Reduced Stress, Enhanced Interaction: A Study on the Mechanisms of Integrated Online-Offline Interventions Improving Parent-Child Interaction Quality in Autistic Families

This study investigates the efficacy and mechanisms of a parent-mediated intervention for children with autism, combining two distinct phases: a 6-week online phase of one-to-one parent-child interaction guidance, followed by an offline phase involving group parent-child social activities. The goal is to improve problem behaviors and the quality of parent-child interaction. Twenty-six child-caregiver pairs participated in a randomized controlled design, assigned to either an immediate intervention group or a waiting-list control group. Scales measured children's problem behaviours, parent-child interaction quality, and parental stress to evaluate outcomes and mediating mechanisms. Results showed significant reductions in both intensity and frequency of problem behaviours, as well as a marked decrease in parent-child conflict. Behavioural gains were stable during the maintenance period, with further increases in parent-child closeness seen at follow-up, indicating robust outcome stability. Parenting stress fully mediated the relationship between intervention participation and improvements in parent-child interaction. The findings highlight that a blended online-offline parent-mediated intervention, consisting of a clearly defined online and offline phase, effectively improves problem behaviours in children with autism and promotes parent-child relationship development. Parental stress is a key psychological mechanism in the efficacy of this intervention.