Behavioural interventions for children on the autism spectrum | FOI document library

Study Article author (year)

Study	Article author (year)	Country	Study design	N	Boys (%)	Age (mths)	Outcome domains reported	Intervention category	Control group	Primary setting	Person delivering
72	Rogers et al. (2019)	USA	Random	118	77.97	21.02	Autism characteristics, adaptive functioning, cognition	NDBI	TAU	Home	Parent delivered
72	Rogers et al. (2012)	USA	Random	98	77.55	20.98	Autism characteristics, adaptive functioning, cognition	NDBI	TAU	Health	Parent delivered
73	Rogers et al. (2014)	USA	Non-random	14	63.64	9	Autism characteristics, cognition	NDBI	TAU	Health	Parent delivered
74	Ruiz (2020)	USA	Random	40	97.5	60.38	Autism characteristics	NDBI	TAU	Community	Clinician
75	Shawler (2017)	USA	Random	51	86.27	27.69	Cognition	Behavioural	TAU	NA	Clinician and parent
76	Sheinkopf and Siegel (1998)	USA	Cohort	22	NR	34.55	Autism characteristics, cognition	Behavioural	TAU	Home	Clinician
77	Shire et al. (2017)	USA	Random	113	77.88	31.63	Autism characteristics	NDBI	TAU	Community	Teacher delivered
78	Sinai-Gavrilov et al. (2020)	Israel	Non-random	51	82.35	44.37	Adaptive functioning, cognition	NDBI	Eclectic	Early education	Teacher delivered
79	Solomon et al. (2014)	USA	Random	128	82.03	50.19	Autism characteristics, cognition, family outcomes, adverse effects	Developmental	TAU	Home	Parent delivered
80	Spjut Jansson et al. (2016)	Sweden	Cohort	52	72.5	36.09	Autism characteristics, adaptive functioning	Developmental	Eclectic	Home	Clinician
81	Stadnick et al. (2015)	USA	Non-random	30	80	54.83	Autism characteristics, adaptive functioning, adverse effects	NDBI	TAU	Community	Parent delivered

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Study	Article author (year)	Country	Age (mths)	Boys (%)	Outcome domains reported	Intervention category	Control group	Primary setting	Person delivering
82	Stahmer et al. (2020)	USA	25	68	Autism characteristics, adaptive functioning, cognition, family outcomes	NDBI	TAU	Community	Parent delivered
83	Strauss et al. (2012)	NA	44	93.18	Autism characteristics, adaptive functioning, cognition, adverse effects	Behavioural	Eclectic	Home	Clinician and parent
84	Sullivan (2014)	USA	48	77.08	Autism characteristics, cognition	NDBI	TAU	Home	Clinician and parent
85	Tonge et al. (2006)	Australia	70	82.86	Family outcomes, adverse effects	Behavioural	TAU	Health	Parent delivered
85	Tonge et al. (2014)	Australia	70	82.86	Autism characteristics, adaptive functioning, cognition	Behavioural	TAU	Health	Parent delivered
86	Tsang et al. (2007)	Hong Kong	34	85.29	Autism characteristics, adaptive functioning, cognition	TEACCH	TAU	Early education	Teacher delivered
87	Van der Paelt et al. (2016)	Belgium	55	80	Autism characteristics, adaptive functioning, cognition	Behavioural	Eclectic	Community	Clinician
87	Van der Paelt et al. (2016)	Belgium	65	81.54	Autism characteristics, adaptive functioning, cognition	Developmental	Eclectic	Community	Clinician
88	Vernon et al. (2019)	USA	23	86.96	Autism characteristics, adaptive functioning, cognition	NDBI	TAU	Community	Clinician and parent
88	Barrett et al. (2020)	USA	21	NR	Autism characteristics, cognition	NDBI	TAU	Home	Clinician and parent

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Study	Article author (year)	Country	Study design	N	Boys (%)	Age (mths)	Outcome domains reported	Intervention category	Control group	Primary setting	Person delivering
89	Vinen et al. (2018)	Australia	Cohort	59	88.14	37.4	Autism characteristics, cognition	NDBI	Eclectic	Community	Clinician
90	Vivanti et al. (2014)	Australia	Cohort	57	87.72	41.18	Autism characteristics, adaptive functioning, cognition	NDBI	Eclectic	Community	Clinician
91	Warreyn and Roeyers (2014)	Belgium	Random	36	75	77.9	Autism characteristics	Developmental	TAU	Health	Clinician
92	Waters et al. (2020)	USA	Non-random	94	95.74	40.1	Adaptive functioning, cognition	Behavioural	TAU	Community	Clinician and parent
93	Whalen et al. (2010)	USA	Random	24	NR	NR	Cognition	Technology-based	TAU	Early education	Teacher delivered
94	Whitehouse et al. (2017)	Australia	Random	75	78.75	39.78	Autism characteristics, adaptive functioning, cognition	Technology-based	TAU	Home	Parent delivered
95	Xu et al. (2018)	China	Random	36	88.89	44.94	Autism characteristics	NDBI	Eclectic	Early education	Teacher delivered
95	Xu et al. (2017)	China	Random	36	94.44	44.94	Autism characteristics, cognition, adverse effects	NDBI	TAU	Early education	Teacher delivered
96	Zachor et al. (2007)	NA	Cohort	39	94.87	28.24	Autism characteristics, cognition	Behavioural	Eclectic	Health	Clinician
97	Zachor and Ben Itzchak (2010)	Israel	Cohort	78	91.03	25.4	Adaptive functioning, cognition	Behavioural	Eclectic	Early education	Clinician and parent
98	Zhou et al. (2018)	China	Non-random	43	88.37	26.55	Autism characteristics, cognition, adverse effects	NDBI	TAU	Health	Parent delivered

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B3. Quality of the evidence used within this report

B3.1 Randomised controlled trials

The assessed risk of bias level (low risk, some concerns, high risk) for each of the five domains within the Cochrane RoB 2.0 tool (Sterne et al., 2019) for each of the randomised controlled trial studies included within this report are displayed in Table B2.

Table B2: Domain and overall risk of bias assessments for included randomised controlled trials using Cochrane RoB 2.0

Notes: Study refers to the IDs in Table B1.

Low risk assessments are highlighted in green.

Risk assessments of some concern are highlighted in yellow. High risk assessments are highlighted in red.

Study	Randomisation process	Deviations from intended interventions	Missing outcome data	Measurement of the outcome	Selection of the reported result	Overall
1	Some concerns	Low risk	Low risk	Low risk	Low risk	Some concerns
3	Low risk	Low risk	Low risk	Low risk	Some concerns	Some concerns
7	High risk	Low risk	`redacted`	Low risk	Low risk	High risk
9	Low risk	Low risk	Low risk	Some concerns	Some concerns	Some concerns
11	Some concerns	Some concerns	Low risk	Low risk	Low risk	Some concerns
12	Some concerns	Low risk	Low risk	High risk	Low risk	High risk
15	Some concerns	Low risk	Low risk	High risk	Some concerns	High risk
19	Some concerns	Low risk	Low risk	Low risk	Some concerns	Some concerns
21	High risk	Low risk	Some concerns	Some concerns	Some concerns	High risk
28	Low risk	Low risk	Low risk	Low risk	Some concerns	Some concerns
30	Some concerns	Low risk	Low risk	Low risk	Some concerns	Some concerns
33	Low risk	Low risk	Some concerns	Some concerns	Some concerns	Some concerns
36	Some concerns	Some concerns	Low risk	High risk	Some concerns	High risk
34	Low risk	Low risk	Low risk	Low risk	High risk	High risk

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Randomisation process	Deviations from intended interventions	Missing data	Measurement of the outcome	Selection of the reported result	Overall concerns
37	Low risk	Low risk	Low risk	Some concerns	Some concerns
38	Some concerns	Low risk	Some concerns	High risk	High risk
40	Low risk	Low risk	Some concerns	Low risk	Some concerns
41	Low risk	Low risk	High risk	Some concerns	High risk
43	Low risk	Low risk	Low risk	Some concerns	Some concerns
45	Low risk	Low risk	Some concerns	Low risk	Some concerns
47	Low risk	Low risk	High risk	Low risk	High risk
48	Some concerns	Low risk	High risk	Some concerns	High risk
51	Low risk	Low risk	Low risk	Some concerns	High risk
52	High risk	Low risk	Low risk	High risk	High risk
53	Low risk	Some concerns	High risk	Some concerns	High risk
55	Low risk	Low risk	Low risk	Some concerns	Some concerns
56	Some concerns	Low risk	Low risk	Some concerns	Some concerns
57	High risk	Low risk	Low risk	Some concerns	High risk
58	Low risk	Low risk	High risk	Some concerns	High risk
59	Low risk	Low risk	Low risk	Some concerns	Some concerns
60	Some concerns	Low risk	Low risk	Some concerns	Some concerns
62	Low risk	Low risk	Low risk	High risk	High risk
64	Low risk	Low risk	Some concerns	High risk	High risk
65	Some concerns	Low risk	Low risk	Some concerns	High risk
67	High risk	Low risk	Low risk	Some concerns	High risk
68	High risk	Low risk	Some concerns	High risk	High risk
69	High risk	Low risk	High risk	Some concerns	High risk

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Study	Randomisation process	Deviations from intended interventions	Missing outcome data	Measurement of the outcome	Selection of the reported result	Overall risk
72	Low risk	Low risk	Low risk	Low risk	Low risk	Low risk
74	Low risk	Low risk	High risk	Low risk	Some concerns	High risk
75	Some concerns	Low risk	Low risk	High risk	Some concerns	High risk
77	Low risk	Low risk	Low risk	Low risk	Some concerns	High risk
79	Low risk	Low risk	Some concerns	High risk	Low risk	High risk
84	High risk	Low risk	High risk	Low risk	Some concerns	High risk
85	Low risk	Low risk	Low risk	Low risk	Some concerns	Some concerns
88	Low risk	Low risk	Low risk	Low risk	Some concerns	Some concerns
91	High risk	High risk	High risk	Low risk	Some concerns	High risk
93	High risk	Low risk	Low risk	Some concerns	Some concerns	High risk
94	Some concerns	Low risk	Low risk	High risk	Some concerns	High risk
95	Low risk	Low risk	Low risk	High risk	Some concerns	High risk

B3.2 Non-randomised study designs

The assessed risk of bias level (low risk, moderate risk, serious risk) for each of the five domains within the ROBINS-I tool (Sterne et al., 2016) For each of the non-randomised studies included within this report are displayed in Table B4.

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Table B3: Domain and overall risk of bias assessments for included non-randomised studies using ROBINS-I

Notes: Study refers to the IDs in Table B1.

Low risk assessments are highlighted in green.

Moderate risk assessments are highlighted in yellow.

Serious risk assessments are highlighted in red.

Bias due to confounding	Bias in selection of participants	Bias in classification of interventions	Bias due to deviations from intended interventions	Bias due to missing data	Bias in measurement of outcomes	Bias in selection of the reported result	Overall
Moderate risk	Low risk	Low risk					Serious risk
Serious risk	Low risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk
Moderate risk	Moderate risk	Low risk	Low risk	Low risk	Low risk	Low risk	Serious risk
Serious risk	Low risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Serious risk	Low risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Low risk	Low risk	Low risk					Serious risk
Moderate risk	Low risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Low risk	Moderate risk	Moderate risk
Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Low risk	Moderate risk	Moderate risk
Serious risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk

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Study	Bias due to confounding	Bias in selection of participants	Bias in classification of interventions	Bias due to deviations from intended interventions	Bias due to missing data	Bias in measurement of outcomes	Bias in selection of the reported result	Overall
17	Serious risk	Serious risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk
18	Serious risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
20	Serious risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
22	Serious risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
23	Serious risk	Serious risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk
24	Serious risk	Serious risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
25	Serious risk	Low risk	Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk
26	Serious risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
27	Moderate risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk
29	Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
31	Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
32	Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk	Moderate risk	Serious risk
35	Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk	Moderate risk	Serious risk
39	Serious risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk

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Bias due to confounding	Bias in selection of participants	Bias in classification of interventions intended interventions	Bias due to deviations from	Bias due to missing data	Bias in measurement of outcomes	Bias in selection of the reported result	Overall
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Low risk	Moderate risk
Serious risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk	Moderate risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk	Moderate risk
Serious risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Serious risk	Low risk	Low risk	Low risk	Serious risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Low risk	Moderate risk	Moderate risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
Moderate risk	Moderate risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk
Moderate risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk

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Study	Bias due to confounding	Bias in selection of participants	Bias in classification of interventions	Bias due to deviations from intended interventions	Bias due to missing data	Bias in measurement of outcomes	Bias in selection of the reported result	Overall
80	Moderate risk	Low risk	Low risk	Low risk	Moderate risk	Low risk	Moderate risk	Moderate risk
81	Moderate risk	Low risk	Low risk	Low risk			Moderate risk	Serious risk
82		Low risk	Low risk		Moderate risk		Moderate risk	Serious risk
83	Moderate risk	Low risk	Low risk	Low risk		Serious risk	Moderate risk	Serious risk
86	Moderate risk	LOW risk	Low risk	Low risk		Serious risk	Moderate risk	Serious risk
87	Moderate risk	Low risk	Low risk	Low risk		Serious risk	Moderate risk	Serious risk
89	Moderate risk	Low risk	Low risk	Low risk	Low risk	Low risk	Moderate risk	Moderate risk
90	Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	serious risk
92	Moderate risk	Low risk	Low risk	Moderate risk	Low risk	Low risk	Moderate risk	Moderate risk
96	Moderate risk	Low risk	Low risk	Low risk	Low risk		Moderate risk	Serious risk
97	Moderate risk	Low risk	Low risk	Low risk	Low risk	Serious risk	Moderate risk	Serious risk
98	Moderate risk	LOW risk	Low risk	Low risk		Serious risk	Moderate risk	Serious risk

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B4. Efficacy across all and within individual outcome domains

B4.1 All outcome measures

The analysis of all outcome measures included 98 studies. The combined effect size was small and significant (g = 0.32, 95% CI 0.26 to 0.38, tau² = 0.11; Figure B2). The funnel plot did indicate evidence of small study effect (Figure B3), which was confirmed through formal testing (Egger’s intercept = 1.22, p = 0.002). Adjusting for this effect (imputing 19 studies) resulted in a reduction in effect size (Hedges’ g = 0.23, 95%CI 0.17 – 0.29, p < 0.001), although still small and statistically significant.

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Figure B2.1. Forest plot of all outcome measures

Note: Figures B2.1-B2.3 comprise one figure, displayed across multiple pages to ensure readability. An accessible version of the data displayed in this figure is presented in Table B4 below.

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Figure B2.2. Forest plot of all outcomes

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Figure B2.3. Forest plot of all outcomes

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Table B4. Table version of forest plot of all outcome measures.

Note: This table presents the information displayed in Figure B2 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%CI)	Weight (%)
Argumedes 2021	0.22 (-0.58, 1.01)	0.85
Azarbehi 2012	0.30 (-0.71, 1.31)	0.61
Bearss 2015	0.31 (0.01, 0.60)	1.78
Bentenuto 2020	0.11 (-0.57, 0.78)	1.01
Bernard-Opitz 2004	0.62 (-0.62, 1.87)	0.45
Blackman 2020	1.47 (0.24, 2.71)	0.46
Bordini 2020	-0.01 (-0.51, 0.49)	1.33
Boyd 2014	-0.03 (-0.40, 0.34)	1.55
Cariveau 2019	-0.09 (-1.23, 1.04)	0.52
Carr 2007	1.25 (-0.01, 2.52)	0.43
Chang 2016	0.61 (0.10, 1.11)	1.31
Charman 2021	0.20 (-0.30, 0.69)	1.32
Chiang 2016	0.14 (-0.52, 0.81)	1.04
Cohen 2006	0.51 (-0.11, 1.13)	1.1
Coleman 2017	0.46 (-0.47, 1.39)	0.69
Colombi 2018	0.31 (-0.17, 0.78)	1.38
D’Elia 2014	0.33 (-0.38, 1.04)	0.93
Dai 2018	-0.30 (-1.02, 0.41)	0.95
Dawson 2010	0.43 (-0.16, 1.01)	1.13
Dixon 2019	1.08 (0.14, 2.02)	0.68
Drew 2002	0.33 (-0.48, 1.13)	0.83
Duifhuis 2017	0.31 (-0.51, 1.14)	0.78
Eikeseth 2002	0.68 (-0.19, 1.56)	0.75
Eikeseth 2012	0.60 (0.07, 1.12)	1.28
Eldevik 2006	0.69 (-0.09, 1.48)	0.85
Eldevik 2010	0.61 (-0.18, 1.40)	0.85
Eldevik 2012	0.50 (-0.16, 1.16)	1.04
Estes 2014	0.02 (-0.39, 0.43)	1.52
Fava 2011	0.18 (-0.64, 1.00)	0.81
Felzer-Kim 2020	0.56 (-0.45, 1.57)	0.61
Feng 2019	0.04 (-0.45, 0.53)	1.35
Flanagan 2011	0.49 (0.00, 0.97)	1.33
Fox 2018	-0.08 (-1.36, 1.20)	0.42
Frey 2015	-0.06 (-0.74, 0.61)	1.01
Furukawa 2018	0.29 (-0.58, 1.16)	0.74
Gengoux 2019	0.47 (-0.13, 1.07)	1.13
Gengoux 2021	0.26 (-0.33, 0.86)	1.14
Ginn 2017	0.49 (-0.22, 1.20)	0.97

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Study

Study	Hedges’ g (95%CI)	Weight (%)
Gomes 2019	0.84 (-0.03, 1.72)	0.74
Goods 2013	0.27 (-0.85, 1.39)	0.53
Grahame 2015	0.08 (-0.51, 0.67)	1.17
Grindle 2012	0.76 (-0.09, 1.61)	0.78
Gulsrud 2019	1.00 (-0.11, 2.10)	0.53
Haglund 2021	0.57 (0.12, 1.02)	1.43
Hampton 2020	0.13 (-0.37, 0.63)	1.33
Haraguchi 2020	-0.01 (-0.51,0.49)	1.32
Hardan 2015	0.41 (-0.17, 0.98)	1.17
Ho 2020	0.19 (-0.60, 0.97)	0.86
Holzinger 2019	0.20 (-0.88, 1.29)	0.54
Howard 2005	0.83 (0.16, 1.50)	0.97
ladarola 2018	0.17 (-0.15, 0.50)	1.71
Ingersoll 2010	0.94 (0.10, 1.78)	0.79
Johnson 2019	0.33 (-0.32, 0.97)	1.06
Jouen 2017	-0.18 (-0.97,0.60)	0.87
Kaale 2012	0.26 (-0.25, 0.76)	1.33
Kasari 2006	0.33 (-0.32, 0.98)	1.12
Kasari 2010	0.18 (-0.47, 0.82)	1.06
Kasari 2015	0.42 (-0.02, 0.86)	1.47
Lawton 2012	0.65 (-0.34, 1.64)	0.63
Leaf 2017	1.26 (0.16, 2.35)	0.55
Magiati 2007	0.25 (-0.38, 0.88)	1.1
Manohar 2019	0.38 (-0.17, 0.94)	1.25
Matthews 2018	0.90 (0.22, 1.57)	1.02
Nojiri 2019	0.55 (-0.11, 1.21)	1.05
Nowell 2019	0.38 (-0.55, 1.32)	0.66
Oosterling 2010	0.19 (-0.34, 0.71)	1.29
Pajareya 2011	0.31 (-0.43, 1.06)	0.91
Peters-Scheffer 2013	0.50 (-0.15, 1.16)	1.01
Reitzel 2013	0.05 (-1.05, 1.14)	0.52
Remington 2007	0.12 (-0.49, 0.73)	1.09
Rogers 2006	-0.12 (-1.24, 1.01)	0.53
Rogers 2012	-0.04 (-0.45, 0.36)	1.53
Rogers 2014	0.65 (-0.43, 1.74)	0.55
Ruiz 2020	0.12 (-0.55, 0.78)	1.04
Shawler 2017	0.35 (-0.25, 0.96)	1.13
Sheinkopf 1998	0.74 (-0.11, 1.60)	0.77
Shire 2017	0.03 (-0.34, 0.40)	1.6
Sinai-Gavrilov 2020	0.23 (-0.31, 0.77)	1.24
Solomon 2014	0.07 (-0.34, 0.48)	1.47
SpjutJansson 2016	-0.02 (-0.88, 0.83)	0.79
Stadnick 2015	0.56 (-0.16, 1.27)	0.95

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Study	Hedges’ g (95%CI)	Weight (%)
Stahmer 2020	0.47 (-0.34, 1.28)	0.83
Strauss 2012	0.07 (-0.53, 0.66)	1.13
Sullivan 2014	0.33 (-0.25, 0.91)	1.17
Tonge 2006	0.32 (-0.15, 0.79)	1.41
Tsang 2007	-0.08 (-0.75, 0.58)	1.04
VanderPaelt 2016	0.04 (-0.46, 0.54)	1.29
Vernon 2019	0.30 (-0.50, 1.11)	0.83
Vinen 2018	0.08 (-0.42, 0.59)	1.32
Vivanti 2014	0.04 (-0.48, 0.55)	1.32
Warreyn 2014	0.49 (-0.20, 1.18)	0.99
Waters 2020	0.61 (0.19, 1.04)	1.49
Whalen 2010	0.45 (-0.35, 1.24)	0.85
Whitehouse 2017	0.19 (-0.32, 0.69)	1.38
Xu 2017	0.54 (-0.11, 1.20)	1.03
Zachor 2007	0.93 (0.28, 1.58)	1.05
Zachor 2010	-0.19 (-0.64, 0.26)	1.44
Zhou 2018	0.70 (0.06, 1.35)	1.07
Overall Effect (RVE)	0.32 (0.26, 0.38)	100
Prediction Interval	(-0.33, 0.98)	NA

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Figure B3. Funnel plot of all outcomes

B4.2 Autism characteristics

Autism characteristics outcomes were reported in 82 studies. The combined effect size was small and significant (g = 0.32, 95% CI 0.24 to 0.39, tau² = 0.11; Figure B4). The funnel plot did indicate evidence of small study effect (Figure B5), which was confirmed through formal testing (Egger’s intercept = 1.22, p = 0.002). Adjusting for this effect (imputing 14 studies) resulted in a reduction in effect size (Hedges’ g = 0.22, 95%CI 0.15 – 0.29, p < 0.001), although still small and statistically significant.

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Figure B4.1. Forest plot of autism characteristic outcomes.

Note: Figures B4.1-B4.3 comprise one figure, displayed across multiple pages to ensure readability. An accessible version of the data displayed in this figure is presented in Table B5 below.

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Figure B4.2: Forest plot of autism characteristic outcomes

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Figure B4.3: Forest plot of autism characteristic outcomes.

Study	Hedges’ g (95% Cl)	Weight (%)
Strauss 2012	0.53 (-0.06, 1.13)	1.38
Sullivan 2014	0.00 (-0.58, 0.58)	1.41
Tonge 2006	0.36 (-0.11, 0.83)	1.65
Tsang 2007	-0.20 (-0.86, 0.46)	1.24
VanderPaelt 2016	0.05 (-0.45, 0.55)	1.57
Vernon 2019	1.08 (0.20, 1.95)	0.90
Vinen 2018	0.17 (-0.34, 0.67)	1.57
Vivanti 2014	-0.07 (-0.58, 0.44)	1.55
Warreyn 2014	0.49 (-0.20, 1.18)	1.19
Whitehouse 2017	0.16 (-0.35, 0.67)	1.56
Xu 2017	0.56 (-0.10, 1.21)	1.26
Zachor 2007	0.64 (0.00, 1.27)	1.30
Zhou 2018	0.58 (-0.08, 1.23)	1.24

Overall Effect (RVE) 0.32 (0.24, 0.39) 100 Prediction Interval (-0.36, 0.99)

-2.0 -1.5 -1.0 0.5 0.0 0.5 1.0 1.5 2.0 Hedges’ g

Table B5. Table version of forest plot of autism characteristic outcome measures.

Note: This table presents the information displayed in Figure B4 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%Cl)	Weight (%)
Argumedes 2021	0.22 (-0.58, 1.01)	1.02
Azarbehi 2012	0.27 (-0.72, 1.25)	0.77
Bearss 2015	0.26 (-0.03, 0.55)	2.05
Bentenuto 2020	0.13 (-0.54, 0.81)	1.22
Bernard-Opitz 2004	0.81 (-0.46, 2.08)	0.53
Blackman 2020	1.51 (0.27, 2.76)	0.55
Bordini 2020	0.34 (-0.14, 0.82)	1.62
Boyd 2014	0.01 (-0.37, 0.38)	1.93
Cariveau 2019	-0.06 (-1.19, 1.07)	0.63
Carr 2007	1.06 (-0.17, 2.29)	0.55
Chang 2016	0.64 (0.14, 1.15)	1.56
Charman 2021	0.18 (-0.31, 0.67)	1.59
Chiang 2016	0.14 (-0.52, 0.81)	1.23

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Study	Hedges’ g (95%CI)	Weight (%)
Coleman 2017	0.46 (-0.47, 1.39)	0.82
Colombi 2018	0.41 (-0.07, 0.89)	1.62
D’Elia 2014	0.25 (-0.46, 0.96)	1.16
Dawson 2010	0.34 (-0.25, 0.92)	1.39
Drew 2002	0.35 (-0.43, 1.14)	1.02
Duifhuis 2017	0.34 (-0.49, 1.16)	0.95
Eldevik 2006	0.82 (0.03, 1.60)	1.04
Estes 2014	-0.12 (-0.52, 0.27)	1.82
Fava 2011	0.51 (-0.32, 1.33)	0.97
Feng 2019	0.04 (-0.45, 0.53)	1.6
Flanagan 2011	0.60 (0.11, 1.08)	1.57
Fox 2018	-0.38 (-1.78, 1.01)	0.45
Frey 2015	-0.16 (-0.83, 0.51)	1.22
Furukawa 2018	-0.04 (-0.93, 0.86)	0.89
Gengoux 2019	0.68 (0.07, 1.30)	1.34
Gengoux 2021	0.09 (-0.50, 0.69)	1.37
Ginn 2017	0.74 (0.01, 1.46)	1.13
Goods 2013	0.23 (-0.90, 1.35)	0.63
Grahame 2015	0.07 (-0.53, 0.66)	1.36
Gulsrud 2019	1.02 (-0.09, 2.13)	0.66
Haglund 2021	0.57 (0.12, 1.02)	1.69
Hampton 2020	0.10 (-0.39, 0.60)	1.59
Haraguchi 2020	-0.14 (-0.64, 0.36)	1.57
Hardan 2015	0.57 (-0.01, 1.14)	1.41
Ho 2020	0.99 (0.16, 1.81)	0.97
Holzinger 2019	0.19 (-0.92, 1.30)	0.66
ladarola 2018	0.32 (-0.00, 0.65)	2
Ingersoll 2010	0.94 (0.10, 1.78)	0.95
Johnson 2019	0.02 (-0.62, 0.65)	1.3
Jouen 2017	-0.19 (-0.98, 0.59)	1.02
Kaale 2012	0.32 (-0.19, 0.82)	1.56
Kasari 2006	0.35 (-0.30, 0.99)	1.3
Kasari 2010	0.18 (-0.47, 0.82)	1.28
Kasari 2015	0.49 (0.04, 0.93)	1.72
Lawton 2012	0.65 (-0.34, 1.64)	0.77
Leaf 2017	1.26 (0.16, 2.35)	0.66
Magiati 2007	0.06 (-0.56, 0.68)	1.32
Manohar 2019	0.87 (0.30, 1.44)	1.42
Matthews 2018	1.00 (0.32, 1.68)	1.21
Nojiri 2019	0.48 (-0.17, 1.13)	1.26
Nowell 2019	0.20 (-0.73, 1.13)	0.82
Oosterling 2010	0.11 (-0.41, 0.63)	1.53
Pajareya 2011	-0.12 (-0.86, 0.62)	1.1

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Study	Hedges’ g (95%CI)	Weight (%)
Peters-Scheffer 2013	0.40 (-0.26, 1.06)	1.24
Reitzel 2013	0.43 (-0.63, 1.49)	0.7
Remington 2007	0.16 (-0.49, 0.80)	1.3
Rogers 2012	-0.15 (-0.55, 0.26)	1.82
Rogers 2014	0.71 (-0.38, 1.80)	0.67
Ruiz 2020	0.12 (-0.55, 0.78)	1.22
Sheinkopf 1998	0.41 (-0.40, 1.23)	0.99
Shire 2017	0.03 (-0.34, 0.40)	1.89
Solomon 2014	0.09 (-0.28, 0.45)	1.89
SpjutJansson 2016	0.15 (-0.71, 1.01)	0.92
Stadnick 2015	0.72 (0.00, 1.45)	1.13
Stahmer 2020	0.53 (-0.28, 1.33)	1
Strauss 2012	0.53 (-0.06, 1.13)	1.38
Sullivan 2014	0.00 (-0.58, 0.58)	1.41
Tonge 2006	0.36 (-0.11, 0.83)	1.65
Tsang 2007	-0.20 (-0.86, 0.46)	1.24
VanderPaelt 2016	0.05 (-0.45, 0.55)	1.57
Vernon 2019	1.08 (0.20, 1.95)	0.9
Vinen 2018	0.17 (-0.34, 0.67)	1.57
Vivanti 2014	-0.07 (-0.58, 0.44)	1.55
Warreyn 2014	0.49 (-0.20, 1.18)	1.19
Whitehouse 2017	0.16 (-0.35, 0.67)	1.56
Xu 2017	0.56 (-0.10, 1.21)	1.26
Zachor 2007	0.64 (0.00, 1.27)	13
Zhou 2018	0.58 (-0.08, 1.23)	1.24
Overall Effect (RVE)	0.32 (0.24, 0.39)	100
Prediction Interval	(-0.36, 0.99)	NA

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Figure B5. Funnel plot of autism characteristic outcomes

B4.3 Adaptive functioning

Adaptive functioning outcomes were reported by 47 studies. The combined effect size was small and significant (g = 0.24, 95% CI 0.12 to 0.36, tau² = 0.09; Figure B6). The funnel plot did not indicate evidence of small study effect (Figure B7), which was confirmed through formal testing (Egger’s intercept = 0.73, p = 0.255).

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Figure B6.1. Forest plot of adaptive functioning outcomes

Note: Figures B6.1-B6.2 comprise one figure, displayed across multiple pages to ensure readability. An accessible version of the data displayed in this figure is presented in Table B6 below.

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Figure B6.2. Forest plot of adaptive functioning outcomes

[Image not converted to Markdown – “Forest Plot” – check the source PDF page for the actual content]

Study Remington 2007

Rogers 2012

Sinai-Gavrilov 2020

SpjutUansson 2016

Stadnick 2015

Stahmer 2020

Strauss 2012

Tonge 2006

Tsang 2007

VanderPaelt 2016

Vernon 2019

Vivanti 2014

Waters 2020

Whitehouse 2017

Zachor 2010

Overall Effect (RVE) Prediction Interval

Study	Hedges’ g (95% Cl)	Weight (%)
Remington 2007	0.31 (-0.28, 0.91)	2.24
Rogers 2012	-0.02 (-0.42, 0.39)	3.04
Sinai-Gavrilov 2020	0.16 (-0.38, 0.70)	2.42
SpjutUansson 2016	-0.11 (-0.96, 0.75)	1.48
Stadnick 2015	0.64 (-0.08, 1.36)	1.81
Stahmer 2020	-0.05 (-0.84, 0.74)	1.61
Strauss 2012	-0.25 (-0.84, 0.34)	2.27
Tonge 2006	-0.10 (-0.57, 0.36)	2.79
Tsang 2007	-0.62 (-1.30, 0.05)	1.95
VanderPaelt 2016	0.06 (-0.44, 0.57)	2.61
Vernon 2019	0.06 (-0.73, 0.85)	1.62
Vivanti 2014	-0.14 (-0.66, 0.37)	2.54
Waters 2020	0.71 (0.28, 1.13)	2.95
Whitehouse 2017	0.29 (-0.20, 0.77)	2.66
Zachor 2010	-0.21 (-0.66, 0.24)	2.85

Overall Effect (RVE) | 0.24 (0.12, 0.36) | 100 | Prediction Interval | (-0.38, 0.86) |

Table B6. Table version of forest plot of adaptive functioning outcome measures.

Note: This table presents the information displayed in Figure B6 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%Cl)	Weight (%)
Azarbehi 2012	0.45 (-0.64, 1.53)	1.02
Bearss 2015	0.22 (-0.07, 0.51)	3.6
Bordini 2020	-0.39 (-0.91, 0.13)	2.52
Boyd 2014	-0.22 (-0.60, 0.17)	3.16
Cohen 2006	0.66 (0.04, 1.28)	2.11
Colombi 2018	0.24 (-0.24, 0.72)	2.72
D’Elia 2014	0.18 (-0.52, 0.89)	1.87
Dawson 2010	0.44 (-0.15, 1.03)	2.24
Eikeseth 2002	0.55 (-0.23, 1.33)	1.64
Eikeseth 2012	0.60 (0.07, 1.12)	2.52
Eldevik 2006	0.57 (-0.19, 1.33)	1.68

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Study	Hedges’ g (95%CI)	Weight (%)
Eldevik 2010	0.57 (-0.22, 1.37)	1.61
Eldevik 2012	0.48 (-0.18, 1.14)	1.98
Fava 2011	-0.24 (-1.05, 0.58)	1.56
Flanagan 2011	0.47 (-0.01, 0.96)	2.62
Frey 2015	0.85 (0.16, 1.54)	1.91
Gengoux 2019	0.24 (-0.35, 0.83)	2.25
Gengoux 2021	0.39 (-0.21, 0.99)	2.21
Gomes 2019	0.65 (-0.36, 1.65)	1.16
Grindle 2012	0.89 (0.04, 1.73)	1.48
Haraguchi 2020	-0.06 (-0.56, 0.44)	2.62
Hardan 2015	0.46 (-0.11, 1.03)	2.32
Ho 2020	0.13 (-0.65, 0.90)	1.65
Holzinger 2019	-0.32 (-1.39, 0.75)	1.06
Howard 2005	0.78 (0.11, 1.44)	1.92
ladarola 2018	0.10 (-0.22, 0.42)	3.47
Johnson 2019	0.77 (0.11, 1.42)	2
Jouen 2017	-0.50 (-1.30, 0.29)	1.6
Magati 2007	0.38 (-0.25, 1.02)	2.1
Pajareya 2011	1.18 (0.43, 1.92)	1.73
Peters-Scheffer 2013	0.94 (0.25, 1.64)	1.9
Reitzel 2013	-0.25 (-1.38, 0.89)	0.96
Remington 2007	0.31 (-0.28, 0.91)	2.24
Rogers 2012	-0.02 (-0.42, 0.39)	3.04
Sinai-Gavrilov 2020	0.16 (-0.38, 0.70)	2.42
SpjutJansson 2016	-0.11 (-0.96, 0.75)	1.48
Stadnick 2015	0.64 (-0.08, 1.36)	1.81
Stahmer 2020	-0.05 (-0.84, 0.74)	1.61
Strauss 2012	-0.25 (-0.84, 0.34)	2.27
Tonge 2006	-0.10 (-0.57, 0.36)	2.79
Tsang 2007	-0.62 (-1.30, 0.05)	1.95
VanderPaelt 2016	0.06 (-0.44, 0.57)	2.61
Vernon 2019	0.06 (-0.73, 0.85)	1.62
Vivanti 2014	-0.14 (-0.66, 0.37)	2.54
Waters 2020	0.71 (0.28, 1.13)	2.95
Whitehouse 2017	0.29 (-0.20, 0.77)	2.66
Zachor 2010	-0.21 (-0.66, 0.24)	2.85
Overall Effect (RVE)	0.24 (0.12, 0.36)	100
Prediction Interval	(-0.38, 0.86)	NA

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Figure B7. Funnel plot of adaptive functioning outcomes

B4.4 Cognition and language

Cognition and language outcomes were reported by 64 studies. The combined effect size was small and significant (g = 0.30, 95% CI 0.22 to 0.38, tau² = 0.05; Figure B8). The funnel plot did indicate evidence of small study effect (Figure B9), which was confirmed through formal testing (Egger’s intercept = 1.63, p < 0.001). Adjusting for this effect (imputing 15 studies) resulting in a reduction in effect size (Hedges’ g = 0.19, 95%CI 0.10 – 0.28, p < 0.001), although still small and statistically significant.

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Figure B8.1. Forest plot of cognition outcomes

Note: Figures B8.1-B8.2 comprise one figure, displayed across multiple pages to ensure readability. An accessible version of the data displayed in this figure is presented in Table B7 below.

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Figure B8.2. Forest plot of cognition outcomes

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Table B7. Table version of forest plot of cognition and language outcome measures.

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Note: This table presents the information displayed in Figure B8 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%CI)	Weight (%)
Azarbehi 2012	0.28 (-0.73, 1.28)	0.78
Bentenuto 2020	0.08 (-0.59, 0.76)	1.47
Bordini 2020	0.39 (-0.09, 0.87)	2.27
Boyd 2014	-0.06 (-0.42, 0.30)	2.99
Cariveau 2019	-0.19 (-1.33, 0.95)	0.63
Carr 2007	1.83 (0.45, 3.21)	0.45
Chang 2016	0.53 (0.03, 1.03)	2.17
Cohen 2006	0.36 (-0.25, 0.98)	1.66
Colombi 2018	0.34 (-0.14, 0.81)	2.29
D’Elia 2014	0.40 (-0.31, 1.11)	1.37
Dawson 2010	0.45 (-0.13, 1.03)	1.83
Dixon 2019	1.08 (0.14, 2.02)	0.88
Drew 2002	0.21 (-0.59, 1.02)	1.13
Eikeseth 2002	0.79 (-0.16, 1.74)	0.85
Eldevik 2006	0.67 (-0.14, 1.48)	1.12
Eldevik 2010	0.76 (-0.03, 1.55)	1.16
Eldevik 2012	0.59 (-0.07, 1.26)	1.5
Fava 2011	-0.10 (-0.92, 0.72)	1.1
Felzer-Kim 2020	0.56 (-0.45, 1.57)	0.77
Fox 2018	0.21 (-0.91, 1.33)	0.65
Gengoux 2019	0.39 (-0.22, 0.99)	1.72
Ginn 2017	0.46 (-0.25, 1.18)	1.35
Gomes 2019	1.04 (0.29, 1.79)	1.26
Goods 2013	0.42 (-0.69, 1.52)	0.67
Grahame 2015	-0.00 (-0.59, 0.59)	1.77
Grindle 2012	0.25 (-0.60, 1.10)	1.04
Gulsrud 2019	0.86 (-0.23, 1.94)	0.69
Hampton 2020	0.17 (-0.32, 0.67)	2.19
Haraguchi 2020	0.15 (-0.36, 0.66)	2.13
Hardan 2015	0.33 (-0.24, 0.91)	1.84
Ho 2020	-0.13 (-0.90, 0.65)	1.2
Holzinger 2019	0.28 (-0.78, 1.34)	0.72
Howard 2005	0.92 (0.25, 1.60)	1.48
Jouen 2017	0.10 (-0.68, 0.89)	1.17
Kaale 2012	-0.04 (-0.55, 0.46)	2.15
Kasari 2006	0.11 (-0.52, 0.74)	1.63
Kasari 2015	-0.11 (-0.53, 0.31)	2.63
Magiati 2007	0.09 (-0.53, 0.71)	1.66

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Study	Hedges’ g (95%CI)	Weight (%)
Oosterling 2010	0.28 (-0.20, 0.77)	2.26
Peters-Scheffer 2013	0.53 (-0.09, 1.15)	1.67
Remington 2007	0.51 (-0.08, 1.11)	1.75
Rogers 2006	-0.12 (-1.24, 1.01)	0.65
Rogers 2012	0.08 (-0.32, 0.48)	2.75
Rogers 2014	0.60 (-0.49, 1.68)	0.69
Shawler 2017	0.35 (-0.25, 0.96)	1.71
Sheinkopf 1998	1.07 (0.17, 1.98)	0.94
Sinai-Gavrilov 2020	0.37 (-0.18, 0.91)	1.96
Solomon 2014	-0.02 (-0.49, 0.44)	2.3
Stahmer 2020	0.30 (-0.49, 1.10)	1.14
Strauss 2012	0.21 (-0.40, 0.83)	1.68
Sullivan 2014	0.54 (-0.04, 1.12)	1.81
Tonge 2006	0.01 (-0.45, 0.47)	2.37
Tsang 2007	0.06 (-0.60, 0.72)	1.51
VanderPaelt 2016	-0.01 (-0.51, 0.49)	2.16
Vernon 2019	0.28 (-0.52, 1.08)	1.14
Vinen 2018	-0.18 (-0.69, 0.32)	2.15
Vivanti 2014	0.28 (-0.24, 0.79)	2.09
Waters 2020	0.41 (-0.01, 0.84)	2.59
Whalen 2010	0.56 (-0.25, 1.36)	1.13
Whitehouse 2017	0.17 (-0.33, 0.67)	2.18
Xu 2017	0.46 (-0.19, 1.11)	1.54
Zachor 2007	1.22 (0.55, 1.89)	1.48
Zachor 2010	-0.17 (-0.62, 0.28)	2.43
Zhou 2018	0.81 (0.16, 1.46)	1.55
Overall Effect (RVE)	0.30 (0.22, 0.38)	100
Prediction Interval	(-0.14, 0.74)	NA

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Figure B9. Funnel plot of cognition and language outcomes

B4.5 Family outcomes

Family outcomes were reported by 20 studies. The combined effect size was small and significant (g = 0.39, 95% CI 0.21 to 0.58, tau² = 0.18; Figure B10). The funnel plot did not indicate evidence of small study effect (Figure B11), which was confirmed through formal testing (Egger’s intercept = 0.48, p = 0.533).

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Figure B10. Forest plot of family outcomes

Note: An accessible version of the data displayed in this figure is presented in Table B8 below.

Study	Favours intervention	Hedges’ g (95% Cl)	Weight (%)
Bearss 2015		0.37 (0.08, 0.66)	7.23
Blackman 2020	*	1.18 (0.00, 2.35)	2.74
Charman 2021		0.24 (-0.25, 0.74)	5.95
Dai 2018		-0.30 (-1.02, 0.41)	4.69
Estes 2014		0.04 (-0.35, 0.44)	6.61
Fox 2018		0.26 (-0.86, 1.39)	2.90
Grahame 2015		0.38 (-0.22, 0.97)	5.40
Holzinger 2019		0.16 (-0.96, 1.29)	2.90
Johnson 2019		0.37 (-0.27, 1.01)	5.12
Kasari 2015		1.05 (0.60, 1.49)	6.31
Manohar 2019		0.39 (-0.16, 0.94)	5.66
Matthews 2018		1.02 (0.34, 1.71)	4.87
Nojiri 2019		0.62 (-0.05, 1.28)	5.00
Nowell 2019		0.83 (-0.12, 1.78)	3.54
Oosterling 2010		0.23 (-0.32, 0.78)	5.66
Reitzel 2013		-0.27 (-1.32, 0.78)	3.16
Remington 2007		-0.08 (-0.66, 0.50)	5.48
Solomon 2014		0.19 (-0.20, 0.58)	6.67
Stahmer 2020		0.97 (0.12, 1.81)	3.99
Tonge 2006		0.51 (0.03, 0.98)	6.13

Overall Effect (RVE) | | | 0.39 (0.21, 0.58) | 100 |

Prediction Interval (-0.53, 1.31)

Table B8. Table version of forest plot of family outcome measures.

Note: This table presents the information displayed in Figure B10 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%Cl)	Weight (%)
Bearss 2015	0.37 (0.08, 0.66)	7.23
Blackman 2020	1.18 (0.00, 2.35)	2.74
Charman 2021	0.24 (-0.25, 0.74)	5.95
Dai 2018	-0.30 (-1.02,0.41)	4.69
Estes 2014	0.04 (-0.35,0.44)	6.61

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Study

Hedges’ g (95%CI) Weight (%)

Fox 2018 - 0.26 (-0.86, 1.39) - 2.9 Grahame 2015 - 0.38 (-0.22, 0.97) - 5.4 Holzinger 2019 - 0.16 (-0.96, 1.29) - 2.9 Johnson 2019 - 0.37 (-0.27, 1.01) - 5.12 Kasari 2015 - 1.05 (0.60, 1.49) - 6.31 Manohar 2019 - 0.39 (-0.16, 0.94) - 5.66 Matthews 2018 - 1.02 (0.34, 1.71) - 4.87 Nojiri 2019 - 0.62 (-0.05, 1.28) - 5 Nowell 2019 - 0.83 (-0.12, 1.78) - 3.54 Oosterling 2010 - 0.23 (-0.32, 0.78) - 5.66 Reitzel 2013 - -0.27 (-1.32, 0.78) - 3.16 Remington 2007 - -0.08 (-0.66,0.50) - 5.48 Solomon 2014 - 0.19 (-0.20, 0.58) - 6.67 Stahmer 2020 - 0.97 (0.12, 1.81) - 3.99 Tonge 2006 - 0.51 (0.03, 0.98) - 6.13

Overall Effect (RVE) - 0.39 (0.21, 0.58) - 100 Prediction Interval (-0.53, 1.31) NA

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Figure B11. Funnel plot of family outcomes

B4.6 Adverse effects

Adverse effects outcomes were reported by 27 studies. The combined effect size was small and significant (g = 0.24, 95% CI 0.09 to 0.39, tau² = 0.09; Figure B12). The funnel plot did not indicate evidence of small study effect (Figure B13), which was confirmed through formal testing (Egger’s intercept = 0.96, p = 0.220).

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Figure B12. Forest plot of adverse effects outcomes

Note: An accessible version of the data displayed in this figure is presented in Table B9, which follows.

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Table B9. Table version of forest plot of adverse effects outcome measures.

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Note: This table presents the information displayed in Figure B12 in an accessible format. Positive Hedges’ g values favour the behaviourally based intervention, negative Hedges’ g values favour the comparison group.

Study	Hedges’ g (95%CI)	Weight (%)
Bearss 2015	0.35 (0.05, 0.64)	6.61
Blackman 2020	1.73 (0.45, 3.02)	1.44
Charman 2021	0.10 (-0.39, 0.59)	4.88
D’Elia 2014	0.79 (0.06, 1.52)	3.24
Drew 2002	0.55 (-0.30, 1.41)	2.66
Duifhuis 2017	0.05 (-0.77, 0.87)	2.81
Estes 2014	0.08 (-0.36, 0.51)	5.37
Fava 2011	0.09 (-0.73, 0.92)	2.79
Fox 2018	0.50 (-0.64, 1.64)	1.75
Furukawa 2018	0.54 (-0.31, 1.39)	2.7
Ginn 2017	0.35 (-0.35, 1.06)	3.42
Haraguchi 2020	0.00 (-0.50, 0.50)	4.83
Holzinger 2019	0.26 (-0.87, 1.39)	1.78
Johnson 2019	0.18 (-0.46, 0.81)	3.81
Jouen 2017	-0.27 (-1.06, 0.52)	2.97
Kasari 2015	-0.31 (-0.73, 0.12)	5.45
Manohar 2019	0.22 (-0.33, 0.77)	4.44
Matthews 2018	0.66 (0.00, 1.32)	3.69
Peters-Scheffer 2013	-0.25 (-1.00, 0.50)	3.17
Reitzel 2013	-0.04 (-1.13, 1.04)	1.89
Remington 2007	-0.28 (-0.86, 0.31)	4.14
Solomon 2014	0.22 (-0.13, 0.57)	6.12
Stadnick 2015	0.39 (-0.32, 1.09)	3.41
Strauss 2012	-0.23 (-0.82, 0.36)	4.11
Tonge 2006	0.71 (0.22, 1.19)	4.95
Xu 2017	0.65 (-0.01, 1.31)	3.68
Zhou 2018	0.73 (0.10, 1.36)	3.87
Overall Effect (RVE)	0.24 (0.09, 0.39)	100
Prediction Interval	(-0.40, 0.88)	NA

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Figure B13. Funnel plot of adverse effects outcomes

B5. Investigating the effect of dose

B5.1 Relationship between dose and efficacy

Table B10 provides model statistics for the linear models which investigate the relationship between dose (monthly and total clinician hours) and efficacy of behaviourally based interventions as compared to a control group. This is reported across all available outcomes, as well as within three outcome domains: autism characteristics, adaptive functioning, and cognition and language.

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Table B10.1. Linear model statistics for association between dose (monthly clinician hours) and autism characteristic, adaptive functioning and cognition and language outcomes.

Note: These tables have been grouped together using a number-letter referencing system as they are related.

Dose/outcome domain	N	β	95%CI	p-value
All outcomes	34	0.001	-0.0006 to 0.0031	0.195
Autism characteristics	31	0.001	-0.0022 to 0.0034	0.666
Adaptive functioning	18	0.003	0.0004 to 0.0062	0.025
Cognition and language	21	0.002	0.0002 to 0.0037	0.029

Table B10.2. Linear model statistics for association between dose (total clinician hours) and autism characteristic, adaptive functioning and cognition and language outcomes.

Dose/outcome domain	N	β	95%CI	p-value
All outcomes	34	0.00005	0.000003 to 0.000998	0.036
Autism characteristics	31	-0.00002	-0.0001 to 0.0001	0.700
Adaptive functioning	18	0.00009	0.00002 to 0.00015	0.007
Cognition and language	21	0.00008	0.00001 to 0.00014	0.022

Relationship between dose and change from baseline to follow-up separately within the intervention group and the comparison group

Table B11 provides model statistics for the linear models which investigate the relationship between dose (monthly and total clinician hours) and change from pre- to post-intervention in the group of children who underwent behaviourally based intervention. This is reported across all available outcomes, as well as within three outcome domains: autism characteristics, adaptive functioning, and cognition and language.

Table B11.1. Linear model statistics for association between dose (monthly clinician hours) and autism characteristic, adaptive functioning and cognition and language outcomes for change from pre to post in the intervention group

Note: These tables have been grouped together using a number-letter referencing system as they are related.

Outcome domain	N	β	95%CI	p-value
All outcomes	33	0.004	0.0004 to 0.0083	0.031
Autism characteristics	29	0.003	-0.001 to 0.008	0.115
Adaptive functioning	17	0.007	0.0003 to 0.0134	0.040
Cognition and language	20	0.004	-0.0006 to 0.0092	0.085

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Table B11.2. Linear Model Statistics for Association Between Dose (Total Clinician Hours) and Autism Characteristic, Adaptive Functioning and Cognition and Language Outcomes for Change from Pre to Post in the Intervention Group

Outcome domain	N	β	95%CI	p-value
All outcomes	33	0.00007	0.00003 to 0.00010	<0.001
Autism characteristics	29	0.00001	-0.00007 to 0.00009	0.840
Adaptive functioning	17	0.00005	0.00001 to 0.00010	0.017
Cognition and language	20	0.00012	0.00005 to 0.00019	0.001

All Outcomes

The linear and non-linear models of total and monthly clinician-delivered hours of intervention by effect size for the change from baseline to follow-up in the behaviourally based intervention group, with 95% confidence intervals, for all outcomes are shown in Figure B14.

Figure B14.1. Linear Model of Monthly Clinician-Delivered Dose by Effect Size (Hedges’ g) for Change in All Outcomes from Pre- to Post-Intervention in the Intervention Group.

Note: These figures have been grouped together using a number-letter referencing system as they are related. Hedges’ g > 0 = improvement in outcomes from baseline to follow-up. Hedges’ g > 0 = decrease in outcomes from baseline to follow-up.

[Image of graph showing Hedges’ g vs Monthly clinician-delivered hours]

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Figure B14.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in all outcomes from pre- to post-intervention in the intervention group.

Figure B14.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in all outcomes from pre- to post-intervention in the intervention group.

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Figure B14.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in all outcomes from pre- to post-intervention in the intervention group.

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Figure B15.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for

change in autism characteristic outcomes from pre- to post-intervention in the intervention group.

Figure B15.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in autism characteristic outcomes from pre- to post-intervention in the intervention group.

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Figure B15.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in autism characteristic outcomes from pre- to post-intervention in the intervention group.

Figure B15.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in autism characteristic outcomes from pre- to post-intervention in the intervention group.

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Adaptive functioning

Figure B16.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for change in adaptive functioning outcomes from pre- to post-intervention in the intervention group.

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Figure B16.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in adaptive functioning outcomes from pre- to post-intervention in the intervention group.

[Image not converted to Markdown – “Figure B16.2” – check the source PDF page for the actual content]

Figure B16.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in adaptive functioning outcomes from pre- to post-intervention in the intervention group.

[Image not converted to Markdown – “Figure B16.3” – check the source PDF page for the actual content]

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Figure B16.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in adaptive functioning outcomes from pre- to post-intervention in the intervention group.

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Figure B17.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for

change in cognition and language outcomes from pre- to post-intervention in the intervention group.

Figure B17.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in cognition and language outcomes from pre- to post-intervention in the intervention group.

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Figure B17.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for change in cognition and language outcomes from pre- to post-intervention in the intervention group.

[Image not converted to Markdown – “Figure B17.3” – check the source PDF page for the actual content]

Figure B17.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for change in cognition and language outcomes from pre- to post-intervention in the intervention group.

[Image not converted to Markdown – “Figure B17.4” – check the source PDF page for the actual content]

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Comparison group

Table B12 provides model statistics for the linear models which investigate the relationship between dose (monthly and total clinician hours) and change from baseline to follow-up in the group of children who did not undergo behaviourally based intervention (i.e., the comparison group). This is reported across all available outcomes, as well as within three outcome domains: autism characteristics, adaptive functioning, and cognition and language.

Table B12.1. Linear model statistics for association between dose (monthly clinician hours) and autism characteristic, adaptive functioning and cognition and language outcomes for change from baseline to follow-up in the comparison group

Note: These tables have been grouped together using a number-letter referencing system as they are related.

Dose/outcome domain	N	β	95%Cl	p-value
All outcomes	17	0.0001	-0.006 to 0.006	0.965
Autism characteristics	17	0.0002	-0.006 to 0.006	0.940
Adaptive functioning	12	-0.0028	-0.021 to 0.016	0.767
Cognition and language	12	0.0025	-0.002 to 0.007	0.291

Table B12.2. Linear model statistics for association between dose (total clinician hours) and a autism characteristic, adaptive functioning and cognition and language outcomes for change from baseline to follow-up in the comparison group

Dose/outcome domain	N	β	95%Cl	p-value
All outcomes	19	0.0001	-0.0001 to 0.0004	0.378
Autism characteristics	18	0.0001	-0.0002 to 0.0004	0.470
Adaptive functioning	12	0.0004	-0.0004 to 0.0012	0.295
Cognition and language	13	0.0002	0.00003 to 0.00035	0.021

All outcomes

The linear and non-linear models of total and monthly clinician-delivered hours of intervention by effect size for the change from baseline to follow-up in the comparison group, with 95% confidence in tervals, for all outcomes are shown in Figure B18.

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Figure B18.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for

change in all outcomes from pre- to post-intervention in the comparison group.

Figure B18.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in all outcomes from pre- to post-intervention in the comparison group.

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Figure B18.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in all outcomes from pre- to post-intervention in the comparison group.

Figure B18.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in all outcomes from pre- to post-intervention in the comparison group.

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Autism characteristics

The linear and non-linear models of total and monthly clinician-delivered hours of intervention by effect size for the change from baseline to follow-up in the comparison group, with 95% confidence intervals, for autism characteristic outcomes are shown in Figure B19.

Figure B19.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for change in autism characteristic outcomes from pre- to post-intervention in the comparison group.

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Figure B19.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in autism characteristic outcomes from pre- to post-intervention in the comparison group.

Figure B19.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in autism characteristic outcomes from pre- to post-intervention in the comparison group.

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Figure B19.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in autism characteristic outcomes from pre- to post-intervention in the comparison group.

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Figure B20.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for

change in adaptive functioning outcomes from pre- to post-intervention in the comparison group.

Figure B20.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in adaptive functioning outcomes from pre- to post-intervention in the comparison group.

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Figure B20.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in adaptive functioning outcomes from pre- to post-intervention in the comparison group.

Figure B20.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in adaptive functioning outcomes from pre- to post-intervention in the comparison group.

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Cognition and language

Figure B21.1. Linear model of monthly clinician-delivered dose by effect size (Hedges’ g) for change in cognition and language outcomes from pre- to post-intervention in the comparison group.

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Figure B21.2. Linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in cognition and language outcomes from pre- to post-intervention in the comparison group.

Figure B21.3. Non-linear model of monthly clinician-delivered dose by effect size (Hedges’ g)

for change in cognition and language outcomes from pre- to post-intervention in the comparison group.

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Figure B21.4. Non-linear model of total clinician-delivered dose by effect size (Hedges’ g) for

change in cognition and language outcomes from pre- to post-intervention in the comparison group.

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B6. Investigating the effect of population, intervention, and study design factors on efficacy

Results and forest plots for each subgroup analysis are shown for each outcome domain in Figures B22-B26.

Figure B22. Results of subgroup analysis for autism characteristic outcome domain

Note: An accessible version of the data displayed in this figure is presented in Table B13, which follows. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies.

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Table B13. Table version of results of subgroup analysis for autism characteristic outcome domain

Note: This table presents the information displayed in Figure B22 in an accessible format. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies. NA = not applicable.

Subgroup	N studies	Hedges’ g (95% CI)	F	p	Tau²
Subgroup: Parent involvement	NA	NA	0.15	0.93	0.12
Clinician	25	0.33 (0.20 to 0.46)	NA	NA	NA
Clinician and parent	18	0.30 (0.12 to 0.48)	NA	NA	NA
Parent delivered	31	0.33 (0.21 to 0.46)	NA	NA	NA
Teacher delivered	8	0.26 (0.01 to 0.51)	NA	NA	NA
Subgroup: Age	NA	NA	2.72	0.104	0.11
0-1 years	7	0.15 (-0.15 to 0.44)	NA	NA	NA
2-4 years	61	0.36 (0.27 to 0.44)	NA	NA	NA
5-6 years	13	0.21 (0.08 to 0.34)	NA	NA	NA
Subgroup: Intervention category	NA	NA	1.03	0.503	0.12
Behavioural	30	0.37 (0.25 to 0.49)	NA	NA	NA
Developmental	13	0.23 (0.09 to 0.37)	NA	NA	NA
NDBI	31	0.35 (0.22 to 0.49)	NA	NA	NA
Other	3	0.27 (-0.92 to 1.46)	NA	NA	NA
TEACCH	4	0.05 (-0.32 to 0.43)	NA	NA	NA
Technology-based	2	0.02 (-2.19 to 2.23)	NA	NA	NA
Subgroup: Comparison group	NA	NA	0.05	0.82	0.12
Eclectic	15	0.38 (0.16 to 0.50)	NA	NA	NA
TAU	69	0.31 (0.23 to 0.39)	NA	NA	NA
Subgroup: Setting	NA	NA	0.16	0.922	0.12
Community	9	0.28 (0.02 to 0.54)	NA	NA	NA
Early education	17	0.37 (0.19 to 0.54)	NA	NA	NA
Health	35	0.31 (0.19 to 0.42)	NA	NA	NA
Home	25	0.31 (0.18 to 0.45)	NA	NA	NA
Subgroup: Study design	NA	NA	0.37	0.693	0.12
Cohort	13	0.26 (0.09 to 0.43)	NA	NA	NA
Non-random	23	0.35 (0.19 to 0.52)	NA	NA	NA
Random	45	0.32 (0.22 to 0.41)	NA	NA	NA

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Figure B23. Results of subgroup analysis for adaptive functioning outcome domain

Note: An accessible version of the data displayed in this figure is presented in Table B14, which follows. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies.

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Table B14. Table version of results of subgroup analysis for adaptive functioning outcome domain

Note: This table presents the information displayed in Figure B23 in an accessible format. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies. NA = not applicable.

Subgroup	N studies	Hedges’ g (95% CI)	F	p	Tau²
Subgroup: Parent involvement	NA	NA	1.82	0.194	0.09
Clinician	14	0.32 (0.12 to 0.53)	NA	NA	NA
Clinician and parent	17	0.26 (0.03 to 0.48)	NA	NA	NA
Parent delivered	13	0.27 (0.02 to 0.51)	NA	NA	NA
Teacher delivered	4	-0.11 (-0.60 to 0.38)	NA	NA	NA
Subgroup: Age	NA	NA	0.67	0.563	0.1
0-1 years	3	0.12 (-0.60 to 0.85)	NA	NA	NA
2-4 years	36	0.21 (0.07 to 0.34)	NA	NA	NA
5-6 years	7	0.42 (-0.02 to 0.86)	NA	NA	NA
Subgroup: Intervention category	NA	NA	1.14	0.476	0.09
Behavioural	27	0.32 (0.16 to 0.49)	NA	NA	NA
Developmental	5	0.36 (-0.23 to 0.95)	NA	NA	NA
NDBI	11	0.17 (-0.00 to 0.34)	NA	NA	NA
TEACCH	3	-0.23 (-1.06 to 0.60)	NA	NA	NA
Technology-based	2	-0.01 (-4.86 to 4.84)	NA	NA	NA
Subgroup: Comparison group	NA	NA	0.75	0.396	0.1
Eclectic	14	0.17 (-0.01 to 0.36)	NA	NA	NA
TAU	33	0.27 (0.12 to 0.42)	NA	NA	NA
Subgroup: Setting	NA	NA	0.57	0.644	0.1
Community	7	0.27 (-0.08 to 0.62)	NA	NA	NA
Early education	16	0.31 (0.06 to 0.57)	NA	NA	NA
Health	12	0.12 (-0.11 to 0.34)	NA	NA	NA
Home	14	0.26 (0.02 to 0.50)	NA	NA	NA
Subgroup: Study design	NA	NA	0.13	0.878	0.1
Cohort	15	0.27 (0.04 to 0.50)	NA	NA	NA
Non-random	16	0.20 (-0.05 to 0.44)	NA	NA	NA
Random	16	0.25 (0.06 to 0.45)	NA	NA	NA

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Figure B24. Results of subgroup analysis for cognition and language outcome domain

Note: An accessible version of the data displayed in this figure is presented in Table B15, which follows. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies.

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Table B15. Table version of results of subgroup analysis for cognition and language outcome domain

Note: This table presents the information displayed in Figure B24 in an accessible format. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies. NA = not applicable.

Subgroup	N studies	Hedges’ g (95% CI)	F	p	Tau²
Subgroup: Parent involvement	NA	NA	0.99	0.414	0.05
Clinician	20	0.41 (0.20 to 0.63)	NA	NA	NA
Clinician and parent	20	0.32 (0.18 to 0.45)	NA	NA	NA
Parent delivered	18	0.22 (0.07 to 0.36)	NA	NA	NA
Teacher delivered	7	0.22 (-0.06 to 0.51)	NA	NA	NA
Subgroup: Age	NA	NA	0.54	0.605	0.05
0-1 years	6	0.32 (0.05 to 0.60)	NA	NA	NA
2-4 years	49	0.28 (0.18 to 0.37)	NA	NA	NA
5-6 years	7	0.47 (0.01 to 0.94)	NA	NA	NA
Subgroup: Intervention category	NA	NA	1.22	0.475	0.04
Behavioural	28	0.41 (0.25 to 0.57)	NA	NA	NA
Developmental	7	0.06 (-0.08 to 0.21)	NA	NA	NA
NDBI	23	0.29 (0.17 to 0.41)	NA	NA	NA
Other	2	0.21 (-2.79 to 3.21)	NA	NA	NA
TEACCH	3	0.11 (-0.52 to 0.73)	NA	NA	NA
Technology-based	3	0.25 (-0.29 to 0.79)	NA	NA	NA
Subgroup: Comparison group	NA	NA	0.62	0.439	0.05
Eclectic	16	0.23 (0.01 to 0.46)	NA	NA	NA
TAU	48	0.34 (0.25 to 0.43)	NA	NA	NA
Subgroup: Setting	NA	NA	0.61	0.619	0.05
Community	6	0.17 (-0.13 to 0.46)	NA	NA	NA
Early education	20	0.37 (0.18 to 0.56)	NA	NA	NA
Health	21	0.29 (0.13 to 0.45)	NA	NA	NA
Home	18	0.30 (0.15 to 0.45)	NA	NA	NA
Subgroup: Study design	NA	NA	2.16	0.131	0.05
Cohort	16	0.33 (0.08 to 0.58)	NA	NA	NA
Non-random	20	0.39 (0.25 to 0.52)	NA	NA	NA
Random	28	0.22 (0.13 to 0.32)	NA	NA	NA

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Figure B25. Results of subgroup analysis for family outcomes domain

Note: An accessible version of the data displayed in this figure is presented in Table B16, which follows. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies.

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Table B16. Table version of results of subgroup analysis for family outcome domain

Note: This table presents the information displayed in Figure B25 in an accessible format. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies. NA = not applicable.

Subgroup	N studies	Hedges’ g (95% Cl)	F	p	Tau²
Subgroup: Parent involvement	NA	NA	0.98	0.616	0.19
Clinician	2	-0.07 (-2.84 to 2.71)	NA	NA	NA
Clinician and parent	2	0.28 (-5.37 to 5.92)	NA	NA	NA
Parent delivered	16	0.44 (0.24 to 0.64)	NA	NA	NA
Subgroup: Age	NA	NA	0.01	0.986	0.22
0-1 years	2	0.40 (-5.31 to 6.12)	NA	NA	NA
2-4 years	14	0.39 (0.14 to 0.64)	NA	NA	NA
5-6 years	4	0.42 (0.08 to 0.76)	NA	NA	NA
Subgroup: Intervention category	NA	NA	1.26	0.425	0.23
Behavioural	11	0.35 (0.09 to 0.62)	NA	NA	NA
Developmental	2	0.21 (-0.04 to 0.45)	NA	NA	NA
NDBI	6	0.50 (-0.03 to 1.03)	NA	NA	NA
Subgroup: Comparison group	NA	NA	0.93	0.477	0.2
Eclectic	2	0.69 (-3.61 to 4.98)	NA	NA	NA
TAU	18	0.35 (0.17 to 0.53)	NA	NA	NA
Subgroup: Setting	NA	NA	4.84	0.044	0.18
Health	11	0.53 (0.23 to 0.82)	NA	NA	NA
Home	9	0.20 (0.01 to 0.39)	NA	NA	NA
Subgroup: Study design	NA	NA	0.17	0.691	0.2
Non-random	6	0.50 (-0.15 to 1.15)	NA	NA	NA
Random	13	0.39 (0.20 to 0.58)	NA	NA	NA

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Figure B26. Results of subgroup analysis for adverse effects outcome domain

Note: An accessible version of the data displayed in this figure is presented in Table B17, which follows. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies.

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Table B17. Table version of results of subgroup analysis for adverse effects outcome domain

Note: This table presents the information displayed in Figure B26 in an accessible format. The F and the p statistic are from the Wald-type test. If statistically significant (p < 0.05), this indicates that there is a difference in efficacy of the intervention between levels of the subgroup. Tau² is a measure of statistical heterogeneity, which gives an estimation of the extent to which an effect estimate is inconsistent across studies. NA = not applicable.

Subgroup	N studies	Hedges’ g (95% Cl)	F	p	Tau²
Subgroup: Parent involvement	NA	NA	3.1	0.148	0.08
Clinician	3	-0.06 (-0.78 to 0.65)	NA	NA	NA
Clinician and parent	7	0.00 (-0.33 to 0.34)	NA	NA	NA
Parent delivered	16	0.34 (0.15 to 0.53)	NA	NA	NA

| Subgroup: Age | NA | NA | 1 | 0.498 | 0.1 | | 0-1 years | 2 | 0.24 (-2.63 to 3.11) | NA | NA | NA | | 2-4 years | 19 | 0.30 (0.10 to 0.50) | NA | NA | NA | | 5-6 years | 6 | 0.06 (-0.22 to 0.33) | NA | NA | NA |

| Subgroup: Intervention category | NA | NA | 0.41 | 0.774 | 0.11 | | Behavioural | 12 | 0.20 (-0.06 to 0.46) | NA | NA | NA | | Developmental | 2 | 0.33 (-1.64 to 2.29) | NA | NA | NA | | NDBI | 9 | 0.24 (-0.07 to 0.55) | NA | NA | NA | | Other | 2 | 0.44 (-0.75 to 1.62) | NA | NA | NA |

| Subgroup: Comparison group | NA | NA | 2.15 | 0.215 | 0.09 | | Eclectic | 4 | -0.00 (-0.65 to 0.65) | NA | NA | NA | | TAU | 23 | 0.30 (0.14 to 0.46) | NA | NA | NA |

| Subgroup: Setting | NA | NA | 0.47 | 0.646 | 0.11 | | Early education | 3 | 0.41 (-0.94 to 1.76) | NA | NA | NA | | Health | 13 | 0.27 (0.00 to 0.54) | NA | NA | NA | | Home | 11 | 0.16 (-0.03 to 0.35) | NA | NA | NA |

| Subgroup: Study design | NA | NA | 19.28 | 0.038 | 0.09 | | Cohort | 2 | -0.27 (-0.43 to-0.10) | NA | NA | NA | | Non-random | 12 | 0.32 (0.03 to 0.62) | NA | NA | NA | | Random | 13 | 0.25 (0.06 to 0.44) | NA | NA | NA |

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