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Milieu Teaching and Autism Ranking: Insufficient/Mixed evidence

Current Research

We have identified 17 scientific studies published in peer-reviewed journals in which milieu teaching was identified as the main intervention or in which milieu teaching was identified as a core component of a multi-component programme. These trials included more than 100 children, most of pre-school age, diagnosed as being autistic (including children with autistic disorder or pervasive development disorder - not otherwise specified).

  • Two of the studies (Christensen-Sandfort and Whinnery, 2013; Ogletree et al, 2012; Stephens, 2008) examined milieu teaching and three of the studies (Mancil et al, 2009; Ingersoll et al, 2012; Ingersoll, 2011) examined milieu teaching delivered alongside other interventions or compared to other interventions (such as functional communication training or responsive interaction).
  • Two of the studies (Hancock and Kaiser, 2002; Kaiser and Roberts, 2013; Kaiser et al, 2000) examined enhanced milieu teaching while two other studies (Kasari et al, 2014; Olive et al, 2007) examined enhanced milieu teaching delivered alongside other interventions (functional communication training or a voice output communication aid).  The study by Kaiser and Roberts, 2013 compared EMT delivered by therapists to EMT delivered by parents and therapists.
  • One of the studies (Franco et al, 2013) examined prelinguistic milieu teaching and three of the studies (McDuffie et al, 2012; Yoder and Stone, 2006a; Yoder and Stone, 2006b) examined a specific form of prelinguistic milieu teaching (RPMT) in comparison to the Picture Exchange Communication System.
  • One of the studies (Wetherby and Woods, 2006) examined milieu teaching as a component of a combined­, multi-component intervention package (the Social Interaction Project).

Most of the studies reported positive benefits including increased language skills and improved social interaction.  

The studies by Ingersoll et al (2012, 2011) reported more mixed results, suggesting that milieu teaching led to more overall language, prompted language, and requests than responsive interaction but that responsive interaction led to more comments than milieu teaching.

The study by Kaiser and Roberts (2013) reported that EMT delivered by parents and therapists was more effective than EMT delivered by therapists alone.Please note: we have not evaluated studies which included only some of the elements of milieu teaching (such as incidental teaching or manding) or where milieu teaching was not specifically identified as the main teaching technique.

Updated
17 Jun 2022
Last Review
01 Jan 2017
Next Review
01 Jun 2023