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Parent-mediated early intervention for young children with autism spectrum disorder
T Diggle1, H R McConachie, V R Randle
1Department of Child Health, The University of Newcastle, University of Newcastle, Newcastle upon Tyne, UK, NE2 4AE. T.J.Diggle@newcastle.ac.uk
Insights
Parent-mediated early intervention shows promise for autistic children, improving child language and maternal knowledge. However, more research is needed due to limited studies and small sample sizes in this area.
Area of Science:
- Developmental Psychology
- Pediatric Medicine
- Special Education
Background:
- Autism spectrum disorder (ASD) prevalence has increased significantly, affecting at least 1 in 400 children.
- Families of children with ASD require substantial support and services.
- Parental involvement in intervention strategies is recognized for its benefits to both children and parents.
Purpose of the Study:
- To review the effectiveness of parent-mediated early intervention for children aged 1 to 6 years 11 months with ASD.
- To assess benefits for both children with ASD and their parents.
Main Methods:
- Systematic search of psychological, educational, and biomedical databases.
- Inclusion of only randomized or quasi-randomized studies focusing on parent-implemented early intervention.
- Comparison against no treatment, waiting list, or alternative intervention groups with objective child outcome measures.
Main Results:
- Limited to two studies, findings were mixed.
- One study indicated parent training improved child language and maternal knowledge of autism.
- Another study found intensive, professional-led intervention superior to parent-mediated intervention for child outcomes, with no difference in parent/teacher perceptions.
Conclusions:
- The current evidence base is insufficient for practice implications due to the small number and heterogeneity of studies.
- There is a critical need for large-scale randomized controlled trials (RCTs) with short- and long-term outcomes and economic evaluations.
- Barriers to randomization, such as service availability, hinder research in parent-mediated early intervention for ASD.
Background:
Recent estimates concerning the prevalence of autistic spectrum disorder are much higher than those reported 30 years ago, with at least 1 in 400 children affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children.
Objectives:
The objective of this review was to determine the extent to which parent-mediated early intervention has been shown to be effective in the treatment of children aged 1 year to 6 years 11 months with autistic spectrum disorder. In particular, it aimed to assess the effectiveness of such interventions in terms of the benefits for both children and their parents.
Search Strategy:
A range of psychological, educational and biomedical databases were searched. Bibliographies and reference lists of key articles were searched, field experts were contacted and key journals were hand searched.
Selection Criteria:
Only randomised or quasi-randomised studies were included. Study interventions had a significant focus on parent-implemented early intervention, compared to a group of children who received no treatment, a waiting list group or a different form of intervention. There was at least one objective, child related outcome measure.
Data Collection And Analysis:
Appraisal of the methodological quality of included studies was carried out independently by two reviewers. Differences between the included studies in terms of the type of intervention, the comparison groups used and the outcome measures were too great to allow for direct comparison.
Main Results:
The results of this review are based on data from two studies. Two significant results were found to favour parent training in one study: child language and maternal knowledge of autism. In the other, intensive intervention (involving parents, but primarily delivered by professionals) was associated with better child outcomes on direct measurement than were found for parent-mediated early intervention, but no differences were found in relation to measures of parent and teacher perceptions of skills and behaviours.
Reviewer'S Conclusions:
This review has little to offer in the way of implications for practice: there were only two studies, the numbers of participants included were small, and the two studies could not be compared directly to one another. In terms of research, randomised controlled trials involving large samples need to be carried out, involving both short and long-term outcome information and full economic evaluations. Research in this area is hampered by barriers to randomisation, such as availability of equivalent services.