects varied as a function of specific features of the intervention, samples, and outcomes measured. Twenty‐seven studies testing the effects of NDBIs were extracted from data collected for the Autism Intervention Meta‐analysis (Project AIM), a comprehensive meta‐analysis of group design, nonpharmacological intervention studies for children with autism aged 0–8 years. We extracted effect sizes for 454 outcomes from these studies for use in meta‐regression analyses testing associations between intervention effects and mean participant chronological age, language age, autism symptomatology, percentage of sample reported as male, cumulative intervention intensity, interventionist, outcome boundedness, outcome proximity, and risk of parent/teacher training correlated measurement error. The extant literature on NDBIs documents effects on social communication, language, play, and cognitive outcomes. However, our confidence in the positive and significant summary effects for these domains is somewhat limited by methodological concerns. Intervention effects were larger for context‐bound outcomes (relative to generalized), and for proximal outcomes (relative to distal). Our results indicate that NDBIs have promise as an approach for supporting development for some, but not all of the core and related features of autism in early childhood. Confidence in summary effect estimates is limited by study quality concerns, particularly an overreliance on measures subject to high detection bias. The results of this review support the use of proximity and boundedness as indicators of the limits of intervention effects. Lay summary Naturalistic Developmental Behavioral Interventions may increase language, social communication, play skills, and cognition in young children with autism, but these increases are largest for skills directly targeted by the intervention, and in contexts that are similar to that of the intervention. These conclusions are tempered by some concerns regarding research design across the studies that have been conducted to date. Autism Res 2021, 14: 817–834. © 2021 International Society for Autism Research and Wiley Periodicals LLC

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Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

Section: Factors That May Influence Intervention Effectsmentioning

confidence: 99%

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Understanding the Effects of Naturalistic Developmental Behavioral Interventions: A Project AIM Meta‐analysis

et al. 2021

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“…Readers could refer to existing metaanalyses on early intervention for some insight into evidence of e cacy (e.g. (Sandbank et al, 2020)). Finally, due to the extent and variation of speci c outcome measures used in autism research and clinical practice, we have not reported the exact measurement tools that studies used within these domains.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Play-based interventions to support social and communication development in autistic children aged 2-8 years: A scoping review

Gibson¹,

Pritchard²,

Lemos³

2020

Preprint

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Play is often considered by practitioners to be a natural and enjoyable context for providing intervention and support to autistic children. However, the literature on play-based interventions is large and heterogeneous.This means it is challenging for families and practitioners to navigate the evidence base and make choices about differing play-based approaches. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform decision-making.We used a scoping review methodology to find peer reviewed intervention studies of play-based approaches totargeting language, social and communication outcomes for autistic children aged 2-8 years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs).We identified 388 studies, covering many intervention types, for inclusion. Just over 50% had <10 participants. Girls and minority background groups were under-represented. In our summary we suggest important dimensions for appraisal of play-based interventions, including considering the role of play in an intervention and the extent to which approaches are child-led.

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“…As early as the 1980s, intervention researchers have sought to modify how caregivers speak to their autistic children in an effort to positively influence autistic children's development [e.g., Harris, Wolchik, & Milch, 1982]. Because caregivers spend more time with their children than clinicians, coaching caregivers to talk to their children in particular ways is a promising intervention strategy [Sandbank et al, 2020b]. Recently, these interventions have focused on increasing caregiver talk that is responsive to children's behavior, and elicits their participation in interactions of increasing duration and complexity.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Literature Review of Autism Research on Caregiver Talk

Bottema‐Beutel

Kim

2020

Autism Research

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Describing how caregivers' talk to their autistic children, and how their talk may influence social and language outcomes, has important implications for developmental theory and intervention research. In this systematic literature review, we examine 294 caregiver talk variables extracted from 65 studies, provide a narrative overview of research findings, and link measurement approaches to various theories of language development. The majority of variables included only talk directed to children (90%), and specified the speech act being performed (57%). More than one‐third of variables measured talk that was responsive to children's attention, activities, or communication (38%), and slightly less than a third measured variables that elicited children's communication or engagement. Semantic aspects of talk were specified in 41% of variables, structural features were measured in 20% of variables, and suprasegmental features were measured in only 1% of variables. Talk quantity (without reference to other aspects of talk) was measured in 8% of variables. We found strong support that talk related to children's attention is implicated in autistic children's language development, but this construct has been measured inconsistently in terms of semantic, structural, and functional features. There is also evidence for bi‐directional relationships between caregiver's talk and autistic children's development on a variety of semantic and structural variables. Lay Summary In our review, we found many differences in how researchers measured caregiver's talk, but also some promising leads. Researchers should continue examining caregiver talk related to children's focus of attention to clarify how this type of language contributes to autistic children's development. We also found interesting research on how children influence caregiver's talk, and encourage researchers to continue to study how this occurs.

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Intervention Effects on Language in Children With Autism: A Project AIM Meta-Analysis

Cited by 60 publications

References 127 publications

Understanding the Effects of Naturalistic Developmental Behavioral Interventions: A Project AIM Meta‐analysis

Understanding the Effects of Naturalistic Developmental Behavioral Interventions: A Project AIM Meta‐analysis

Play-based interventions to support social and communication development in autistic children aged 2-8 years: A scoping review

A Systematic Literature Review of Autism Research on Caregiver Talk

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