Parent-mediated Training: A Randomized Control Trial for Interventions for Chinese Parent of Child with Autism Spectrum Disorder

Globally, the prevalence of Autism Spectrum Disorder (ASD) has shown an increasing trend. From year 2000 to 2022, yielding a prevalence of individuals who diagnosed with ASD from 1 in 132 to 1 in 31. ASD is a neurodevelopmental disorder that manifest in two domains: (1) deficit in social communication, (2) repetitive patterns of behaviour and restricted interest; the symptoms in each domain are presented in early developmental period. For deficit in social communication, the core symptoms commonly presented as difficult in emotional regulation, inappropriate response to other’s feeling and inability to joint play with peers. For repetitive pattern of behaviour and restricted interest, the core symptoms commonly presented as strong preference to highly specific routines, hyper-sensitivities or unusual reaction to stimuli and mannerism. These symptoms can be identified at toddlerhood to early childhood. In order to improve the core symptoms on children with ASD, parents are the main caregivers that can learn the implementation of effective interventions onto the child who are required parental support, and at the same time maintaining the mental well-being while caregiving a child with behavioural problems and deficit in social communication. Parent-mediated intervention is a behavioural approach focuses on imitation and play that aims to improve social communication and joint attention in children with ASD Previous research studies consistently indicated that parent-mediated interventions are beneficial for pre-schoolers with ASD, especially on the positive effect in the core symptoms of ASD in child. For the clinical needs, Hong Kong government provides subsidized public services for early diagnosis and treatment for autism children, however the coverage intervention was less than 25% and the average waiting time for public mental health service was 8-24 months due to the overwhelming demands. In Hong Kong public mental health service for child and adolescent, parenting training is provided by nurse clinic where supporting parents to learn desirable parental responses in manging challenging behaviours. Psychiatric nurses are function as a case coordinator to facilitate the family toward the treatment goal by using effective parent-mediated intervention. However, various types of parent-mediated training approach has resulted differently in treatment outcome in children with ASD, including some of the studies with insignificant improvement in challenging behaviour and social interaction. Parent-mediated intervention (PMI) aimed to improve the core symptoms of children with ASD and increase the confidence level among parent through generalization of the parenting skills in daily practice. Through capitalizing teachable moments, the family can improve mutual understanding and further enables their children to observe, learn and develops secured emotional bonds with parents under a more positive learning climate Previous research studies had focused on the clinical improvement in ASD core symptoms are tended to be child-centered interventions, however insignificant effect were commonly reported on young child. Parent-mediated interventions are regarded as one of the cost-effective public mental health services for children with ASD. In fact, various kinds of parent-mediated training approach for child with ASD had uncertainty of definition and training methods. Different treatment outcomes and effectiveness were reported in different approaches, in which reflecting a lack of the generalizability of specific treatment method for early parent-mediated training. In view of the clinical needs and literature review of previous studies, this study aims to conduct a pilot randomized control trial project of an effective parent-mediated training program that could improving the core symptoms of children with autism spectrum disorder.