Past, present, and future of non-pharmacological interventions for autism spectrum disorder

Background: Non-pharmacological interventions (NPIs) have become increasingly important in addressing the complex and heterogeneous needs of individuals with autism spectrum disorder (ASD), particularly in light of the limitations associated with pharmacological treatments. Objective: This study aimed to systematically map the global research landscape and thematic evolution of NPIs for ASD from 2001 to 2025 using bibliometric approaches. Methods: A total of 341 English-language articles were retrieved from the Web of Science Core Collection. Microsoft Excel and Biblioshiny were employed to perform descriptive analysis, co-authorship network mapping, keyword co-occurrence analysis, and thematic evolution analysis based on Keywords Plus. Results: The findings indicate a sustained increase in research output, particularly after 2011, with publication volume peaking in 2024 and citation impact continuing to rise. Music therapy, applied behavior analysis, and repetitive transcranial magnetic stimulation emerged as the most influential intervention approaches. The United States led in both publication volume and academic impact, followed by China and the United Kingdom. Thematic evolution analysis revealed a gradual shift from behavior-oriented frameworks toward mechanism-informed and context-sensitive approaches, with increasing attention to early intervention, population heterogeneity, and family involvement. Conclusion: Research on NPIs for ASD is undergoing a transition toward more integrative, individualized, and evidence-based paradigms. Future studies should prioritize longitudinal designs, cross-cultural validation, and the translation of mechanistic insights into scalable, real-world interventions.