Coaching parents in communication changed how parents and children interacted
A three-centre randomised trial of parent-mediated therapy for young autistic children
Reviewed by Sian Trombley, CCCFounder, Thrive Family Company
Strong confidence
Source citation
Green J., Charman T., McConachie H., Aldred C., Slonims V., Howlin P., et al. (2010). Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. The Lancet. https://doi.org/10.1016/S0140-6736(10)60587-9
Published 1 January 2010 · Added to Thrive 26 July 2026 · Reviewed 26 July 2026
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PACT tested something simple and radical: coach the parent, using video feedback, in reading and responding to their child's communication.
Published research findings
The study
152 young autistic children were randomly assigned to treatment as usual, or treatment as usual plus a parent-mediated communication programme with video review.
What researchers examined
Whether parent-mediated therapy improved autism symptom severity and parent-child communication.
What they found
Parent synchrony and child communicative initiations improved substantially. The primary autism severity measure did not show a statistically significant change at the trial endpoint.
Thrive editorial interpretation
What this may mean for families
Parent-mediated therapy is about improving communication and connection, not about reducing autistic traits.
What this doesn't tell us
Important limitations
The primary outcome measure may have been insensitive to the kind of change the therapy produces.
Evidence confidence describes how much weight this study's design can carry — not how strongly the finding applies to any individual child or family.
Therapist perspective — Thrive interpretation, not a finding of the study
Therapist Perspective
Parents often hear that they must find a specialist. This trial says the most powerful daily intervention already lives in the house.
Practical family considerations
Follow your child's lead and respond to their initiations — that is the intervention.
This research summary is educational and does not replace individualized medical, psychological or therapeutic advice.
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Six years later, the parent-coached group still showed reduced symptom severity
2016 · Randomized controlled trial
Strong confidence
Why it matters
Early work with parents may set a slightly different developmental slope, with differences becoming visible over years rather than months.