Effectiveness of early parent-mediated autism interventions in improving parent-child interaction: A systematic review and brief meta-analysis

The current systematic review and brief meta-analysis investigates the effects of parent-mediated autism interventions on different types of parent-child interaction (PCI) outcomes, specifically responsive interaction style, dialogue participation, and purpose of communicative acts. A systematic literature search was conducted and studies had to meet the following inclusion criteria: (a) age of the children ranged between 1 and 6 years old, (b) children had a confirmed diagnosis of autism spectrum disorder (c) interventions were delivered directly by the parent or the main caregiver, (d) quantitative assessment of PCI outcome (e.g., joint engagement, responsiveness, parental communication, sensitivity) was reported both preceding and following the intervention, (e) the study design was a randomized trial in which participants were randomly assigned to a treatment or control group (i.e., active control or treatment-as-usual). 20 studies reporting 30 independent effect sizes conducted between the years 2000 and 2022 were included in the final analyses. The synthesis of the results suggested positive, medium to large effects for the impact of parent-mediated autism interventions on the PCI outcomes. Furthermore, moderating effects of training dosage and type of control group were found. Future randomized controlled trials focusing on PCI outcomes should be conducted to further demonstrate how PCI can be characterized and targeted. Such studies would have implications on specific dimensions to be focused during parent-mediated interventions. Keywords: autism spectrum disorder, parent-child interaction, responsiveness, childinitiations, shared attention, social-communicative acts