A number of studies of parent-mediated interventions in autism spectrum disorder have been published in the last 15 years. We reviewed 19 randomized clinical trials of parent-mediated interventions for children with autism spectrum disorder between the ages of 1 and 6 years and conducted a meta-analysis on their efficacy. Meta-analysis outcomes were autism spectrum disorder symptom severity, socialization, communication-language, and cognition. Quality of evidence was rated as moderate for autism spectrum disorder symptom severity, communication-language, and cognition, and very low for socialization. Weighted Hedges’ g varied from 0.18 (communication-language) to 0.27 (socialization) and averaged 0.23 across domains. We also examined the relationship between outcome and dose of parent training, type of control group, and type of informant (parent and clinician). Outcomes were not significantly different based on dose of treatment. Comparing parent training to treatment-as-usual did not result in significantly different treatment effects than when parent training was compared to an active comparison group. Based on parent report only, treatment effects were significant for communication-language and non-significant for socialization, yet the opposite was found based on clinician-rated tools. This meta-analysis suggests that while most outcome domains of parent-delivered intervention are associated with small effects, the quality of research is improving.
AdamsonLBBakemanRDecknerDF (2004) The development of symbol-infused joint engagement. Child Development75(4): 1171–1187.
2.
*AldredCGreenJAdamsC (2004) A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry45(8): 1420–1430.
3.
AnagnostouEJonesNHuertaM. (2015) Measuring social communication behaviors as a treatment endpoint in individuals with autism spectrum disorder. Autism19(5): 622–636.
4.
Baker-EriczénMStahmerABurnsA (2007) Child demographics associated with outcomes in a community-based pivotal response training program. Journal of Positive Behavior Interventions9(1): 52–60.
5.
BakkerMvan DijkAWichertsJM (2012) The rules of the game called psychological science. Perspectives on Psychological Science: A Journal of the Association for Psychological Science7(6): 543–554.
6.
BearssKJohnsonCSmithT. (2015) Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. Journal of American Medical Association313(15): 1524–1533.
7.
BeaudoinAJSebireGCoutureM (2014) Parent training interventions for toddlers with autism spectrum disorder. Autism Research and Treatment2014: e839890.
8.
BrandABradleyMTBestLA. (2008) Accuracy of effect size estimates from published psychological research. Perceptual and Motor Skills106(2): 645–649.
9.
Brookman-FrazeeLStahmerABaker-EriczénMJ. (2006) Parenting interventions for children with autism spectrum and disruptive behavior disorders: opportunities for cross-fertilization. Clinical Child and Family Psychology Review9(3–4): 181–200.
10.
CardNA (2012) Applied Meta-Analysis for Social Science Research. New York: Guilford Press.
11.
*CarterASMessingerDSStoneWL. (2011) A randomized controlled trial of Hanen’s “more than words” in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry and Allied Disciplines52(7): 741–752.
12.
*CasenhiserDMShankerSGStiebenJ (2013) Learning through interaction in children with autism: preliminary data from a social-communication-based intervention. Autism17(2): 220–241.
13.
CohenJ (1988) Statistical Power Analysis for the Behavioral Sciences. 2nd ed.Hillsdale, NJ: Lawrence Erlbaum.
14.
DawsonGRogersSMunsonJ. (2010) Randomized, controlled trial of an intervention for toddlers with autism: the early start Denver model. Pediatrics125(1): e17–e23.
15.
*DrewABairdGBaron-CohenS. (2002) A pilot randomised control trial of a parent training intervention for pre-school children with autism. Preliminary findings and methodological challenges. European Child & Adolescent Psychiatry11(6): 266–272.
16.
ElsabbaghMDivanGKohY-J. (2012) Global prevalence of autism and other pervasive developmental disorders. Autism Research5(3): 160–179.
17.
GehannoJFRollinLDarmoniS (2013) Is the coverage of Google Scholar enough to be used alone for systematic reviews. BMC Medical Informatics and Decision Making13: 7.
18.
*GreenJCharmanTMcConachieH.; the PACT Consortium (2010) Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. The Lancet375(9732): 2152–2160.
19.
GuyattGOxmanADAklEA. (2011) GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology64(4): 383–394.
20.
*HardanAYGengouxGWBerquistKL. (2015) A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Journal of Child Psychology and Psychiatry56(8): 884–892.
21.
HedgesLVOlkinI (1985) Statistical Methods for Metaanalysis. Orlando, FL: Academic Press.
22.
HigginsJPTThompsonSG (2002) Quantifying heterogeneity in a meta-analysis. Statistics in Medicine21(11): 1539–1558.
23.
Huedo-MedinaTBSánchez-MecaJMarín-MartínezF. (2006) Assessing heterogeneity in meta-analysis: Q statistic or I2 index?Psychological Methods11(2): 193–206.
KaminskiJWValleLAFileneJH. (2008) A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology36(4): 567–589.
26.
*KasariCGulsrudAPaparellaT. (2015) Randomized comparative efficacy study of parent-mediated interventions for toddlers with autism. Journal of Consulting and Clinical Psychology83(3): 554–563.
27.
*KasariCGulsrudACWongC. (2010) Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders40(9): 1045–1056.
28.
*KasariCLawtonKShihW. (2014) Caregiver-mediated intervention for low-resourced preschoolers with autism: an RCT. Pediatrics134(1): e72–e79.
KoegelLKKoegelRLAshbaughK. (2014) The importance of early identification and intervention for children with or at risk for autism spectrum disorders. International Journal of Speech-Language Pathology16(1): 50–56.
31.
KoegelRLSymonJBKoegelLK (2002) Parent education for families of children with autism living in geographically distant areas. Journal of Positive Behavior Interventions4(2): 88–103.
32.
LangRMachalicekWRispoliM. (2009) Training parents to implement communication interventions for children with autism spectrum disorders (ASD): a systematic review. Evidence-Based Communication Assessment and Intervention3(3): 174–190.
MeadanHOstroskyMMZaghlawanHY. (2009) Promoting the social and communicative behavior of young children with autism spectrum disorders: a review of parent-implemented intervention studies. Topics in Early Childhood Special Education29(2): 90–104.
National Research Council (2001) Education Children with Autism. Washington, DC: National Academy Press.
37.
*NefdtNKoegelRSingerG. (2010) The use of a self-directed learning program to provide introductory training in pivotal response treatment to parents of children with autism. Journal of Positive Behavior Interventions12(1): 23–32.
38.
OonoIPHoneyEJMcConachieH (2013) Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Evidence-Based Child Health: A Cochrane Review Journal8(6): 2380–2479.
39.
*PajareyaKNopmaneejumruslersK (2011) A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for pre-school children with autistic spectrum disorders. Autism15(5): 563–577.
40.
PattersonSYSmithVMirendaP (2012) A systematic review of training programs for parents of children with autism spectrum disorders: single subject contributions. Autism16(5): 498–522.
41.
*PoslawskyIENaberFBABakermans-KranenburgMJ. (2015) Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI): a randomized controlled trial. Autism19(5): 588–603.
42.
Ray-SubramanianCEHuaiNWeismerSE (2011) Brief report: adaptive behavior and cognitive skills for toddlers on the autism spectrum. Journal of Autism and Developmental Disorders41(5): 679–684.
43.
*RickardsALWalstabJEWright-RossiRA. (2007) A randomized, controlled trial of a home-based intervention program for children with autism and developmental delay. Journal of Developmental and Behavioral Pediatrics28(4): 308–316.
44.
*RobertsJWilliamsKCarterM. (2011) A randomised controlled trial of two early intervention programs for young children with autism: centre-based with parent program and home-based. Research in autism spectrum disorders. 5(4): 1553–1566.
45.
RosenthalR (1991) Meta-Analytic Procedures for Social Research. Newbury Park, CA: SAGE.
46.
SchreibmanLDawsonGStahmerAC. (2015) Naturalistic developmental behavioral interventions: empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders45(8): 2411–2428.
47.
SchultzTRSchmidtCTStichterJP (2011) A review of parent education programs for parents of children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities26(2): 96–104.
48.
*SillerMHutmanTSigmanM (2013) A parent-mediated intervention to increase responsive parental behaviors and child communication in children with ASD: a randomized clinical trial. Journal of Autism and Developmental Disorders43(3): 540–555.
49.
SmithTBuchGAGambyTE (2000) Parent-directed, intensive early intervention for children with pervasive developmental disorder. Research in Developmental Disabilities21(4): 297–309.
50.
*SolomonRVan EgerenLAMahoneyG. (2014) PLAY project home consultation intervention program for young children with autism spectrum disorders: a randomized controlled trial. Journal of Developmental and Behavioral Pediatrics35(8): 475–485.
SuppoJFloydK (2012) Parent training for families who have children with autism: a review of the literature. Rural Special Education Quarterly31(2): 12–26.
53.
SymonJB (2001) Parent education for autism: issues in providing services at a distance. Journal of Positive Behavior Interventions3(3): 160–174.
54.
ThompsonGAMcFerranKSGoldC (2014) Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: a randomized controlled study. Child: Care, Health and Development40(6): 840–852.
55.
*TongeBBreretonAKiomallM. (2014) A randomised group comparison controlled trial of “preschoolers with autism”: a parent education and skills training intervention for young children with autistic disorder. Autism18(2): 166–177.
56.
UK National Institute for Health and Care Excellence (NICE) (2013) Autism in under 19s: support and management. Available at: https://www.nice.org.uk/guidance/cg170
57.
WarrenZMcPheetersMLSatheN. (2011) A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics127(5): e1303–e1311.
58.
*WelterlinATurner-BrownLHarrisS. (2012) The home TEACCHing program for toddlers with autism. Journal of Autism and Developmental Disorders42(9): 1827–1835.
59.
WetherbyAMWoodsJJ (2006) Early social interaction project for children with autism spectrum disorders beginning in the second year of life: a preliminary study. Topics in Early Childhood Special Education26(2): 67–82.
60.
*WetherbyAMGuthrieWWoodsJ. (2014) Parent-implemented social intervention for toddlers with autism: an RCT. Pediatrics134(6): 1084–1093.
61.
WolfFM (1986) Meta-Analysis: Quantitative Methods for Research Synthesis. Newbury Park, CA: SAGE.
62.
YangSPaynterJMGilmoreL (2016) Vineland adaptive behavior scales: II profile of young children with autism spectrum disorder. Journal of Autism and Developmental Disorders46(1): 64–73.
63.
ZwaigenbaumLBrysonSLordC. (2009) Clinical assessment and management of toddlers with suspected autism spectrum disorder: insights from studies of high-risk infants. Pediatrics123(5): 1383–1391.
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