Early Parent-Mediated Training for Social-Communication Skills in Toddlers and Preschoolers With ASD: A Systematic...

This study systematically reviewed the effects of early parent-mediated training designed to promote social and communication skills among toddlers and preschoolers with autism spectrum disorder (ASD).

This study focused on randomized controlled trials (RCTs) and statistically validated effect sizes using meta-analysis. Relevant studies published in domestic and international journals between 2014 and 2024 were selected using PubMed, Web of Science, EMBASE, RISS, KISS, and the Yonsei University Library, following the PRISMA flow chart. A total of 15 RCTs that met the inclusion criteria were included for analysis. During the systematic review, the participants' general characteristics, intervention methods and duration, intervention effects, and assessment tools were examined. In addition, effect size analysis, heterogeneity assessment, publication bias evaluation, and sensitivity analysis were performed using the Comprehensive Meta-Analysis 4.0 program.

All Fifteen RCTs included children with ASD. Early parent-mediated training showed moderate to large effects in improving social skills (1.09), communication skills (0.70), and reducing challenging behaviors (0.74), which were all statistically significant. The overall effect size was 0.80 (95% CI: 0.53-1.10). Although high heterogeneity (I² = 89%) was observed, the subgroup analysis suggested that intervention duration was a primary contributing factor. Although publication bias was observed, it did not significantly impact the results, and sensitivity analysis confirmed the stability of the findings.

Early parent-mediated training is empirically supported as an effective strategy for promoting the development of children with ASD. Future research should examine its long-term effects, address heterogeneity, and work toward the standardization of intervention protocols.