Background: Early parent-implemented intervention enhances parent-child interaction and improves language skills in children with autism spectrum disorders (ASD). Parent coaching is often delivered as standard care for children with ASD, where parents are taught to apply strategies in their child’s play activities and daily routines to achieve the prior stated goals. However, the ability to conduct parent coaching in physical in-clinic sessions is limited by resource constraints such as clinic space and therapist manpower. Furthermore, parents may experience difficulties with the generalisation of intervention strategies taught in the clinic to their natural home environments. In this study, telerehabilitation is evaluated as an alternative platform to deliver parent coaching for parent-implemented interventions to children with ASD in their homes. Methods: This parallel-group, randomised, controlled, non-inferiority trial aims to evaluate the effectiveness of parent coaching delivered through video conferencing (telerehabilitation) versus in-clinic (standard care) delivery. Children aged 15 to 48 months (n = 200) who meet the cut-off score for ASD on the Autism Diagnostic Observation Schedule-2 are eligible. Parent-child dyads are randomly assigned to receive parent coaching either through weekly telerehabilitation or standard care. The primary outcome is the child’s development as measured by the subscale and composite scores of a standardised developmental assessment. Primary analysis will determine if the lower boundary of the 95% confidence interval for the mean difference in pre-post change between groups exceeds −5 (the non-inferiority margin). Secondary outcomes are the child’s adaptive behaviour, parent-child interaction, parental stress, and family quality of life. Outcomes will be measured pre-intervention, midterm, and post-intervention. Secondary analysis will determine if there is any between-group difference for the pre-post change in scores at the 5% significance level using two-sample t-test or Mann-Whitney U test. Discussion: As a randomised controlled trial of a moderately large scale, this study will contribute to the limited existing literature on the effectiveness of parent coaching via telerehabilitation for early parent-implemented intervention for children with ASD. The results of this study will provide insights on whether telerehabilitation is comparable to conventional in-clinic parent coaching in enhancing parent-child interaction and improving language skills. Trial registration: ClinicalTrials.gov NCT05792449. Registered (retrospectively) on 31 March 2023.

Background/Objectives: With rising autism prevalence, parent coaching has emerged as a useful model for teaching parents responsive strategies to support their child’s social communication and interaction skills within daily routines and play contexts. Telehealth parent coaching provides benefits of real-time guided generalisation in naturalistic environments as well as cost savings for families and providers. Methods: This randomised controlled trial examined whether parent coaching delivered via synchronous video conferencing was non-inferior to in-person sessions for improving the primary outcome of developmental skills in children with autism. 200 parent-child dyads were randomly assigned to receive 16 to 18 weekly parent coaching sessions based on naturalistic, relationship-focused intervention principles, delivered either through video conferencing (telerehabilitation arm) or in-person (standard arm). Results: Participants in both groups demonstrated comparable improvement in developmental skills, together with comparable changes in adaptive functioning, parent-child interaction, parental stress reduction and family quality of life. Conclusions: The findings of this study support video conferencing as a feasible and acceptable alternative platform for parent coaching while providing cost savings. However, given this study’s high attrition rate and the limited evidence base for telehealth parent coaching, additional research is needed to further validate the findings and parameters of use for optimal outcomes.