Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

There has been increasing interest in parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs). The objective of this systematic review and meta-analysis was to examine the effect of PMIs compared to no PMI for children with ASD aged 2–17 years. The primary outcome was...

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Autores principales:	Charlotte Engberg Conrad, Marie Louise Rimestad, Jeanett Friis Rohde, Birgitte Holm Petersen, Christoffer Bruun Korfitsen, Simon Tarp, Cathriona Cantio, Marlene Briciet Lauritsen, Mina Nicole Händel
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	autistic disorder autism spectrum disorder parent-mediated intervention caregiver-mediated intervention early intervention treatment outcome Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/65a41c6be89f4c398658a232dfa75e8e
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spelling	oai:doaj.org-article:65a41c6be89f4c398658a232dfa75e8e2021-11-12T05:19:24ZParent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis1664-064010.3389/fpsyt.2021.773604https://doaj.org/article/65a41c6be89f4c398658a232dfa75e8e2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.773604/fullhttps://doaj.org/toc/1664-0640There has been increasing interest in parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs). The objective of this systematic review and meta-analysis was to examine the effect of PMIs compared to no PMI for children with ASD aged 2–17 years. The primary outcome was adaptive functioning rated by a parent or clinician. The secondary outcomes were long-term adaptive functioning rated by the parents, adverse events, core symptoms of ASD, disruptive behavior, parental well-being, quality of life of the child rated by the parents and anxiety. The MEDLINE, PsycInfo, Embase, and CINAHL databases were searched in March 2020. The Cochrane Risk of Bias Tool was used to rate the individual studies, and the certainty in the evidence was evaluated using GRADE. We identified 30 relevant randomized controlled trials (RCTs), including 1,934 participants. A clinically relevant effect of PMIs on parent-rated adaptive functioning was found with a low certainty of evidence [Standard mean difference (SMD): 0.28 (95% CI: −0.01, 0.57)] on Vineland Adaptive Behavior Scales (VABS), whereas no clinically relevant effect was seen for clinician-rated functional level, with a very low certainty of evidence [SMD on Clinical Global Impressions (CGI)-severity scale: SMD −0.45 [95% CI: −0.87, −0.03)]. PMIs may slightly improve clinician-rated autism core symptoms [SMD: −0.35 (95% CI: −0.71, 0.02)]. Additionally, no effect of PMIs on parent-rated core symptoms of ASD, parental well-being or adverse effects was identified, all with a low certainty of evidence. There was a moderate certainty of evidence for a clinically relevant effect on disruptive behavior [SMD: 0.55 (95% Cl: 0.36, 0.74)]. The certainty in the evidence was downgraded due to serious risk of bias, lack of blinding, and serious risk of imprecision due to few participants included in meta-analyses. The present findings suggest that clinicians may consider introducing PMIs to children with ASD, but more high-quality RCTs are needed because the effects are not well-established, and the results are likely to change with future studies. The protocol for the systematic review is registered at the Danish Health Authority website (www.sst.dk).Charlotte Engberg ConradMarie Louise RimestadJeanett Friis RohdeJeanett Friis RohdeBirgitte Holm PetersenChristoffer Bruun KorfitsenSimon TarpSimon TarpCathriona CantioCathriona CantioMarlene Briciet LauritsenMina Nicole HändelMina Nicole HändelFrontiers Media S.A.articleautistic disorderautism spectrum disorderparent-mediated interventioncaregiver-mediated interventionearly interventiontreatment outcomePsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	autistic disorder autism spectrum disorder parent-mediated intervention caregiver-mediated intervention early intervention treatment outcome Psychiatry RC435-571
spellingShingle	autistic disorder autism spectrum disorder parent-mediated intervention caregiver-mediated intervention early intervention treatment outcome Psychiatry RC435-571 Charlotte Engberg Conrad Marie Louise Rimestad Jeanett Friis Rohde Jeanett Friis Rohde Birgitte Holm Petersen Christoffer Bruun Korfitsen Simon Tarp Simon Tarp Cathriona Cantio Cathriona Cantio Marlene Briciet Lauritsen Mina Nicole Händel Mina Nicole Händel Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
description	There has been increasing interest in parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs). The objective of this systematic review and meta-analysis was to examine the effect of PMIs compared to no PMI for children with ASD aged 2–17 years. The primary outcome was adaptive functioning rated by a parent or clinician. The secondary outcomes were long-term adaptive functioning rated by the parents, adverse events, core symptoms of ASD, disruptive behavior, parental well-being, quality of life of the child rated by the parents and anxiety. The MEDLINE, PsycInfo, Embase, and CINAHL databases were searched in March 2020. The Cochrane Risk of Bias Tool was used to rate the individual studies, and the certainty in the evidence was evaluated using GRADE. We identified 30 relevant randomized controlled trials (RCTs), including 1,934 participants. A clinically relevant effect of PMIs on parent-rated adaptive functioning was found with a low certainty of evidence [Standard mean difference (SMD): 0.28 (95% CI: −0.01, 0.57)] on Vineland Adaptive Behavior Scales (VABS), whereas no clinically relevant effect was seen for clinician-rated functional level, with a very low certainty of evidence [SMD on Clinical Global Impressions (CGI)-severity scale: SMD −0.45 [95% CI: −0.87, −0.03)]. PMIs may slightly improve clinician-rated autism core symptoms [SMD: −0.35 (95% CI: −0.71, 0.02)]. Additionally, no effect of PMIs on parent-rated core symptoms of ASD, parental well-being or adverse effects was identified, all with a low certainty of evidence. There was a moderate certainty of evidence for a clinically relevant effect on disruptive behavior [SMD: 0.55 (95% Cl: 0.36, 0.74)]. The certainty in the evidence was downgraded due to serious risk of bias, lack of blinding, and serious risk of imprecision due to few participants included in meta-analyses. The present findings suggest that clinicians may consider introducing PMIs to children with ASD, but more high-quality RCTs are needed because the effects are not well-established, and the results are likely to change with future studies. The protocol for the systematic review is registered at the Danish Health Authority website (www.sst.dk).
format	article
author	Charlotte Engberg Conrad Marie Louise Rimestad Jeanett Friis Rohde Jeanett Friis Rohde Birgitte Holm Petersen Christoffer Bruun Korfitsen Simon Tarp Simon Tarp Cathriona Cantio Cathriona Cantio Marlene Briciet Lauritsen Mina Nicole Händel Mina Nicole Händel
author_facet	Charlotte Engberg Conrad Marie Louise Rimestad Jeanett Friis Rohde Jeanett Friis Rohde Birgitte Holm Petersen Christoffer Bruun Korfitsen Simon Tarp Simon Tarp Cathriona Cantio Cathriona Cantio Marlene Briciet Lauritsen Mina Nicole Händel Mina Nicole Händel
author_sort	Charlotte Engberg Conrad
title	Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
title_short	Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
title_full	Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
title_fullStr	Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
title_full_unstemmed	Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
title_sort	parent-mediated interventions for children and adolescents with autism spectrum disorders: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/65a41c6be89f4c398658a232dfa75e8e
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Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

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