Leveraging technology to make parent training more accessible: Randomized trial of in-person versus online executive function training for parents of autistic children.

All outcomes were parent-reported. No blinded observer rated the child's executive function, and parents knew which training they received. This could inflate the apparent benefit. More than half of the children in both groups were receiving psychotherapy during the trial, and about half were on psychotropic medication. The improvement seen could partly or wholly reflect those concurrent treatments rather than the parent training. Effect sizes were small (0.27 to 0.42) for most outcomes. The one medium effect (parent strain, 0.66) is the most clinically meaningful finding. The sample was predominantly white, non-Latinx, with highly educated, mostly female parents and mostly male children. Results may not generalize to other families. Total training time was about 8 hours, which the authors describe as low-intensity. This is a brief program, not a comprehensive intervention. No measure of parent knowledge of executive function was collected, so the link between what parents learned and child outcomes could not be tested.

NIH extramural funding. One author (LK) receives financial compensation for the BRIEF, the instrument used to measure the child's executive function. Five authors (LC, LK, KA, MAW, LGA) receive financial compensation for the Unstuck and On Target manuals, which form the content of the training. The in-person sessions were led by two of the Unstuck authors (LK or MW).

Do not read the improvement in both groups as proof the training works. All outcomes were parent-reported with no blinded observer, more than half of the children were receiving psychotherapy during the trial, and about half were on psychotropic medication. The small gains could reflect time, the extra attention of being in a research study, or those concurrent treatments rather than the parent training itself.