Social Communication Interventions

Abstract

Initiations of social communication skills, including prelinguistic and spoken behavior to share and to request, are a core challenge for children with autism spectrum disorder (ASD). Prelinguistic behaviors including eye contact and gestures to request and to share (joint attention) are strongly associated with later language growth and, therefore, are a critical focus for children who are pre- or minimally verbal. Forty-one studies including randomized controlled trials (RCTs) and single-case designs (SCDs) examining social communication skills are reviewed in this chapter. On average, both RCTs and SCDs were of “moderate” methodological quality using published metrics for rating internal validity. Additional criteria to examine the external validity of the studies were also applied. Advances in external validity included specific recruitment of populations less frequently examined in research, delivery of intervention in community settings, and emergence of long-term follow-up studies. The studies were limited by assessment and reporting of composite social communication outcomes. Collapsing outcomes across behavioral form and function occludes understanding of which specific behaviors are changing over time. In studies in which outcomes are collapsed, lower level or simpler skills (e.g., responding to joint attention, eye contact to request) may drive change in overall outcome scores. Detailed examination of changes in specific social communication behaviors will promote better understanding of the influence of different interventions on child outcomes.