Quick Reference Guide: An Umbrella Review of Speech-Language Interventions to Support Autistic Children and Youth

Background and Aims Speech-language pathologists (SLPs) have reported using over 30 interventions to support autistic children and youth, but large caseloads limit time to review relevant research for informed clinical decision-making. To support the implementation of evidence-based practice, this umbrella review evaluates and compares the evidence for these interventions to provide clinicians, researchers and policymakers with an easy-access guide summarizing the existing evidence. Methods The protocol was pre-registered in PROSPERO. Eight databases were searched to identify systematic reviews of randomized controlled trials. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Systematic Reviews. Summary tables were developed synthesizing the outcomes relevant to the field of speech-language pathology. Main Contributions Twenty-three systematic reviews of interventions used by SLPs met our inclusion criteria and were categorized as either general intervention approaches or specific manualized interventions. Seven intervention approaches were identified (joint attention, caregiver-delivered, technology-assisted caregiver-delivered, play-based, pragmatic, social pragmatic, social skills), and all had consistent evidence for at least one positive outcome. Four of six manualized interventions had consistent evidence of a positive effect for at least one outcome (Early Start Denver Model; Joint Attention, Symbolic Play, Engagement, Regulation; PEERS ® ; Social Stories TM ). Conclusions and Implications This umbrella review generated an overview of the existing evidence for interventions that may be used by SLPs to support autistic children and youth. Variability in evidence quantity and how outcomes were synthesized prohibited assessing relative efficacy or providing clinical recommendations on which interventions have the best evidence to support their use in practice; however, SLPs will be able to use the quick reference guide in conjunction with their clinical experience and client preferences to provide evidence-based practice. For researchers, results highlighted a need for the use of a consistent outcome measure to support comparison between interventions, describe participants in further detail and prioritize systematic reviews of interventions that are sufficiently similar in format and goals.