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Meta-Analysis
. 2025 Jul:119:102588.
doi: 10.1016/j.cpr.2025.102588. Epub 2025 May 3.

Characterizing predictors of response to behavioral interventions for children with autism spectrum disorder: A meta-analytic approach

Lacey Chetcuti  1 , Mirko Uljarević  2 , Rachel K Schuck  2 , Antonio Y Hardan  2 , Grace W Gengoux  2 , David Trembath  3 , Yagnesh Vadgama  4 , Kandice J Varcin  3 , Giacomo Vivanti  5 , Andrew J O Whitehouse  6 , Maria Helton  7 , Thomas W Frazier  8
Affiliations
Meta-Analysis

Characterizing predictors of response to behavioral interventions for children with autism spectrum disorder: A meta-analytic approach

Lacey Chetcuti et al. Clin Psychol Rev. 2025 Jul.

Abstract

A comprehensive understanding of specific factors contributing to variability in responsiveness of children with autism to interventions is paramount for making evidence-based clinical and policy decisions. This meta-analysis examined child and family characteristics, as well as intervention design factors, associated with outcomes of behavioral interventions for children with autism. A systematic review identified 95 studies published between 1987 and 2024, encompassing 6780 children on the autism spectrum and 2150 independent effect sizes. Results indicated that stronger post-intervention effects were observed across intervention approaches for children with higher cognitive, language, and other developmental abilities, greater adaptive functioning, and fewer autism-related features. Additionally, interventions of longer duration and greater total hours were associated with stronger post-intervention outcomes. In contrast, intervention approach (Early Intensive Behavioral Intervention, Naturalistic Developmental Behavioral Interventions, or Developmental Interventions), delivery agent, and child age at intervention onset did not significantly predict the strength of post-intervention outcomes. While study methodology and reporting quality were marginally associated with predictive strength, adjusting for these factors had minimal impact on the reported findings. The insights from this meta-analysis have significant implications for the development of personalized intervention models for children with autism. These models have the potential to optimize outcomes and offer critical guidance for decision-making in both the service and policy levels, ensuring efficient and equitable allocation of resources.

Keywords: Autism spectrum disorder; Early intensive behavioral intervention; Heterogeneity; Naturalistic developmental behavioral intervention; Predictors of response.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Uljarević has received grant or research support from the NIMH, Simons Foundation, Autism Speaks, and PTEN Research. He has served on the editorial boards of the Journal of Autism and Developmental Disorders, PLoS One, Frontiers in Psychiatry, and Frontiers in Neuroscience. He has co-authored the Stanford Social Dimensions Scale (SSDS) and has equity options in iSCAN-R and AI-Measures. Dr. Hardan has received grant or research support from the National Institutes of Health (NIH), Autism Speaks, and the Simons Foundation Autism Research Initiative. He has served on the advisory board/Data and Safety Monitoring Board of Roche. He has co-authored the Stanford Social Dimensions Scale (SSDS). He has served as a consultant to BioBridge, Roche, Finch Therapeutics, and the PTEN Research Foundation and has equity options in iSCAN-R and AI-Measures. He has served on the editorial boards of the Journal of Autism and Developmental Disorders and Child Psychiatry and Human Development. He has held patents (in preparation, filed, or granted) on N-acetyl cysteine, pregnenolone, and arginine vasopressin. Dr. Trembath has received research support in the past 10 years from the NHMRC, MRFF, Autism CRC, Channel 7 Children's Research Foundation, Stan Perron Charitable Foundation, The Kids Research Institute Australia, Speech Pathology Australia, Playgroup NSW Inc, Commonwealth Department of Health, Queensland Government Department of Tourism Industry and Sport, Queensland Government Department of Education, Australian Government Department of Social Services, Griffith University and Massey University. From 2018-2020, Dr. Trembath was tasked with developing and acting as Program Director for two programs in Applied Behaviour Analysis (Graduate Certificate, Masters) at Griffith University. He has been an associate editor of Augmentative and Alternative Communication and member of the extended editorial board of Research in Autism Spectrum Disorders. Dr. Varcin has received grant funding from the Autism CRC and acted as a consultant for training purposes for The Australian Psychological Society Limited. Dr. Vivanti has received research support from the National Institutes of Health (NIH), the Autism Science Foundation, and EarliTec Diagnostics, Inc., as well as royalties from the books Implementing the Group-based Early Start Denver Model for Young Children with Autism and Clinical Guide to Early Interventions for Children with Autism, published by Springer. He has served on the editorial board of the Journal of Early Intervention and is an Associate Editor of the Journal of Autism and Developmental Disorders. Dr. Whitehouse has received funding from the NHMRC, Autism CRC, and the Angela Wright Bennett foundation. He was an originator of the Inklings-iBASIS intervention, and has been on the editorial board of the Journal of Autism and Developmental Disorders, Autism Research, and Research in Autism Spectrum Disorders. Dr. Frazier has received funding or research support from, acted as a consultant to, received travel support from, and/or received a speaker’s honorarium from the PTEN Research Foundation, SYNGAP Research Fund, Malan Syndrome Foundation, ADNP Kids Research Foundation, Quadrant Biosciences, Autism Speaks, Impel NeuroPharma, F. Hoffmann-La Roche AG Pharmaceuticals, the Cole Family Research Fund, Simons Foundation, Ingalls Foundation, Forest Laboratories, Ecoeos, IntegraGen, Kugona LLC, Shire Development, Bristol-Myers Squibb, Roche Pharma, MaraBio, Scioto Biosciences, Linus Biotechnology, National Institutes of Health, and the Brain and Behavior Research Foundation, has equity options in Quadrant Biosciences/Autism Analytica, MaraBio, has an investor stake in Autism EYES LLC, and is a co-owner of iSCAN-R and AI-Measures.

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