Abstract
We conducted an overview of reviews to determine the effects of naturalistic developmental behavioral interventions (NDBIs; Schreibman et al. (2015) J Autism Dev Disorders 45:2411–2428) on children with autism spectrum disorder under 8 years old. We conducted an electronic database search of Academic Search Premier, CINHAL, ERIC, Medline, and APA PsycINFO in October 2022 and August 2023 and utilized snowball methods to locate relevant reviews of NDBI. We included reviews meeting the following inclusion criteria: (1) review included a meta-analytic synthesis for at least one child outcome; (2) primary studies examined a NDBI; (3) primary studies included children with ASD with a mean pre-treatment age under eight years; (4) primary studies were conducted using a two-group comparison design; and (5) review was published in English. We extracted data on characteristics of the review, participant characteristics from the primary studies, intervention characteristics, and assessed the risk of bias of the included reviews. We conducted a narrative synthesis across outcomes reported in the included reviews. We included five reviews from six reports in this overview. Two reviews included studies that examined the Early Start Denver Model, two reviews included studies that examined the Pivotal Response Treatment, and one review included studies examining NDBIs collectively. We found positive effects of NDBIs on child’s communication/language, cognition, and adaptive behavior. We found mixed effects for NDBIs on autism symptomatology and restricted and repetitive behaviors. Examination of moderator analyses reported in the included reviews suggested variables influencing the effects of NDBIs included proximity of outcome to intervention, boundedness of outcome to intervention, and study location. As shown in this overview, positive effects of NDBI for young children with ASD are supported by meta-analytic evidence. While the overall findings for NDBI across reviews are positive, the findings on specific outcomes and influential variables moderating the effects of NDBI are inconsistent. Additional evidence from randomized controlled trials and future meta-analyses are needed to strengthen our knowledge of the effects of NDBI for young children with ASD.
Protocol Registration: PROSPERO CRD42022353045.
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Notes
Consistent with reporting guidelines for overview of reviews, we have used u in reference to the number (count) of primary research studies included in the reviews.
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The research reported in this overview was supported, in part, by funding from the US Department of Health and Human Services, Administration for Community Living, Administration on Intellectual and Developmental Disabilities (AIDD) (Awards 90DDUC0071; 90DDUC0140) and the US Department of Education Office of Special Education Programs (H325H190004). The opinions expressed, however, are those of the authors and do not necessarily reflect the official position of a Department or Office.
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Brian Reichow was serving as an Associate Editor for the Journal of Autism and Developmental Disorders at the time of submission and publication but did not have any input on the review or decisions of the manuscript. The authors report no other perceived or real conflicts of interest that are directly or indirectly related to the work submitted to publication.
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Song, J., Reilly, M. & Reichow, B. Overview of Meta-Analyses on Naturalistic Developmental Behavioral Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-023-06198-x
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DOI: https://doi.org/10.1007/s10803-023-06198-x