Telehealth-Delivered Parent-Mediated Interventions for Young Children with Autism Spectrum Disorder: A Systematic Review of Effectiveness, Access, and Equity

Abstract

Autism spectrum disorder (ASD) affects children’s communication, social interaction, and behaviour, creating challenges for families in accessing appropriate interventions. Telehealth-delivered parent-mediated interventions provide caregivers with training and support through information and communication technologies and have the potential to improve access to ASD services, particularly for underserved populations. However, evidence on their effectiveness, accessibility, and equity remains fragmented, as do findings on the demographic and geographic factors that influence their success. This systematic review examined the effectiveness of telehealth-delivered parent-mediated interventions for young children with ASD, assessed their implications for access and equity, and evaluated demographic and geographic factors associated with intervention outcomes. Peer-reviewed studies were identified from academic databases. Thirty-two studies were initially identified, of which two were excluded for not meeting the inclusion criteria. The remaining studies were synthesized using narrative and thematic analysis. The findings indicate that telehealth-delivered parent-mediated interventions generally improve outcomes for both parents and children. Parent outcomes included improved intervention fidelity, self-efficacy, knowledge, competence, and reduced parental stress. Child outcomes included reductions in problem behaviours, including irritability, lethargy, and hyperactivity, as well as improvements in language and motor development, adaptive skills, social communication, joint attention, and social reciprocity. Regarding access and equity, telehealth improved access to interventions for families in remote, rural, and underserved areas. However, its equity benefits were not universal, as socioeconomic disadvantage and limited English proficiency may create barriers to participation. The review also identified access to technology, parental age, family involvement, individual parental needs, primary language, and rural–urban location as factors that influence intervention success. The review concludes that telehealth-delivered parent-mediated interventions are an effective approach for supporting young children with ASD, but their benefits depend on contextual and demographic factors. Intervention designers and implementers should therefore incorporate accessibility, language, technological, and family-specific considerations to enhance effectiveness and promote equitable access.