Asian Journal of Pediatric Research

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterised by persistent challenges in social communication, restricted and repetitive patterns of behaviour, and, in many cases, atypical sensory processing. For several decades, applied behaviour analysis (ABA) and sensory integration (SI) therapy have occupied dominant positions in clinical practice and educational provision for children on the spectrum. While both approaches rest on substantive evidence bases, each has attracted mounting scrutiny concerning methodological rigour, ethical acceptability, and adequacy in addressing the full range of developmental needs across the diverse ASD population. This critical review examines the theoretical foundations and principal limitations of ABA and SI, before turning to an appraisal of the wider landscape of emerging and complementary intervention approaches. Drawing on a narrative review of peer-reviewed literature published primarily between 2000 and 2026, the article synthesises evidence for a range of complementary frameworks and argues for a shift towards personalised, multimodal, and autonomy-respecting models of behaviour support. The literature informing this review was identified through comprehensive searches of multiple academic databases, including Web of Science, Scopus, PubMed, and Google Scholar. The alternatives considered include naturalistic developmental behavioural interventions, pivotal response treatment, developmental relationship-based models such as DIR/Floortime and Relationship Development Intervention, social communication therapies including the Preschool Autism Communication Trial (PACT) and JASPER programmes, cognitive behavioural therapy adaptations for autism, and mindfulness-based approaches. Technology-mediated strategies — encompassing robotic, computer-assisted, and virtual reality interventions — are also examined alongside family-centred, parent-mediated, and neurodiversity-affirming frameworks. Significant gaps — including questions of long-term outcomes, cultural generalisability, and individual variability — are identified throughout. The review concludes that no single intervention paradigm is sufficient to meet the diverse needs of children with ASD, and that integrated approaches grounded in scientific rigour, developmental sensitivity, and respect for autistic identity represent the most promising direction for both clinical practice and future research.