Effectiveness of Distance Educational Programs for parents of children diagnosed with Autism Spectrum Disorder: an integrative review

Andrade, Jullie Gottschall Lima; Carmo, Andreia Cristina Feitosa do; Tamanaha, Ana Carina; Perissinoto, Jacy

doi:10.1590/2317-1782/20242023291en

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CRITICAL REVIEW OR SCOPING REVIEW • CoDAS 36 (5) • 2024 • https://doi.org/10.1590/2317-1782/20242023291en copy

Effectiveness of Distance Educational Programs for parents of children diagnosed with Autism Spectrum Disorder: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to analyze the scientific literature on distance education programs for parents/caregivers in the development of children with Autism Spectrum Disorder (ASD).

Research Method

the PICO strategy was used to identify the research problem. The databases Medline, ERIC, LILACs, EMBASE, CINAHL, Web of Science, and Scopus were searched using specific descriptors and free terms. There were no restrictions on time or language. Articles on online educational programs for parents of children with ASD were selected, focusing on the impact of these programs on the development of children up to six years old.

Selection Criteria

studies were selected based on standard eligibility criteria, including full-text reading after initial screening using the RAYYAN software. Primary studies such as clinical trials and systematic reviews evaluating distance education programs for parents of children with ASD were included.

Data Analysis

the RAYYAN software was used for initial study selection. Articles were hierarchically organized based on title and abstract, followed by full-text reading to apply eligibility criteria.

Results

the initial search yielded 1019 articles, of which 192 were identified as duplicates. After initial screening and full-text reading, 37 articles were analyzed, of which six were deemed eligible to answer the research question. Among the eligible studies, one was a systematic review and five were experimental studies. Experimental studies highlighted positive impacts on areas such as daily routines, behavioral flexibility, and communication. The systematic review provided preliminary evidence that distance education programs for parents can enhance knowledge about ASD, increase adherence to interventions, and foster the development of social and communication skills in children.

Conclusion

the findings suggest that remote parent guidance programs may effectively improve knowledge about ASD, increase parent adherence to interventions, and promote the development of social and communication skills in children with ASD.

Keywords:
Autism; Telemedicine; Child Development; Parents; Autism Spectrum Disorder

DATABASE	STRATEGY	Qty.
PUBMED	("parents"[MeSH Terms] OR ("caregiver s"[All Fields] OR "caregivers"[MeSH Terms] OR "caregivers"[All Fields] OR "caregiver"[All Fields] OR "caregiving"[All Fields]) OR "parents"[Text Word] OR "family relations"[MeSH Terms] OR "single mother"[Text Word]) AND ("autism spectrum disorder"[MeSH Terms] OR "autistic disorder"[MeSH Terms]) AND ("education, distance"[MeSH Terms] OR ("education"[All Fields] AND "distance"[All Fields]) OR "distance education"[All Fields] OR ("distance"[All Fields] AND "education"[All Fields]) OR "e-learning"[All Fields] OR ("internet"[MeSH Terms] OR "internet"[All Fields] OR "internet s"[All Fields] OR "internets"[All Fields]) OR ("computability"[All Fields] OR "computable"[All Fields] OR "computating"[All Fields] OR "computation"[All Fields] OR "computational"[All Fields] OR "computations"[All Fields] OR "compute"[All Fields] OR "computed"[All Fields] OR "computer s"[All Fields] OR "computers"[MeSH Terms] OR "computers"[All Fields] OR "computer"[All Fields] OR "computes"[All Fields] OR "computing"[All Fields] OR "computional"[All Fields]) OR "internet based intervention"[MeSH Terms] OR "on line intervention"[Text Word])	221
ERIC	(caregivers OR "family relationship" OR "child parent relation" OR “parenting skills”) AND (autism OR “autistic disorders” OR “autistic children” OR “autism spectrum disorders”) AND (“distance education” OR “distance learning” OR tele-education OR "visual classroom" OR e-learnings OR "internet-based intervention" OR "web-based intervention" OR internet) AND ("parent education") AND adult education	488
EMBASE	('child parent relation'/exp OR 'child parent relation' OR 'child parent relationship' OR 'child parent spatial pattern' OR 'correlation, parent child' OR 'parent child correlation' OR 'parent child relation' OR 'parent child relationship' OR 'parent infant bonding' OR 'parent infant relation' OR 'parent-child relations' OR 'parental role' OR 'parenting' OR 'parent'/exp OR 'biological parent' OR 'parent' OR 'parents' OR 'single parent'/exp OR 'lone parent' OR 'mother, unmarried' OR 'parent, single' OR 'single parent' OR 'unmarried mother' OR 'unwed mother' OR 'family relation'/exp OR 'family relation' OR 'family relations' OR 'caregiver'/exp OR 'care giver' OR 'caregiver' OR 'caregivers' OR 'carer' OR 'carers' OR 'family caregiver' OR 'family caregivers') AND ('autism'/exp OR 'kanner syndrome' OR 'pdd (pervasive developmental disorder)' OR 'autism' OR 'autism spectrum disorder' OR 'autism, early infantile' OR 'autism, infantile' OR 'autistic child' OR 'autistic children' OR 'autistic disorder' OR 'autistic spectrum disorder' OR 'child development disorders, pervasive' OR 'childhood autism' OR 'classical autism' OR 'early infantile autism' OR 'infantile autism' OR 'infantile autism, early' OR 'pervasive child development disorders' OR 'pervasive developmental disorder' OR 'pervasive developmental disorders' OR 'typical autism') AND ('distance learning'/exp OR 'distance education' OR 'distance learning' OR 'education, distance' OR 'tele-education' OR 'teleeducation' OR 'virtual classroom' OR 'virtual education' OR 'e learning'/exp OR 'e-learning' OR 'e-schooling' OR 'electronic education' OR 'electronic educational technology' OR 'electronic learning' OR 'on-line education' OR 'on-line learning' OR 'online education' OR 'online learning' OR 'online schooling' OR 'web-based intervention'/exp OR 'internet-based intervention' OR 'internet-intervention' OR 'online-based intervention' OR 'online-intervention' OR 'web intervention' OR 'web-based intervention' OR 'telehealth'/exp OR 'e-health' OR 'ehealth' OR 'tele-health' OR 'telehealth')	187
LILAC’s	("distance education" OR "educacao a distancia"OR e-leraning OR tele-educac* OR internet OR "web basead intervention" OR "online education" OR "educacao online") AND (autism* OR autisti) AND (pais OR maes OR parentes OR familia OR cuidador*)	132
CINAHL	("parent education" OR caregivers OR "family relationship" OR "child parent relation" OR "parenting skills") AND (autism OR "autistic disorders" OR "autistic children" OR "autism spectrum disorders") AND ("distance education" OR "distance learning" OR “tele-education” OR "visual classroom" OR “e-learnings” OR "internet-based intervention" OR "web-based intervention" OR internet)
Web of Science	("parent education" OR caregivers OR "family relationship" OR "child parent relation" OR "parenting skills") AND (autism OR "autistic disorders" OR "autistic children" OR "autism spectrum disorders") AND ("distance education" OR "distance learning" OR “tele-education” OR "visual classroom" OR “e-learnings” OR "internet-based intervention" OR "web-based intervention" OR internet)	40
SCOPUS	(“parent education" OR caregivers OR "family relationship" OR "child parent relation" OR "parenting skills") AND (autism OR "autistic disorders" OR "autistic children" OR "autism spectrum disorders") AND ("distance education" OR "distance learning" OR “tele-education” OR "visual classroom" OR “e-learnings” OR "internet-based intervention" OR "web-based intervention" OR internet)	123

Author	Year	Location	Objectives	Participants	Study Type	Method	Main Outcomes
Guðmundsdóttir et al.(²⁷27 Guðmundsdóttir K, Ala’i-Rosales S, Sigurðardóttir ZG. Extending caregiver training via telecommunication for rural icelandic children with autism. Rural Spec Educ Q. 2018;38(1):26-42. http://doi.org/10.1177/8756870518783522. http://doi.org/10.1177/8756870518783522... )	2018	Iceland	Develop and evaluate an effective telehealth procedure for skill gains in children with ASD.	3	Single-case experimental	Mixed: face-to-face and synchronous online	Family 1: Training was not effective for increasing sentence length, but was effective for increasing social responsiveness. Family 2: Highly effective for social responsiveness and requests. Family 3: Effective for social responsiveness and ineffective for sentence length.
Ibañez et al.(²³23 Ibañez LV, Kobak K, Swanson A, Wallace L, Warren Z, Stone WL. Enhancing interactions during daily routines: a randomized controlled trial of a web-based tutorial for parents of young children with ASD. Autism Res. 2018;11(4):667-78. http://doi.org/10.1002/aur.1919. PMid:29316336. http://doi.org/10.1002/aur.1919... )	2018	USA	Examine the effectiveness of an interactive web-based parental tutorial to enhance children with ASD's engagement in daily routines.	104 = Tutorial group (n = 52) or Control group (n = 52)	Randomized controlled trial	Online - Asynchronous	The tutorial group showed gains in daily routines, changed routine-related behaviors, and achieved broad outcomes for both children and parents, such as improvement in social communication and reduction in problem behaviors. Children and their parents were able to progress through lower levels of participation (i.e., tolerant) and reached higher levels of participation.
Douglas et al.(²⁴24 Douglas SN, Kammes R, Nordquist E. Online communication training for parents of children with autism spectrum disorder. Comm Disord Q. 2017;39(3):415-25. http://doi.org/10.1177/1525740117727491. http://doi.org/10.1177/1525740117727491... )	2017	USA	Evaluate the effect of an online training for parents on the communication skills of children with ASD.	3	Single-case experimental	Mixed: face-to-face and online - Asynchronous	In terms of communication opportunity skill: moderate effect. In communication: Family 1 and 3 showed moderate effects and Family 2 showed strong effects. Parental response: Families 1 and 3 exhibited high effects, and Family 2 showed strong effects.
Hong et al.(²⁸28 Hong ER, Gong L, Ganz JB, Neely L. Self-paced and video-based learning: parent training and language skills in japanese children with ASD. Except Educ Int. 2018;28(2):1-19. https://doi.org/10.5206/eei.v28i2.7762. https://doi.org/10.5206/eei.v28i2.7762... )	2018	Japan	Evaluate the effectiveness of an online training package in language development for children with ASD and communication deficits.	3	Single-case experimental	Online - Asynchronous	One of the families dropped out of the study due to difficulty with technology. Family 1: There was a substantial increase in communication skills; Family 2: There was a moderate increase; In specific communication objectives: Family 1 showed an immediate increase in the number of communication opportunities provided; Family 2 showed a consistent increase in the number of different words used.
Kunze et al.(²⁵25 Kunze MG, Machalicek W, Wei Q, St. Joseph S. Coaching via telehealth: caregiver-mediated interventions for young children on the waitlist for an autism diagnosis using single-case design. J Clin Med. 2021;10(8):1654. http://doi.org/10.3390/jcm10081654. PMid:33924440. http://doi.org/10.3390/jcm10081654... )	2021	USA	Evaluate the effectiveness of an online parent training program in reducing inflexible behaviors in children with ASD.	6	Single-case experimental	Mixed: face-to-face and online - Synchronous and Asynchronous	Family 1 dropped out due to an incident related to the pandemic; there was improvement in flexible behaviors and a decrease in inflexible behaviors in all families.
Parsons et al.(²⁶26 Parsons D, Cordier R, Vaz S, Lee HC. Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: systematic review. J Med Internet Res. 2017;19(8):e198. http://doi.org/10.2196/jmir.6651. PMid:28807892. http://doi.org/10.2196/jmir.6651... )	2017	Australia	Developed and evaluated an effective telehealth procedure for skill gains in children with ASD. An effective telehealth procedure for skill gains in children with ASD	3	Systematic Review	Mixed: face-to-face and synchronous online	Family 1: Training was not effective for increasing sentence length but was effective for increasing social responsiveness. Family 2: Highly effective for social responsiveness and requests. Family 3: Effective for social responsiveness and ineffective for sentence length.

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[1] Conflict of interests: nothing to declare.