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Cited by 606Autism Spectrum Disorder ResearchBehavioral and Psychological StudiesChild Nutrition and Feeding Issues

Project AIM: Autism intervention meta-analysis for studies of young children.

Open access
Sandbank, Micheal, Bottema-Beutel, Kristen, Crowley, Shannon, Cassidy, Margaret, Dunham, Kacie, Feldman, Jacob I., Crank, Jenna, Albarran, Susanne A. +3 more·2020·Psychological Bulletin
DOI 10.1037/bul0000215PMC PMC8783568
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Abstract

In this comprehensive systematic review and meta-analysis of group design studies of nonpharmacological early interventions designed for young children with autism spectrum disorder (ASD), we report summary effects across 7 early intervention types (behavioral, developmental, naturalistic developmental behavioral intervention [NDBI], TEACCH, sensory-based, animal-assisted, and technology-based), and 15 outcome categories indexing core and related ASD symptoms. A total of 1,615 effect sizes were gathered from 130 independent participant samples. A total of 6,240 participants, who ranged in age from 0-8 years, are represented across the studies. We synthesized effects within intervention and outcome type using a robust variance estimation approach to account for the nesting of effect sizes within studies. We also tracked study quality indicators, and report an additional set of summary effect sizes that restrict included studies to those meeting prespecified quality indicators. Finally, we conducted moderator analyses to evaluate whether summary effects across intervention types were larger for proximal as compared with distal effects, and for context-bound as compared to generalized effects. We found that when study quality indicators were not taken into account, significant positive effects were found for behavioral, developmental, and NDBI intervention types. When effect size estimation was limited to studies with randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and NDBI intervention types. This was also the case when outcomes measured by parent report were excluded. Finally, when effect estimation was limited to RCT designs and to outcomes for which there was no risk of detection bias, no intervention types showed significant effects on any outcome. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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  • Traditional ABA (DTT) has been shown to have some beneficial effects on outcomes such as language, social functioning, adaptive behavior, cognitive ability, and challenging behaviors.

    “While this traditional form of ABA therapy (commonly referred to as Discrete Trial Training [DTT; Smith, 2001]) has been shown to have some beneficial effects on outcomes such as language, social functioning, adaptive behavior, cognitive ability, and challenging behaviors (Sandbank et al., 2020), there is a paucity of experimental evidence regarding long-term effects on adult outcomes (Jónsdóttir”

    From Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework (2022) · cites this paper as Sandbank et al., 2020

    The Results, “Summary Effects by Intervention and Outcome Type” (page not provided), report significant positive effects for behavioral interventions across adaptive, cognitive, language, social-communication, and social-emotional/challenging-behavior outcomes. The Methods, “Coding Procedures” (page not provided), list DTT as one example in that broader category. The reported effects are not specific to DTT, so the source does not establish every listed benefit for DTT itself. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • For children up to 8 years old, NDBIs yielded more favorable developmental outcomes when compared to other interventions.

    “A recent meta-analysis by Sandbank et al. (2020) demonstrated that, for children up to 8 years old, NDBIs yielded more favorable developmental outcomes when compared to other interventions.”

    From Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework (2022) · cites this paper as Sandbank et al., 2020

    The Method > Search section includes studies whose participants had an average age of 0–8 years, not necessarily studies in which every child was 8 or younger. The Discussion > Promising Intervention Types section identifies NDBIs as well supported by randomized trials, and the Results > Summary Effects section reports positive effects for some outcomes. But the paper also identifies developmental interventions as promising; it does not establish that NDBIs produced better developmental outcomes than other interventions. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • NDBIs have been shown to have positive effects on standardized measures of language and social-communication.

    “NDBIs (Schreibman et al., 2015) have emerged as a group of particularly promising naturalistic interventions that have been shown to have positive effects on standardized measures of language and social-communication (e.g. Sandbank et al., 2020; Tiede & Walton, 2019).”

    From Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework (2022) · cites this paper as Sandbank et al., 2020

    The Results (Summary Effects by Intervention and Outcome Type; page unavailable) report significant NDBI effects on language and social communication in the RCT analysis. But the paper does not establish that both effects were found on standardized measures: its Study Quality results describe frequent observational and researcher-created measures, and language was not significant when caregiver-report outcomes were excluded. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cites

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1 of the 221 references couldn’t be matched to a known paper.

Research works printed but not linked: 16

  1. Ayres AJ (2005). Sensory integration and the child, 25th anniversary edition. Los Angeles: Western Psychological Services.
  2. Azarbehi AC (2009). The effectiveness of early intervention programs for children with autism: A one-year follow-up study of intense behavioural intervention versus preschool integration (Unpublished doctoral dissertation). Academic Unit of Psychology of The University of New Brunswick, Fredericton, New Brunswick.
  3. Bahrick LE, & Todd JT (2012). Multisensory processing in autism spectrum disorders: Intersensory processing disturbance as a basis for atypical development. In Stein BE and Wallace MT (Eds), The new handbook of multisensory processes (pp. 1453– 1508). Cambridge, MA: MIT Press.
  4. Benjamini Y, & Yekutieli D (2001). The control of the false discovery rate in multiple testing under dependency. The Annals of Statistics, 29(4), 1165– 1188.
  5. Bruner J (1982). The organization of action and the nature of the adult-infant transaction. In Tronick E (Ed.), Social interchange in infancy: Affect, cognition, and communication. Baltimore, MD: University Park Press.
  6. Clionsky LN (2012). Child directed interaction training for young children with autism spectrum disorders: The impact on child language, social skills, adaptive skills, and problematic behaviors (Unpublished doctoral dissertation). University of Florida, Gainesville, FL.
  7. Elder LM (2011). The relationship between parent training and parent-child interaction in autism (Unpublished doctoral dissertation). University of Washington, Seattle, WA.
  8. Espanola E (2015). A randomized comparison of two instructional sequences for imitation intervention for children with autism spectrum disorders (Unpublished doctoral dissertation). Florida International University, Miami, FL.
  9. Kaiser AP (1993). Parent-implemented language intervention: An environmental system perspective. In Kaiser AP & Gray DB (Eds.), Enhancing children’s communication: Research foundations for intervention (Vol. 2, pp. 63– 84). Baltimore: Brookes.
  10. Lipsey MW, & Wilson DB (2001). Applied social research methods series; Vol. 49. Practical meta-analysis. Thousand Oaks, CA, US: Sage Publications, Inc.
  11. Lord C, Rutter M, DiLavore P, Risi S, Gotham K, & Bishop SL (2012). Autism Diagnostic Observation Schedule, second edition (ADOS-2) manual (Part I): Modules 1–4. Los Angeles, CA: Western Psychological Services.
  12. McCalla MK (2014). Enhancing the social interactions of preschool children with autism: The effectiveness of a peer-mediated (Unpublished doctoral dissertation). The University of Alabama at Birmingham, Birmingham, AL.
  13. Page CE (2012). The social and emotional benefits of therapeutic riding on children with autism spectrum disorder (Unpublished doctoral dissertation). Institute of Transpersonal Psychology, Palo Alto, CA.
  14. Vygotsky L (1978). Mind in society. Cambridge, MA: Harvard University Press.
  15. Welsh K (2009). The use of dogs to impact joint attention in children with Autism Spectrum Disorders (Unpublished doctoral dissertation). Walden University, Minneapolis, MN.
  16. Wild DL (2012). The impact of canine assistance for children with autism and the family unit (Unpublished doctoral dissertation). Walden University, Minneapolis, MN.

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Authors
Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., Mahbub, P., & Woynaroski, T. G.
Affiliations
  • The University of Texas at Austin (US)
  • Boston College (US)
  • Vanderbilt University (US)
  • Mount Holyoke College (US)
ORCID
Venue
Psychological Bulletin
Publisher
American Psychological Association (APA)
Published
2020-01
Volume
146
Issue
1
Pages
1-29
ISSN
  • 0033-2909 (ISSN-L)
  • 1939-1455
DOI
10.1037/bul0000215
PMC
PMC8783568
OpenAlex
W2990306783
Cited by
606
References
221
Citations by year
2026: 96 · 2025: 92 · 2024: 115 · 2023: 96 · 2022: 100 · 2021: 72 · 2020: 34
FWCI
29.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Bulletin (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Texas Digital Library (University of Texas)
Funders
  • National Institutes of Health (U54HD083211, T32 MH064913)
  • National Institute on Deafness and Other Communication Disorders (1R21DC016144)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, early intervention, young children, non-pharmacological treatment, naturalistic developmental behavioral intervention, TEACCH, animal-assisted interventions, sensory interventions, technology-based interventions, behavioral interventions, developmental intervention, detection bias
MeSH terms
Autism Spectrum Disorder, Child, Child, Preschool, Female, Humans, Infant, Male, Outcome Assessment, Health Care, Early Medical Intervention

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