Parent Coaching via Telehealth for Autism in Early Childhood: Examining Effectiveness, Feasibility and Cost-Effectiveness via a Randomised Controlled Trial

Background/Objectives: With rising autism prevalence, parent coaching has emerged as a useful model for teaching parents responsive strategies to support their child’s social communication and interaction skills within daily routines and play contexts. Telehealth parent coaching provides benefits of real-time guided generalisation in naturalistic environments as well as cost savings for families and providers. Methods: This randomised controlled trial examined whether parent coaching delivered via synchronous video conferencing was non-inferior to in-person sessions for improving the primary outcome of developmental skills in children with autism. 200 parent-child dyads were randomly assigned to receive 16 to 18 weekly parent coaching sessions based on naturalistic, relationship-focused intervention principles, delivered either through video conferencing (telerehabilitation arm) or in-person (standard arm). Results: Participants in both groups demonstrated comparable improvement in developmental skills, together with comparable changes in adaptive functioning, parent-child interaction, parental stress reduction and family quality of life. Conclusions: The findings of this study support video conferencing as a feasible and acceptable alternative platform for parent coaching while providing cost savings. However, given this study’s high attrition rate and the limited evidence base for telehealth parent coaching, additional research is needed to further validate the findings and parameters of use for optimal outcomes.