How Do Speech-Language Pathology Social Communication Interventions Incorporate the Strengths and Perspectives of Autistic Children and Their Families: A Scoping Review.

PURPOSE: It is important to understand how social communication interventions for autistic people align with neurodiversity-affirming approaches, including strength-based and family-centered care principles. In this scoping review, we explored how the strengths and perspectives of autistic children and their families are included in speech-language pathology social communication interventions. We searched OVID Medline, Embase, PsycINFO, and Web of Science databases, used supplementary search methods, and conducted a gray literature search. Data were extracted using the Population, Concept, and Context framework for scoping reviews. MAJOR FINDINGS: 26 articles were included in our analysis. Most studies described only deficits associated with autism. Most studies explicitly reported parents' perspectives on intervention goals, activities, or outcome measures; children's perspectives were rarely included. Most speech-language pathology documents from the gray literature recommended strength-based, and family-centered service delivery. CONCLUSION: Strength-based and family-centered values have been recommended in speech-language pathology practice for decades yet were not consistently reflected in social communication interventions for autistic children. Our discussion offers several suggestions for taking a strength-based approach to speech-language pathology practice and advancing child and family involvement toward shared decision-making. Our ideas may prompt speech-language pathology researchers and clinicians to reflect on their own approaches to autism and social communication interventions.Lay Abstract/Plain Language SummaryWhy was this study done?Autistic children and youth often participate in social communication interventions. These interventions can be delivered by healthcare professionals including speech-language pathologists. It is important to find out if these interventions talk about autistic people's strengths and if they include autistic people's and their families' perspectives. These principles are important to make sure that interventions are neurodiversity-affirming. To answer this question, we searched for academic articles that talked about speech-language pathology social communication interventions for autistic children and youth. We used a research methodology called a scoping review. We wanted to find out whether and how these speech-language pathology interventions included the strengths and perspectives of autistic children and their families.What did the researchers find?We included 26 articles and analyzed them. We found that most studies described only the deficits associated with autism. Most studies included the perspectives of parents in their interventions, but children's perspectives were rarely reported. We also looked at speech-language pathology documents related to autism and found that most of these documents recommended strength-based and family-centered services.What are important takeaways?Most existing social communication interventions in the field of speech-language pathology focused on autistic people's deficits and used person-first language (e.g., person with autism) which describes autism as a diagnosis to have rather than an aspect of someone's identity. Our discussion about our paper suggests how researchers and clinicians can incorporate autistic people's strengths and be neurodiversity-affirming in their interventions. We also discuss ways to involve autistic children and their families in intervention decision-making, including as co-researchers. We hope that this paper will encourage speech-language pathology researchers and clinicians to think about how they view autism, and if their interventions are neurodiversity-affirming.