Communication interventions for autism spectrum disorder in minimally verbal children

This new Cochrane Intervention Review assessed the effects of communication interventions for autism spectrum disorders (ASD) in minimally verbal children.

The review included two randomised controlled trials (154 children aged 32 months to 11 years) of communication interventions for ASD in minimally verbally children compared with a control group (treatement as usual). One RCT used a verbally based intervention (focused playtime intervention; FPI) administered by parents in the home, whereas the other used an alternative and augmentative communication (AAC) intervention (Picture Exchange Communication Systems; PECS) administered by teachers in a school setting.

The FPI study found no significant improvement in spoken communication, measured using the expressive language domain of the Mullen Scale of Early Learning expressive language, at postintervention. However, this study found that children with lower expressive language at baseline (less th an 11.3 months age-equivalent) improved more than children with better expressive language and that the intervention produced expressive language gains in some children. The PECS study found that children enrolled in the AAC intervention were significantly more likely to use verbal initiations and PECS symbols immediately postintervention; however, gains were not maintained 10 months later. There was no evidence that AAC improved frequency of speech, verbal expressive vocabulary or childrens social communication or pragmatic language immediately postintervention. Overall, neither of the interventions (PECS or FPI) resulted in maintained improvements in spoken or non-verbal communication in most children.

The review authors rated the quality of the evidence as very low because there were only two eligible studies, both of which involved few participants and had some methodological limitations that increased their risk of bias.

The review authors concluded that there is limited evidence that verbally based and AAC interventions improve spoken and non-verbal communication in minimally-verbal children with ASD.

Read the full review here.