A Parent-Mediated Telehealth Program for Children with Autism Spectrum Disorder : Promoting Parents' Ability to Stimulate the Children's Learning, Reduce Parenting Stress, and Boost Their Sense of Parenting Empowerment.

There was no control group, so natural maturation, regression to the mean, attention from therapists, or other services could explain the changes. Only 23 of the 27 families completed the program, and the pre-post analyses used those 23 families. The sample was small and came from one public autism center in southern Italy, so results may not apply to other settings or families. Parents were mostly mothers, and children were toddlers aged 27 to 53 months with mean mental age 24.0 months, so the study says little about older children or other caregivers. Parent stress and empowerment were self-reported, and parent teaching ability was rated by therapists using a study-created 10-item tool, so measurement error is possible. The paper does not report whether the therapists rating videos were blinded to the time point or to treatment details. The program combined many components, including telehealth, therapist coaching, video lessons, home visits, support groups and chat, so the contribution of any single component cannot be separated.

The study was funded by Azienda Sanitaria Provinciale di Trapani. No other conflicts of interest are reported in the supplied text.

Do not read the pre-post improvements as proof that the telehealth program caused them. The study had no control group, only 23 of 27 families completed, and the families received several supports together, including therapist modeling in clinic and home, synchronous video coaching, asynchronous recorded sessions, therapist feedback, video lessons, monthly support groups and chat with an autism expert.