Early intervention for very young children with or at high likelihood for autism spectrum disorder: An overview of reviews.
Lauren Franz, Cara D Goodwin, Amber Rieder and 2 others
PMID 35582893WHAT IT FOUND
Early interventions for children under three improved development, but the evidence quality was critically low.
Gains were largest on specific skills targeted in therapy, not on standardized tests. Current guidelines recommending 25 to 40 hours weekly are not supported by high-quality evidence.
Key findings
01Six of the seven systematic reviews included in this overview had critically low methodological quality.
02Intervention effects were largest on proximal, intervention-specific measures and smaller on distal, standardized assessments.
03There is limited evidence to support recommendations for very intensive interventions (25–40 hours per week) in young children with ASD.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Six of the seven systematic reviews included had critically low methodological quality. All randomized controlled trials included in the analysis had a high risk of bias, particularly regarding blinding of participants and outcome assessors. There was significant overlap in the primary studies included in the different reviews, meaning the same evidence was counted multiple times. The most recent review included was from 2018, so the evidence was not current as of the search date in 2020. Heterogeneity in intervention types, doses, and outcome measures made it difficult to compare effectiveness across studies.
The easy way to misread this
Do not assume that improvements in specific, therapy-targeted skills translate to broader developmental gains. The review found that effects were largest on proximal measures and smaller on standardized tests, and the underlying evidence quality was critically low.