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      Parent-mediated interventions versus usual care in children with autism spectrum disorders: A protocol for a systematic review with meta-analysis and Trial Sequential Analysis

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          Abstract

          Introduction

          Autism spectrum disorder encompasses diverse patterns of social communication and repetitive, restricted behaviours. Various interventions have been developed to reduce the negative consequences of this disorder and improve levels of functioning, and recently interest in parent-mediated interventions has increased. Previous reviews and meta-analyses have investigated the effects of the parent-mediated interventions, however; a systematic review with meta-analysis of high quality has not been performed since 2013. This protocol for a systematic review with meta-analysis aims to describe the methods and purpose of synthesising current evidence regarding the effects (both positive and adverse) of parent-mediated interventions in both children with autism and their parents.

          Methods

          Electronic searches will be conducted in Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), American Psychological Association PsycInfo (PsycInfo) and Science Citation Index Expanded (SCI-EXPANDED). Randomised clinical trials of parent-mediated interventions for children with autism and control groups of usual care, waiting list or no treatment will be included. Two reviewers will independently screen, select and collect data. Methodological quality of included studies will be evaluated using Cochrane methodology. The primary outcome will be autism symptom severity as measured by the Autism Diagnostic Observation Schedule. Secondary outcomes will be adaptive functioning, adverse effects, child language, child´s quality of life, parental quality of life and parental stress. Meta-analyses and Trial Sequential Analysis will be performed.

          Discussion

          This is the study protocol for a systematic review and meta-analysis of parent-mediated interventions versus usual care for children with ASD. Results of the review will inform clinicians and parents about the current evidence of the effects, both positive and negative, of parent-mediated interventions on younger children with autism and their parents, through improved methodology and inclusion of new studies.

          PROSPERO registration number: 385188

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          Most cited references112

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          Is Open Access

          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
            • Record: found
            • Abstract: found
            • Article: not found

            Measuring inconsistency in meta-analyses.

              • Record: found
              • Abstract: not found
              • Article: not found

              Bias in meta-analysis detected by a simple, graphical test

                Author and article information

                Contributors
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS One
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 May 2025
                2025
                : 20
                : 5
                : e0323798
                Affiliations
                [1 ] Psychiatry, Aalborg University Hospital, Moelleparkvej, Aalborg, Denmark
                [2 ] Child and Adolescent Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
                [3 ] Department of Clinical Research, University of Southern Denmark, Odense, Denmark
                [4 ] Master International A/S, Copenhagen, Denmark
                [5 ] Mental Health Services in the Capital Region of Denmark, Denmark
                [6 ] Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Denmark
                [7 ] Department of Child and Adolescent Psychiatry, Copenhagen University Hospital – Psychiatry Region Zealand, Roskilde, Denmark
                [8 ] Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark
                [9 ] Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
                [10 ] Department of Clinical Medicine, Aarhus University, Denmark
                [11 ] Department of Clinical Medicine, Aalborg University, Denmark
                University of Catania, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-7063-6122
                Article
                PONE-D-25-02938
                10.1371/journal.pone.0323798
                12083817
                40378107
                ab8d3718-95c0-4f25-ab7a-329f2bf8a2e6
                © 2025 Conrad et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 January 2025
                : 15 April 2025
                Page count
                Figures: 0, Tables: 2, Pages: 19
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003554, Lundbeck Foundation;
                Award ID: R389-2021-1597
                Funded by: funder-id http://dx.doi.org/10.13039/501100007437, TrygFonden;
                Award ID: 155050
                Funded by: funder-id http://dx.doi.org/10.13039/501100009708, Novo Nordisk Fonden;
                Award ID: NNF22SA0081180
                Funded by: funder-id http://dx.doi.org/10.13039/501100004046, Karen Elise Jensens Fond;
                Funded by: funder-id http://dx.doi.org/10.13039/501100011076, Simon Fougner Hartmanns Familiefond;
                This work was supported by The Lundbeck Foundation, grant number R389-2021-1597, TrygFonden, grant number 155050, Novo Nordisk Foundation, grant number NNF22SA0081180, Karen Elise Jensen Foundation, and the Simon Fougner Hartmann Family Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Study Protocol
                Biology and Life Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Social Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Metaanalysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Metaanalysis
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Research and Analysis Methods
                Research Assessment
                Systematic Reviews
                Biology and Life Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Autism
                Social Sciences
                Psychology
                Developmental Psychology
                Pervasive Developmental Disorders
                Autism Spectrum Disorder
                Autism
                Medicine and Health Sciences
                Medical Conditions
                Neurodevelopmental Disorders
                Autism
                Biology and Life Sciences
                Neuroscience
                Developmental Neuroscience
                Neurodevelopmental Disorders
                Autism
                Medicine and Health Sciences
                Neurology
                Neurodevelopmental Disorders
                Autism
                Biology and Life Sciences
                Psychology
                Behavior
                Parenting Behavior
                Social Sciences
                Psychology
                Behavior
                Parenting Behavior
                Medicine and Health Sciences
                Health Care
                Quality of Life
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Custom metadata
                No datasets were generated or analysed during the current study. All relevant data will be made available upon study completion.

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