Impact of reading intervention on the phonological awareness of children with autism spectrum disorder: a systematic review and meta-analysis.

Sample sizes ranged from 5 to 133 participants, most of whom were male, so the findings may not generalise to girls or to children with different severity profiles. Most studies did not blind the intervention facilitators or outcome evaluators, and two nonrandomised studies had no control group. The interventions varied widely (shared reading, multimedia software, virtual programmes), so the pooled result does not identify which approach works best. GRADE rated the certainty of evidence as low for randomised trials and very low for nonrandomised trials, citing risk of bias, inconsistency in assessment tools, and imprecision from small samples. Only two of the eight studies reported mental age; the rest relied on chronological age alone, and the authors note that ASD is a heterogeneous condition where cognition affects performance.

No funding or conflicts of interest were declared by the review authors. The review also noted that potential conflicts of interest in the included studies were undetected.

Do not read the pooled improvement as proof that any specific reading programme works for every child with ASD. The certainty of evidence is low for randomised trials and very low for nonrandomised ones, the individual studies used different interventions with different children, and two of the eight showed no improvement while one showed a decline after training ended.