Reexamining Pathways Early Autism Intervention in Children Before and After the Third Birthday: A Randomized Control Trial.

The study was not powered to detect a small effect for children over 3, so the over-3 social communication result should not be read as proof of benefit or proof of no benefit. Post-intervention assessors were not blind to group assignment, which can inflate results, although testing was done by a researcher unfamiliar with the family. There were no 3-month or 6-month follow-up data because of the COVID-19 pandemic, so durability is unknown. The intervention was short, and the authors state that this did not allow time for more complex social communication skills. Eight families could not receive post-intervention assessments due to pandemic restrictions, and twelve families did not complete the intervention or receive post-assessment for illness, death, relocation, or scheduling problems. The analysed sample was 67 children, and two children were excluded because they were above the valid age range for the CSBS DP. The sample was limited to children with English or Spanish as the primary home language. No other procedural fidelity measures were obtained for interventionists. The control group received services as usual from varied community providers, so the comparison is against real-world services rather than a specific dose or model.

The paper names the Texas Higher Education Coordinating Board as funder. No author conflict-of-interest declaration is provided in the supplied text.

Do not conclude Pathways works equally well for children over 3. The study did not show a clear benefit for that group, and it was not powered to detect a small effect.