Efficacy of focused social and communication intervention practices for young children with autism spectrum disorder: A meta-analysis

Abstract

Focused intervention practices (FIPs) are widely used to improve social communication skills, as they are specifically aimed at enhancing skills identified as being problematic in children with autism spectrum disorder ASD, such as imitation, eye contact, gestures, joint attention and play. This meta-analysis was performed to ascertain the overall effectiveness of FIPs in children with ASD 6 years of age and younger. Five electronic searches were conducted, 1828 references were retrieved, and 43 studies 59 outcome measures were included in the meta-analysis. Studies included 785 participants 41.6 months with ASD. The overall socio-communicative effect size for each specific skill imitation, joint attention, and play was calculated using the Hedges’ g (g) for group design studies, and the Nonoverlap of All Pairs (NAP) for single case design studies. Random-effects metaregression models and correlations were also used to assess whether the results were different according to population and intervention characteristics. The impact of possible publication bias was analysed. The results suggest that, whereas FIPs have medium to large positive effects (g = 0.51; NAP = 0.86), those where caregivers or teachers play an active role (g = 0.50; NAP = 0.89) have medium effect sizes. All social and communicative skills outcomes of FIPs have medium effect sizes (Imitation: g = 0.42, NAP = 0.90; Joint attention: g = 0.54, NAP = 0.86; Play: g = 0.47, NAP = 0.81). Effect sizes were greater when participants’ preintervention ages were lower and treatment dosage was higher. When it comes to achieving substantial improvements, factors to be highlighted are the role of caregivers and adaptation of the programme to the characteristics of the child. Implementation of early intervention programmes should be substantiated by a sufficient amount of information about the characteristics of each participant. Professionals should take this information into account in order to select as accurately as possible those procedures that are most effective and feasible.