Parent-mediated Paediatric Autism Communication Therapy (PACT): a focus group study of parental experience

Parent-mediated interventions are increasingly recommended for children with Autism Spectrum Disorder (ASD). This study explores parental experiences of Paediatric Autism Communication Therapy (PACT), a parent-mediated intervention focused on social communication. PACT uses video feedback to analyze parent-child play sequences with the parent and to support parental reflexivity about the most appropriate interactive style for developing their child's socio-communicative skills.

We conducted a qualitative study using focus groups with 20 parents, among the 60 families who completed PACT with their children with ASD. Data analysis was conducted using Interpretative Phenomenological Analysis.

Five main key themes stand out (1) Video feedback enhanced parental perspective and recognition of children's emergent skills; (2) Parents transitioned from feeling incompetent to supported and empowered; (3) Daily integration and mutual shared enjoyment reinforced the intervention's effects; (4) Parent-child play is not a prerequisite that is uniformly present among all parents, yet it is one of the main levers in PACT. Cultural approaches are necessary to support this skill to prevent it from becoming an obstacle to the course of therapy; and (5) PACT had systemic repercussions on partners and siblings we have to deal with to support the engagement of parents who are concerned about this family impact.

PACT was positively received by parents, enhancing their observational skills and sense of competence. However, cultural factors and family dynamics significantly influenced its implementation and outcomes.