The increase in intervention diversity to improve core difficulties in autism has resulted in the development and proliferation of a variety of measures to assess change. The Clinical Global Impressions (CGI) scale has been recommended for use in pharmacological autism clinical trials to monitor individuals' progress. No specific recommendations have been made for an outcome measure for psychosocial interventions. This review aimed to evaluate available evidence of a use of the CGI scale as an outcome measure in psychosocial interventions for autism characteristics. A systematic search of electronic databases identified 22 primary studies utilising the CGI scale to evaluate change across a range of social, communication and behavioural interventions for autistic people. The lack of consistency in the use of the measure was evident. This applied to the variety of constructs being measured, inconsistent application and scoring methods, which all limited the CGI scale's reliability and validity. Despite the widespread use of the CGI scale in psychosocial clinical trials for autistic people, the lack of standardisation hampers conclusions regarding the evidence of its effectiveness in measuring change. Standardisation of the use of the CGI scale is essential to ensure comprehensive evaluation of interventions.Lay AbstractMany different therapies and supports exist to help autistic people with social, communication, and behavioural differences. To understand whether these interventions are working, researchers need good tools to measure change. One commonly used tool in medical studies is the Clinical Global Impressions (CGI) scale, which helps clinicians rate a person's overall improvement. Although the CGI scale is recommended for autism medication studies, there are no clear guidelines for using it in psychosocial (non-medical) interventions. In this review, we looked at research studies that used the CGI scale to measure change after psychosocial interventions for autistic people. We found 22 studies that used the CGI scale in very different ways. The studies measured a wide range of skills and behaviours, and they often used the CGI scale differently from one another. This inconsistency makes it difficult to trust the results or compare findings across studies. Although the CGI scale is widely used, the lack of standard guidelines means it may not reliably show whether psychosocial interventions are effective. To improve research and ensure that interventions are properly evaluated, it is important to develop clear, standardised ways of using the CGI scale.
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