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., Meer, L. v. d., & 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

Publication date: 16 Aug 2024 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
10
Publication authors identified as autistic
1 / 10 (10.0%)
  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.

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Cited references
38
Total cited references integrated for this publication.
Cited references with an identified autistic author
2 / 38 (5.3%)
Cited author occurrences identified as autistic
3 / 184 (1.6%)
Among occurrences linked to AutiHub author records: 3 / 52 (5.8%). Distinct cited authors identified as autistic: 3 / 159 (1.9%).
Cited author occurrences linked to AutiHub author records
52 / 184 (28.3%)
Distinct linked cited authors: 36 / 159 (22.6%)
Linked cited-author occurrences not identified as autistic
49 / 52 (94.2%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 49 / 184 (26.6%). Distinct linked cited authors not identified as autistic: 33 / 36 (91.7%).
2 cited bibliography entries could not be fully enriched from DOI metadata.
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