Systematic review of outcome measures used in support programs designed to enhance the functioning for autistic children and adolescents and ICF content mapping.

Abstract

1) To identify outcome measures used in support programs designed to enhance functioning in autistic children and adolescents, and 2) To map the content of these measures to the domains of the International Classification of Functioning, Disability and Health (ICF). A systematic review was conducted. Searches were performed in Medline/PubMed, EMBASE and Virtual Health Library databases, with no restrictions imposed regarding language or year of publication. Studies that used outcome measures to assess functioning and/or disability in autistic individuals up to 18 years of age were included. A total of 20 outcome measures were identified. The <i>Vineland Adaptive Behavior Scales</i> was the most used outcome measure. The most frequently associated ICF domains were d7 "Interpersonal interactions and relationships," d3 "Communication," and b1 "Mental functions." The most extensively assessed component was activities and participation. Bladder and bowel control (b5 "digestive, metabolic, and endocrine functions" and b6 "genitourinary and reproductive functions"), multitasking (d2 "general tasks and demands"), and environmental factors (e2 "natural environment and human-made changes" and e4 "attitudes") were each linked only once to the outcome measures. None of the studies addressed the body structures component. No single instrument adequately encompasses all ICF domains, underscoring a significant gap in current assessment tools. The domains of body structures, environmental factors and some body functions were under-assessed in studies involving autistic children and adolescents.