Early intervention delivered by parents to young children with autism spectrum disorder

Diggle TT J, McConachie HH R

Published Online:

January 21, 2009

Children with autism spectrum disorder pose significant challenges within families. The involvement of parents in implementing intervention strategies designed to help their autistic children has a long history and is an approach used widely in current practiceFindings of the review are based on only two studies of sufficient quality and are therefore limited. There is some evidence to suggest that parent training may provide benefits to both children and parents. However, large-scale randomised controlled trials are needed, to involve both short and long-term outcome information, to evaluate for which children parent-mediated early intervention may be most beneficial, and to include economic evaluations.

Abstract (click to read)

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 until January 2002.. 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.

Authors' 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.

This record should be cited as:

Diggle TT J, McConachie HH R. Parent-mediated early intervention for young children with autism spectrum disorder. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003496. DOI: 10.1002/14651858.CD003496

Assessed as up to date:

January 29, 2002

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Primary Review Group:

Developmental, Psychosocial and Learning Problems Group

Health topics:

Developmental, psychosocial, and learning problems > Developmental problems > Autistic spectrum disorder

Demographic:

Children

Cochrane group topics:

Developmental, Psychosocial and Learning Problems > DEVELOPMENTAL PROBLEMS > AUTISTIC SPECTRUM DISORDER > Autism