Effects of Parent Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis

Published in the Journal of Autism and Developmental Disorders in 20222.

Authors Wai Man Cheng, Timothy B. Smith, Marshall Butler, Tina M. Taylor, and Devan Clayton from Brigham Young University.




The article is a meta-analysis, which means it combines and analyzes the results of multiple previous studies on the same topic. The topic of this meta-analysis is parent-implemented interventions (PIIs) for children with autism spectrum disorder (ASD). PIIs are interventions that train and support parents to deliver evidence-based practices to their children with ASD at home or in natural settings. The authors wanted to evaluate the effectiveness of PIIs on various outcomes for children with ASD, such as positive behavior, social skills, language, communication, adaptive behavior, life skills, and maladaptive behavior. They also wanted to examine if the effectiveness of PIIs was influenced by different factors, such as the quality of the studies, the type of intervention, the age of the children, the severity of ASD, and the duration and intensity of the intervention.




The authors searched for randomized controlled trials (RCTs) that compared PIIs with control conditions (such as no intervention, treatment as usual, or alternative interventions) for children with ASD aged 0 to 18 years. They found 51 RCTs that met their inclusion criteria, involving a total of 2,637 children with ASD and their parents. They extracted the effect sizes of the PIIs on the different outcomes and calculated the average effect size across all studies. They also performed subgroup analyses and meta-regression to test for potential moderators of the effect size.




  • PIIs had a moderately strong overall effect on the outcomes of children with ASD (g = 0.553), meaning that children who received PIIs performed better than children who did not receive PIIs on average.
  • The effect of PIIs was similar for parent and observer ratings of the outcomes, indicating that the improvements were observable and not biased by parental expectations or satisfaction.
  • The effect of PIIs was similar for different domains of outcomes, such as positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and adaptive behavior/life skills (g = 0.239). This suggests that PIIs can improve multiple aspects of functioning and development for children with ASD.
  • The effect of PIIs was not moderated by any of the study, intervention, or participant characteristics that the authors tested, such as the quality of the studies, the type of intervention, the age of the children, the severity of ASD, and the duration and intensity of the intervention. This implies that PIIs are effective across a variety of circumstances and can be tailored to the individual needs and preferences of each family.
  • The effect of PIIs was lower for studies that had a lower risk of research bias (g = 0.47) than for studies that had a higher risk of research bias (g = 0.64). This indicates that some of the studies may have overestimated the effect of PIIs due to methodological limitations, such as lack of blinding, randomization, or allocation concealment.




The authors concluded that PIIs are a promising and feasible way to support children with ASD and their families, especially in contexts where access to professional services is limited or unavailable. They recommended that future research should address the limitations of the existing studies, such as improving the quality and reporting of the RCTs, using standardized and validated outcome measures, and exploring the mechanisms and mediators of the effect of PIIs. They also suggested that future research should examine the long-term effects of PIIs, the cost-effectiveness of PIIs, and the factors that influence the implementation and sustainability of PIIs in real-world settings.



Q1. What is the article about?


Ans. The article is a meta-analysis that evaluates the effects of parent-implemented interventions (PIIs) on children with autism spectrum disorder (ASD) .


Q2. What is the conclusion of the meta-analysis?


Ans. The meta-analysis found that PIIs are effective in improving outcomes for children with ASD. The study also identified several moderators that did not significantly affect the effectiveness of PIIs .


Q3. What are some of the moderators that were evaluated in the study?


Ans. The study evaluated several moderators, including indicators of research quality, parent and observer ratings, and indicators of child characteristics .


Q4. What are some of the benefits of PIIs?


Ans. PIIs have been shown to improve positive behavior/social skills, language/communication, maladaptive behavior, and adaptive behavior/life skills in children with ASD .


Q5. What are some of the challenges faced by families with children with ASD?


Ans. Obtaining intensive intervention for children with ASD can prove challenging for many parents due to costs, limitations of time, travel distance, access to appropriate services, long waitlists, and lack of insurance coverage .




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