Abstract
Background
Self-directed web-based parent-mediated intervention programs may help counter some barriers associated with access to evidence-based practices.
Methods
The current study is a systematic review of 14 studies that included parent-mediated intervention programs for children with Autism Spectrum Disorder (ASD), reported on child outcomes, and included a self-directed, web-based component.
Results
Online interventions with self-directed components were efficacious in increasing parent fidelity, child social-communication behaviors, adaptive behaviors, and decreasing anxiety. Studies reviewed were of moderate to high quality and varied in experimental design, inclusion of representative samples, and fidelity reporting.
Conclusions
Web-based parent-mediated interventions are establishing a promising evidence-base in the literature and may expand access to evidence-based treatment for autistic children. Future research in this area calls for additional investigation on the effect of coaching, implementation with community samples, instructional design features, and use of multimodal outcome measures.
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References
Anagnostou, E., Jones, N., Huerta, M., Halladay, A. K., Wang, P., Scahill, L., & Dawson, G. (2015). Measuring social communication behaviors as a treatment endpoint in individuals with autism spectrum disorder. Autism, 19(5), 622–636. https://doi.org/10.1177/1362361314542955
Bearss, K., Burrell, T. L., Stewart, L., & Scahill, L. (2015). Parent training in autism spectrum disorder: What’s in a name? Clinical Child and Family Psychology Review, 18(2), 170–182.
Breitenstein, S. M., Gross, D., & Christophersen, R. (2014). Digital delivery methods of parenting training interventions: A systematic review. Worldviews on Evidence-Based Nursing, 11(3), 168–176. https://doi.org/10.1111/wvn.12040
Cohen, S., Conduit, R., Lockley, S. W., Rajaratnam, S. M. W., & Cornish, K. M. (2014). The relationship between sleep and behavior in autism spectrum disorder (ASD): A review. Journal of Neurodevelopmental Disorders, 6(1), 44. https://doi.org/10.1186/1866-1955-6-44
Conaughton, R. J., Donovan, C. L., & March, S. (2017). Efficacy of an internet-based CBT program for children with comorbid High Functioning Autism Spectrum Disorder and anxiety: A randomised controlled trial. Journal of Affective Disorders, 218, 260–268. https://doi.org/10.1016/j.jad.2017.04.032
Cotter, A. M., & Brestan-Knight, E. (2020). Convergence of Parent Report and Child Behavior using the Dyadic Parent-Child Interaction Coding System (DPICS). Journal of Child and Family Studies, 29(11), 3287–3301. https://doi.org/10.1007/s10826-020-01813-2
Di Pietro, N. C., Whiteley, L., & Illes, J. (2012). Treatments and services for neurodevelopmental disorders on advocacy websites: Information or evaluation? Neuroethics, 5, 197–209. https://doi.org/10.1007/s12152-011-9102-z
Douglas, S. N., Kammes, R., & Nordquist, E. (2018). Online communication training for parents of children with Autism Spectrum Disorder. Communication Disorders Quarterly, 39(3), 415–425. https://doi.org/10.1177/1525740117727491
Eames, C., Daley, D., Hutchings, J., Whitaker, C. J., Jones, K., Hughes, J. C., & Bywater, T. (2009). Treatment fidelity as a predictor of behaviour change in parents attending group-based parent training. Child: Care, Health and Development, 35(5), 603–612. https://doi.org/10.1111/j.1365-2214.2009.00975.x
Federico, A., Shi, D., & Bradshaw, J. (2021). Agreement between parental report and clinician observation of infant developmental skills. Frontiers in Psychology, 12, 734341. https://doi.org/10.3389/fpsyg.2021.734341
Fuller, E. A., & Kaiser, A. P. (2020). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of Autism and Developmental Disorders, 50(5), 1683–1700. https://doi.org/10.1007/s10803-019-03927-z
Gibson, A. N., Kaplan, S., & Vardell, E. (2017). A survey of information source preferences of parents of individuals with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(7), 2189–2204. https://doi.org/10.1007/s10803-017-3127-z
Grant, N., Rodger, S., & Hoffmann, T. (2015). Evaluation of autism-related health information on the web. Journal of Applied Research in Intellectual Disabilities, 28(4), 276–282. https://doi.org/10.1111/jar.12127
Hall, C. M., Culler, E. D., & Frank-Webb, A. (2016). Online dissemination of resources and services for parents of children with autism spectrum disorders (ASDs): A systematic review of evidence. Review Journal of Autism and Developmental Disorders, 3(4), 273–285. https://doi.org/10.1007/s40489-016-0083-z
Healy, S., & Marchand, G. (2020). The feasibility of Project CHASE: A Facebook-delivered, parent-mediated physical activity intervention for children with Autism. International Journal of Disability, Development and Education, 67(2), 225–242. https://doi.org/10.1080/1034912X.2019.1597968
Hume, K., Bellini, S., & Pratt, C. (2005). The usage and perceived outcomes of early intervention and early childhood programs for young children with autism spectrum disorder. Topics in Early Childhood Special Education, 25(4), 195–207. https://doi.org/10.1117/02711214050250040101
Ibañez, L. V., Kobak, K., Swanson, A., Wallace, L., Warren, Z., Stone, W. L., & Stone, W. L. (2018). Enhancing interactions during daily routines: A randomized controlled trial of a web-based tutorial for parents of young children with ASD. Autism Research, 11(4), 667–678. https://doi.org/10.1002/aur.1919
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of Autism and Developmental Disorders, 36(4), 487–505. https://doi.org/10.1007/s10803-006-0089-y
Ingersoll, B., Wainer, A. L., Berger, N. I., Pickard, K. E., & Bonter, N. (2016). Comparison of a Self-Directed and Therapist-Assisted Telehealth Parent-Mediated Intervention for Children with ASD: A Pilot RCT. Journal of Autism and Developmental Disorders, 46(7), 2275–2284. https://doi.org/10.1007/s10803-016-2755-z
Kaminski, J. W., Valle, L. A., Filene, J. H., & Boyle, C. L. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 36(4), 567–589. https://doi.org/10.1007/s10802-007-9201-9
Karst, J. S., & Van Hecke, A. V. (2012). Parent and family impact of autism spectrum disorders: A review and proposed model for intervention evaluation. Clinical Child and Family Psychology Review, 15(3), 247–277. https://doi.org/10.1007/s10567-012-0119-6
Knapp, C., Madden, V., Wang, H., Sloyer, P., & Shenkman, E. (2011). Internet use and eHealth literacy of low-income parents whose children have special health care needs. Journal of Medical Internet Research, 13(3):e75. https://doi.org/10.2196/jmir.1697
Knutsen, J., Wolfe, A., Burke, B. L., Hepburn, S., Lindgren, S., & Coury, D. (2016). A systematic review of telemedicine in Autism Spectrum Disorders. Review Journal of Autism and Developmental Disorders, 3(4), 330–344. https://doi.org/10.1007/s40489-016-0086-9
Kratochwill, T. R., Hitchcock, J. H., Horner, R. H., Levin, J. R., Odom, S. L., Rindskopf, D. M., & Shadish, W. R. (2013). Single-Case Intervention Research Design Standards. Remedial and Special Education, 34(1), 26–38. https://doi.org/10.1177/0741932512452794
Law, G. C., Neihart, M., & Dutt, A. (2018). The use of behavior modeling training in a mobile app parent training program to improve functional communication of young children with autism spectrum disorder. Autism, 22(4), 424–439. https://doi.org/10.1177/1362361316683887
Liptak, G. S., Benzoni, L. B., Mruzek, D. W., Nolan, K. W., Thingvoll, M. A., Wade, C. M., & Fryer, G. E. (2008). Disparities in diagnosis and access to health services for children with autism: Data from the National Survey of Children’s Health. Journal of Developmental and Behavioral Pediatrics, 29(3), 152–160. https://doi.org/10.1097/DBP.0b013e318165c7a0
Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M., Charman, T., Dawson, G., Durand, V. M., Grossman, L., Guthrie, D., Harris, S., Kasari, C., Marcus, L., Murphy, S., Odom, S., Pickles, A., Scahill, L., Shaw, E., Siegel, B., & Yoder, P. (2005). Challenges in evaluating psychosocial interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), 695–708. https://doi.org/10.1007/s10803-005-0017-6
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.
Maenner, M. J., Shaw, K. A., & Baio, J. (2020). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveillance Summaries, 69(4), 1–12. https://doi.org/10.15585/mmwr.ss6904a1
McGarry, E., Vernon, T., & Baktha, A. (2020). Brief report: a pilot online pivotal response treatment training program for parents of toddlers with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(9), 3424–3431. https://doi.org/10.1007/s10803-019-04100-2
McIntyre, L. L., & Phaneuf, L. (2008). A three-tier model of parent education in early childhood: Applying a problem-solving model. Topics in Early Childhood Special Education, 27(4), 214–222. https://doi.org/10.1177/0271121407311239
Miller, L. E., Perkins, K. A., Dai, Y. G., & Fein, D. A. (2017). Comparison of parent report and direct assessment of child skills in toddlers. Research in Autism Spectrum Disorders, 41, 57–65. https://doi.org/10.1016/j.rasd.2017.08.002
Mohr, D. C., Duffecy, J., Ho, J., Kwasny, M., Cai, X., Burns, M. N., & Begale, M. (2013). A randomized controlled trial evaluating a manualized TeleCoaching protocol for improving adherence to a web-based intervention for the treatment of depression. PLoS ONE, 8(8), e70086. https://doi.org/10.1371/journal.pone.0070086
Montes, G., Halterman, J. S., & Magyar, C. I. (2009). Access to and satisfaction with school and community health services for US children with ASD. Pediatrics, 124(Supplement 4), S407–S413. https://doi.org/10.1542/peds.2009-1255L
Murphy, M. A., & Ruble, L. A. (2012). A comparative study of rurality and urbanicity on access to and satisfaction with services for children with autism spectrum disorders. Rural Special Education Quarterly, 31(3), 3–11. https://doi.org/10.1177/875687051203100302
Nevill, R. E., Lecavalier, L., & Stratis, E. A. (2016). Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism, 22(2), 84–98. https://doi.org/10.1177/1362361316677838
Nieuwboer, C. C., Fukkink, R. G., & Hermanns, J. M. (2013). Online programs as tools to improve parenting: A meta-analytic review. Children and Youth Services Review, 35(11), 1823–1829. https://doi.org/10.1016/j.childyouth.2013.08.008
Parsons, D., Cordier, R., Vaz, S., & Lee, H. C. (2017). Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: Systematic review. Journal of Medical Internet Research, 19(8), e6651. https://doi.org/10.2196/jmir.6651
Pew Research Center. (2019). Mobile Technology and Home Broadband 2019. Retrieved from https://www.pewinternet.org/2019/06/13/mobile-technology-and-home-broadband-2019/
Pickard, K. E., Kilgore, A. N., & Ingersoll, B. R. (2016). Using community partnerships to better understand the barriers to using an evidence-based, parent-mediated intervention for autism spectrum disorder in a medicaid system. American Journal of Community Psychology, 57(3–4), 391–403. https://doi.org/10.1002/ajcp.12050
Pickard, K., Rowless, S., & Ingersoll, B. (2019). Understanding the impact of adaptations to a parent-mediated intervention on parents’ ratings of perceived barriers, program attributes, and intent to use. Autism, 23(2), 338–349. https://doi.org/10.1177/1362361317744078
Płatos, M., & Wojaczek, K. (2018). Broadening the scope of peer-mediated intervention for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 48(3), 747–750. https://doi.org/10.1007/s10803-017-3429-1
PracticeWise (2021). Blue menu of evidence-based psychosocial interventions for youth. (2021, March). Retrieved from https://www.practicewise.com/Community/BlueMenu
Ratliff-Black, M., & Therrien, W. (2020). Parent-mediated interventions for school-age children with ASD: A meta-analysis. Focus on Autism and Other Developmental Disabilities, 36(1), 3–13. https://doi.org/10.1177/1088357620956904
Reichow, B. (2011). Development, procedures, and application of the evaluative method for determining evidence-based practices in autism. In Evidence-based practices and treatments for children with autism (pp. 25–39). Springer.
Rieth, S. R., Haine-Schlagel, R., Burgeson, M., Searcy, K., Dickson, K. S., & Stahmer, A. C. (2018). Integrating a parent-implemented blend of developmental and behavioral intervention strategies into speech-language treatment for toddlers at risk for autism spectrum disorder. Seminars in Speech and Language, 39(2), 114–124.
Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. Guilford Publications.
Rush, D. D., & Shelden, M. L. (2011). The early childhood coaching handbook. Brookes Publishing Company.
Safer-Lichtenstein, J., Hamilton, J., & McIntyre, L. L. (2019). Examining demographics in randomized control trials of group social skills interventions for individuals with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(8), 3453–3461. https://doi.org/10.1007/s10803-019-04063-4
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428. https://doi.org/10.1007/s10803-015-2407-8
Sone, B. J., Lee, J., & Roberts, M. Y. (2021). Comparing instructional approaches in caregiver-implemented intervention: An interdisciplinary systematic review and meta-analysis. Journal of Early Intervention. 43(4) 339–360. https://doi.org/10.1177/1053815121989807
Stuckey, R., & Domingues-Montanari, S. (2017). Telemedicine is helping the parents of children with neurodevelopmental disorders living in remote and deprived areas. Paediatrics and International Child Health, 37(3), 155–157. https://doi.org/10.1080/20469047.2017.1315914
Sutherland, R., Trembath, D., & Roberts, J. (2018). Telehealth and autism: A systematic search and review of the literature. International Journal of Speech-Language Pathology, 20(3), 324–336. https://doi.org/10.1080/17549507.2018.1465123
Tager-Flusberg, H., Rogers, S., Cooper, J., Landa, R., Lord, C., Paul, R., Rice, M., Stoel-Gammon, C., Wetherby, A., & Yoder, P. (2009). Defining spoken language benchmarks and selecting measures of expressive language development for young children with autism spectrum disorders. Journal of Speech, Language, and Hearing Research : JSLHR, 52(3), 643. https://doi.org/10.1044/1092-4388(2009/08-0136)
Thomas, H., Ciliska, D., & Dobbins, M. (2003). Quality assessment tool for quantitative studies. Effective Public Health Practice Project McMaster University.
Thomas, K. C., Morrissey, J. P., & McLaurin, C. (2007). Use of autism-related services by families and children. Journal of Autism and Developmental Disorders, 37(5), 818–829.
Tomeny, K. R., McWilliam, R. A., & Tomeny, T. S. (2019). Caregiver-implemented intervention for young children with autism spectrum disorder: A systematic review of coaching components. Review Journal of Autism and Developmental Disorders, 7(2), 168–181. https://doi.org/10.1007/s40489-019-00186-7
Turgeon, S., Lanovaz, M. J., & Dufour, M. M. (2021). Effects of an interactive web training to support parents in reducing challenging behaviors in children with autism. Behavior Modification 45(5), 1–28. https://doi.org/10.1177/0145445520915671
Vismara, L. A., McCormick, C., Young, G. S., Nadhan, A., & Monlux, K. (2013). Preliminary findings of a telehealth approach to parent training in autism. Journal of Autism and Developmental Disorders, 43(12), 2953–2969. https://doi.org/10.1007/s10803-013-1841-8
Vismara, L. A., McCormick, C. E. B., Wagner, A. L., Monlux, K., Nadhan, A., & Young, G. S. (2018). Telehealth parent training in the Early Start Denver Model: Results from a randomized controlled study. Focus on Autism and Other Developmental Disabilities, 33(2), 67–79. https://doi.org/10.1177/1088357616651064
Wainer, A. L., & Ingersoll, B. R. (2013). Disseminating ASD interventions: A pilot study of a distance learning program for parents and professionals. Journal of Autism and Developmental Disorders, 43(1), 11–24. https://doi.org/10.1007/s10803-012-1538-4
Wainer, A. L., & Ingersoll, B. R. (2015). Increasing access to an ASD imitation intervention via a telehealth parent training program. Journal of Autism and Developmental Disorders, 45(12), 3877–3890. https://doi.org/10.1007/s10803-014-2186-7
Waligórska, A., Pisula, E., Waligórski, M., & Letachowicz, M. (2012). AutismPro system in supporting treatment of children with autism in Poland. Pediatrics International, 54(5), 693–700. https://doi.org/10.1111/j.1442-200X.2012.03637.x
Ward-Horner, J., & Sturmey, P. (2010). Component analyses using single-subject experimental designs: A review. Journal of Applied Behavior Analysis, 43(4), 685–704. https://doi.org/10.1901/jaba.2010.43-685
Whalley, B., & Hyland, M. E. (2013). Placebo by proxy: The effect of parents’ beliefs on therapy for children’s temper tantrums. Journal of Behavioral Medicine, 36(4), 341–346.
Whitehouse, A. J. O., Granich, J., Alvares, G., Busacca, M., Cooper, M. N., Dass, A., & Anderson, A. (2017). A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism Spectrum Disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 58(9), 1042–1052. https://doi.org/10.1111/jcpp.12752
Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Journal of Consulting and Clinical Psychology, 74(3), 426. https://doi.org/10.1037/0022-006X.74.3.426
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A version of this paper was presented at the International Society for Autism Research Conference in 2019.
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EG conceived/designed the study, conducted database searches, oversaw data collection, conducted the literature review, and drafted and edited the manuscript. AT, HR, and SA were involved in data collection and drafting the manuscript. LLM participated in study design and revision of the final manuscript. All authors read and approved the final manuscript.
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Glenn, E., Taiwo, A., Arbuckle, S. et al. Self-Directed Web-Based Parent-Mediated Interventions for Autistic Children: A systematic review. Rev J Autism Dev Disord 10, 505–522 (2023). https://doi.org/10.1007/s40489-022-00307-9
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DOI: https://doi.org/10.1007/s40489-022-00307-9