Proposals for Current Intervention Methods for Children with Autism Spectrum Disorder (ASD): A Systematic Literature Review

2. FRAMEWORK.

• • BACKGROUND.

    • INTERNATIONAL.

In Switzerland, Daniolou et al. (2022) conducted a study aimed at determining the effectiveness of early interventions for children with the condition through a systematic review. The methodology followed a systematic-review design. The sample consisted of 33 documents evaluating effectiveness in improving cognitive ability, language, and adaptive behavior among preschool children with ASD. The results identified significant outcomes from early interventions in cognitive ability (p = .02), skills within their context (p = .01), and motor skills (p = .01).

• • • NATIONAL.

Benavente (2021) conducted a study whose main purpose was to analyze processes for increasing social skills in children with the condition from 2010 to 2021. The methodology followed a systematic-review design. The sample consisted of 15 documents evaluating skill acquisition among children with the condition. The results indicated that strategy acquisition depends on a series of educational conditions based on appropriate public management for children with ASD. In addition, the strategies applied have a significant effect on the child’s condition, enabling children not only to develop social skills but also behavioral and communication strategies for interacting with their environment.

3. RESEARCH METHODOLOGY.

Based on the objectives proposed for the study, research was selected in English and Spanish. The literature-collection technique was structured and guided by the PRISMA methodology.

Accordingly, the studies were searched using the following terminology: “autism,” “ASD,” and “interventions.” In addition, prior studies were required to meet the preceding criteria. The English Boolean connectors “OR” and “AND” were also used to combine terms in order to locate scientific articles.

The search for relevant articles for the study was conducted in the following databases: Scopus, BMJ Open, Dialnet, Elsevier, and SAGE Journals.

The selected studies were research studies based on interventions for children with the condition. The children with ASD on whom these studies were based came from different contexts, including South America, North America, Europe, and Asia. Studies were recruited from the period 2013 to 2023, that is, publications from a ten-year range.

The inclusion criteria were therefore: studies published between 2013 and 2023; quantitative studies; studies evaluating children with ASD in different contexts; and peer-reviewed indexed studies. The exclusion criteria were: duplicate studies, studies not available in full, and studies whose sample did not include children with ASD.

The complete analysis of the studies is presented in the following tables.

4. MAIN RESULTS.

The results of Fulceri et al. (2023) indicate that integrated coordination among professionals also facilitates change in people with ASD, since continuous interventions and periodic redefinition of care for people with the condition are important for achieving continued improvements and outcomes. Challenges include service provision across all domains or stages of life and effective coordination among providers and health services. Solutions to ensure health, improve living and educational conditions, and promote the social and employment inclusion of people with the condition are therefore essential aspects of the approach. In summary, the main objective of an integrated care pathway is to improve quality of care by improving individual outcomes, promoting safety, increasing the satisfaction of people and caregivers, and optimizing the use of resources. Further research is needed to promote the development of clinical pathways that integrate recommendations from international consensus documents with the specific needs of people with the condition.

Pervin et al. (2022) report that different treatment modalities have currently been developed for patients with ASD. Cognitive and behavioral interventions include comprehensive treatment models and focused interventions. Comprehensive treatment models are conceptually organized practice processes that address the core deficits of ASD over an extended period in children aged 1 to 2 years. In the study of an intervention for children and adolescents with ASD, no differences were found in intervention effectiveness between high-income and middle-income countries. In summary, there is little evidence to conclude that effective interventions produce behavioral change specifically because of the treatment applied to the child. Therefore, none of the interventions can yet be considered evidence-based, since additional research and mutually agreed methodological standards are needed to provide a more secure basis for evidence-based treatments.

Yi et al. (2022) argue that the model provides significant help because the involvement of both the immediate and extended family is important when supporting a child with the condition. In this way, the child can interact appropriately as behaviors are reinforced and family members provide models for the child to imitate—models of appropriate conduct and respect for others and for oneself. Daily-living behaviors are likewise reinforced through models found within the family. In this way, the child can adequately develop skills in response to the challenges imposed by a non-inclusive world.

Rech et al. (2022) report that research to date has consisted of small studies and that study designs have often been poor. There is a tendency to overlook the well-being of people with the condition and focus on stopping certain behaviors without recognizing why they occur or that they may be useful to people with the condition. Studies found that physical activity has many benefits for people with the condition, such as increasing well-being, supporting emotional regulation, improving gait and balance, and raising activity levels. However, most studies did not analyze health and fitness outcomes and focused instead on outcomes that have not been identified as important by people with the condition.

Walsh et al. (2021) suggest that most interventions focus only on the patient and are based on participation, tolerance, and anticipating the problems that may arise. In this regard, improvements in communication with patients who have the condition emphasized the use of behavioral intervention; consequently, the outcomes of patient-centered behavioral interventions were predominantly positive. The authors argue that adapting health services to people with the condition is a priority, although only a small amount of scientific literature has considered how such interventions can be implemented effectively. Future studies involving the community of people with the condition should assess what matters to them and provide precise details about the interventions implemented. It is also important to emphasize that physical activity is effective in reducing risk and managing long-term physical and mental health conditions in this population. The health of people with the condition is, on average, poorer than that of the general population, so exercise could be particularly useful for them, although little is known in this area.

5. Conclusions and implications of the research for the population.

• It is concluded that there are different types of interventions for people with ASD. The intervention with the strongest scientific support based on significant changes is applied behavior analysis (ABA). ABA therapists use the Antecedent-Behavior-Consequence (ABC) approach to target and improve specific behaviors: the antecedent is the stimulus, such as a request, that prompts a particular behavior; the behavior is the response resulting from the stimulus; and the consequence is the response to that behavior, such as positive reinforcement.
• The second intervention with the greatest evidence is the SCERTS model, which focuses on increasing the child’s productive development within their context. Its objectives also focus on developing appropriate and effective communication between the child and their environment, so that the child can acquire skills that can be reinforced by their closest family members and by the