Informing the development of a novel intervention targeting the psychosocial skills of children with developmental language disorder: a systematic review of existing parent-led interventions (Preprint)

Abstract

BACKGROUND This systematic review takes a transdiagnostic approach to synthesising the current, high-quality evidence of parent-led psychosocial interventions for children with neurodevelopmental disorders (NDDs). OBJECTIVE This study aims to inform the development of a novel intervention targeting psychosocial skills of children with Developmental Language Disorder (DLD), for whom there is no current support for the high levels of psychosocial difficulties they experience. METHODS Thirty-seven interventions met the pre-specified inclusion criteria; trials must have compared interventions to a control group, or have an eight-week follow-up, must have been published in English after 2000, with participants aged 2-13 years old who met diagnostic criteria for seven specified NDDs. For inclusion, interventions also had to include discrete parent-led components and measures of child psychosocial outcomes. Synthesis of evidence included: participant characteristics, intervention procedures, psychosocial outcomes of both child and parent, intervention contents, active components and quality of evidence. The Child Psychosocial Skills Taxonomy was also developed and used to understand the active components commonly used across the evidence-based interventions. RESULTS All interventions that met criteria were designed for children with autism spectrum disorder (n=17) or attention deficit hyperactive disorder (n=20). Interventions ranged hugely in their length (2-50 weeks; 3-34 sessions) and delivery (individual vs. group sessions; online vs. face-to-face sessions). Four intervention components were most used across effective interventions: parent-child interaction training, teaching parenting behaviours and emotion management for both parent and child. An association between parent wellbeing and improved child psychosocial outcomes is suggested, however this association is limited by the lack of data provided. Therapeutic and researcher contact appears to have a role in improving intervention engagement. Accessibility issues are discussed, with some studies reporting a bias in engagement towards families with higher education and lower life stressors, but higher symptom severity. CONCLUSIONS Evidence-based psychosocial interventions are required for children with NDDs other than autism spectrum disorder and attention deficit hyperactivity disorder. The active components identified should be considered in future intervention development, alongside therapeutic contact. Future studies need to improve accessibility of interventions to those from lower income and educational backgrounds, and those with more life stressors.