Recently emerging intervention studies for toddlers with autism spectrum disorders (ASD) were reviewed through a systematic assessment of intervention outcomes, research rigor, and intervention features. The review includes published peer-reviewed experimental studies of toddlers with high risk for or diagnosis of ASD in which the majority of interventions occurred before age 36 months. Of 20 identified research studies, 6 were group comparison studies, all of which showed small to large magnitudes of effect when a uniform metric was applied. Fourteen were single-case design (SCD) studies, all of which reported effects on a variety of outcomes. When grouped by area of intervention focus (communication, general development, family well-being, imitation, joint attention, and play), commonly identified needs within focus areas were for replication, common measures, and authentic practices. A majority of studies in most focus areas showed strong to acceptable levels of research rigor, though this is an area of ongoing need.
AdamsonL. B.McArthurD.MarkovY.DunbarB.BakemanR. (2001). Autism and joint attention: Young children’s responses to maternal bids. Journal of Applied Developmental Psychology, 22, 439-453.
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
BatesE.SnyderL.BrethertenI.VolterraV. (1979). The emergence of symbols in language and action: Similarities and differences. Papers and Reports on Child Language Development, 17, 106-118.
5.
*Brookman-FrazeeL.KoegelR. L. (2004). Using parent/clinician partnerships in parent education programs for children with autism. Journal of Positive Behavior Interventions, 6, 195-213.
6.
Brookman-FrazeeL.VismaraL.DrahotaA.StahmerA.OpendenD. (2009). Parent training interventions for children with autism spectrum disorders. In MatsonJ. (Ed.), Applied behavior analysis for children with autism spectrum disorders (pp. 237-257). New York, NY: Springer.
7.
*CardonT.WilcoxM. (2011). Promoting imitation in young children with autism: A comparison of reciprocal imitation training and video modeling. Journal of Autism and Developmental Disorders, 41, 654-666. doi:10.1007/s10803-010-1086-8
8.
*CarterA. S.MessingerD. S.StoneW. L.CelimliS.NahmiasA. S.YoderP. (2011). A randomized controlled trial of Hanen’s “More Than Words” in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 52, 741-752. doi:10.1111/j.1469-7610.2011.02395.x
9.
CicchettiD. V. (2011). On the reliability and accuracy of the evaluative method for identifying evidence-based practices in autism. In ReichowB.DoehringP.CicchettiD. V.VolkmarF. R. (Eds.), Evidence-based practices and treatments for children with autism (pp. 41-51). New York, NY: Springer.
10.
CoakleyT. (2010). State guidance documents for young children with autism spectrum disorders: Content and comparison. Infants & Young Children, 23, 145-164.
11.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
12.
CooperH. (2010). Research synthesis and meta-analysis: A step-by-step approach (4th ed.). Los Angeles, CA: SAGE.
13.
CoppleC.BredekampS. (Eds.). (2009). Developmentally appropriate practice in early childhood programs serving children from birth through age 8 (3rd ed.). Washington, DC: National Association for the Education of Young Children.
14.
*DawsonG.RogersS.MunsonJ.SmithM.WinterJ.GreensonJ.VarleyJ. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, e17-e23.
15.
DempseyI.KeenD. (2008). A review of processes and outcomes in family-centered services for children with a disability. Topics in Early Childhood Special Education, 28, 42-52.
16.
*DrewA.BairdG.Baron-CohenS.CoxA.SlonimsV.WheelwrightS.CharmanT. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism: Preliminary findings and methodological challenges. European Child & Adolescent Psychiatry, 11, 266-272.
17.
DunstC. J.BruderM. B.TrivetteC. M.HambyD. (2006). Everyday activity settings, natural learning environments, and early intervention practice. Journal of Policy and Practice in Intellectual Disabilities, 3, 3-10.
18.
DunstC. J.TrivetteC. M.HambyD. W. (2007). Meta-analysis of family-centered helpgiving practices research. Mental Retardation and Developmental Disabilities Research Reviews, 13, 370-378.
19.
EikesethS. (2009). Outcome of comprehensive psycho-educational interventions for young children with autism. Research in Developmental Disabilities, 30, 158-178.
20.
EldevikS.HastingsR. P.HughesC.JahrE.EikesethS.CrossS. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child & Adolescent Psychology, 38, 439-450.
21.
*EschB. E.CarrJ. E.GrowL. L. (2009). Evaluation of an enhanced stimulus-stimulus pairing procedure to increase early vocalizations of children with autism. Journal of Applied Behavior Analysis, 42, 225-241.
22.
FeldmanR.GreenbaumC. W.YirmiyaN. (1999). Mother–Infant affect synchrony as an antecedent of the emergence of self-control. Developmental Psychology, 35, 223-231. doi:10.1037/0012-1649.35.1.223
23.
GerstenR.FuchsL. S.ComptonD.CoyneM.GreenwoodC.InnocentiM. S. (2005). Quality indicators for group experimental and quasi-experimental research in special education. Exceptional Children, 71(2), 149-164.
24.
GuralnickM. J. (1998). Effectiveness of early intervention for vulnerable children: A developmental perspective. American Journal on Mental Retardation, 102, 319-345.
25.
HattieJ. (2009). Visible learning: A synthesis of over 800 meta-analyses relating to achievement. London, England: Routledge.
26.
HebbelerK. M.Gerlach-DownieS. G. (2002). Inside the black box of home visiting: A qualitative analysis of why intended outcomes were not achieved. Early Childhood Research Quarterly, 17, 28-51. doi:10.1016/s0885-2006(02)00128-x
27.
HedgesL.OlkinI. (1985). Statistical models for meta-analysis. New York, NY: Academic Press.
28.
HigginsJ. P. T.GreenS. (2008). Cochrane handbook for systematic reviews of interventions. Chichester, UK: Wiley.
29.
*HineJ. F.WoleryM. (2006). Using point-of-view video modeling to teach play to preschoolers with autism. Topics in Early Childhood Special Education, 26, 83-93.
30.
HornerR. H.CarrE. G.HalleJ.McGeeG.OdomS.WoleryM. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165-179.
31.
HowlinP.MagiatiI.CharmanT. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114, 23-41.
32.
Individuals With Disabilities Education Act. 20 U.S.C. § 1400 (2004).
33.
*IngersollB.DvortcsakA.WhalenC.SikoraD. (2005). The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus on Autism & Other Developmental Disabilities, 20, 213-222.
34.
*IngersollB.GergansS. (2007). The effect of a parent-implemented imitation intervention on spontaneous imitation skills in young children with autism. Research in Developmental Disabilities, 28, 163-175. doi:10.1016/j.ridd.2006.02.004
JadadA. R.MooreR. A.CarrollD.JenkinsonC.ReynoldsD. J. M.GavaghanD. J.McQuayH. J. (1996). Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Controlled Clinical Trials, 17, 1-12.
37.
JohnsonC. P.MyersS. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183-1215. doi:doi/10.1542
38.
*JonesE. A.CarrE. G.FeeleyK. M. (2006). Multiple effects of joint attention intervention for children with autism. Behavior Modification, 30, 782-834.
39.
JuniP.WitschiA.BlochR.EggerM. (1999). The hazards of scoring the quality of clinical trails for meta-analysis. Journal of the American Medical Association, 282, 1054-1060.
40.
*LandaR. J.HolmanK. C.O’NeillA. H.StuartE. A. (2011). Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 52, 13-21. doi:10.1111/j.1469-7610.2010.02288.x
41.
LandryS. H.SmithK. E.SwankP. R. (2006). Responsive parenting: Establishing early foundations for social, communication, and independent problem-solving skills. Developmental Psychology, 42, 627-642.
42.
*LeewS. V.SteinN. G.GibbardW. B. (2010). Weighted vests’ effect on social attention for toddlers with autism spectrum disorders. Canadian Journal of Occupational Therapy, 77(2), 113-124.
43.
Lewis-SnyderG.StoiberK. C.KratochwillT. R. (2002). Evidence-based interventions in school psychology: An illustration of task force coding criteria using group-based research design. School Psychology Quarterly, 17, 423-465.
LordC.RisiS.DiLavoreP. S.ShulmanC.ThurmA.PicklesA. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694-701.
46.
LordC.RutterM.DiLavoreP. C.RisiS. (1999). Autism diagnostic observation schedule - WPS (ADOS-WPS). Los Angeles, CA: Western Psychological Services.
47.
LordC.RutterM.Le CouteurA. (1994). Autism Diagnostic Interview–Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659-685.
48.
LuysterR.GothamK.GuthrieW.CoffingM.PetrakR.PierceK.. . . LordC. (2009). The Autism Diagnostic Observation Schedule—Toddler Module: A new module of a standardized diagnostic measure for autism spectrum disorders. Journal of Autism & Developmental Disorders, 39(9), 1305-1320.
49.
MahoneyG.BoyceG.FewellR. R.SpikerD.WheedenC. A. (1998). The relationship of parent-child interaction to the effectiveness of early intervention services for at-risk children and children with disabilities. Topics in Early Childhood Special Education, 18, 5-17.
50.
MahoneyG.KimJ. M.LinC. (2007). Pivotal behavior model of development learning. Infants & Young Children: An Interdisciplinary Journal of Special Care Practices, 20, 311-325.
51.
McArthurD. (1996). Joint attention in preverbal children: Autism and developmental language disorder. Journal of Autism and Developmental Disorders, 26, 481-496.
52.
McConachieH.DiggleT. (2007). Parent implemented early intervention for young children with autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice, 13, 120-129.
53.
MoherD.PhamB.JonesA.CookD. J.JadadA. R.MoherM.KlassenT. P. (1998). Does quality of reports of randomized trials affect estimates of intervention efficacy reported in meta-analyses?Lancet, 352, 609-613.
54.
MullenE. M. (1995). Mullen Scales of Early Learning (AGS ed.). Circle Pines, MN: American Guidance Service.
55.
MundyP.SigmanM.KasariC. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20, 115-128.
56.
MundyP.StellaJ. (2000). Joint attention, social orienting, and nonverbal communication in autism. In WetherbyA. M.PrizantB. M. (Eds.), Autism spectrum disorders (pp. 55-77). Baltimore, MD: Brookes.
57.
National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press.
58.
OdomS. L.BrantlingerE.GerstenR.HornerR. H.ThompsonB.HarrisK. R. (2005). Research in special education: Scientific methods and evidence-based practices. Exceptional Children, 71, 137-148.
59.
OdomS. L.WoleryM. (2003). A unified theory of practice in early intervention/early childhood special education: Evidence-based practices. Journal of Special Education, 37, 164-173.
60.
PaparellaT.KasariC. (2004). Joint attention skills and language development in special needs populations. Infants & Young Children: An Interdisciplinary Journal of Special Care Practices, 17, 269-280.
61.
*ParkJ. H.Alber-MorganS. R.Cannella-MaloneH. (2011). Effects of mother-implemented Picture Exchange Communication System (PECS) training on independent communicative behaviors of young children with autism spectrum disorders. Topics in Early Childhood Special Education, 31, 37-47. doi:10.1177/0271121410393750
62.
PetticrewM.RobertsH. (2006). Systematic reviews in the social sciences: A practical guide. Malden, MA: Blackwell.
63.
PolaninJ. R. (2012, May). Options for assessing study quality. Oral presentation given at Campbell Colloquium, Copenhagen, Denmark.
64.
ReichowB. (2011). Development, procedures, and application of the evaluative method for determining evidence-based practices in autism. In ReichowB.DoehringP.CicchettiD. V.VolkmarF. R. (Eds.), Evidence-based practices and treatments for children with autism (pp. 25-39). New York, NY: Springer.
65.
ReichowB. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 512-520. doi:10.1007/s10803-011-1218-9
66.
ReichowB.BartonE. E.VolkmarF. R.CicchettiD. V. (2007, May). The status of research on interventions for young children with autism spectrum disorders. Poster presented at the International Meeting for Autism Research, Seattle, WA.
67.
ReichowB.VolkmarF. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40, 149-166. doi:10.1007/s10803-009-0842-0
68.
ReichowB.VolkmarF. R. (2011). Introduction to evidence-based practices in autism: Where we started. In ReichowB.DoehringP.CicchettiD. V.VolkmarF. R. (Eds.), Evidence-based practices and treatments for children with autism (pp. 3-24). New York, NY: Springer.
69.
ReichowB.VolkmarF. R.CicchettiD. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38, 1311-1319.
70.
ReichowB.WoleryM. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA Young Autism Project Model. Journal of Autism and Developmental Disorders, 39, 23-41.
71.
RobinsD. L.FeinD.BartonM. L.GreenJ. A. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131-144.
72.
*RochaM. L.SchreibmanL.StahmerA. C. (2007). Effectiveness of training parents to teach joint attention in children with autism. Journal of Early Intervention, 29, 154-173.
73.
RogersS. J.VismaraL. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37, 8-38.
74.
RothsteinH. R.SuttonA. J.BorensteinM. (2005). Publication bias in meta-analysis: Prevention, assessment, and adjustments. Chichester, UK: Wiley.
75.
SandallS. R.HemmeterM. L.SmithB. J.McLeanM. E. (2005). DEC recommended practices: A comprehensive guide for practical application in early intervention/early childhood special education. Missoula, MT: Division for Early Childhood, Council for Exceptional Children.
76.
SchertzH. H.BakerC.HurwitzS.BennerL. (2011). Principles of early intervention reflected in toddler research in autism spectrum disorders. Topics in Early Childhood Special Education, 31, 4-21. doi:10.1177/0271121410382460
77.
*SchertzH. H.OdomS. L. (2007). Promoting joint attention in toddlers with autism: A parent-mediated developmental model. Journal of Autism and Developmental Disorders, 37, 1562-1575.
78.
SchoplerE.ReichlerR. J.RennerB. R. (1988). The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services.
79.
ShernoffE. S.KratochwillT. R.StoiberK. C. (2002). Evidence-based interventions in school psychology: An illustration of task force coding criteria using single-participant research design. School Psychology Quarterly, 17, 390-422.
80.
SiegelM.BeaulieuA. A. (2012). Psychotropic medications in children with autism spectrum disorders: A systematic review and synthesis for evidence-based practice. Journal of Autism and Developmental Disorders, 42, 1592-1605.
81.
SigmanM. D.RuskinE. (1999). Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays. Monographs of the Society for Research in Child Development, 64(1), 1-142.
82.
SillerM.SigmanM. (2008). Modeling longitudinal change in the language abilities of children with autism: Parent behaviors and child characteristics as predictors of change. Developmental Psychology, 44, 1691-1704. doi:10.1037/a0013771
83.
SilvermanW. K.HinshawS. P. (2008). The second special issue on evidence-based psychosocial treatments for children and adolescents: A 10-year update. Journal of Clinical Child and Adolescent Psychology, 37, 1-7.
84.
SlavinR. E. (1986). Best evidence synthesis: An alternative to metaanalytic and traditional reviews. Educational Researcher, 15, 5-11.
85.
SnyderP. (2006). Best available research evidence: Impact on research in early childhood. In BuysseV.WesleyP. W. (Eds.), Evidence-based practice in the early childhood field (pp. 35-70). Washington, DC: Zero to Three.
86.
SparrowS. S.BallaD. A.CicchettiD. V. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service.
87.
SparrowS. S.CicchettiD. V.BallaD. A. (2005). Vineland Adaptive Behavior Scales (2nd ed.). Circle Pines, MN: American Guidance Service.
88.
SpectorJ. E. (2011). Sight word instruction for students with autism: An evaluation of the evidence base. Journal of Autism and Developmental Disorders, 41, 1411-1422.
89.
StrausS. E.RichardsonW. S.GlasziouP.HaynesR. B. (2005). Evidence-based medicine: How to practice and teach EBM (3rd ed.). Edinburgh, Scotland: Elsevier.
90.
Tager-FlusbergH.RogersS.CooperJ.LandaR.LordC.PaulR.YoderP. (2009). Defining spoken language benchmarks and selecting measures of expressive language development for young children with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 52, 643-652.
91.
TomaselloM.FarrarM. J. (1986). Joint attention and early language. Child Development, 57, 1454-1463.
92.
TrivetteC. M.DunstC. J.HambyD. W. (2010). Influences of family-systems intervention practices on parent-child interactions and child development. Topics in Early Childhood Special Education, 30, 3-19. doi:10.1177/0271121410364250
93.
TronickE. (2007). The neurobehavioral and social-emotional development of infants and children. New York, NY: Norton.
94.
*VanDerHeydenA. M.SnyderP.DiCarloC. F.StricklinS. B.VigianosL. A. (2002). Comparison of within-stimulus and extra-stimulus prompts to increase targeted play behaviors in an inclusive early intervention program. Behavior Analyst Today, 3(2), 188-197.
95.
Virués-OrtegaJ. (2010). Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes. Clinical Psychology Review, 30, 387-399. doi:10.1016/j.cpr.2010.01.008
96.
*VismaraL. A.LyonsG. L. (2007). Using perseverative interests to elicit joint attention behaviors in young children with autism: Theoretical and clinical implications for understanding motivation. Journal of Positive Behavior Interventions, 9, 214-228.
97.
*VismaraL. A.RogersS. J. (2008). The early start Denver model: A case study of an innovative practice. Journal of Early Intervention, 31, 91-108.
98.
*WetherbyA. M.WoodsJ. J. (2006). Early social interaction project for children with autism spectrum disorders beginning in the second year of life: A preliminary study. Topics in Early Childhood Special Education, 26, 67-82.
99.
*ZachorA. D.Ben ItzchakE.RabinovichA.-L.LahatE. (2007). Change in autism core symptoms with intervention. Research in Autism Spectrum Disorders, 1, 304-317.
100.
ZwaigenbaumL.ThurmA.StoneW.BaranekG.BrysonS.IversonJ.SigmanM. (2007). Studying the emergence of autism spectrum disorders in high-risk infants: Methodological and practical issues. Journal of Autism and Developmental Disorders, 37, 466-480.
