Low-intensity parent- and clinician-delivered support for young autistic children in Aotearoa New Zealand: a randomised controlled trial

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Waddington, H., Jordan, P., Hammond, M. D., Tupou, J., Patrick, L., Macaskill, E., Davies, G., Pillar, S., van der Meer, L., & Whitehouse, A. (2024). Low-intensity parent- and clinician-delivered support for young autistic children in Aotearoa New Zealand: a randomised controlled trial. The Lancet Regional Health - Western Pacific, 51, 101173. https://doi.org/10.1016/j.lanwpc.2024.101173

Journal or book title
The Lancet Regional Health - Western Pacific
Publisher
Elsevier BV
Volume
51
Pages
101173
Article number
101173
Publication date: 16 Aug 2024 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
10
Publication authors identified as autistic
2 / 10 (20.0%)
  1. Hannah Waddington
  2. Phoebe Jordan *
  3. Matthew D. Hammond
  4. Jessica Tupou
  5. Lee Patrick *
  1. Ella Macaskill
  2. Georgia Davies
  3. Sarah Pillar
  4. Larah van der Meer
  5. Andrew Whitehouse

Abstract

Background Aotearoa New Zealand does not provide publicly-funded intensive autism support. While parent-mediated supports are promising, children and families may also benefit from direct clinician support. We tested the efficacy of a low-intensity programme involving parent- and clinician-delivered support for autistic children. Methods This single-blind, two-arm randomised controlled trial assessed outcomes of a six-month low-intensity parent- and clinician-delivered support (2–3 h per week) based on the Early Start Denver Model compared to a control group who received monthly support calls and assistance with referrals. Children aged 1–4.5 years who were autistic or showing signs of autism and their parents were randomised to the low-intensity or control group by a blinded statistician using the Urn minimisation method. Assessments were conducted at baseline and immediately following the support period (24-weeks post-baseline). The primary outcome was child engagement during an interaction with their parent. The trial was pre-registered with ANZCTR: U1111-1260-2529. Findings From March 2021 to May 2023, 56 families were randomised to either the low-intensity or control group. Following drop-outs, 21 families in the low-intensity group and 24 in the control group were included in analysis. There was large and significantly greater improvement in children's engagement in the low-intensity group compared to the control group (F (1, 43) = 21.47, p < 0.0001, η p 2 = 0.33). There was one recorded adverse event unrelated to the support and two adverse effects related to the support. Interpretation A low-intensity parent- and clinician-delivered support can improve engagement between an autistic child and their parent during play. Low-intensity supports may be beneficial in areas where access to clinical autism supports is limited. Funding Emerging Researcher First Grant from the Health Research Council of New Zealand.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 07:51.

Cited references
38
With a DOI
30
Without a DOI, from raw bibliography text
8
2 / 38 (5.3%) cited references include at least one author identified as autistic.
References with data to complete
1 / 38 (2.6%)
References with detected author names
37 / 38 (97.4%)
Without detected author names
1
Without a structured title
0
Without a stable identifier
8
References with raw author names still to review
0
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
184
From DOI or external metadata
184
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
70 / 184 (38.0%) names are linked to an author already present in AutiHub. 114 / 184 (62.0%) names are not yet linked.
Names linked to a person identified as autistic
3 / 184 (1.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 3 / 70 (4.3%). Distinct people identified as autistic: 3 / 159 (1.9%).
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