Interventions for social and community participation for adults with intellectual disability, psychosocial disability or on the autism spectrum: An umbrella systematic review.
Melita J Giummarra, Ivana Randjelovic, Lisa O'Brien
PMID 36189003WHAT IT FOUND
Person-centred planning and individualised support consistently improved social participation, while group social skills training showed limited or inconsistent effects for adults on the autism spectrum.
Interventions that provided real-world community access and active mentoring were more effective than those focusing solely on building individual skills.
Key findings
01Person-centred planning reduced loneliness and improved self-determination, social inclusion, and community participation, though effects on social network size were inconsistent.
02For adults on the autism spectrum, group-based social skills training had inconsistent effects on social responsiveness and conversation skills, while individualised training improved social event attendance and skills.
03Interventions that incorporated real-world contexts and provided frequent contact with facilitators were more effective at helping people apply learned social skills.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The quality of the included systematic reviews was low to moderate, with 77.2% meeting less than 50% of AMSTAR criteria. Many original studies did not report specific outcome measures or the magnitude of effects, making it difficult to compare interventions. There was significant heterogeneity in study designs, with many lacking control groups, which limits causal inference. The review excluded interventions targeting environmental or systemic barriers, focusing only on individual-level or service-level interventions. Cost-effectiveness data was almost entirely absent, with only two studies reporting on resource use.
Declared interests
The review did not report specific funding sources or conflicts of interest for the umbrella review itself. However, it noted that 96.5% of the included systematic reviews did not report their study funders, and 78.9% did not assess or account for risk of bias.
The easy way to misread this
Do not interpret the positive findings for group social skills training as applicable to all disabilities. For adults on the autism spectrum, group-based training showed limited and inconsistent effects, whereas individualised approaches were more effective. Additionally, the overall evidence quality is low, so these findings should guide clinical reasoning rather than dictate rigid protocols.