A Systematic Review of the Role of Parent Characteristics in Parent-Mediated Interventions for Children with Autism Spectrum Disorder
- 57 Downloads
Parent-mediated interventions (PMI) are increasingly being used to target skill deficits in children with Autism Spectrum Disorder (ASD). Evidence documenting the benefits of PMI is accumulating, however, little is known about whether parent characteristics impact children’s treatment outcomes. We reviewed the PMI literature using PRISMA guidelines to address this gap. We identified 115 PMI studies published between 1987 and September 2018; of these, only 11 examined the contributions of baseline parent/caregiver characteristics on children’s outcomes. These studies vary widely in regard to the interventions employed and outcome measures explored. Early intervention programs were the most common form of treatment and stress was the most frequently targeted parent/caregiver characteristic. Results indicated that stress, socioeconomic status, and the broad autism phenotype may be related to children’s outcomes, with varying effects depending on the specific treatment and outcome examined. These results underscore the need for systematic research on the role of parent baseline characteristics in PMI. A deeper understanding of the relationship between parent/caregiver variables and child outcomes may inform treatment selection and elucidate key mechanisms of therapeutic change.
KeywordsAutism spectrum disorder Parent characteristics Parent-mediated intervention Parent stress
This study was partially funded by NIMH award to ADM (R01MH105506).
Compliance with Ethical Standards
This study did not involve human subjects.
Conflict of Interest
All authors declare that they have no conflict of interest.
- Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., & Murphy, M. M. (2004). Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome. Am J Ment Retard, 109(3), 237–254. https://doi.org/10.1352/0895-8017(2004)109<237:PWACIM>2.0.CO;2.
- Abidin, R. R. (1995). Parenting stress index (PSI) manual (3rd ed.). Charlottesville: Pediatric Psychology Press.Google Scholar
- American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3 rd ed., rev.). Washington, DC: Author.Google Scholar
- Baranek, G. T., Watson, L. R., Turner-Brown, L., Field, S. H., Crais, E. R., Wakeford, L., et al. (2015). Preliminary efficacy of adapted responsive teaching for infants at risk of autism spectrum disorder in a community sample. Autism Res Treat, 2015, 1–16. https://doi.org/10.1155/2015/386951.CrossRefGoogle Scholar
- Bayley, N. (1993). Bayley Scales of Infant Development. San Antonio, TX: The psychological corporation, Harcourt brace & company.Google Scholar
- Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. https://doi.org/10.1097/00004583-199910000-00011.CrossRefPubMedGoogle Scholar
- Bishop, D. V. M., Maybery, M., Wong, D., Maley, A., Hill, W., & Hallmayer, J. (2004). Are phonological processing deficits part of the broad autism phenotype? American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 128B(1), 54–60. https://doi.org/10.1002/ajmg.b.3003915211632.
- Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50, 184–198. https://doi.org/10.1111/j.1365-2788.2005.00768.x.CrossRefPubMedGoogle Scholar
- Bolton, P., Macdonald, H., Pickles, A., Rios, P., Goode, S., Crowson, M., Bailey, A., & Rutter, M. (1994). A case-control family history study of autism. Child Psychology & Psychiatry & Allied Disciplines, 35(5), 877–900. https://doi.org/10.1111/j.1469-7610.1994.tb02300.x7962246.
- Brookman-Frazee, L., Vismara, L., Drahota, A., Stahmer, A., & Openden, D. (2009). Parent training interventions for children with autism spectrum disorders. In Applied behavior analysis for children with autism spectrum disorders (pp. 237–257). New York, NY: Springer Science + Business Media.CrossRefGoogle Scholar
- Carr, T., Shih, W., Lawton, K., Lord, C., King, B., & Kasari, C. (2016). The relationship between treatment attendance, adherence, and outcome in a caregiver-mediated intervention for low-resourced families of young children with autism spectrum disorder. Autism, 20(6), 643–652. https://doi.org/10.1177/1362361315598634.CrossRefPubMedGoogle Scholar
- Cohen, S., Doyle, W. J., & Baum, A. (2006). Socioeconomic status is associated with stress hormones. Psychosomatic Medicine, 68(3), 414–420. https://doi.org/10.1097/01.psy.0000221236.37158.b916738073.CrossRefPubMedGoogle Scholar
- Crnic, K. A., & Greenberg, M. T. (1990). Minor parenting stresses with young children. Child Development, 61(5), 1628–1637. https://doi.org/10.1111/j.1467-8624.1990.tb02889.x.CrossRefPubMedGoogle Scholar
- Crockett, J. L., Fleming, R. K., Doepke, K. J., & Stevens, J. S. (2007). Parent training: Acquisition and generalization of discrete trials teaching skills with parents of children with autism. Research in Developmental Disabilities, 28(1), 23–36. https://doi.org/10.1016/j.ridd.2005.10.00316338118.CrossRefPubMedGoogle Scholar
- Estes, A., Olson, E., Sullivan, K., Greenson, J., Winter, J., Dawson, G., & Munson, J. (2013). Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain Dev, 35(2), 133–138. https://doi.org/10.1016/j.braindev.2012.10.004.CrossRefPubMedGoogle Scholar
- Factor, R. S., Swain, D. M., & Scarpa, A. (2018). Child autism spectrum disorder traits and parenting stress: The utility of using a physiological measure of parental stress. Journal of Autism and Developmental Disorders, 48(4), 1081–1091. https://doi.org/10.1007/s10803-017-3397-5.CrossRefPubMedGoogle Scholar
- Fenson, L., Dale, P. S., Reznick, J. S., Thal, D., Bates, E., Hartung, J. P., et al. (1993). MacArthur communicative development inventories (CDI). Baltimore, MD: Paul H. Brookes Publishing.Google Scholar
- Gantman, A., Kapp, S. K., Orenski, K., & Laugeson, E. A. (2012). Social skills training for young adults with high-functioning autism spectrum disorders: A randomized controlled pilot study. Journal of Autism and Developmental Disorders, 42(6), 1094–1103. https://doi.org/10.1007/s10803-011-1350-6.CrossRefPubMedGoogle Scholar
- Gau, S. S. F., Chou, M. C., Chiang, H. L., Lee, J. C., Wong, C. C., Chou, W. J., & Wu, Y. Y. (2012). Parental adjustment, marital relationship, and family function in families of children with autism. Research in Autism Spectrum Disorders, 6(1), 263–270. https://doi.org/10.1016/j.rasd.2011.05.007.CrossRefGoogle Scholar
- Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., le Couteur, A., Leadbitter, K., Hudry, K., Byford, S., Barrett, B., Temple, K., Macdonald, W., Pickles, A., & PACT Consortium. (2010). Parent-mediated communication-focused treatment for preschool children with autism (PACT); a randomised controlled trial. The Lancet, 375, 2152–2160. https://doi.org/10.1016/S0140-6736(10)60587-9.CrossRefGoogle Scholar
- Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(3), 629–642. https://doi.org/10.1007/s10803-012-1604-y22790429.CrossRefPubMedGoogle Scholar
- Ingersoll, B., & Dvortcsak, A. (2010). Teaching social communication to children with autism: A practitioner's guide to parent training. New York, NY: Guilford Press.Google Scholar
- Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620. https://doi.org/10.1111/j.1469-7610.2005.01567.x16712638.CrossRefPubMedGoogle Scholar
- Kasari, C., Gulsrud, A. C., Wong, C. C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056. https://doi.org/10.1007/s10803-010-0955-520145986.CrossRefPubMedPubMedCentralGoogle Scholar
- Kasari, C., Lawton, K., Shih, W., Barker, T. V., Landa, R., Lord, C., Orlich, F., Wetheby, A., & Senturk, D. (2014a). Caregiver-mediated intervention for low-resourced preschoolers with autism: An RCT. Pediatrics, 134(1), e72–e79. https://doi.org/10.1542/peds.2013-3229.CrossRefPubMedPubMedCentralGoogle Scholar
- Kasari, C., Siller, M., Huynh, L., Shih, W., Swanson, M., Hellemann, G., & Sugar, C. (2014b). Randomized controlled trial of parental responsivenss intervention for toddlers at high risk for autism. Infant Behavior and Development, 37, 711–721. https://doi.org/10.1016/j.infbeh.20.14.08.007.CrossRefPubMedGoogle Scholar
- Kazdin, A. E., & Weisz, J. R. (2003). Evidence-based psychotherapies for children and adolescents. New York, NY: Guilford Press.Google Scholar
- Koren-Karie, N., & Oppenheim, D. (1997). The insightfulness assessment coding manual. Center for Research in Child Development, University of Haifa. Haifa, Israel.Google Scholar
- Krug, D., Arick, J., & Almond, P. (1993). Autism screening instrument for educational planning. Austin, TX: Pro-Ed.Google Scholar
- Lafasakis, M., & Sturmey, P. (Eds.). (2007). Training parent implementation of discrete-trial teaching: Effects on generalization of parent teaching and child correct responding. Journal of Applied Behavior Analysis, 40(4), 685–689. https://doi.org/10.1901/jaba.2007.685-68918189100.
- Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2009). Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 596–606. https://doi.org/10.1007/s10803-008-0664-5.CrossRefPubMedGoogle Scholar
- Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (1999). Autism diagnostic observation schedule (ADOS). Los Angeles, CA: Western Psychological Services.Google Scholar
- Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., Dilavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. J of Autism Dev Disord, 30(3), 205–223. https://doi.org/10.1023/A:1005592401947.
- Losh, M., Adolphs, R., Poe, M. D., Couture, S., Penn, D., Baranek, G. T., & Piven, J. (2009). Neuropsychological profile of autism and the broad autism phenotype. Archives of General Psychiatry, 66(5), 518–526. https://doi.org/10.1001/archgenpsychiatry.2009.3419414711.CrossRefPubMedPubMedCentralGoogle Scholar
- Luiz, D., Barnard, A., Knoesen, N., Kotras, N., Horrocks, S., McAlinden, P., Challis, D. & O’Connell, R (2006). GMDS-ER 2–8—Griffith mental developmental scales-extended revised: 2 to 8 years. Hogrefe, Oxford: The Test Agency.Google Scholar
- Mahoney, G., & Macdonald, J. (2007). Autism and developmental delays in young children: The responsive teaching curriculum for parents and professionals. Austin: PRO-ED.Google Scholar
- Mahoney, G., & Solomon, R. (2016). Mechanism of developmental change in the PLAY project home consultation intervention program: Evidence from a randomized control trial. Journal of Autism and Developmental Disorders, 46(5), 1860–1871. https://doi.org/10.1007/s10803-016-2720-x26830414.CrossRefPubMedGoogle Scholar
- McGuire, J. & Richman, N. (1988). Preschool behaviour checklist handbook. Windsor, Berkshire: NFER-Nelson.Google Scholar
- Moes, D. (1995). Parent education and parenting stress. In R. L. Koegel & L. K. Koegel (Eds.), Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities (pp. 79–94). Baltimore, MD: Brookes.Google Scholar
- Mullen, E. M. (1995). Mullen scales of early learning. Circle pines, MN. American Guidance Service.Google Scholar
- National Research Council. (2001). Educating children with autism. Committee on educational interventions for children with autism, division of behavioral and social sciences and education. National Academy Press.Google Scholar
- Parr, J. R., Gray, L., Wigham, S., McConachie, H., & LeCouteur, A. (2015). Measuring the relationship between the parental broader autism phenotype, parent-child interaction, and children's progress following parent mediated intervention. Research in Autism Spectrum Disorders, 20, 24–30. https://doi.org/10.1016/j.rasd.2015.07.006.CrossRefGoogle Scholar
- Piven, J., Palmer, P., Landa, R., Santangelo, S., Jacobi, D., & Childress, D. (1997). Personality and language characteristics in parents from multiple-incidence autism families. American Journal of Medical Genetics, 74(4), 398–411. https://doi.org/10.1002/(SICI)1096-8628(19970725)74:4<398:AID-AJMG11>3.0.CO;2-D.CrossRefPubMedGoogle Scholar
- Reaven, J., Blakely-Smith, A., Zapapas, L., & Ridge, K. (2009). Cognitive behavioral group treatment for adolescents with high-functioning autism spectrum disorders and anxiety: A pilot study. The Journal of Psychological Practice, 15, 217–243. https://doi.org/10.1155/2012/423905.CrossRefGoogle Scholar
- Reaven, J., Blakeley-Smith, A., Nichols, S., & Hepburn, S. (2011). Facing your fears: Group therapy for managing anxiety in children with high-functioning autism spectrum disorders. Baltimore, MD: Brookes.Google Scholar
- Reaven, J., Washington, L., Moody, E. J., Stern, J. A., Hepburn, S. L., & Blakeley-Smith, A. (2015). Examining the relationship between parental anxiety and treatment response in children and adolescents with autism spectrum disorder and anxiety. Journal of Autism and Developmental Disorders, 45(8), 2464–2473. https://doi.org/10.1007/s10803-015-2410-025778837.CrossRefPubMedPubMedCentralGoogle Scholar
- Reed, P., Howse, J., Ho, B., & Osborne, L. A. (2017). Relationship between perceived limit-setting abilities, autism spectrum disorder severity, behaviour problems and parenting stress in mothers of children with autism spectrum disorder. Autism, 21(8), 952–959. https://doi.org/10.1177/1362361316658775.CrossRefPubMedGoogle Scholar
- Rickards, A. L., Walstab, J. E., Wright-Rossi, R. A., Simpson, J., & Reddihough, D. S. (2007). A randomized, controlled trial of a home-based intervention program for children with autism and developmental delay. Journal of Developmental and Behavioral Pediatrics, 28(4), 308–316. https://doi.org/10.1097/DBP.0b013e318032792e17700083.CrossRefPubMedGoogle Scholar
- Ruppert, T., Machalicek, W., Hansen, S. G., Raulston, T., & Frantz, R. (2016). Training parents to implement early interventions for children with autism spectrum disorders. In Early intervention for young children with autism spectrum disorder (pp. 219–256). Cham, Switzerland: Springer International Publishing.Google Scholar
- Siller, M., Hutman, T., & Sigman, M. (2013). A parent-mediated intervention to increase responsive parental behaviors and child communication in children with ASD: A randomized clinical trial. Journal of Autism and Developmental Disorders, 43(3), 540–555. https://doi.org/10.1007/s10803-012-1584-y.CrossRefPubMedPubMedCentralGoogle Scholar
- Silva, L. M. T., Schalock, M., & Gabrielsen, K. (2011). Early intervention for autism with a parent-delivered ongoing massage program: A randomized controlled trial. American Journal of Occupational Therapy, 65(5), 550–559. https://doi.org/10.5014/ajot.2011.00066122026323.CrossRefPubMedGoogle Scholar
- Smith, L. E., Hong, J., Seltzer, M. M., Greenberg, J. S., Almeida, D. M., & Bishop, S. L. (2010). Daily experiences among mothers of adolescents and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(2), 167–178. https://doi.org/10.1007/s10803-009-0844-y.CrossRefPubMedGoogle Scholar
- Sofronoff, K., Silva, J., & Beaumont, R. (2017). The secret agent society social-emotional skills program for children with a high-functioning autism spectrum disorder: A parent-directed trial. Focus on Autism and Other Developmental Disabilities, 32(1), 55–70. https://doi.org/10.1177/1088357615583467.CrossRefGoogle Scholar
- Sparrow, S., Balla, D., & Cicchetti, D. V. (1984). Vineland adaptive behavior scales – interview edition. Circle pines, MD. American Guidance Service.Google Scholar
- Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior scales. Circle Pines, MN: AGS Publishing.Google Scholar
- Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state–trait anxiety Inventory STAI (Form Y). Palo Alto, CA: Mind Garden.Google Scholar
- Stadnick, N. A., Drahota, A., & Brookman-Frazee, L. (2013). Parent perspectives of an evidence-based intervention for children with autism served in community mental health clinics. Journal of Child and Family Studies, 22(3), 414–422. https://doi.org/10.1007/s10826-012-9594-0.CrossRefPubMedGoogle Scholar
- Stadnick, N. A., Stahmer, A., & Brookman-Frazee, L. (2015). Preliminary effectiveness of project ImPACT: A parent-mediated intervention for children with autism spectrum disorder delivered in a community program. Journal of Autism and Developmental Disorders, 45(7), 2092–2104. https://doi.org/10.1007/s10803-015-2376-y25633920.CrossRefPubMedPubMedCentralGoogle Scholar
- Strauss, K., Vicari, S., Valeri, G., D'Elia, L., Arima, S., & Fava, L. (2012). Parent inclusion in early intensive behavioral intervention: The influence of parental stress, parent treatment fidelity and parent-mediated generalization of behavior targets on child outcomes. Research in Developmental Disabilities, 33(2), 688–703. https://doi.org/10.1016/j.ridd.2011.11.008.CrossRefPubMedGoogle Scholar
- Sussman, F. (1999). More than words: Helping parents promote communication and social skills in children with autism spectrum disorder. Toronto. In ON. Canada: The Hanen Centre.Google Scholar
- de Veld, D. M. J., Howlin, P., Hoddenbach, E., Mulder, F., Wolf, I., Koot, H. M., Lindauer, R., & Begeer, S. (2017). Moderating effects of parental characteristics on the effectiveness of a theory of mind training for children with autism: A randomized controlled trial. Journal of Autism and Developmental Disorders, 47(7), 1987–1997. https://doi.org/10.1007/s10803-017-3117-1.CrossRefPubMedPubMedCentralGoogle Scholar
- Wallace, K. S., & Rogers, S. J. (2010). Intervening in infancy: Implications for autism Spectrum disorders. Journal of Child Psychology and Psychiatry, 51(12), 1–30. https://doi.org/10.1111/j.1469-7610.2010.02308.x20868374.CrossRefGoogle Scholar
- Watson, L. R., Crais, E. R., Baranek, G. T., Turner-Brown, L., Sideris, J., Wakeford, L., et al. (2017). Parent-mediated intervention for one-year-olds screened as at-risk for autism spectrum disorder: A randomized controlled trial. Journal of Autism and Developmental Disorders, 47(11), 3520–3540. https://doi.org/10.1007/s10803-017-3268-0.CrossRefPubMedGoogle Scholar
- Wetherby, A. M., & Woods, J. (2008). Developmental approaches to treatment. In Autism spectrum disorders in infants and toddlers: Diagnosis, assessment, and treatment (pp. 170–206). New York, NY: Guilford Press.Google Scholar
- World Health Organization. (2016). Questions and answers about autism spectrum disorders (ASD). Retrieved from: http://www.who.int/features/qa/85/en/ (accessed 1 June 2016).