There’s No Place Like Home

For parents and caregivers of children with autism, new research shows that there’s no place like home—or the park or a classroom—to provide effective learning opportunities to support their child’s development of language, social communication, and play.

Highly structured and formal interventions are valuable, and now there is evidence to show that techniques that family members and other caregivers offer in natural settings are valuable, too.

Micheal Sandbank was principal investigator of a research team that conducted the first meta-analysis of studies designed for young children with autism. Sandbank is an assistant professor in the Department of Special Education in the College of Education. The multi-university research team examined 130 reviewed studies of non-pharmacological interventions.

The interventions are particularly effective for supporting language, social communication, and play development, she says.

The analysis was published in the journal Psychological Bulletin and marks the first meta-analysis of 130 reviewed studies of non-pharmacological interventions designed for young children with autism.

“There is more high-quality evidence supporting these interventions for natural settings, or naturalistic developmental behavior interventions (NDBIs) than some traditional approaches for aiding young children with autism,” Sandbank says.

NDBIs are early intervention techniques that are implemented in everyday settings by clinicians, educators, and other caregivers, as opposed to more structured and formalized interventions. These techniques use behavioral strategies to teach developmentally appropriate skills to young children with autism.

An NDBI strategy for teaching a child to say the word ‘ball’ might include playing with a ball in the park, saying the word multiple times, and using it in context.

These strategies were created to be easily integrated into routine activities throughout the day to have maximum impact for children.

Although NBDIs are not new, categorizing them as a specific type of intervention is, Sandbank says.

In 2015, the developers of these interventions wrote a consensus statement declaring that they were similar approaches guided by a shared philosophy. “This statement allowed us to consider their evidence together, rather than separately,” Sandbank says. “We also found similarly strong evidence that developmental interventions are effective for supporting social communication development in children with autism.”

“Meta-analysis allows us to see whether interventions are more or less effective depending on different characteristics of the participants and the intervention – it helps us determine what works and for whom,” Sandbank says.

The meta-analysis showed that although traditional intervention methods such as early intensive behavioral intervention have promising evidence supporting their use, more high-quality research is needed.

In addition, the research concluded that there is little evidence to support the effectiveness of several other types of interventions, including TEACCH, which focuses on learning strengths and preferences of the individual with autism; sensory-based interventions; animal-assisted interventions; and interventions mediated solely through technology. Approaches that integrate technology, such as high-tech augmentative and alternative communication devices, into more established interventions appear promising, according to this meta-analysis.

Additional research by Sandbank and the team on autism interventions has found that interventions are often more effective for kids with more language skills and are more effective for improving spoken language compared with understood language.

The team is continuing to explore other findings related to how intervention results vary based on different characteristics of the intervention, participants, or the outcomes that are being tracked.

“The evidence regarding intervention for children on the autism spectrum has been rapidly transforming,” Sandbank says. “The last decade has seen the publication of more than 100 group design studies of intervention, including at least 50 randomized controlled trials. These studies attest to the fact that access to intervention in early childhood can yield a range of positive outcomes for the children receiving it, but we have further to go to improve the quality of our evidence.”