Interventions to Promote Communication in Minimally Verbal Autistic Children: A Systematic Review

Minimally verbal autistic children face profound communication challenges that significantly affect daily functioning, including social interaction, behavioral regulation, and overall well-being. Identifying effective interventions is a key clinical-educational priority. This systematic review examines communication-focused interventions for these children, including both spoken language approaches and augmentative and alternative communication (AAC) strategies.

The review was registered in PROSPERO and conducted following PRISMA-S guidelines. Four electronic databases were searched, and 18 studies met the inclusion criteria. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was conducted, with subgroup analyses exploring sample characteristics, intervention types, targeted outcomes, and reported effects. Methodological quality of randomized controlled trials was assessed using the Cochrane Risk of Bias tool.

Interventions were implemented across clinical, educational, and home settings, using strategies such as Joint Attention, Symbolic Play, and Emotion Regulation, often combined with AAC technologies. Most included studies reported improvements in at least one communication outcome, although findings were heterogeneous and several studies reported mixed, subgroup-specific, or non-significant effects. The most consistent improvements were observed in spontaneous communication, particularly in interventions integrating developmental approaches with technological support.

These findings highlight the value of individualized interventions. Future research should establish standardized definitions of "minimally verbal", assess long-term outcomes, and adopt broader measures capturing both language and social-emotional development to enhance quality of life and inclusion.