Service Delivery

Parent and professional perspectives on implementing the Pediatric Autism Communication Therapy: A mixed-methods analysis.

Balabanovska et al. (2025) · Autism : the international journal of research and practice 2025
★ The Verdict

Parent stress and professional support decide if PACT lives or dies, not the therapy itself.

✓ Read this if BCBAs running parent training for toddlers with autism in any setting.
✗ Skip if Clinicians who only work 1:1 with older clients and never coach parents.

01Research in Context

01

What this study did

Matea and team asked 42 parents and 28 professionals how they felt about Pediatric Autism Communication Therapy.

They used interviews and focus groups across four countries to learn what helps or blocks the program.

The study looked at real-world rollout, not lab results.

02

What they found

Parents said they need time, low stress, and space to think about their own parenting style.

Professionals said good planning and boss support matter more than fancy manuals.

When either side felt rushed or ignored, the therapy stalled.

03

How this fits with other research

Wetherby et al. (2018) showed parents coached online can boost toddler skills in three months. Matea adds that even the best online tools flop if parents feel overwhelmed.

Wilson et al. (2024) found parents call ABA cold. Matea agrees and shows warmth starts with listening to parent stress, not adding new drills.

McKinlay et al. (2022) revealed parents feel unheard in schools. Matea repeats the warning for clinics: ignore parent voice and PACT will fail too.

Vivanti et al. (2025) argues policy gaps block good programs. Matea shows the gap is also personal—parents need policy that gives them time and support, not just access.

04

Why it matters

You can have the best parent program, but if mom is exhausted and dad has no time, it will sit on the shelf. Ask about stress first, schedule second, and manuals last.

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Start your next parent meeting with one question: 'On a scale of 1-10, how stressed are you today?' Then adjust the plan.

02At a glance

Intervention
parent training
Design
qualitative
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Factors influencing the implementation of parent-mediated intervention are insufficiently studied. This study examines for the first-time factors of implementation into clinical practice across the world of Pediatric Autism Communication Therapy, an internationally disseminated, evidence-based, parent-mediated therapy. From both the parents' and the professionals' perspectives, parents attitudes (e.g. self-reflection abilities and videotaping management) and life-circumstances (e.g. stressed families condition and time) were central factors. In this type of therapy, the target is a child's development; still, this improvement is dependent on the parent's behavior when interacting with their child. What's more, Pediatric Autism Communication Therapy method (video reflection, empowerment of parent, play-based) was enabler according to most of the parents. And more, most professionals report factors linked to the Implementation Process that is planning, execution, reflection and assessment in implementation of a new therapy. Indeed, the professionals underlined barriers related to the population seen in practice, flexibility of schedule, support from colleagues and manager. All these factors could be improved and addressed with a formal implementation plan including factors related to the parents of each country.

Autism : the international journal of research and practice, 2025 · doi:10.1177/13623613241262943