Parent-implemented language and communication intervention in children with autism spectrum disorder : a systematic review and meta-analysis

Abstract

Objective: This systematic review and meta-analysis evaluated the strength of evidence for the efficacy of parent-implemented intervention on improving social communication and language in young children aged 2;00-6;11 with autism spectrum disorder (ASD). Methods: The study protocol was registered on Open Science Framework. Nine electronic databases were searched for studies published in English. The included studies, which were randomized controlled trials (RCTs) or single case experimental designs (SCEDs), were appraised with the Joanna Briggs Institute Critical Appraisal Tools. Standard mean differences were calculated for common outcome constructs from RCTs for meta-analysis. Results: A total of 22 studies (three RCTs and 19 SCEDs) were included, with a total of 229 participants. Overall, studies had methodological flaws reducing the strength of the evidence. The SCEDs were found to have diverse outcome measures, lacking a strong basis for statistical comparison. Meta-analysis with RCTs indicated that intervention may have a significant large effect on social communication compared to control conditions (g = 0.815, 95% CI [0.491, 1.138]). For constructs of receptive and expressive language, it was inconclusive whether intervention had true effects. Conclusion: Preliminary evidence suggests that parent-implemented communication interventions might have promising effects on social communication. Higher-quality studies with a common set of outcome measures are needed.