Implementation and Effectiveness of Non-Specialist Mediated Interventions for Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis
45 Pages Posted: 10 Dec 2018More...
Background: Several psychological interventions are used to address the communication and social skill deficits among children with Autism Spectrum Disorders. These interventions have shown an improvement in social skills and communication among these children. This systematic review and meta-analysis aims to assess the effectiveness and quality of evidence for these interventions using the GRADE recommendations.
Methods: An academic search was conducted in eight electronic databases including PubMed, Scopus and Web of Science, through April, 2017. Randomized controlled trials assessing the effectiveness of non-specialist psychological interventions were included, without any restriction to age, sex, language and year of publication. Outcomes pertaining to communication and social skills and caregiver-child relationship were introduced in the meta-analysis when reported in > 2 studies.
Results: A total of 22 studies were published post-2010 while only 2 were published prior to it. A significant improvement was noted in adaptive behaviors (SMD=0.60); child anxiety (SMD= 0.59); communication (SMD= 0.226); joint engagement (SMD= 0.67); motor skills (SMD=0.24); parental distress (SMD=0.48); parental self-efficacy (SMD= 0.49); parent-child relationship (SMD=0.67); repetitive behaviors (SMD= 0.33); self-regulation (SMD=0.54); social skills (SMD=0.53); symptom severity (SMD=0.51) and visual reception (SMD= 0.29), while no significant improvement was noted in child distress (SMD=0.158) and joint attention (SMD=0.17).
Interpretation: Non-specialist mediated interventions for autism spectrum disorders demonstrate effectiveness across a range of outcomes for the children and their caregivers. A majority of clinical trials had a low risk of bias and the quality of evidence across outcomes ranged from very low to high.
Declaration of Interest: The authors declare that they have no conflict of interests.
Ethical Approval: Not applicable.
Keywords: Autism; non-specialist; psychological interventions; mediated
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