Priorities and Perspectives Regarding Goals and Outcomes of Support for Autistic Children Under 12 Years: A...

Autistic individuals, family members, and professionals often hold differing perspectives on the goals and outcomes of supports for autistic children under 12 years. While traditional approaches prioritise the acquisition of neurotypical behaviours, emerging frameworks emphasise autonomy, self-determination, and well-being. This systematic review synthesised findings from 15 studies using qualitative, quantitative, and mixed-methods designs, which were assessed for methodological quality using the Joanna Briggs Institute checklists. Communication, social inclusion, and child well-being emerged as shared priorities. Notable differences were observed; professionals tended to focus on normative developmental goals such as skill acquisition and behavioural compliance, while autistic individuals and family members more often valued flexibility, self-advocacy, and strengths-based approaches. Tensions persist between medicalised and neurodiversity-affirming paradigms. To ensure supports align with what matters to autistic people, future research should prioritise co-design with autistic individuals and families, embrace cultural responsiveness, and develop tools that can flexibly but consistently assess neurodiversity-affirming outcomes. These steps will support more ethical, inclusive, and meaningful goal-setting practices in autism research and support.Lay AbstractAutistic children, their families, and the people who support them often want different things from autism services. Some approaches still focus on teaching autistic children to behave more like non-autistic children, such as making eye contact or using spoken language. However, many autistic people and families are calling for support that values autistic ways of being and prioritises well-being, comfort, and meaningful participation. This systematic review brought together findings from 15 research studies published in the last 10 years. These studies explored what goals matter most to autistic adults, parents, and professionals when supporting autistic children aged 0-12. We reviewed studies that used interviews, surveys, or mixed methods and assessed their quality using standard research checklists. Across studies, several shared priorities emerged. Communication was important to everyone, but in broad terms supporting children to express themselves in the ways that work best for them, including through alternative augmentative communication or non-spoken communication. Stakeholders also consistently valued children's emotional well-being, mental health, and feeling safe and understood. Many studies highlighted the importance of autonomy, including supporting children to make choices, develop a sense of identity, and have control in their daily lives. Traditional goals such as reducing autistic traits, encouraging eye contact, or teaching neurotypical social skills were often rated as less important. There was strong agreement that supports should help children build comfort, confidence, and inclusion rather than force conformity.