Focused intervention practices (FIPs) are widely used to improve social communication skills, as they are specifically aimed at enhancing skills identified as being problematic in children with autism spectrum disorder (ASD), such as imitation, eye contact, gestures, joint attention and play. A meta-analysis studied the overall effectiveness of FIPs in children with ASD 6 years of age or younger. «Bejerano-Martín A, Canal-Bedia R, Magán-Maganto M,...»1 Both group and single case design studies were accepted. Altogether 43 studies with 59 outcome measures and 785 participants were included. Total treatment dosage ranged from 8 to 259 h in the group-design studies and from 5.0–40.2 h in the single-case design studies. The number of studies found for eye contact (n = 6) and gestures (n = 2) was low and thus, a meta-analysis could not be performed to determine the effect sizes of these skills.
The first aim of this study was to examine FIPs for young children with ASD in terms of: their effectiveness in relation to basic social-communication skills; and their benefits according to selected participant and programme characteristics. The second objective was to examine whether different aspects, such as participant and FIP characteristics (e.g., age, IQ, language level, dosage of intervention, and family and/or teacher actively participation in the intervention) will moderate treatment outcomes.
Group design studies: Interventions on social communication skills showed positive outcomes in the 18 group-design studies reviewed. The effect size for social and communicative competence was medium sized (g = 0.51, 95%CI 0.37-0.65). Nine studies with group design included caregivers or teachers as active components in treatment programmes. The effect size for social and communicative competence was medium sized (g = 0.50, 95%CI 0.32-0.68).
All studies: The results suggest that, whereas FIPs have medium to large positive effects (g = 0.51; NAP = 0.86), those where caregivers or teachers play an active role (g = 0.50; NAP = 0.89) have medium effect sizes. All social and communicative skills outcomes of FIPs have medium effect sizes (Imitation: g = 0.42, NAP = 0.90; Joint attention: g = 0.54, NAP = 0.86; Play: g = 0.47, NAP = 0.81). Effect sizes were slightly greater when participants' preintervention ages were lower (group design studies) and treatment dosage was higher (single design studies). Pre-intervention IQ and expressive or receptive language skills had no influence on effect sizes.
Comment: Description of patient characteristics is insufficient, which complicates the analysis of applicability