Pragmatic Language Interventions for Autistic Children: Evidence, Generalisation, and Neurodiversity-Informed Directions
DOI:
https://doi.org/10.54536/jnll.v4i2.8532Keywords:
Autism, Inclusive Education, Neurodiversity, Pragmatic Language, Social CommunicationAbstract
Autistic children do not experience pragmatic-language difficulties in the same way. Some may need support with conversation, inference, or communication repair, whereas others communicate effectively when the setting, task, or communication partner is familiar. This review examines what recent intervention research can-and cannot-tell us about supporting these differences. Literature published mainly between 2015 and 2025 was identified through PubMed, ERIC, citation searching, and relevant publisher databases. Earlier studies were retained when they informed current intervention models or debates. The reviewed approaches included explicit pragmatic teaching, naturalistic and play-based intervention, parent- and peer-mediated programmes, school-based support, and the use of technology. Many studies reported improvement in the behaviours or skills directly addressed during intervention. Evidence of lasting change in ordinary classrooms, homes, and peer relationships was much more limited. This distinction is important, since performing a practised task successfully is not the same as communicating more easily in daily life. Conclusions were also restricted by small samples, considerable variation between interventions, and the use of measures that were often closely related to the content taught. The review further considers how intervention goals are defined. Teaching may be helpful when it gives a child additional ways to communicate, participate, or manage misunderstandings. It is more difficult to justify when it mainly rewards behaviour that appears more neurotypical. Future work should examine outcomes chosen with autistic people, include children with a wider range of communication profiles, and consider partners and environments as part of pragmatic support.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Andreou, G., Lymperopoulou, V., & Aslanoglou, V. (2022). Developmental language disorder and autism spectrum disorder: Similarities in pragmatic language abilities-A systematic review. International Journal of Developmental Disabilities. https://doi.org/10.1080/20473869.2022.2132669
Baethge, C., Goldbeck-Wood, S., & Mertens, S. (2019). SANRA-A scale for the quality assessment of narrative review articles. Research Integrity and Peer Review, 4, 5. https://doi.org/10.1186/s41073-019-0064-8
Bauminger-Zviely, N., Estrugo, Y., Samuel-Magal, K., Friedlin, A., Heishrik, L., Koren, D., & Bar-Yehuda, S. (2020). Communicating without words: School-based RCT social intervention in minimally verbal peer dyads with ASD. Journal of Clinical Child & Adolescent Psychology, 49(6), 837–853. https://doi.org/10.1080/15374416.2019.1660985
Binns, A. V., & Oram Cardy, J. (2019). Developmental social pragmatic interventions for preschoolers with autism spectrum disorder: A systematic review. Autism & Developmental Language Impairments, 4, 1–18. https://doi.org/10.1177/2396941518824497
Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, 102080. https://doi.org/10.1016/j.cpr.2021.102080
Crompton, C. J., Sharp, M., Axbey, H., Fletcher-Watson, S., Flynn, E. G., & Ropar, D. (2020). Neurotype-matching, but not being autistic, influences self and observer ratings of interpersonal rapport. Frontiers in Psychology, 11, 586171. https://doi.org/10.3389/fpsyg.2020.586171
Deniz, E., Francis, G., Torgerson, C., & Toseeb, U. (2024). Parent-mediated play-based interventions to improve social communication and language skills of preschool autistic children: A systematic review and meta-analysis. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-024-00463-0
Denman, D., Speyer, R., Munro, N., Pearce, W. M., Chen, Y.-W., & Cordier, R. (2017). Psychometric properties of language assessments for children aged 4–12 years: A systematic review. Frontiers in Psychology, 8, 1515. https://doi.org/10.3389/fpsyg.2017.01515
Félix, J., Santos, M. E., & Benítez-Burraco, A. (2024). Specific language impairment, autism spectrum disorders and social (pragmatic) communication disorders: Is there overlap in language deficits? A review. Review Journal of Autism and Developmental Disorders, 11, 86–106. https://doi.org/10.1007/s40489-022-00327-5
Gabarron, E., Skafle, I., Nordahl-Hansen, A., & Wynn, R. (2023). Social media interventions for autistic individuals: Systematic review. Frontiers in Psychiatry, 14, 1089452. https://doi.org/10.3389/fpsyt.2023.1089452
Georgiou, N., & Spanoudis, G. (2021). Developmental language disorder and autism: Commonalities and differences on language. Brain Sciences, 11(5), 589. https://doi.org/10.3390/brainsci11050589
Gernsbacher, M. A., & Pripas-Kapit, S. R. (2012). Who’s missing the point? A commentary on claims that autistic persons have a specific deficit in figurative language comprehension. Metaphor and Symbol, 27(1), 93–105. https://doi.org/10.1080/10926488.2012.656255
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47, 2519–2534. https://doi.org/10.1007/s10803-017-3166-5
Jaswal, V. K., & Akhtar, N. (2019). Being versus appearing socially uninterested: Challenging assumptions about social motivation in autism. Behavioral and Brain Sciences, 42, e82. https://doi.org/10.1017/S0140525X18001826
Kapp, S. K. (Ed.). (2020). Autistic community and the neurodiversity movement: Stories from the frontline. Palgrave Macmillan. https://doi.org/10.1007/978-981-13-8437-0
Leadbitter, K., Buckle, K. L., Ellis, C., & Dekker, M. (2021). Autistic self-advocacy and the neurodiversity movement: Implications for autism early intervention research and practice. Frontiers in Psychology, 12, 635690. https://doi.org/10.3389/fpsyg.2021.635690
Lee, J. D., & Meadan, H. (2021). Parent-mediated interventions for children with ASD in low-resource settings: A scoping review. Review Journal of Autism and Developmental Disorders, 8(3), 285–298. https://doi.org/10.1007/s40489-020-00218-7
Liu, Q., Hsieh, W.-Y., & Chen, G. (2020). A systematic review and meta-analysis of parent-mediated intervention for children and adolescents with autism spectrum disorder in mainland China, Hong Kong, and Taiwan. Autism, 24(8), 1960–1979. https://doi.org/10.1177/1362361320943380
Liu, Y., Tian, X., Mao, H., Cheng, L., Wang, P., & Gao, Y. (2024). Research on pragmatic impairment in autistic children during the past two decades (2001–2022): Hot spots and frontiers—Based on CiteSpace bibliometric analysis. Frontiers in Psychology, 15, 1276001. https://doi.org/10.3389/fpsyg.2024.1276001
Milton, D. E. M. (2012). On the ontological status of autism: The “double empathy problem.” Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008
Nevill, R. E., Lecavalier, L., & Stratis, E. A. (2018). Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism, 22(2), 84–98. https://doi.org/10.1177/1362361316677838
Norbury, C. F. (2014). Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. Journal of Child Psychology and Psychiatry, 55(3), 204–216. https://doi.org/10.1111/jcpp.12154
O’Keeffe, C., & McNally, S. (2023). A systematic review of play-based interventions targeting the social communication skills of children with autism spectrum disorder in educational contexts. Review Journal of Autism and Developmental Disorders, 10, 51–81. https://doi.org/10.1007/s40489-021-00286-3
Panagiotakopoulou, A., Vasileiou, I., & Katsarou, D. V. (2024). Investigation of sexual education programs for adolescents with autism and the role of parents in providing support. Materia Socio-Medica, 36(2), 155-159. https://doi.org/10.5455/msm.2024.36.155-159
Parsons, L., Cordier, R., Munro, N., Joosten, A., & Speyer, R. (2017). A systematic review of pragmatic language interventions for children with autism spectrum disorder. PLOS ONE, 12(4), e0172242. https://doi.org/10.1371/journal.pone.0172242
Parsons, L., Cordier, R., Munro, N., & Joosten, A. (2019). A randomized controlled trial of a play-based, peer-mediated pragmatic language intervention for children with autism. Frontiers in Psychology, 10, 1960. https://doi.org/10.3389/fpsyg.2019.01960
Pereira, T., & Lousada, M. (2023). Psychometric properties of standardized instruments that are used to measure pragmatic intervention effects in children with developmental language disorder: A systematic review. Journal of Autism and Developmental Disorders, 53, 1764–1780. https://doi.org/10.1007/s10803-022-05481-7
Pereira, T., Ramalho, A. M., Valente, A. R. S., Sá Couto, P., & Lousada, M. (2022). The effects of the Pragmatic Intervention Programme in children with autism spectrum disorder and developmental language disorder. Brain Sciences, 12(12), 1640. https://doi.org/10.3390/brainsci12121640
Pereira, T., Ramalho, A. M., Sá Couto, P., & Lousada, M. (2025). Exploring the effectiveness of the Pragmatic Intervention Programme with children with autism spectrum disorder and developmental language disorder: A non-randomised controlled trial. Autism, 29(3), 726–739. https://doi.org/10.1177/13623613241287017
Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., Mahbub, P., & Woynaroski, T. G. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1–29. https://doi.org/10.1037/bul0000215
Sasson, N. J., Faso, D. J., Nugent, J., Lovell, S., Kennedy, D. P., & Grossman, R. B. (2017). Neurotypical peers are less willing to interact with those with autism based on thin slice judgments. Scientific Reports, 7, 40700. https://doi.org/10.1038/srep40700
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 2411–2428. https://doi.org/10.1007/s10803-015-2407-8
Singhania, R. (2025). Examining early communication profiles in preschool children with autism spectrum disorders in Dubai, U.A.E.: A comparative analysis of cognitive, language and symbolic play abilities. American Journal of Life Science and Innovation, 4(1), 8-20. https://doi.org/10.54536/ajlsi.v4i1.2645
Sitoy, R. E., Abrigondo, O. C., Dormiendo, J. C., & Jamen, M. B. B. (2025). Parents’ participation in fostering effective communication through prompting techniques for children with autism spectrum disorder. American Journal of Human Psychology, 3(1), 99-106. https://doi.org/10.54536/ajhp.v3i1.2770
Trembath, D., Gurm, M., Scheerer, N. E., Trevisan, D. A., Paynter, J., Bohadana, G., Roberts, J., & Iarocci, G. (2019). Systematic review of factors that may influence the outcomes and generalizability of parent-mediated interventions for young children with autism spectrum disorder. Autism Research, 12(9), 1304–1321. https://doi.org/10.1002/aur.2168
Vasileiou, I. (2026a). Artificial intelligence in autism spectrum disorder: A systematic review of AI-supported screening, education, and intervention technologies. European Journal of Special Education Research, 12(5), 1-19. https://doi.org/10.46827/ejse.v12i5.6741
Vasileiou, I. (2026b). Enhancing executive functions to improve academic achievement in school-aged children: A systematic review of educational, cognitive, and digital interventions. Journal of Education and Practice, 17(6), 1-12. https://doi.org/10.7176/JEP/17-6-01
Watkins, L., O’Reilly, M., Kuhn, M., Gevarter, C., Lancioni, G. E., Sigafoos, J., & Lang, R. (2015). A review of peer-mediated social interaction interventions for students with autism in inclusive settings. Journal of Autism and Developmental Disorders, 45(4), 1070–1083. https://doi.org/10.1007/s10803-014-2264-x
Yu, B., & Sterponi, L. (2023). Toward neurodiversity: How conversation analysis can contribute to a new approach to social communication assessment. Language, Speech, and Hearing Services in Schools, 54(1), 27–41. https://doi.org/10.1044/2022_LSHSS-22-00041
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