Parent-mediated early intervention for young children with autism spectrum disorder: Revision of a Cochrane Collaboration systematic review
Autism spectrum disorders (ASD) affect more than 1% of children and is usually evident in behaviour before the age of three years.
A child with ASD lacks understanding of how to interact with another person, may not have developed language or understand other
people’s communication, and may insist on routines and repetitive behaviours. This early pattern of difficulties is a challenge for parents.
Therefore, helping parents to develop strategies for interaction and management of behaviour is an obvious route for early intervention.
The present review brings up to date one published in 2003, which found only two well-designed studies. This review, based on a
new protocol, includes 17 randomised controlled trials, most published since 2010, in which interventions delivered by parents were
compared with no treatment or local services, or alternative child-centred intervention such as nursery attendance, or another parent delivered intervention that differed in some way from the main condition. We were able to combine outcome information and so
increase confidence in the results. All the studies were rated on the quality of their evidence, which was then taken into account in
judging how firmly conclusions could be drawn.
The studies varied in the content of what parents were trained to do, and over what length of time parents had contact with professionals.
Parents received training either individually with their child or in groups with other parents. In the majority of the studies, the
interventions aimed to help parents be more observant and responsive during interactions with their child in order to help their child
develop communication skills.
In summary, the review finds sufficient evidence that the ways in which parents interacted with their children did change as intended.
The review also suggests improvement in child outcomes such as understanding of language and severity of autism characteristics as
a result of interventions delivered by parents. However, important outcomes such as other aspects of children’s language, children’s adaptive skills and parent stress did not show change. The evidence is not yet strong for any outcome and would benefit from researchers
measuring effects in the same ways.