Enhanced milieu teaching to improve language and social communication skills in young children with Autism spectrum disorder : a systematic review and meta-analysis

Abstract

Objective: This systematic review (SR) evaluated the effectiveness of enhanced milieu teaching (EMT) on the language and social communication skills of children with autism spectrum disorder (ASD). Methods: The study protocol was pre-registered at PROSPERO. This SR followed the framework of Cochrane Handbook for Systematic Review of Interventions. Fifteen Electronic databases were searched to relevant studies. Two reviewers independently selected studies based on pre-determined inclusion criteria and appraised the methodological quality of studies using the Critical Appraisal of Treatment Evidence checklist. Results: Eleven English studies were included, ten of which were single-subject studies. However, a majority of them did not have high quality. For instance, they were lacking in randomization and blinding of assessors. Furthermore, there was a lack of group studies of high quality of evidence. Results suggested that EMT was effective in facilitating the language and social communication development of children with ASD. Meta-analysis was not conducted due to the lack of homogeneity of data and inadequate group studies present. Conclusion: EMT was shown to be promising in single subject studies, but future research should incorporate RCT across multiple centers to determine if the intervention’s effectiveness.