REVIEW article
Front. Psychiatry
Sec. Autism
Parent-mediated early intervention in infants and toddlers at elevated likelihood for autism: a systematic review of randomized controlled trials
Eugenia Conti 1,2
Francesca Ieri 1
Sara Calderoni 2,1
Fabio Apicella 1
Natasha Chericoni 1
Valeria Costanzo 1
viviana marchi 1
Andrea Guzzetta 2,1
Costanza Colombi 1
1. Stella Maris Foundation (IRCCS), Calambrone, Italy
2. Universita degli Studi di Pisa, Pisa, Italy
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Abstract
The current prevalence of Autism Spectrum Disorder (ASD) has risen to 1 in 31, according to a recent report of the USA Centers for Disease Control and Prevention. While prodromal signs of ASD can be observed during the first months of life, most care approaches usually require a diagnosis before children can receive autism-specialized intervention services. A novel approach consists in providing parent-mediated intervention to infants higher likelihood for autism with the aim to decrease disability and perhaps impacting on developmental trajectory. The aim of this review is to summarize evidence on outcomes from Randomized Control Trials (RCTs) of parent-mediated early interventions in infants with very early ASD signs and/or with an elevated likelihood for ASD, in order to inform clinical practice. A systematic literature search was performed by using the following databases from 2014 until 17 February 2025: Pubmed, EMBASE, Scopus, Web of Science, OVID (PsycInfo). Papers were selected based on the following inclusion criteria: i) RCT studies; ii) Mean age of children enrolled in RCT studies ≤ 18 months; iii) English language published studies; iv) Infants presenting autistic signs or infants at elevated likelihood for ASD. Eleven studies were included and analyzed in regard to sample characteristics, enrollment strategies, outcome measures and intervention types.
Summary
Keywords
autism, Early Intervention, Evidence-Basedpractice, Parent-mediated, preemptive, Randomized controlled trial (RCT), Toddler outcomes
Received
31 July 2025
Accepted
02 February 2026
Copyright
© 2026 Conti, Ieri, Calderoni, Apicella, Chericoni, Costanzo, marchi, Guzzetta and Colombi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sara Calderoni
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.