| Screening decision | Screening conclusion |
|---|---|
| Passes screens | Eligible for review |
| Rating | Design | Attrition | Baseline equivalence | Reassignment | Confounding factors |
|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | Low | Established on baseline measures of the outcomes; not established on race/ethnicity and SES | No | No |
In addition to the outcomes assigned a moderate rating, six outcomes in this study were assigned a low rating: the Parent Daily Hassles scale at immediate post-test, two play behavior outcomes at immediate post-test and three months, and the Parental Efficacy Questionnaire at immediate post-test. These outcomes were assigned a low rating because they had high attrition and did not satisfy the baseline equivalence requirements.
| Study participants | Participants were 78 parent–child dyads in the Netherlands who were Dutch-speaking families with children ages 0 to 5 years who had been diagnosed with autism spectrum disorder (ASD) and lived together in the same permanent residence. Dyads were randomly assigned to either the treatment or comparison care-as-usual group. Most of the dyads included the child’s mother (90 percent), a married parent (82 percent), and Dutch nationals (90 percent). Average child age was 42 months, and average parent age was 37 years. |
|---|---|
| Setting | The study was conducted at a medical center in Utrecht, the Netherlands. |
| Intervention services | Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI) consisted of five biweekly home visits ranging from 60 to 90 minutes conducted by one of two trained interventionists. During visits, interventionists provided video vignettes of parent–child interactions in daily activities recorded in prior sessions in order to help parents gain insights into and sensitivity toward their child’s symptoms of ASD. Visits were spaced about two weeks apart and the total length of the intervention was about three months. Study participants, but not interventionists, were blinded to study assignment as both the treatment and comparison groups received home visits. |
| Comparison conditions | Dyads in the comparison group received the usual care for parents with a child with a new ASD diagnosis: parents were offered home-based nursing care, which consisted of an average of five 90-minute home visits conducted by one of three interventionists. The authors note that the number and frequency of home visits varied depending on parent preference. |
| Staff characteristics and training | Site visits were conducted by trained professionals with more than three years of experience working for the medical center in this study. All possessed either bachelor’s or master’s degrees in nursing, social work, or psychology. The interventionists were trained in the intervention and participated in weekly feedback sessions with the study authors. |
| Funding sources | Two of the authors were supported by awards from the Netherlands Organization for Scientific Research (VICI grant no. 453-09-003). |
| Author affiliation | The authors contributed to the design and development of VIPP-AUTI as part of a collaborative project between the University Medical Center Utrecht and Leiden University. |
Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Early Social and Communication Scales (ESCS): Initiating Joint Attention (3 month follow-up) |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
3-month |
72 dyads | Adjusted mean = 33.42 | Adjusted mean = 34.41 | MD = -0.99 | Study reported = -0.15 | Not statistically significant, p = 0.51 |
|
| Moderate | Early Social and Communication Scales (ESCS): Initiating Joint Attention (post-test) |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
72 dyads | Adjusted mean = 33.79 | Adjusted mean = 36.09 | MD = -2.30 | Study reported = -0.35 | Not statistically significant, p = 0.15 |
|
| Moderate | Early Social and Communication Scales (ESCS): Responding to Joint Attention (3 month follow-up) |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
3-month |
72 dyads | Adjusted mean = 51.68 | Adjusted mean = 52.94 | MD = -1.26 | Study reported = -0.07 | Not statistically significant, p = 0.77 |
|
| Moderate | Early Social and Communication Scales (ESCS): Responding to Joint Attention (post-test) |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
72 dyads | Adjusted mean = 48.63 | Adjusted mean = 54.06 | MD = -5.43 | Study reported = -0.35 | Not statistically significant, p = 0.15 |
|
| Moderate | Emotional Availability Scales (EAS): Child Involvement |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
76 dyads | Adjusted mean = 5.02 | Adjusted mean = 4.99 | MD = 0.03 | Study reported = 0.06 | Not statistically significant, p = 0.78 |
|
| Moderate | Emotional Availability Scales (EAS): Child Responsiveness |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
76 dyads | Adjusted mean = 5.25 | Adjusted mean = 5.19 | MD = 0.06 | Study reported = 0.05 | Not statistically significant, p = 0.83 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | Parental Emotional Availability Scales (EAS): Non-intrusiveness |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
76 dyads | Adjusted mean = 4.06 | Adjusted mean = 3.94 | MD = 0.12 | Study reported = 0.47 | Statistically significant, p = 0.04 |
|
| Moderate | Parental Emotional Availability Scales (EAS): Sensitivity |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
76 dyads | Adjusted mean = 6.34 | Adjusted mean = 6.36 | MD = -0.02 | Study reported = 0.13 | Not statistically significant, p = 0.56 |
|
| Moderate | Parental Emotional Availability Scales (EAS): Structuring |
FavorableUnfavorable or ambiguousNo Effect |
VIPP-AUTI vs. usual care, Utrecht |
Immediate post-test |
76 dyads | Adjusted mean = 3.74 | Adjusted mean = 3.82 | MD = -0.08 | Study reported = 0.12 | Not statistically significant, p = 0.59 |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Early Social and Communication Scales (ESCS): Initiating Joint Attention |
The Early Social and Communication Scales (ESCS) assess joint attention skills, behaviors, and related forms of social interaction in children. |
Observer-coded |
The author reported an intra-class correlation between two independent coders of 0.92. |
Early Social and Communication Scales (ESCS): Responding to Joint Attention (3 month follow-up) |
The Early Social and Communication Scales (ESCS) assess joint attention skills, behaviors, and related forms of social interaction in children. | Observer-coded | The author reported an intra-class correlation between two independent coders of 0.94. |
Early Social and Communication Scales (ESCS): Responding to Joint Attention (post-test) |
The Early Social and Communication Scales (ESCS) assess joint attention skills, behaviors, and related forms of social interaction in children. |
Observer-coded |
The author reported an intra-class correlation between two independent coders of 0.94. |
Emotional Availability Scales (EAS): Child Involvement |
The Emotional Availability Scales (EAS): Child Involvement scale measures parent-child interactions for intensity of child's efforts to engage the parent in interactions. |
Observer-rated |
Scale from 1 to 7. Interrater reliability for the child involvement scale was 0.75. |
Emotional Availability Scales (EAS): Child Responsiveness |
The Emotional Availability Scales (EAS): Child Responsiveness scale measures parent-child interactions for intensity of child's responsiveness to parent's engagement. |
Observer-rated |
Scale from 1 to 7. Interrater reliability for the child responsiveness scale was 0.73. |
| Outcome measure | Description of measure | Data collection method | Properties of measure |
|---|---|---|---|
Parental Emotional Availability Scales (EAS): Non-intrusiveness |
The Parental Emotional Availability Scales (EAS): Non-intrusiveness scale measures parent-child interactions for absence of interfering, overprotectiveness, and overwhelming behaviors. |
Observer-rated |
Scale from 1 to 5. Interrater reliability for the non-intrusiveness scale was 0.77. |
Parental Emotional Availability Scales (EAS): Sensitivity |
The Parental Emotional Availability Scales (EAS): Sensitivity scale measures parent-child interactions for parent's responsiveness to child's emotional signals and adjusting communication style for child's emotions. |
Observer-rated |
Scale from 1 to 9. Interrater reliability for the sensitivity scale was 0.77. |
Parental Emotional Availability Scales (EAS): Structuring |
The Parental Emotional Availability Scales (EAS): Structuring scale measures parent-child interactions for parent's ability to support child's learning and exploration and respect autonomy. |
Observer-rated |
Scale from 1 to 5. Interrater reliability for the structuring scale was 0.78. |
