Table 3.

Summary of the 10 selected trials.

Authors	Mean age of participants	Duration	Intervention content	Format	Control	Main outcomes (operational definitions and tools)	Effectiveness
Esposito et al [27]	47 months	4 weeks	App games: a game play app to train for vocabulary, attention, and imitation skills	Self-use	Behavioral therapy	Cognitive and social skills: vocabulary, attention, and imitation skills (1) Target improvement (2) Game scores	Ineffective: (1) Attention: P=.06 Imitation of actions with objects: P=.84. Receptive identification of objects: P=.21 (2) Attention: P=.47 Imitation of actions with objects: P=.02 Receptive identification of objects: P=.32
Thiemann- Bourque et al [31]	Exptl gpa: 48 months Ctl gpb: 46 months Peers: 40 to 61 months	9 to 19 weeks	SGDc with trained peers: promoting communication through SGD and trained peers, guided by trained school staff	In-session training	Untrained peers	Social skills: communication behaviors (1) Rate of communication (2) Balanced initiation and response during interactions	Effective: (1) Rate of communication: P<.001 (2) Balanced initiation and response; P=.047
Fletcher- Watson et al [33]	Exptl gp: 49.30 months Ctl gp: 49.96 months	2 months	FindMe app: a game play app to train for attending to people (touching the single person on the screen) and following social cues (touch the item being pointed and looked at)	Self-use	TAUd	Social skills: social communication skills (1) BOSCCe (2) ADOS-2f (3) MCDIg (4) CSBS-DPh	Ineffective: (1) Overall: P=.29 Social communication: P=.56 (2) Communication: P=.93 Reciprocal social interaction: P=.40 Social effect: P=.52 Restricted repetitive behavior: P=.81 (3) Words understood: P=.12 Words produced: P=.09 Gestures: P=.07 (4) Social communication: P=.31 Gestures: P=.93
Parsons et al [35]	Exptl gp: 64.4 months Ctl gp: 60.8 months	3 months	TOBYi app: a game play app to train for visual motor (perception and discrimination of sensory information), imitation (copy an action), language (recognize and reproduce object and action names), and social skills (eye gaze, gestures, etc)	Self-use	Delayed treatment	Cognitive and social skills: visual motor, imitation, language, and social skills MSELj CSBSMSELk ToPMSELl POMMSELm SPTMSELn	Partially effective: (1) Visual reception: P=.39 Fine motor: P=.15 Receptive language: P=.04 Expressive language: P=.30 (2) Social domain: P<.001 Speech domain: P=.07 Symbolic domain: P<.001 (3) ToP: P=.12 (4) POM: P=.02 (5) SPT: P=.95
Novack et al [30]	69.29 months	4 weeks	Camp Discovery app: identifying the correct words based on the instructions they heard	In-session training	Delayed treatment	Cognitive skills: receptive language skills (1) Number of new target words learned	Effective (1) Number of words learned: P<.001
Whitehouse et al [32]	3.38 years	6 months	TOBY app: a game play app to train for visual motor (perception and discrimination of sensory information), imitation (copy an action), language (recognize and reproduce object and action names), and social skills (eye gaze, gestures, etc)	Self-use	TAU	Cognitive and social skills: early behavioral intervention (1) ATECo (2) MSEL (3) VABS-IIp	Partially effective: (1) Total: P=.14 Communication: P=.08 Sociability: P=.50 Sensory: P=.20 Physical: P=.28 (2) Receptive language: P=.32 Expressive language: P=.89 Visual reception: P=.03 Fine motor: P=.07 (3) Total composite: P=.08 Communication: P=.10 Socialization: P=.35 Daily living skills: P=.03 Motor skills: P=.08
Cheng et al [26]	Exptl gp: 11.3 years Ctl gp: 10.9 years	3 weeks	3DFERq app: identifying facial expressions and the associations between situations and emotions	Self-use	Paper- based	Social skills: emotional facial recognition skills (1) Achievement scores in the app game	Effective (1) Posttest between group score difference: P<.001
Zink et al [34]	Exptl gp: 12.5 years Ctl gp: 12.0 years	Not described	App with self-constructed pictures: showing dental procedures with images and audio comments	In-session training	PECSr	Social skills: patient-dentist communication (1) Number of attempts required for skill acquisition (2) Number of dental appointments required to complete dental cleaning	Effective (1) Number of attempts required for skills acquisition: P<.001 (2) Number of dental appointments required: P<.001
Hayes et al [28]	All aged 18 years (except one aged 17)	1 month	VidCoach app: use of video modeling and video prompting strategies to learn interview skills	Self-use	TAU	Social skills: job interview skills (1) Scores in interview performance assessed by employers	Effective (1) Scores improved in intervention group: P<.001
Gentry et al [29]	24 years	3 months	PDAs in iPod: Training on iPod Touch–based apps and strategies to support their job	Self-use	Delayed treatment	Cognitive skills: job coaching support (1) Cumulative job coaching hours (2) Monthly job coaching hours	Effective (1) Difference in cumulative coaching hours: P<.001 (2) Difference in monthly coaching hours: P<.001

^aExptl gp: experimental group.

^bCtl gp: control group.

^cSGD: speech-generating device

^dTAU: treatment as usual.

^eBOSCC: Brief Observation of Social Communication Change.

^fADOS-2: Autism Diagnostic Observation Schedule second edition.

^gMCDI: MacArthur Communicative Development Inventory.

^hCSBS-DP: Communication and Symbolic Behavior Scale – Developmental Profile.

ⁱTOBY: Therapy Outcomes By You.

^jMSEL: Mullen Scales of Early Learning.

^kCSBS: Communication and Symbolic Behavior Scale.

^lToP: Test of Playfulness.

^mPOM: Pragmatic Observation Measure.

ⁿSPT: Symbolic Play Test.

^oATEC: Autism Treatment Evaluation Checklist.

^pVABS-II: Vineland Adaptive Behavior Scale second edition.

^q3DFER: 3D complex facial expression recognition.

^rPECS: picture exchange communication system.

^sPDA: personal digital assistant.