Using implementation science frameworks to explore barriers and facilitators for parents' use of therapeutic strategies following a parent-mediated autism intervention.
Sophie Carruthers, Natasha Mleczko, Stephanie Page and 7 others
PMID 36314780WHAT IT FOUND
Most parents continued using PACT-G strategies years after therapy, driven by seeing their child's communication and wellbeing improve.
Key barriers were lack of time, the child's changing mood, and forgetting the techniques without reminders. Support from therapists and school staff helped sustain use.
Key findings
01Most parents still used the strategies, but a third said they did not use them as much as they would have liked.
02Seeing progress in their child's communication and wellbeing was the primary motivator for continuing to use the techniques.
03The main barriers were practical: finding time, accommodating the child's mood and behavior, and forgetting to use the strategies without external prompts.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is qualitative and reports themes, not effect sizes or clinical outcomes. Participants were drawn from a research trial, so their experience may differ from community-based families. There was a gap of 14 to 28 months between therapy and the interview, which may have affected memory accuracy. The study did not measure actual fidelity of strategy use, relying entirely on parent self-report. Data collection occurred during the first COVID-19 lockdown, which may have influenced parents' reflections on their routines and support systems.
Declared interests
The PACT-G trial was funded by the National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation programme. One author was funded by the UK Medical Research Council. No commercial conflicts were declared.
The easy way to misread this
Do not interpret the parents' continued use of strategies as evidence that the intervention maintained or improved child outcomes. This study reports on the *process* of implementation (why parents did or did not use the techniques), not on the *efficacy* of those techniques after the trial ended.