Intervention Recommendations for Children With Autism in Light of a Changing Evidence Base

Micheal Sandbank, PhD1; Kristen Bottema-Beutel, PhD2; Tiffany Woynaroski, PhD, CCC-SLP3

Author Affiliations

JAMA Pediatr. Published online November 9, 2020. doi:10.1001/jamapediatrics.2020.4730

In the wake of a rapid transformation of the evidence base regarding autism interventions, the American Academy of Pediatrics (AAP) recently updated guidance on the identification, evaluation, and support of children with autism.1 This guidance is undoubtedly a useful resource for pediatricians serving this population. It does not, however, highlight some notable new evidence on the choice of intervention approach or provide specific recommendations regarding intervention intensity, although it does imply that more intensive services can generally be expected to yield greater improvements. At approximately the same time that AAP guidelines were updated, our team completed a systematic review and meta-analysis2 of all quasi-experimental and randomized studies (known to us) that evaluate any outcome of any intervention for young children (up to age 8 years) with autism. In this Viewpoint, we seek to augment the recent AAP statement by offering medical professionals a brief background on common intervention recommendations, a summary of recent findings, and corresponding additional guidance on intervention intensity and variety. While our recommendations align with several points made by the AAP working group, they diverge to some degree in their emphasis and description of the present evidence base on intervention approach and intensity for young children with autism.