Meta-AnalysisDevelopmental medicine and child neurology2023

Psychological interventions targeting mental health and the mother-child relationship in autism: Systematic review and meta-analysis.

Kavindri Kulasinghe, Koa Whittingham, Amy E Mitchell and 1 others

PMID 36208472

WHAT IT FOUND

Parent-mediated programmes for mothers of young children with autism reduce parenting stress but do not improve maternal depression or general mental health.

Parent-child interaction also improved, but the evidence is low certainty and the 32 interventions are all different.

Key findings

01Across 16 randomised trials, parent-mediated psychological interventions reduced parenting stress (Z = 4.64, p < 0.001; 95% CI −0.46 to −0.19). The authors rate this moderate certainty.

02The same interventions did not reduce maternal depressive symptoms (Z = 1.49, p = 0.14) or improve general mental health (Z = 1.96, p = 0.05). The authors rate the general-mental-health finding as high certainty and the depression finding as low certainty.

03Parent responsiveness (Z = 5.05, p < 0.001) and child initiation (Z = 3.72, p < 0.001) both improved, but the authors rate both as low certainty because the 32 interventions and 32 outcome measures are all different from each other.

STILL TO COME

How it was doneWhat they found

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

32 different interventions and 32 different outcome measures make it impossible to identify which approach works or what the active ingredient is High risk of bias in several studies, including deviation from the intended intervention, missing outcome data, and selection of the reported result Low certainty of evidence for the depression and parent-responsiveness outcomes No established evidence-based psychological therapies (cognitive behavioural therapy, mindfulness-based treatments, acceptance and commitment therapy) were tested in any of the included trials Only English-language publications were included; grey literature was not examined No studies from low- and middle-income countries, despite the majority of young children with autism living in those settings Only one author conducted the risk-of-bias assessment and assigned GRADE ratings Sensitivity analysis showed the parental directiveness effect was likely inflated by high-risk studies

Declared interests

Most of the included studies (28 of 32) were funded by grants, research awards, autism institutions, or universities. A few were unfunded. Most papers reported that the funding institutions did not influence study methodology, data analysis, or reporting. No industry funding is mentioned.

The easy way to misread this

Do not read the significant parenting-stress result as evidence that these programmes treat maternal depression. The depression and general-mental-health meta-analyses were null, and the 32 interventions in this review are all different from each other, so no single approach is supported.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →


The study

Participants
2336 (1188 intervention, 1148 control)
Certainty of evidence
Moderate

Browse

    Cite

    Kavindri Kulasinghe, Koa Whittingham, Amy E Mitchell, et al. Psychological interventions targeting mental health and the mother-child relationship in autism: Systematic review and meta-analysis. Developmental medicine and child neurology. 2023.

    Read the original — we summarise, we never replace the paper.