Intervention characteristics and speech therapy strategies in care for autistic children in health services: a scoping review

Barros, Renata Chrystina Bianchi de; Ferreira, Eric Batista; Silva, Priscila Mara Ventura Amorim; Khalil, Mariana Minante; Oliveira, Ana Paula de Moraes

doi:10.1590/2317-1782/e20250012pt

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Critical Review or Scoping Review • CoDAS 37 (6) • 2025 • https://doi.org/10.1590/2317-1782/e20250012en linkcopy

Intervention characteristics and speech therapy strategies in care for autistic children in health services: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose to identify and systematize speech therapy practices with autistic children in healthcare services reported as an evaluative and therapeutic strategy in Brazil.

Research strategies a scoping review following the guidelines of the Joanna Briggs Institute and PRISMA-ScR. Articles, essays, reviews, and gray literature available until July 4, 2024, were retrieved from databases such as PubMed, Scielo, Scopus, Web of Science, ProQuest Central, Embase, EBSCOhost, BVS, BDTD, and Google Scholar. Reference lists and relevant systematic reviews were also checked for additional documents.

Selection criteria based on the PCC format (Participants: autistic children aged 2 to 12 years; Concept: speech therapy assessment and treatment strategies; Context: Brazil).

Data analysis data were extracted using a pre-designed matrix considering author, type/year of publication, objective, sample, autism concept, type/strategy of intervention, setting, and conclusion. Descriptive quantitative and qualitative analyses were performed.

Results a total of 49 studies were included in the review, allowing the identification that speech therapy practices targeting autistic children in Brazilian healthcare services predominantly involve therapeutic and evaluative approaches, mainly carried out in university clinics.

Conclusion although speech therapy has advanced in the personalization of care and adaptation of therapeutic strategies, there is still a predominance of interventions focused on diagnosis and rehabilitation, with a limited number of studies addressing health promotion and social inclusion actions.

Keywords:
Autism; Autism Spectrum Disorder; Rehabilitation of Speech and Language Disorders; Speech-Language Pathology; Brazil

Objective	To identify and systematize the ways in which speech-language pathology practice with autistic children in health services is reported as an assessment and therapeutic strategy in Brazil.
PCC	Population (P)	Concept (C)	Context (C)
Limits	Autistic children, aged 2 to 12	Speech-language pathology assessment and therapy strategies	Brazil
Construction and Combination	“Child”, “Child, Preschool”, “Autism Spectrum Disorder”, “Autistic Disorder”, “Asperger Syndrome”	Audiology, “Rehabilitative of Speech and Language Disorders”	“Speech, Language and Hearing Sciences”, “Speech Therapy”, Brazil OR Brasil Brazilian OR Brazilians
Used	(Child OR “Child, Preschool”) AND (“Autism Spectrum Disorder” OR “Autistic Disorder” OR “Asperger Syndrome”) AND (“Speech, Language and Hearing Sciences” OR Audiology OR “Rehabilitation of Speech and Language Disorders” OR “Speech Therapy”) AND (Brazil OR Brasil or brazilian or Brazilians)
Source	Strategy			# of Papers	Date
BDTD	(Todos os campos: Criança OR “Pré-Escolar” E Todos os campos:”Transtorno do Espectro Autista” OR “Transtorno Autístico” OR “Síndrome de Asperger” E Todos os campos:Fonoaudiologia OR Audiologia OR “Reabilitação dos Transtornos da Fala e da Linguagem” OR Fonoterapia E Todos os campos:BRASIL OR BRASILEIROS OR BRASILEIRAS OR BRASILEIRO OR BRASILEIRA)			16	04/07/2024
BVS	((child OR children) OR (“Child, Preschool” OR “Preschool Child” OR “Preschool Children”)) AND ((“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR (“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autismo OR “Early Infantile Autism”) OR (“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”)) AND ((“Speech, Language and Hearing Sciences”) OR (audiology) OR (“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR (“Speech Therapy” OR “Speech Therapies”)) AND ((Brazil OR Brasil OR brazilian OR brazilians))			14	04/07/2024
EBSCOHOST Academic Search Premier 5 MEDLINE 3 MEDLINE Complete 3 CINAHL with Full Text 1 Computers & Applied Sciences Complete 1 ERIC 1 Library, Information Science & Technology Abstracts with Full Text 1	(Child OR Children) OR (“Child, Preschool” OR “Preschool Child” OR “Preschool Children”) AND TI (“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR AB (“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR TI (“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autism OR “Early Infantile Autism”) OR AB (“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autism OR “Early Infantile Autism”) OR TI (“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”) OR AB (“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”) AND TI (“Speech, Language and Hearing Sciences”) OR AB (“Speech, Language and Hearing Sciences”) OR TI Audiology OR AB Audiology OR TI (“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR AB (“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR TI (“Speech Therapy” OR “Speech Therapies”) OR AB (“Speech Therapy” OR “Speech Therapies”) AND Brazil OR Brasil or brazilian or brazilians			09	04/07/2024
EMBASE	(‘child’ OR ‘children’ OR ‘child, preschool’ OR ‘preschool child’ OR ‘preschool children’) AND (‘autism spectrum disorder’:ti,ab,kw OR ‘autism spectrum disorders’:ti,ab,kw OR ‘autistic spectrum disorder’:ti,ab,kw OR ‘autistic spectrum disorders’:ti,ab,kw OR ‘autism’/exp OR ‘autistic disorder’:ti,ab,kw OR ‘kanner`s syndrome’:ti,ab,kw OR ‘kanner syndrome’:ti,ab,kw OR ‘infantile autism’:ti,ab,kw OR ‘autism’:ti,ab,kw OR ‘early infantile autism’:ti,ab,kw OR ‘asperger syndrome’/exp OR ‘asperger syndrome’:ti,ab,kw OR ‘asperger disease’:ti,ab,kw OR ‘asperger disorder’:ti,ab,kw OR ‘asperger disorders’:ti,ab,kw OR ‘asperger`s disorder’:ti,ab,kw OR ‘aspergers disorder’:ti,ab,kw OR ‘asperger`s syndrome’:ti,ab,kw OR ‘aspergers syndrome’:ti,ab,kw) AND (‘speech, language’ AND ‘hearing sciences’:ti,ab,kw OR ‘audiology’/exp OR ‘audiology’:ti,ab,kw OR (‘rehabilitation of speech’ AND ‘language disability’/exp) OR (((‘rehabilitation of speech’ AND ‘language disorders’:ti,ab,kw OR ‘language’) AND ‘speech disorder rehabilitation’:ti,ab,kw OR ‘speech’) AND ‘language disorder rehabilitation’:ti,ab,kw) OR ‘speech therapy’/exp OR ‘speech therapy’:ti,ab,kw OR ‘speech therapies’:ti,ab,kw) AND (‘brazil’ OR ‘brasil’ OR ‘brazilian’ OR ‘brazilians’)			35	04/07/2024
Google Scholar	(“Autismo” OR “Transtorno do Espectro Autista” OR TEA OR “Transtorno Autístico” OR “Síndrome de Asperger”) AND Fonoaudiologia AND BRASIL			47	04/07/2024
PROQUEST CENTRAL	((Child OR Children) OR (“Child, Preschool” OR “Preschool Child” OR “Preschool Children”)) AND (abstract(“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR title(“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR abstract(“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autism OR “Early Infantile Autism”) OR title(“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autism OR “Early Infantile Autism”) OR abstract(“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”) OR title(“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”)) AND (abstract(“Speech, Language and Hearing Sciences”) OR title(“Speech, Language and Hearing Sciences”) OR abstract(Audiology) OR title(Audiology) OR abstract(“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR title(“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR abstract(“Speech Therapy” OR “Speech Therapies”) OR title(“Speech Therapy” OR “Speech Therapies”)) AND (Brazil OR Brasil OR brazilian OR brazilians) https://www.proquest.com/search/2656553?accountid=8113			14	04/07/2024
PUBMED	(((((Child OR Children)) OR (“Child, Preschool” OR “Preschool Child” OR “Preschool Children”)) AND ((((((Autism Spectrum Disorder[MeSH Terms]) OR (“Autism Spectrum Disorder”[Title/Abstract] OR “Autism Spectrum Disorders”[Title/Abstract] OR “Autistic Spectrum Disorder”[Title/Abstract] OR “Autistic Spectrum Disorders”[Title/Abstract])) OR (Autistic Disorder[MeSH Terms])) OR (“Autistic Disorder”[Title/Abstract] OR “Kanner’s Syndrome”[Title/Abstract] OR “Kanner Syndrome”[Title/Abstract] OR “Infantile Autism”[Title/Abstract] OR Autism[Title/Abstract] OR “Early Infantile Autism”[Title/Abstract])) OR (Asperger Syndrome[MeSH Terms])) OR (“Asperger Syndrome”[Title/Abstract] OR “Asperger Disease”[Title/Abstract] OR “Asperger Disorder”[Title/Abstract] OR “Asperger Disorders”[Title/Abstract] OR “Asperger’s Disorder”[Title/Abstract] OR “Aspergers Disorder”[Title/Abstract] OR “Asperger’s Syndrome”[Title/Abstract] OR “Aspergers Syndrome”[Title/Abstract]))) AND (((((((“Speech, Language and Hearing Sciences”[Title/Abstract]) OR (Audiology[MeSH Terms])) OR (Audiology[Title/Abstract])) OR (Rehabilitation of Speech and Language Disorders[MeSH Terms])) OR (“Rehabilitation of Speech and Language Disorders”[Title/Abstract] OR “Language and Speech Disorder Rehabilitation”[Title/Abstract] OR “Speech and Language Disorder Rehabilitation”[Title/Abstract])) OR (Speech Therapy[MeSH Terms])) OR (“Speech Therapy”[Title/Abstract] OR “Speech Therapies”[Title/Abstract]))) AND (Brazil OR Brasil or brazilian or brazilians)			15	04/07/2024
SCIELO	(Criança OR Child OR Niño OR “Pré-Escolar” OR “Child, Preschool” OR Preescolar) AND (“Transtorno do Espectro Autista” OR “Autism Spectrum Disorder” OR “Trastorno del Espectro Autista” OR “Transtorno Autístico” OR “Autistic Disorder” OR “Trastorno Autístico” OR “Síndrome de Asperger” OR “Asperger Syndrome” OR “Síndrome de Asperger”) AND (Fonoaudiologia OR “Speech, Language and Hearing Sciences” OR Fonoaudiología OR Audiologia OR Audiology OR Audiología OR “Reabilitação dos Transtornos da Fala e da Linguagem” OR “Rehabilitation of Speech and Language Disorders” OR “Rehabilitación de los Trastornos del Habla y del Lenguaje” OR Fonoterapia OR “Speech Therapy” OR Logopedia) AND (Brasil OR Brazil OR brazilian or brazilians)			03	04/07/2024
SCOPUS	(((ALL (child OR children) OR ALL (“Child, Preschool” OR “Preschool Child” OR “Preschool Children”))) AND ((TITLE-ABS-KEY (“Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders”) OR TITLE-ABS-KEY (“Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR utismo OR “Early Infantile Autism”) OR TITLE-ABS-KEY (“Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome”))) AND ((TITLE-ABS-KEY (“Speech, Language and Hearing Sciences”) OR TITLE-ABS-KEY (audiology) OR TITLE-ABS-KEY (“Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation”) OR TITLE-ABS-KEY (“Speech Therapy” OR “Speech Therapies”)))) AND (ALL (brazil OR brasil OR brazilian OR brazilians))			68	04/07/2024
WEB OF SCIENCE	Child OR Children (Topic) or “Child, Preschool” OR “Preschool Child” OR “Preschool Children” (Topic) and Preprint Citation Index (Exclude – Database) AND”Autism Spectrum Disorder” OR “Autism Spectrum Disorders” OR “Autistic Spectrum Disorder” OR “Autistic Spectrum Disorders” (Topic) or “Autistic Disorder” OR “Kanner’s Syndrome” OR “Kanner Syndrome” OR “Infantile Autism” OR Autism OR “Early Infantile Autism” (Topic) or “Asperger Syndrome” OR “Asperger Disease” OR “Asperger Disorder” OR “Asperger Disorders” OR “Asperger’s Disorder” OR “Aspergers Disorder” OR “Asperger’s Syndrome” OR “Aspergers Syndrome” (Topic) and Preprint Citation Index (Exclude – Database) AND “Speech, Language and Hearing Sciences” (Topic) or Audiology (Topic) or “Rehabilitation of Speech and Language Disorders” OR “Language and Speech Disorder Rehabilitation” OR “Speech and Language Disorder Rehabilitation” (Topic) or “Speech Therapy” OR “Speech Therapies” (Topic) and Preprint Citation Index (Exclude – Database) AND Brazil OR Brasil or brazilian or brazilians (Topic) and Preprint Citation Index (Exclude – Database) https://www.webofscience.com/wos/alldb/summary/15f85a45-0b96-4f98-a3e9-85b2b8fa44a5-f9012fe9/relevance/1			12	04/07/2024
TOTAL				233
TOTAL DUPLICATE REFERENCES	79 DUPLICATE PAPERS DELETED IN RAYYAN 06 DUPLICATE PAPERS DELETED AFTER FINAL READING (other language)			79+06= 85
TOTAL AFTER DUPLICATE DELETION				148

Reference	Publication type	Publication year	Objective	Population and Sample	Autism Concept	Intervention type	Strategies	Intervention place	Conclusions
1. Balestro and Fernandes(²⁰)	Paper	2018	To analyze the perceptions of caregivers of children with ASD regarding the functional communication profile of their children through the application of the Functional Communication Profile-Checklist (PFC-C).	CAREGIVERS = 62 children with ASD caregivers	DSM-IV	Therapeutic and Evaluative	Protocol and questionnaires	Teaching clinic	The hypothesis that it was possible to produce positive changes in the perspectives of parents of children with ASD regarding their children's communication through the administered questionnaire was confirmed.
Balestro and Fernandes(²¹)	Paper	2012	To develop and administer a questionnaire to survey the difficulties perceived by parents and/or caregivers of children with ASD in communicating with their children.	CAREGIVERS = 40 parents and/or children with ASD caregivers	Literature-based	Evaluative	Protocol and questionnaires	Teaching clinic	The administration of the developed questionnaire proved useful in identifying specific communication difficulties within the target population.
3. Balestro et al.(²²)	Paper	2009	To demonstrate the efficiency and efficacy of an interactionist approach in speech-language therapy for 3 subjects with ASD.	CHILDREN = 3 individuals with ASD aged 6, 7 and 8.	Literature-based	Therapeutic and Evaluative	Play-based therapeutic context	Not informed	The cases analyzed demonstrated the efficacy of the interactionist approach in the subjects' language therapy.
4. Barbosa et al.(²³)	Paper	2019	To identify the perceptions of parents of children with ASD regarding the speech-language pathology services within the multiprofessional team at the CAPSij.	CAREGIVERS = 9 parents of ASD children with ASD aged from 2 to 10.	Literature-based	Evaluative	Focus Group	CAPSij	In the parents' conversation, the effects of the clinical listening offered by the team, especially by the speech-language pathologist, were clear. Speech-Language Pathology was considered to be an integral and fundamental part of the mental health field when working with children with autism, which reinforces the value of the listening offered to parents by the team.
5. Botura et al.(²⁴)	Paper	2021	To verify the existence of impairments in the pragmatic skills of Brazilian Portuguese-speaking children with ASD.	CHILDREN	DSM-V	Not applicable	Not applicable	Not applicable	The findings were inconclusive.
6. Campelo et al.(²⁵)	Paper	2009	To analyze the verbal and non-verbal communication skills of autistic children using an analytical model based on communicative acts, identifying the communicative means and functions.	CHILDREN = 6 male individuals with ASD aged from 4 to 10.	DSM-IV	Evaluative	Play-based therapeutic context	Teaching clinic	More communicative acts occurred through gestural means as opposed to vocal and verbal means. There was a wide variety, with a predominance of non-focused, protest, exploratory, and reactive functions.
7. Cardoso and Montenegro(²⁶)	Paper	2009	To determine and compare the functional communicative profiles of two groups of subjects with ASD.	CHILDREN = 8 children and adolescents with ASD aged from 3 to 17.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	Although a difference was identified between the group that underwent a change of therapist and the group that did not, this difference is not statistically significant, which can be attributed to the heterogeneity of the individuals and the small sample size.
8. Castro and Loureiro(²⁷)	Paper	2020	An integrative literature review on music therapy and speech-language pathology regarding social interaction and language in children with ASD.	CHILDREN	DSM-IV	Not applicable	Not applicable	Not applicable	Fourteen studies were found that addressed the interfaces between speech-language pathology and music therapy in interventions for children with ASD regarding communication and social interaction. The results obtained were positive, suggesting that music promotes oral language expression, thereby improving the patient's prognosis.
9. Costa(²⁸)	Dissertation [master]	2021	To investigate the language performance of preschool children diagnosed with ASD and compare it with that of children with typical language development through the application of the Brazilian version of the Preschool Language Assessment Instrument (PLAI-2).	CHILDREN = 15 Individuals with ASD aged from 3 to 5 years and 11 months.	DSM-V	Evaluative	Protocol and questionnaires	Teaching clinic	The sample group performed more poorly on the assessed skills compared to the comparison group.
10. Costa et al.(²⁹)	Paper	2013	To translate into Brazilian Portuguese and culturally adapt the Children's Communication Checklist-2 (CCC-2), as well as to evaluate its internal consistency.	CAREGIVERS	Literature-based	Not applicable	Not applicable	Not applicable	The study presented the translation and cross-cultural adaptation process for the CCC-2. However, for the test to be widely used in clinical and research settings, validation of the Brazilian version of the instrument is still necessary.
11. Cruz and Gomes(³⁰)	Undergraduate thesis	2020	To identify in the literature the main speech-language pathology interventions for children with ASD.	CHILDREN	DSM-V	Not applicable	Not applicable	Not applicable	It was found that through direct and indirect interventions, there is greater progress in the developmental milestones of these children. This validates that parent training is essential in the therapeutic process for children with ASD, as it promotes family involvement.
12. Cruz and Tamanaha(³¹)	Paper	2021	To analyze interactions involving the participation of nonverbal autistic subjects, grounded in a multimodal approach to human interaction.	CHILDREN = 2 nonverbal individual with ASD aged 7	DSM-V	Therapeutic and Evaluative	PECS Multimodal approach	Not informed	The analyst's attention to what occurs corporeally is crucial for grasping the way autistic children orient themselves to the complex and dynamic interactional ecology.
13. Netrval(³²)	Thesis [doctorate]	2014	To develop a model of quality indicators for the management of Speech-Language Pathology services offered in institutions that serve individuals with ASD.	CHILDREN	DSM-V	Evaluative	Protocol and questionnaires	Multicenter	The administered questionnaire made it possible to learn more about a group of individuals with ASD receiving care in the municipality of São Paulo and the profile of the locations that offer this assistance. The collected data demonstrate that individualized therapeutic planning is still underutilized and that professionals rarely discuss the management of this care.
14. Ferreira et al.(³³)	Paper	2023	To describe early intervention programs for ASD, analyzing and correlating the multi/interprofessional team, the role of Speech-Language Pathology, and family participation in care.	CHILDREN AND CAREGIVERS	DSM-V	Not applicable	Not applicable	Not applicable	Specialized and early intervention for children with ASD and their families has not established a single methodological standard, as a variety of therapeutic approaches exist in different countries, despite the predominance of the Early Start Denver Model.
15. Santos et al.(³⁴)	Paper	2020	To analyze the impact of implementing the Picture Exchange Communication System (PECS) on the comprehension of instructions in children with ASD.	CHILDREN = 20 individuals with ASD aged from 6 to 12.	DSM-V	Therapeutic and Evaluative	PECS Multimodal approach	Teaching clinic	The hypothesis that the use of PECS has a positive effect on the comprehension of instructions was confirmed, as it provided the children with greater communicative and social engagement.
16. Deliberato et al.(³⁵)	Paper	2021	To describe adult mediation and the communicative skills of children with ASD in play-based situations, through storytelling.	CHILDREN = 2 male individuals with TEA aged 2 and 3.	Literature-based	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The research showed that the use of storytelling can be an important avenue for children with ASD with regard to interaction and communication.
17. Donadio et al.(³⁶)	Paper	2023	To measure how Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) improves speech in children with ASD.	CHILDREN = 1 male individual with TEA aged 6.	DSM-V	Therapeutic and Evaluative	Prompt method	Teaching clinic	It was observed that the participant showed improvements in speech, mandibular, labiofacial, and lingual control.
18. Evangelista(³⁷)	Undergraduate thesis	2018	To determine the importance of speech-language pathology in the care process for patients with ASD within the Mental Health Network.	CHILDREN	Literature-based	Not applicable	Not applicable	Not applicable	It was observed that there is a significant gap in publications that address the topic of mental health from the perspective of Speech-Language Pathology, and furthermore, that the integration of Speech-Language Pathology into this field appears to be incipient and fragmented.
19. Fernandes et al.(³⁸)	Paper	2010	To investigate the effect of using computers and specific software in speech-language therapy for autistic children.	CHILDREN = 23 individuals with ASD aged from 3 and 12.	Literature-based	Therapeutic and Evaluative	Informatics games	Teaching clinic	The subjects showed different reactions to the proposal of using computer resources during speech-language therapy.
20. Fernandes et al.(³⁹)	Paper	2008	To determine the existence of observable differences based on the characteristics of the functional communication profile and socio-cognitive performance of children and adolescents with ASD.	CHILDREN = 46 individuals with ASD aged from 7 to 9.	Literature-based	Therapeutic and Evaluative	Language workshop	Teaching clinic	The results did not indicate statistically significant differences based on the characteristics of the functional communication profile and socio-cognitive performance, although differences were observable.
21. Fernandes et al.(⁴⁰)	Paper	2010	To investigate the effect of providing guidance to mothers of autistic children on the children's communication and language processes, communicative profile, and socio-cognitive performance; and to investigate the effect of this guidance on the way mothers observe their children's performance.	PARENT–CHILD DYAD = 26 mother-child with ASD dyads	Literature-based	Parental guidance	Guidance groups	Teaching clinic	It is hypothesized that systematized and specific guidance, provided for short periods of time and with opportunities for follow-up, can contribute to the autistic child's communicative environment and to family understanding.
22. Ferreira et al.(⁴¹)	Paper	2021	To analyze the impact of implementing PECS on the burden index of mothers of children with ASD.	PARENT–CHILD DYAD = 20 mother-child with ASD dyads.	DSM-V	Therapeutic and Evaluative	PECS Multimodal approach	Teaching clinic	There was a trend towards a reduction in maternal burden scores following the implementation of PECS.
23. Freitas et al.(⁴²)	Paper	2021	To describe the communication skills of children with ASD, considering both clinical and family perspectives.	CAREGIVERS = 10 parents and 04 therapists.	DSM-V	Evaluative	Protocol and questionnaires	Teaching clinic	It was found that both parents and therapists reported deficits in the verbal as well as the non-verbal communication skills of children with ASD.
24. Gomes et al.(⁴³)	Paper	2004	To verify whether the clinical behavior of auditory hypersensitivity, as reported in interviews with parents, caregivers, and therapists of autistic children, corresponds to audiological findings, and to determine whether other types of stimuli also lead to auditory hypersensitivity.	CHILDREN = 46 individuals with ASD aged from 5 to 20.	DSM-IV	Evaluative	Protocol and questionnaires	Teaching clinic	Behavioral responses to sounds are not associated with the hypersensitivity of the auditory pathways, but rather with processing difficulties in the cerebral cortex, involving systems that are generally impaired in ASD, such as the limbic system.
25. Kamita et al.(⁴⁴)	Paper	2020	To identify and analyze the characteristic findings of Cortical Auditory Evoked Potentials (CAEP) in children and/or adolescents with ASD in comparison with their typically developing peers.	CHILDREN AND ADOLESCENTS	DSM-V	Not applicable	Not applicable	Not applicable	The ASD population may present varied responses to the components of the CAEP (Cortical Auditory Evoked Potentials) in comparison to typically developing individuals.
26. Kwee et al.(⁴⁵)	Paper	2009	To apply the transdisciplinary assessment protocol based on the Treatment and Education of Autistic and related Communication handicapped Children (TEACCH) program in order to observe the development of and make necessary adjustments to the programs of six of its students.	CHILDREN = 6 individuals with ASD aged from 7 to 12.	Literature-based	Therapeutic and Evaluative	Behavioral	Teaching clinic	It was observed that all students in the program made positive progress in all areas and that, despite their individual complexities, the gains in and maintenance of acquired behaviors were achieved and stabilized.
27. Martins and Fernandes(⁴⁶)	Paper	2013	To evaluate changes in the Functional Communication Profile (FCP) and Socio-Cognitive Performance (SCP) of children with Autism Spectrum Disorders (ASD) following two short periods of intervention.	CHILDREN = 21 individuals with ASD from 2 to 12.	DSM-V	Therapeutic and Evaluative	Short-term intervention	Teaching clinic	With the 12-week intervention structure, few changes were observed in the FCP (Functional Communication Profile) and SCP (Socio-Cognitive Performance); therefore, the study suggests that further research of a longer duration is needed.
28. Matas et al.(⁴⁷)	Paper	2009	To describe the audiological and electrophysiological results of individuals with psychiatric disorders, screening for peripheral and/or central auditory disorders.	CHILDREN AND ADOLESCENTS = 40 individuals with ASD from 8 to 19.	DSM-IV	Evaluative	Protocol and questionnaires	Not informed	A high prevalence of auditory impairments was observed in children with psychiatric disorders, although in some analyses, no statistically significant difference was found when the sample group was compared with the control group.
29. Mayerle et al.(⁴⁸)	Paper	2021	To analyze the Mismatch Negativity (MMN) (a brain response to auditory changes based on memory) in children and adolescents with ASD and compare them with a control group.	CAREGIVERS = 68 caregivers of children and adolescents with ASD.	DSM-V	Evaluative	Protocol and questionnaires	Teaching clinic	Children and adolescents with ASD show higher latency and amplitude values in the MMN compared to individuals in the control group.
30. Menezes and Perissinoto(⁴⁹)	Paper	2008	To assess joint attention skills in subjects with ASD across different contexts and with different communication partners.	CHILDREN = 20 children with ASD.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The assessment of joint attention in a play context was effective, and the adult's intervention was reflected in an increase in these behaviors in semi-directed and imitation situations.
31. Miilher and Fernandes(⁵⁰)	Paper	2009	To analyze the progression of functional and grammatical aspects at three distinct time points: initial assessment, after six months of therapy, and after twelve months of therapy.	CHILDREN = 10 male children with ASD aged from 2 to 11.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	There is a relationship between grammatical and pragmatic performance.
32. Miilher and Fernandes(⁵¹)	Paper	2012	To compare the pragmatic profile of communicative initiations with the two-dimensional profile involving aspects of initiation and responsiveness.	CHILDREN = speech therapy recordings from 10 child patients with ASD.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The results highlighted the need to consider the two-dimensional communication profile and emphasized the necessity of qualifying the responses in order to differentiate the child's communicative skills.
33. Misquiatti et al.(⁵²)	Paper	2014	To analyze the socio-cognitive performance of children and adolescents with ASD in two language therapy settings that differ in their physical structure.	CHILDREN AND ADOLESCENTS = 10 children and adolescents with ASD aged from 4 to 13.	Literature-based	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The creation of pre-established physical environments or specific materials is not and should not be considered indispensable for language therapy.
34. Misquiatti et al.(⁵³)	Paper	2015	To assess the burden of family caregivers of children with ASD, according to the caregivers' own perceptions.	CAREGIVERS = 10 family members of children with ASD, and 10 family members of children with language disorders.	DSM-IV	Evaluative	Protocol and questionnaires	Not informed	The observed results showed no difference in the mean burden index between family caregivers of children with ASD and those of children with language disorders.
35. Misquiatti and Fernandes(⁵⁴)	Paper	2011	To analyze the functional communicative profile of children and adolescents with ASD in two different language therapy settings, with the differences concentrated in the physical aspect of the environment.	CHILDREN = 10 children and adolescents with ASD from 4 to 13.	Literature-based	Therapeutic and Evaluative	Environmental enrichment	Teaching clinic	The physical environment studied did not have a significant influence on the functional communicative profile of the autistic subjects, although there were individuals who showed a tendency to perform better in one environment compared to the other.
36. Moraes(⁵⁵)	Dissertation [master]	2019	To verify the effectiveness of a remote stimulation program implemented at LIFDEA-FMUSP.	CHILDREN AND ADOLESCENTS = 30 children and adolescents with ASD aged from 6 to 16.	DSM-V	Therapeutic and Evaluative	Teletherapy	Teaching clinic	It was found that the number of strategies proposed for a single therapeutic intervention objective can vary, revealing the wide variety of possibilities for addressing the characteristics of autism spectrum disorder.
37. Neubauer and Fernandes(⁵⁶)	Paper	2013	To evaluate the use of a checklist, as a substitute for the full protocol, for analyzing the Functional Communication Profile (FCP).	CHILDREN = video recordings of speech therapy sessions with 50 children with ASD aged 3 to 12 years.	DSM-IV	Evaluative	Play-based therapeutic context	Teaching clinic	The checklist can be used as an instrument to monitor the therapeutic processes of children with ASD, but it does not replace the complete instrument.
38. Navarro(⁵⁷)	Paper	2018	To reinterpret speech-language pathology practice in the context of Equine-Assisted Therapy based on Discursive Neurolinguistics (DN).	CHILDREN = 1 male child with ASD.	DSM-V	Therapeutic and Evaluative	Equine-assisted therapy	Not informed	The reinterpretation of speech-language pathology services in the context of Equine-Assisted Therapy, as made possible by Discursive Neurolinguistics (DN), expands upon and explains the events of the equine-assisted therapy setting as a whole.
39. Pereira et al.(⁵⁸)	Paper	2019	To investigate the effects of speech-language pathology intervention with Augmentative and Alternative Communication (AAC) on the communicative acts of children with ASD.	CHILDREN = 3 male children with ASD aged from 2 e 4.	DSM-V	Therapeutic and Evaluative	PECS Multimodal approach	Teaching clinic	The use of AAC (Augmentative and Alternative Communication) in speech-language pathology clinical practice is proving to be promising and effective in promoting the development of communication skills in individuals with ASD.
40. Roncati et al.(⁵⁹)	Paper	2019	To replicate the procedures of Coon and Miguel (reinforcement histories with a specific prompt topography) with children with ASD, who are commonly exposed to tact and echoic prompts when learning verbal behavior.	CHILDREN = 3 male children with ASD aged 3, 6 and 7.	Literature-based	Therapeutic and Evaluative	Prompt method	Not informed	For professionals who plan lessons to teach intraverbal behavior to children with ASD, information about a patient's history with a specific type of prompt can be essential.
41. Rosa(⁶⁰)	Dissertation [master]	2022	To investigate oral story narrative performance in children and adolescents with ASD without intellectual disability (ID).	CHILDREN = 27 male individuals with ASD and without Intellectual disability.	Literature-based	Evaluative	Protocol and questionnaires	Teaching clinic	The sample group achieved performance similar to that of individuals with typical language development in oral story comprehension and superior performance in oral story narrative production.
42. Santos et al.(⁶¹)	Paper	2022	To investigate the contribution of teletherapy to the development of communication skills in children with ASD during the COVID-19 pandemic.	CHILDREN = 8 children with ASD aged from 2 to 8.	DSM-V	Evaluative	Teletherapy	Not informed	The results demonstrated that speech-language teleconsultation for children with ASD during the social isolation resulting from the COVID-19 pandemic proved to be a viable option that produced advancements in the children's communication.
43. Segeren and Fernandes(⁶²)	Paper	2019	To investigate the clinical case profile of a referral health service.	CHILDREN = Medical records of patients who underwent speech-language therapy at LIF-DEA.	DSM-V	Not applicable	Not applicable	Teaching clinic	The study showed the need for systematic records of the work performed, preferably with computerized databases. A limitation in data characterization and a reduction in data loss were observed following digitization.
44. Silva et al.(⁶³)	Paper	2007	To describe the speech-language pathology intervention process for a child diagnosed with autism.	CHILDREN = a 2 year-old boy with ASD.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The therapeutic strategies presented here proved to be effective for the child in question, as she showed progress throughout the speech-language therapy process.
45. Sun et al.(⁶⁴)	Paper	2017	To identify effective methods for stimulating language and communication in children with ASD, which is fundamental for the effective use of available resources to support these children.	CHILDREN = 20 children with ASD aged from 5 to 12.	Literature-based	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	Intervention that includes activities for stimulating executive functions in children with ASD requires further investigation.
46. Tamanaha and Perissinoto(⁶⁵)	Paper	2011	To analyze and compare the scope and rate of the developmental process in children with ASD receiving combined direct and indirect speech-language pathology intervention versus those receiving only indirect intervention.	CHILDREN = 11 male children with ASD and Asperger Syndrome aged from 4 to 10	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	The trend of better performance among the children receiving both interventions showed that the combination of direct and indirect actions is fundamental to the speech-language therapy process for children with ASD.
47. Tamanaha et al.(⁶⁶)	Paper	2008	To evaluate the developmental progress of autistic children in the context of direct and indirect intervention, based on mothers' responses to the Autism Behavior Checklist.	CAREGIVERS = 11 mothers of children with ASD and Asperger Syndrome.	DSM-IV	Therapeutic and Evaluative	Play-based therapeutic context	Teaching clinic	Mothers in both the direct therapy group (GT) and the indirect group (GO) observed behavioral changes. The trend of better scores in the GT was likely due to the efficacy of the direct intervention and not to a lack of attention from the parents in the GO.
48. Tamanaha et al.(⁶⁷)	Paper	2015	To evaluate the efficacy of speech-language therapy intervention for children with Autism Spectrum Disorders.	CHILDREN = 11 children with ASD and mild to moderate intellectual disability.	DSM-V	Therapeutic and Evaluative	Protocol and questionnaires	Teaching clinic	It was concluded that the combination of direct and indirect interventions is fundamental for the improved performance of these children.
49. Santos(⁶⁸)	Thesis [doctorate]	2017	To evaluate the effectiveness of several instruments (PFC-C, FCP-Rr - TP, FCP-Rr - OF, PFC, ToPS) for investigating the pragmatic skills of children with ASD.	CHILDREN = 30 children with ASD	DSM-V	Therapeutic and Evaluative	Protocol and questionnaires	Teaching clinic	The FCP-Rr and PFC-C protocols were sensitive and consistent in assessing the pragmatic skills of individuals with autism based on therapists' responses.

	Absolute frequency	Percentage Frequency
Publication type
Papers	42	85.7%
Dissertation [Master]	3	6.1%
Thesis [Doctorate]	2	4.1%
Undergraduate Thesis	2	4.1%
Concept of autism
DSM-V	20	40.8%
Literature based	15	30.6%
DSM-IV	14	28.6%
Intervention type
Therapeutic and Evaluative	27	67.5%
Evaluative	12	30.0%
Parental guidance	1	2.5%
Intervention location
Teaching clinic	33	78.6%
Not reported	7	16.7%
CAPSij	1	2.4%
Multicenter	1	2.4%
Intervention strategies
Play-based therapeutic context	12	30.0%
Protocol and questionnaires	12	30.0%
PECS Multimodal approach	4	10.0%
Prompt method	2	5.0%
Teletherapy	2	5.0%
Behavioral	1	2.5%
Environmental enrichment	1	2.5%
Equine-assisted therapy	1	2.5%
Focus Group	1	2.5%
Guidance groups	1	2.5%
Short-term intervention	1	2.5%
Informatic games	1	2.5%
Language workshop	1	2.5%

Intervention type	CAPSij	Teaching clinic	Not reported	p-value
Evaluative	1	8	3
Parental guidance	0	1	0	0.7142
Therapeutic and Evaluative	0	23	4
Concept of autism	2004-2012	2013-2024
Literature-based	7	8
DSM-IV	10	4		<0,001
DSM-V	0	20
Intervention strategies	Evaluative	Parental guidance	Therapeutic and Evaluative
PECS Multimodal approach	0	0	4
Behavioral	0	0	1
Play-based therapeutic context	1	0	11
Environmental enrichment	0	0	1
Equine-assisted therapy	0	0	1
Focus Group	1	0	0
Guidance groups	0	1	0	<0.01
Short-term intervention	0	0	1
Informatics games	0	0	1
Prompt method	0	0	2
Language workshop	0	0	1
Protocol and questionnaires	8	0	3
Teletherapy	1	0	1

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