What are we targeting when we support inclusive education for autistic students? A systematic review of 233 empirical studies and call for community partnerships.

Interventions to support mainstream schooling for autistic students involve multiple complex considerations. This systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, aimed to describe inclusive education interventions, their outcomes, and the tools used to measure the outcomes. A total of 233 experimental studies were included in the review. Subsequent result interpretation was performed using a participatory approach. To this end, a group of consultants comprising lived experience experts participated in two consultation sessions. Most studies were randomized controlled trials, single-case experimental design studies, or other quasi-experimental design studies. The social interactions and social skills of autistic students were the most frequently targeted outcomes. Cognitive-behavioral interventions were the predominant intervention type. A wide, heterogeneous set of standardized instruments was used to measure outcomes, indicating a lack of consensus on how to measure school inclusion and participation. The most used measurement tools assessed core autism symptoms, intelligence quotient, and adaptive behaviors. Approximately half of the studies failed to measure implementation considerations. Participatory interpretation of the results through consultation sessions with lived experience experts enabled the highlighting of interactive processes and considerations involved in inclusive education.Lay abstractMultiple complex considerations are involved in supporting mainstream schooling for autistic students. This systematic review aimed to describe inclusive education interventions and outcome measures for autistic students. A total of 233 experimental studies were analyzed. Furthermore, consultation sessions with autistic people, parents, and inclusive education professionals were organized to enable in-depth interpretation of the results using a participatory approach. Cognitive-behavioral interventions were the most common intervention type in the international scientific literature, and social interactions of autistic children were the most frequently targeted outcomes. A lack of consensus on how to measure school inclusion and participation was found. Although some studies considered perspectives on the acceptability of interventions, most of them failed to evaluate implementation aspects. The lived experience experts highlighted tensions between the systematic review findings and the practical realities of inclusive education; this led to discussions about the possible application of the United Nations' definition of inclusion. Overall, empirical research supporting the inclusion of autistic students aligns more closely with the concept of integration, which requires students to adapt to the school context. The focus of inclusion has been shifting from minimizing the unique traits of students with special needs to adapting the environment for them to take a greater part in school activities.