The use of video feedback to promote developmentally supportive parent-child interactions with young children with ASD or at risk: study protocol for a randomized controlled trial (VIFEPOPA-RCT)

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and interaction, and repetitive and restrictive behaviors and interests from an early age. ASD often negatively affects caregiver-child interactions, caregiver emotional well-being and self-efficacy, and quality of family life. Positive caregiver–child interactions are crucial for good developmental outcomes, leading to the development of Parent-Mediated Interventions (PMIs). PMIs tend to follow an expert model where professionals provide direct instruction on treatment techniques and parental behaviors. However, research supports a shift towards a more collaborative and reflective approach, using coaching strategies that highlight caregiver strengths and encourage self-reflection. This study tests a video-feedback intervention (VFI) with parents of young children at risk of ASD. Methods: A randomized controlled trial (RCT) with 60 families, recruited from Early Intervention Centers in Spain, meeting inclusion criteria: adequate use of internet, child aged 24–36 months with a high risk of ASD (M-CHAT-R score ≥ 8), and participant primary caregiver (mother or father) with high anxiety, depression, or parental stress (score ≥ 1 SD above M), and low or medium–low developmentally supportive parental behaviors (PICCOLO score ≤ 40). Families will be randomly assigned to an intervention group (receiving usual services plus VFI) or a control group (usual services). The intervention includes twelve bi-weekly 90-min sessions over six months, with the caregiver. Outcome measures include parenting behaviors, emotional state, self-efficacy, family quality of life, and child development collected at pre-intervention, post- intervention and six-month follow-up. Discussion: The study will assess whether the intervention enhances developmentally supportive parental behaviors, emotional well-being, self-efficacy, and family quality of life, with a secondary positive impact on child development. If proven effective, it could be a cost-effective intervention with both short and long-term benefits.