NEW Rapid Review
24 September 2026
Reliable measurement of social communication change remains a major challenge in autism research. The Brief Observation of Social Communication Change (BOSCC) was developed to detect subtle changes in communication. This rapid review synthesised current evidence on the BOSCC’s responsiveness, validity, and suitability as a clinical trial endpoint.
Systematic searches of PubMed, PsycINFO, CINAHL, and Web of Science identified 19 eligible studies (n = 789). Within-group meta-analyses estimated pre–post standardised mean change (Hedges’ g) for BOSCC and ADOS (Autism Diagnostic Observation Schedule) outcomes, using random-effect (RE) models. The BOSCC total score for intervention arms showed a moderate, significant change (g = −0.32, 95% confidence interval [CI] = [−0.42, −0.22]), with a smaller, non-significant change in control arms (g = −0.15). The Social Communication subscale yielded consistent effects on the intervention arm (g = −0.34, 95% CI = [−0.49, −0.19]), indicating sensitivity to improvements in reciprocal interaction. The restricted and repetitive behaviour (RRB) subscale also showed a moderate significant effect on the intervention arm but with wide confidence intervals indicating a large degree of heterogeneity in this result (g = −0.40, 95% CI = [−0.74, −0.06]). ADOS scores showed a similar pattern of results for the intervention arms, based on a sub-analysis of four studies that included both BOSCC and ADOS scores. Findings indicate that the BOSCC captures clinically meaningful behavioural change across diverse contexts. Variability in RRB outcomes may arise because they are not routinely targeted by supports for social communication, in line with neuro-affirmative approaches.
