Parent-Mediated Interventions for ASD Under 3 Years: A Systematic Review, Meta Analysis, and Moderator Analyses

Journal of Autism and Developmental Disorders

Zhao, X., Kuo, F., et al. (2025).

Journal of Autism and Developmental Disorders, Advance online publication. https://doi.org/10.1007/s10803-025-06845-5.

<div>This systematic review, meta-analysis, and moderator analysis explores the effects of parent-mediated interventions for children with autism under the age of three.&nbsp;</div>

None declared

2000 to April 30, 2024

<div>Randomized controlled trials (RCTs) and quasi-experimental pilot RCTs</div>

31 (26 in meta-analysis)

<div>Parent-mediated interventions had a small, positive effect for children under the age of three on the autism spectrum (<em>g&nbsp;</em>= 0.20). Overall there was low to moderate quality of evidence to support the use of parent-mediated interventions in this population. Specific findings include:</div> <div> <ul> <li>Overall, there were small, significant effects on adaptive skills (<em>g&nbsp;</em>= 0.29), parent-child interaction (<em>g&nbsp;</em>= 0.35), parent responsiveness (<em>g&nbsp;</em>= 0.23), and autism symptoms (<em>g&nbsp;</em>= -0.22).</li> <li>Overall, there was a trivial, significant effect on social communication (<em>g&nbsp;</em>= 0.18) and no significant effect on cognitive function, language, or motor skills.</li> <li>Naturalistic Developmental Behavioral Interventions showed a larger effect size than developmental interventions (<em>g&nbsp;</em>= 0.23 versus 0.16).</li> <li>There were no significant differences in effects for home-based interventions versus home + clinic interventions (<em>g&nbsp;</em>= 0.22 versus 0.10) or face-to-face alone versus face-to-face + online (<em>g&nbsp;</em>= 0.23 versus 0.11).</li> <li>There was no significant difference between outcomes immediately post-intervention and at follow-up, suggesting maintenance.&nbsp;</li> </ul> <div>Limitations to this review include serious risk of bias, heterogeneity between studies, strong publication bias in the area of social communication, and inclusion of studies with reduced methodological rigor.&nbsp;</div> </div>