Telehealth-Based Parent-Mediated Pivotal Response Treatment for Preschool Children With Autism Spectrum Disorder: A Pilot Randomized Controlled Study.
Telehealth parent coaching in PRT delivered from Taiwan boosted preschoolers’ language and daily-living skills while cutting parent stress.
01Research in Context
What this study did
Cheong et al. (2026) ran a 12-week pilot RCT in Taiwan. They compared telehealth parent coaching in Pivotal Response Treatment (TPRT) to weekly parent support calls.
Parents of preschoolers with autism got one-hour Zoom coaching twice a week. Therapists showed short clips, gave live feedback, and set daily practice goals.
What they found
Kids in the TPRT group made medium-to-large gains in language and daily-living skills. Parents in the same group reported lower stress than the support-only parents.
The online model worked: every family finished the sessions and met fidelity checks.
How this fits with other research
Anonymous (2022) asked the same question first. Their Taiwan pilot showed the idea was doable, but they only looked at parent ratings. Pou-Leng adds child-outcome data and an RCT design, so it builds on, not contradicts, the earlier work.
Lindgren et al. (2020) also ran a 12-week telehealth RCT with young autistic kids. They used Functional Communication Training and saw a 98% drop in problem behavior. Pou-Leng used PRT and saw broader language and adaptive gains. The two studies together tell us telehealth parent coaching works, but the best target depends on the goal: stop problem behavior (FCT) or boost language and play (PRT).
Liao et al. (2025) moved the Taiwan telehealth model up to school-age kids and still saw communication gains. Pou-Leng shows the same approach works for preschoolers, closing the age loop.
Why it matters
You can run a full PRT parent program on Zoom and still move language and adaptive scores. No travel, no wait list, and stress drops for Mom and Dad. If your clinic serves rural families or has long intake lists, copy the Taiwan schedule: twice-weekly one-hour coaching, daily 10-minute parent practice, weekly fidelity check. Start with one pilot case this month and track words gained and parent stress each week.
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02At a glance
03Original abstract
PURPOSE: This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary effectiveness of a telehealth-based Pivotal Response Treatment (TPRT) program for preschool children with autism spectrum disorder (ASD) in Taiwan, where access to evidence-based, parent-mediated interventions remains limited in underserved communities. METHODS: Fifty children aged 24-72 months were randomly assigned to either the intervention group, which received a 12-week therapist-guided TPRT program, or the control group receiving general parent support. Parents in the TPRT group attended weekly online coaching sessions and practiced the strategies daily at home. After the 12-week intervention, all participants entered a 4-week follow-up phase, during which TPRT parents independently practiced and applied the learned strategies in daily routines without therapist supervision, allowing evaluation of their autonomous use and short-term maintenance of treatment effects. Post-intervention assessments at the end of the follow-up evaluated child developmental outcomes and parental stress. RESULTS: Compared with controls, the TPRT group showed significantly greater improvements in language and motor development, with medium-to-large effect sizes in adaptive functioning, particularly in daily living and motor domains. Parenting stress significantly decreased, with most parents reporting reduced distress and improved perceptions of child behavior. Program adherence was high (88% daily strategy use, 85% homework completion), and parental satisfaction averaged 93%. CONCLUSIONS: The TPRT program was feasible, well accepted, and associated with meaningful developmental and parental benefits. Findings support the promise of telehealth-delivered, parent-mediated PRT as a scalable model to improve service accessibility for young children with ASD in underserved settings.
Journal of autism and developmental disorders, 2026 · doi:10.1111/j.1651-2227.2001.tb01615.x