Pragmatic Language Interventions for Autistic Children: Evidence, Generalisation, and Neurodiversity-Informed Directions

Abstract

Autistic children do not experience pragmatic-language difficulties in the same way. Some may need support with conversation, inference, or communication repair, whereas others communicate effectively when the setting, task, or communication partner is familiar. This review examines what recent intervention research can-and cannot-tell us about supporting these differences. Literature published mainly between 2015 and 2025 was identified through PubMed, ERIC, citation searching, and relevant publisher databases. Earlier studies were retained when they informed current intervention models or debates. The reviewed approaches included explicit pragmatic teaching, naturalistic and play-based intervention, parent- and peer-mediated programmes, school-based support, and the use of technology. Many studies reported improvement in the behaviours or skills directly addressed during intervention. Evidence of lasting change in ordinary classrooms, homes, and peer relationships was much more limited. This distinction is important, since performing a practised task successfully is not the same as communicating more easily in daily life. Conclusions were also restricted by small samples, considerable variation between interventions, and the use of measures that were often closely related to the content taught. The review further considers how intervention goals are defined. Teaching may be helpful when it gives a child additional ways to communicate, participate, or manage misunderstandings. It is more difficult to justify when it mainly rewards behaviour that appears more neurotypical. Future work should examine outcomes chosen with autistic people, include children with a wider range of communication profiles, and consider partners and environments as part of pragmatic support.