Cited by 161Autism Spectrum Disorder ResearchBehavioral and Psychological StudiesFamily and Disability Support Research

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Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis

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Tarver, Joanne, Palmer, Melanie, Webb, Sophie, Scott, Stephen, Slonims, Vicky, Simonoff, Emily, Charman, Tony·2019·Autism

DOI 10.1177/1362361319830042

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Abstract

There is growing interest in the development of behavioral parent interventions targeting emotional and behavioral problems in children with autism spectrum disorders. Such interventions have potential to improve a number of child and parental well-being outcomes beyond disruptive child behavior. This systematic review and meta-analysis assesses evidence for the efficacy of behavioral parent interventions for disruptive and hyperactive child behavior in autism spectrum disorders, as well as parenting efficacy and stress. A total of 11 articles from nine randomized controlled trials were included. Sufficient data were available to calculate standardized mean difference and show favorable effects of behavioral parent interventions on parent-reported measures of child disruptive behavior (standardized mean difference = 0.67), hyperactivity (standardized mean difference = 0.31) and parent stress (standardized mean difference = 0.37); effects on parent efficacy are less clear (standardized mean difference = 0.39, p = 0.17). There were insufficient data to explore intervention effects on internalizing behavior in autism spectrum disorders, parenting behaviors, or observational and teacher-reported outcomes, providing important avenues for future research. This review adds to growing evidence of the efficacy of behavioral parent interventions for child behavior and parental well-being in autism spectrum disorders (Prospero: CRD42016033979).

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Parent-mediated intervention delivered through telehealth for children with autism spectrum disorder
Liu, Q., Hsieh, W., Cheatham, G. A., & Yin, Y. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd014793 · Cited by 10
Evaluating outcomes of a community-based parent training program for Japanese children with developmental disabilities: a retrospective pilot study
Haraguchi, H., & Inoue, M. (2022) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2022.2070420 · Cited by 10
“2019, Tarver et al .”
Homotypic and Heterotypic Continuity in Psychiatric Symptoms From Childhood to Adolescence in Autistic Youth
Leno, V. C., Hollocks, M. J., Chandler, S., White, P., Yorke, I., Charman, T., Pickles, A. R., Baird, G., & Simonoff, E. A. (2022) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2022.05.010 · Cited by 10
Self-citation
Content analysis of parent training programs for children with neurodisabilities and mental health or behavioral problems: a scoping review
McCrossin, J., Lach, L., & McGrath, P. J. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2021.2017493 · Cited by 11
How effective are group-based psychoeducation programs for parents of children with ASD in Turkey? A systematic review and meta-analysis
AĞIRKAN, M., Koç, M., & Avcı, Ö. H. (2023) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2023.104554 · Cited by 10
The Impact of Father Involvement in the Early Childhood Problematic Behavior
Nafisah, A. D., Pranoto, Y. K. S., & Nuzulia, S. (2023) · JPUD - Jurnal Pendidikan Usia Dini · doi:10.21009/jpud.171.02 · Cited by 8
The effect of fully immersive virtual reality technology combined with psychological and behavioral intervention on autism spectrum disorder
Li, N., Tian, M., Yang, Y., Liu, Z., Sun, L., & Li, B. (2025) · BMC Psychology · doi:10.1186/s40359-025-03460-y · Cited by 11
“However, psychological and behavioral intervention requires long-term investment and patience, which is a challenge for both parents and professionals [20, 21].”
Parent-Mediated Interventions for ASD Under 3 Years: A Systematic Review, Meta Analysis, and Moderator Analyses
Zhao, X., Kuo, F., Chen, X., Li, D., & Duan, H. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06845-5 · Cited by 8
“Fifthly, some meta-analyses lacked a clear assessment of the evidence grade for the outcomes (Cheng et al., 2023; Deb et al., 2020; Postorino et al., 2017; Tarver et al., 2019).”
Influential
Direct observation in a large-scale randomized trial of parent training in children with autism spectrum disorder and disruptive behavior
Swiezy, N. B., Smith, T., Johnson, C. R., Bearss, K. E., Lecavalier, L., Drill, R. B., Warner, D. S., Deng, Y., Xu, Y., Dziura, J., et al. (2021) · Research in Autism · doi:10.1016/j.rasd.2021.101879 · Cited by 7
A Survey of Community Providers on Feeding Problems in Autism Spectrum Disorder
Burrell, T. L., Sharp, W. G., Gillespie, S. E., Pickard, K. E., Brasher, S. N., Buckley, D., & Scahill, L. D. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06013-7 · Cited by 9
“…have demonstrated efficacy in improving social communication and joint attention skills (Ingersoll & Wainer, 2013; Kasari et al., 2015), disruptive behavior (Postorino et al., 2017 ; Tarver et al., 2019 ), as well as sleep and feeding problems (Johnson et al., 2013, 2019 ; Sharp et al., 2019 ).”
Targeting the circadian modulation: novel therapeutic approaches in the management of ASD
Zhang, Y., Chen, Y. J., Li, W., Tang, L., Li, J., & Feng, X. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1451242 · Cited by 7
Parent-mediated Interventions Based on the NDBI for Children With ASD: A Systematic Review of Randomized Controlled Trials
Song, Y., Kong, X., Fu, W., & Song, F. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06791-2 · Cited by 6
“…across several critical domains, including children’s social communication skills (Pacia et al., 2022), disruptive and hyperactive behaviors (Joanne et al., 2019), emotional regulation (Nm et al., 2022), sleep issues (Kirk-patrick et al., 2019), and interventions based on ABA (Eckes et…”
“There is Nowhere Else That I’d Rather be Than with Them”: Parents’ Positive Experiences Parenting Autistic Children
Heyworth, M., McMahon, C. M., Tan, D. W., & Pellicano, E. (2025) · Autism & Developmental Language Impairments · doi:10.1177/23969415251357222 · Cited by 9
“Traditionally, a child ’ s Autistic emotional, sensory, and behavioral pro ﬁ les have been seen as key determinants of such negative outcomes (Enea & Rusu, 2020; Tarver et al., 2019; Yorke et al., 2018).”
Mindfulness and Psychoeducation Are Associated With Improved Perceived and Physiological Health Outcomes in Caregivers of Children With Autism
Iadarola, S., Cai, P., Porto, M., & Mustian, K. M. (2025) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-130.4.280 · Cited by 6
Use of non‐directive therapy for adolescents with autism spectrum disorder: A systematic review
Casper-White, R., Shloim, N., & Hebron, J. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12504 · Cited by 6
Effects of a Parenting Intervention for Emotional and Behavioral Problems in Young Autistic Children Under Conditions of Enhanced Uncertainty: Two-Year Follow-up of a Pilot Randomized Controlled Trial Cohort (ASTAR) During the United Kingdom COVID-19 Pandemic
Palmer, M. L., Leno, V. C., Hallett, V., Mueller, J., Breese, L., Pickles, A. R., Slonims, V., Scott, S., Charman, T., & Simonoff, E. A. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2022.09.436 · Cited by 6
Self-citation
Assessing the Effectiveness of Real-Time Online Parent Training for Parents of Children with Diverse Neurodevelopmental Disorders Residing in the Community
Yamanaka, T., Yuruki, K., Sanabe, Y., Yasutake, M., & Inoue, M. (2023) · Yonago acta medica · doi:10.33160/yam.2023.11.010 · Cited by 6
Perception and behavior toward neuropsychiatric disorders in Saudi Arabia: A systematic review and quality assessment
Woodman, A., Waheed, K. B., Al-Ansari, R. Y., Ahmad, S., Rehman, T. U., Rasheed, M., & Jaoua, N. (2024) · Autism · doi:10.1177/13623613241258544 · Cited by 5
“Ultimately, by protecting and speaking up for the rights of their children, parents can ensure that they receive appropriate services from schools, intervention programs, and health care providers alike (Abikoff et al., 2015; Al-Mohsin et al., 2020; Alshihri et al., 2021; Tarver et al., 2019).”
Using Family Therapy in the Context of Autism: A Scoping Review
Hsiang, C. H.-T., Georgas, S., Tavener, M., & Campbell, L. (2024) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-024-00471-0 · Cited by 5
“…acquisition (e.g., particular parenting principles and behavior strategies) have helped both children and parents (e.g., parent functioning and well-being), these interventions do not indicate changes of parenting behavior nor family relational patterns (Liu & Schertz, 2022; Tarver, et al., 2019).”
Telehealth Parent Training for Challenging Behavior in Children with Developmental Disabilities: A Systematic Review and Meta-Analysis
Adedipe, D., & Walton, K. M. (2025) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-025-00501-5 · Cited by 5
Parent-Mediated Online Art Therapy With a Mother and Her Children With Autism
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“Several other studies support the importance and efficacy of parent-implemented interventions with autistic children (Tarver et al., 2019) and delivery through telehealth (Wainer & Ingersoll, 2015).”
Parent Training for Disruptive Behaviors in Referred Children with Autism Spectrum Disorder: A Randomized Controlled Trial
Breider, S., de Bildt, A. A., Greaves‐Lord, K., Dietrich, A., Hoekstra, P. J., & van den Hoofdakker, B. J. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06567-0 · Cited by 6
“Our findings extend the results of previous studies that showed the efficacy (Postorino et al., 2017; Tarver et al., 2019) of behavioral parent training programs for ASD under more controlled conditions than in routine mental health care.”
Influential
The Family-Check-Up® Autism Implementation Research (FAIR) Study: protocol for a study evaluating the effectiveness and implementation of a family-centered intervention within a Canadian autism service setting
Bennett, T. A., Drmic, I., Gross, J., Jambon, M. M., Kimber, M., Zaidman‐Zait, A., Andrews, K., Frei, J., Duku, E., Georgiades, S., et al. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1309154 · Cited by 6
“Correspondingly, parenting programs have demonstrated benefits among families of autistic children (19, 20), however, provider training and uptake of such programs is low (21).”
BackgroundInfluential
The correlation between brain structure characteristics and emotion regulation ability in children at high risk of autism spectrum disorder
Ding, N., Fu, L., Qian, L., Sun, B., Li, C., Gao, H., Lei, T., & Ke, X. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02369-y · Cited by 6
“Functional communication disorders associated with the core symptoms of ASD and associated mental deficits and nearly 71–80% of autism patients may be associated with emotional behavior problems are the major causes of severely impaired social functioning of autism [80].”
Virtual Parent Coaching of Music Interventions for Young Autistic Children in Mexico
Ruiz, E. H. (2023) · Music Therapy Perspectives · doi:10.1093/mtp/miac030 · Cited by 5
Parent Perceptions of Participating in a Parent-Mediated Program for Young Autistic Children
van Noorden, L. E., Sigafoos, J., Wallace-Watkin, C., & Waddington, H. L. (2023) · Journal of Early Intervention · doi:10.1177/10538151231214749 · Cited by 4
“In addition, parents may experience benefits, including increased self-efficacy (Keen et al., 2010; Schertz et al., 2020), reduced stress (Jurek et al., 2022; Tarver et al., 2019), and increased psychological wellbeing (Estes et al., 2019).”
The Father’s Part: A Pilot Evaluation of a Father-Centered Family Intervention Group in Child and Adolescent Psychiatry
Mestermann, S., Kleinöder, J. M., Arndt, M., Krämer, J., Eichler, A., & Kratz, O. (2023) · Behavioral Sciences · doi:10.3390/bs14010013 · Cited by 4
“Similar results are also seen during the treatment of externalizing disorders, like ADHD [62], conduct disorders [63], or ASD [64,65].”
Result
Comparison of social skills and problem behaviours of children with different developmental disabilities
Aydın, H. U., Tekinarslan, İ. Ç., & Çınar, E. (2024) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2024.2349832 · Cited by 4
“…with developmental disabilities have lower social skills, communication/interaction and language skills and higher problem behaviors compared to their typically developing peers (McCabe and Meller, 2004; Sridevi et al. 2015; Stephen, Hwang, and Wang 2019; Tarver et al. 2019; Totsika et al. 2020).”
The effect of brief acceptance and commitment training on values-based behaviors of Japanese parents of children with autism
Uramoto, M., Moore, C., García, Y., & Kurumiya, Y. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.05.005 · Cited by 4
Autism Spectrum Disorder
Radley, K. C., & Dart, E. H. (2021) · Springer series on child and family studies · doi:10.1007/978-3-030-91665-7_1 · Cited by 4
Improving outcomes for people with autism spectrum disorders by reducing mental health problems: the IAMHealth research programme including one RCT
Simonoff, E. A., Baird, G., Beresford, B., Charman, T., Knapp, M. R. J., Pickles, A. R., Povey, C., Purser, T., Santosh, P., Slonims, V., et al. (2025) · Programme Grants for Applied Research · doi:10.3310/yrkp9867 · Cited by 4
Self-citation
Effectiveness of exercise interventions on gross motor skills in children with autism spectrum disorder: a systematic review and meta-analysis
Feng, M., Hou, Y., Zhou, S., & Song, X. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1745638 · Cited by 3
Au-delà du TED, des compétences parentales à ma portée : évaluation des effets d’un programme de soutien destiné aux parents d’enfants présentant un trouble du spectre de l’autisme
Stipanicic, A., Couture, G., Rivest, C., Rousseau, M., & Paquette, M. (2021) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2021.10.018 · Cited by 3
An individual-supported program to enhance placement in a sheltered work environment of autistic individuals mostly with intellectual disability: a prospective observational case series in an Italian community service
Maggio, R., Turriziani, L., Campestre, C., Cara, M. D., Tripodi, E., Impallomeni, C., Quartarone, A., Passantino, C., & Cucinotta, F. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1225236 · Cited by 3
Adaptation and validation of the Parental Behaviour Scale for Autism Spectrum Disorder in Chinese parents
Zhang, C., Zhou, T., Yi, C., Liu, S., Ye, H., & Zhang, Y. (2022) · Research in Autism · doi:10.1016/j.rasd.2022.102048 · Cited by 3
Examining adaptations necessary to support the implementation of a parent-mediated intervention for children with autism spectrum disorder and moderate feeding problems
Pickard, K. E., Burrell, T. L., Brasher, S. N., Buckley, D., Gillespie, S. E., Sharp, W. G., & Scahill, L. D. (2023) · Autism · doi:10.1177/13623613231166181 · Cited by 4
“The rationale for parent-mediated intervention in managing food selectivity in autistic children is supported by the large body of evidence confirming the efficacy of parent-mediated interventions for disruptive behavior in young children with ASD (Postorino et al., 2017; Tarver et al., 2019).”
Background
Cross-lagged relations between maternal criticism and emotional and behavioral problems in children with ASD
Benson, P. R. (2024) · Research in Autism · doi:10.1016/j.rasd.2024.102358 · Cited by 3
Addressing Challenging Behavior and Social–Emotional Skills in Home-Based Services: A Systematic Review
Gerow, S., Exline, E., Swafford, L. B., Cosottile, D. W., Conroy, M. A., Machalicek, W., Davis, T. N., Wei, Q., & James, A. (2024) · Journal of Positive Behavior Interventions · doi:10.1177/10983007241276423 · Cited by 3
“Five existing reviews have evaluated caregiver-implemented interventions for a specific disability — ASD (Althoff et al., 2019; Hendrix et al., 2022; Nevill et al., 2018; Oono et al., 2013; Tarver et al., 2019).”
Outcomes of the World Health Organization’s Caregiver Skills Training Program for Eritrean and Ethiopian parents of autistic children in the United States
Dababnah, S., Zeleke, W. A., Chung, Y., Adjei, R. A., Dixon, P. J., Salomone, E., & WHO CST Team (2025) · Autism · doi:10.1177/13623613251351345 · Cited by 3
“…to use with their children) have reported a vast array of developmental and behavioral improvements for autistic children (Bearss et al., 2015; Deb et al., 2020; Oono et al., 2016; Pacia et al., 2022; Parsons et al., 2017; Pickles et al., 2016; Reichow et al., 2024; Tarver et al., 2019).”
Overview of autism interventions
Kang, E., McDonald, R. G., & White, S. W. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-816393-1.00004-x · Cited by 3
Understanding the role of early life stress and schizophrenia on anxiety and depressive like outcomes: An experimental study
Oginga, F. O., & Mpofana, T. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.115053 · Cited by 2
The Feasibility of Occupation-Based Coaching for Autistic Children and Primary Caregivers
Tkach, M. M., Dunn, W., & Wolf, T. (2025) · OTJR Occupational Therapy Journal of Research · doi:10.1177/15394492241309322 · Cited by 2
“However, behavioral caregiver approaches have had variable effects on parent efficacy across parent interventions, and the wide range of variability in PSOC scores pre-and post-intervention may explain our null finding (Brennan et al., 2024; Tarver et al., 2019).”
Parental Stress and Coping Strategies in Parents of Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
Mo, S., Shu-qian, L., & Jin, Z. (2025) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-025-00509-x · Cited by 2
Autism Spectrum Disorder in Child and Adolescent Inpatient Psychiatric Settings: Presentation, Clinical Strategies, and Application of the Double Empathy Problem
Morris, A. M., Kasdin, R. G., Shah, S., Hill, I., Bao, K. H., Singletary, W. M., & Rice, T. (2025) · Southern Medical Journal · doi:10.14423/smj.0000000000001857 · Cited by 2

Authors: Tarver, J., Palmer, M., Webb, S., Scott, S., Slonims, V., Simonoff, E., & Charman, T.
Affiliations: Aston University (GB)
King's College London (GB)
Guy's and St Thomas' NHS Foundation Trust (GB)
Corresponding author: Tarver, Joanne
ORCID: Tarver, Joanne
Palmer, Melanie
Webb, Sophie
Scott, Stephen
Slonims, Vicky
Simonoff, Emily
Charman, Tony
Venue: Autism
Publisher: SAGE Publications
Published: 2019-02-28
Volume: 23
Issue: 7
Pages: 1630-1644
ISSN: 1362-3613 (ISSN-L)
1461-7005
DOI: 10.1177/1362361319830042
OpenAlex: W2918863645
Cited by: 161
References: 59
Citations by year: 2026: 23 · 2025: 23 · 2024: 27 · 2023: 27 · 2022: 24 · 2021: 18 · 2020: 16 · 2019: 3
FWCI: 1.94
Type: journal article
Language: en
Open access: green
publications.aston.ac.uk
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Autism (publishedVersion)
PubMed (publishedVersion)
Aston Publications Explorer (Aston University) (submittedVersion)
Research Portal (King's College London) (submittedVersion, other-oa)
Funders: Programme Grants for Applied Research (RP-PG-1211-20016)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Keywords: autism spectrum disorder, child emotional and behavioral problems, disruptive behavior, hyperactivity, parent stress, parental self-efficacy, parental well-being, child internalizing behavior
MeSH terms: Problem Behavior, Autism Spectrum Disorder, Behavior Therapy, Child, Child Behavior Disorders, Humans, Parents, Stress, Psychological, Parenting, Treatment Outcome

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Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis

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