Beyond Intervention: A Scoping Review of Parent Engagement in Parent-Implemented Intervention for Autistic Children.

PURPOSE: Parent-implemented interventions (PII) are evidence-based practices that improve developmental and functional outcomes for autistic children. However, limited attention has been given to the processes of parent engagement within PII, despite its potential to shape intervention sustainability and effectiveness. This scoping review examined how parent engagement has been incorporated and reported in parent-implemented interventions for autistic children in the United States.

METHODS

Following PRISMA-ScR guidelines, PubMed and EBSCO (nine sub-databases) were searched for peer-reviewed studies published between January 2013 and October 2023. Eligible studies were randomized controlled trials conducted in the United States, focused on autistic children, and included a parent-implemented component. Two reviewers independently screened records (94% initial agreement).

RESULTS

Forty-two articles representing 29 unique trials were synthesized. Developmental interventions primarily employed dyadic or combined training formats, while non-developmental interventions more often used parent-only approaches. Fewer than half of the trials reported structured opportunities for parental involvement in planning or problem-solving. Clinician fidelity was consistently measured, whereas parent fidelity was assessed less frequently and often without independent raters. Parent engagement was measured as an outcome in fewer than half of the trials and examined as a predictor or moderator in only a small subset, where higher engagement predicted greater child gains.

CONCLUSION

Parent engagement processes remain inconsistently reported in PII research despite their centrality to intervention delivery. Greater attention to structured involvement, standardized fidelity measures, and long-term maintenance is needed. Clinically, embedding collaborative problem-solving and sustained supports may strengthen parents' competence and enhance intervention outcomes for autistic children.