Parent-mediated early interventions for children with autism spectrum disorder : a systematic review

Abstract

Background: Children with Autism Spectrum Disorder (ASD) have serious impairments in communication and social interaction from their early age, resulting in poor prognosis throughout their life. Parent-mediated early interventions have the potential to, improve communication and language skills, promote parent-children interactions and reduce parental stress for children with ASD.

Objectives: To review the effectiveness of parent-mediated early interventions for both children with ASD and their parents, and to suggest implications for public health practice and future study.

Methods: This was a systematic review focusing on randomized controlled trials (RCTs) of parent-mediated interventions. Bibliographic databases including PubMed, Cochrane, Medline were used for the search. RCTs involving children from 0 to 7 years old with ASD and interventions with parental involvement based on behavioral models, were included. The CONSORT checklist on reporting of randomized trials was used to guide quality assessment of the reviewed studies.

Results: A total of 19 published RCTs from 2005 to 2015 with 1500 children were included. Parent-mediated early interventions were associated with significantly improved parent-child interactions and parental stress in most studies. However, the effects on children’s communication and language skills were inconclusive. Moreover, most studies appeared to be at high risk of bias with small sample sizes. Heterogeneity of outcome measures and control groups precluded a meta-analysis.

Conclusion: Parent-mediated early intervention may promote parent-children interactions and parental mental health. Children’s communication and language skills are probably improved through the interaction with parents with reduced stress, but results remained inconclusive. Larger RCTs with better design and standardization of outcome measures will be required.