What We Detail and What We Miss: Child and Intervention Delivery Characteristics in Communication and Joint Attention Interventions for Autistic Preschool-Aged Children

Purpose: Because autism is heterogeneous and requires individualized intervention delivery, this study describes reported child and intervention delivery characteristics of evidence-based practices (EBPs) using single-case experimental designs (SCEDs) with effectiveness for communication and joint attention outcomes in preschool-aged Autistic children.Methods: We conducted a secondary analysis of 150 studies in the National Clearinghouse on Autism Evidence and Practice review database. We extracted detailed participant demographics (e.g., age, race) and developmental characteristics (e.g., cognition, spoken communication) for each participating preschool-aged Autistic child (N = 348). We extracted delivery characteristics (e.g., interventionist, setting) for each intervention (N = 217), as well as child-received dosage (e.g., duration, number of trials and sessions; N = 484). Inter-rater agreement averaged 90.7%.Results: Sex was frequently reported (92.7%), whereas race (12.7%) and home language (18.4%) were reported less often; when reported, predominant groups were largely represented (e.g., male, 76.4%; White, 61.4%; English-speaking, 73.4%). Only a portion of studies reported developmental characteristics (e.g., cognitive level, 28.2%), yet we observed a full skill range in cognition (35.7% with intellectual disability likely), autism symptomatology (55.6% severe; 35.2% mild-to-moderate), and spoken language (e.g., 36.1% non-speaking; 18.7% speaking). Intervention and dosage characteristics varied in reporting (e.g., interventionist, 91.7%; duration, 23.8%), and were often delivered by researchers (60.8%), in an isolated 1:1 format (77.9%).Conclusion: For preschool-aged Autistic children, this body of literature provides evidence of effectiveness for some specific child and intervention characteristics. Future research is needed for translation and more detailed reporting for ecologically valid clinical application and research replicability.