The effect of caregiver-delivered social-communication interventions on skill generalization and maintenance in ASD.
Parent coaching lifts social-communication skills fast, but without built-in generalization and booster checks the gains shrink once coaching stops.
01Research in Context
What this study did
Hong et al. (2018) pooled every trial they could find where parents were coached to run social-communication lessons at home. They looked only at studies that measured whether the skills lasted after the coaching stopped.
The team compared gains from the first day of coaching to gains seen weeks or months later. They wanted to know if parent-taught skills stick without extra help.
What they found
Kids made big jumps while parents were being coached. Once coaching ended, most gains shrank or drifted back toward baseline.
The drop was clearest for skills used with new people or in new places. Skills used only with mom or dad held up better.
How this fits with other research
Schertz et al. (2018) ran one of the pooled trials. They saw the same fade, yet six-month follow-ups still beat baseline. The meta-average hides this longer win.
Van der Donck et al. (2023) used telehealth coaching and hit 95% parent fidelity with strong child gains. Their single-case design kept brief booster checks, something most meta trials skipped.
Bailey et al. (2000) warned years earlier that generalization plans must be written into the program. Rea’s pool shows most studies still left that step out, so the fade is no surprise.
Why it matters
If you coach parents, add a written generalization plan before you fade support. Schedule brief booster sessions at 4 and 8 weeks. Ask parents to practice the skill with one new adult and in one new room each week. These small steps keep the child’s progress from sliding back.
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02At a glance
03Original abstract
BACKGROUND: Although caregiver-delivered social communication interventions have been considered scientifically proven practices for individuals with autism spectrum disorders, it is not well examined if these types of intervention modes are truly effective in promoting skill generalization and maintenance within those individuals with autism spectrum disorders. AIMS: The purpose of this meta-analysis was to evaluate the status of the extant literature regarding the measures on generalization and/or maintenance of effects of caregiver-delivered communication interventions for children with autism spectrum disorders. METHODS AND PROCEDURES: This systematic literature review and meta-analysis evaluated peer-reviewed research regarding the effects of caregiver-implemented interventions on the maintenance and generalization of the social-communication skills for children with autism spectrum disorders. A total of 34 articles were included following a systematic search. Articles were summarized according to the following categories: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) generalization/maintenance teaching strategy, and (e) latency to maintenance probes. After application of design standards, aggregate Tau-U and non-overlap of pairs effect sizes were calculated with a total of 67 separate contrasts across seven studies. OUTCOMES AND RESULTS: Overall, effect size scores ranged from small to large effects across all comparisons. On average, most of the baseline to maintenance and generalization comparisons produced moderate to large effects. Whereas, small to moderate or even deteriorate effects were found in most of the intervention to maintenance and generalization comparisons. CONCLUSIONS AND IMPLICATIONS: The findings in this review suggest that caregiver-delivered social-communication interventions are likely to result in mixed effects on skill generalization and maintenance within children with autism spectrum disorders. Implications for future research and practice are discussed.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.01.006