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Cited by 366Autism Spectrum Disorder ResearchBehavioral and Psychological StudiesChild Nutrition and Feeding Issues

Behavioural and Developmental Interventions for Autism Spectrum Disorder: A Clinical Systematic Review

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Ospina, Maria B., Krebs Seida, Jennifer, Clark, Brenda, Karkhaneh, Mohammad, Hartling, Lisa, Tjosvold, Lisa, Vandermeer, Ben, Smith, Veronica·2008·PLoS ONE
DOI 10.1371/journal.pone.0003755PMC PMC2582449
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Abstract

BACKGROUND: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD). We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. METHODS AND FINDINGS: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlled trials favoured developmental approaches based on initiative interaction compared to contingency interaction in the amount of time spent in stereotyped behaviours and distal social behaviour, but the effect sizes were not clinically significant. No statistically significant differences were found for: Lovaas versus special education for non-verbal intellectual functioning; Lovaas versus Developmental Individual-difference relationship-based intervention for communication skills; computer assisted instruction versus no treatment for facial expression recognition; and TEACCH versus standard care for imitation skills and eye-hand integration. CONCLUSIONS: While this review suggests that Lovaas may improve some core symptoms of ASD compared to special education, these findings are based on pooling of a few, methodologically weak studies with few participants and relatively short-term follow-up. As no definitive behavioural or developmental intervention improves all symptoms for all individuals with ASD, it is recommended that clinical management be guided by individual needs and availability of resources.

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Authors
Ospina, M. B., Krebs Seida, J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., Vandermeer, B., & Smith, V.
Affiliations
University of Alberta (CA)
Corresponding author
Smith, Veronica
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2008-11-18
Volume
3
Issue
11
Pages
e3755
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0003755
PMC
PMC2582449
OpenAlex
W1988554832
Cited by
366
References
148
Citations by year
2026: 5 · 2025: 7 · 2024: 13 · 2023: 5 · 2022: 19 · 2021: 17 · 2020: 30 · 2019: 21 · 2018: 25 · 2017: 25 · 2016: 16 · 2015: 29 · 2014: 28 · 2013: 34 · 2012: 34
FWCI
1.45
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • Vanderbilt University
  • Alberta Centre for Child, Family and Community Research
  • University of Alberta
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, behavioral interventions, developmental intervention, special education, adaptive behavior, communication skills, intellectual functioning, socialization, stereotypy, TEACCH, computer-assisted instruction, facial expression recognition, imitation skills, intervention efficacy
MeSH terms
Adolescent, Autistic Disorder, Behavior, Child, Child, Preschool, Clinical Trials as Topic, Communication, Education, Special, Humans, Infant, Language Therapy, Psychotherapy, Research Design, Outcome Assessment, Health Care, Early Intervention, Educational

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