Int J Clin Pediatr

International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access

Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc

Journal website https://www.theijcp.org

Original Article

Volume 13, Number 1, May 2024, pages 14-25

Comparative Analysis of Effectiveness of Online Versus Offline Parent-Mediated Therapeutic Intervention in Preschool Children With Autism Spectrum Disorder

**Table 1.** Demographic Characteristics of the Study Group
	Intervention group	P value
*Fisher’s exact test.
Gender
Male	49 (75.4)	40 (72.7)	0.740
Female	16 (24.6)	15 (27.3)
Child’s age (months)
24 - 29	28 (43.1)	21 (38.2)	0.355
30 - 35	31 (47.7)	24 (43.6)
36 - 42	6 (9.2)	10 (8.2)
Mean age (months)	30.58	31.36
Commonest presenting complaint
Delayed speech	29 (44.6)	26 (47.3)
Poor response to name	18 (27.7)	12 (21.8)
Poor eye contact	4 (6.2)	6 (10.9)
Mother’s age at delivery (years)
20 - 29	10 (15.4)	13 (23.6)	0.376
30 - 35	35 (53.8)	30 (54.6)
> 35	20 (30.8)	12 (21.8)
Father’s age at delivery (years)
20 - 29	3 (4.6)	2 (3.6)	0.95*
30 - 35	31 (47.7)	28 (50.9)
> 35	31 (47.7)	25 (45.5)
Mother’s education
High school certificate	1 (1.5)	0	0.921*
Intermediate	0	0
Graduate	32 (49.2)	29 (52.7)
Post graduate	32 (49.2)	26 (47.3)
Father’s education
High school certificate	1 (1.5)	0	0.874*
Intermediate	0	1 (1.8)
Graduate	40 (61.5)	33 (60)
Post graduate	24 (36.9)	21 (38.2)
Kuppuswamy’s socioeconomic scale
Lower middle	3 (4.61)	4 (7.27)	0.723*
Upper middle	47 (72.30)	41 (74.54)
Upper	15 (23.07)	10 (18.18)
Family structure
Nuclear	38 (58.5)	26 (47.3)	0.221
Joint	27 (41.5)	29 (52.7)
Birth order
1	47 (72.3)	43 (78.2)	0.139*
2	18 (27.7)	10 (18.2)
3	0	2 (3.6)

Table 1. Demographic Characteristics of the Study Group

Intervention group

P value

Offline (n = 65) (%)

Online (n = 55) (%)

*Fisher’s exact test.

Gender

Male

49 (75.4)

40 (72.7)

0.740

Female

16 (24.6)

15 (27.3)

Child’s age (months)

24 - 29

28 (43.1)

21 (38.2)

0.355

30 - 35

31 (47.7)

24 (43.6)

36 - 42

6 (9.2)

10 (8.2)

Mean age (months)

30.58

31.36

Commonest presenting complaint

Delayed speech

29 (44.6)

26 (47.3)

Poor response to name

18 (27.7)

12 (21.8)

Poor eye contact

4 (6.2)

6 (10.9)

Mother’s age at delivery (years)

20 - 29

10 (15.4)

13 (23.6)

0.376

30 - 35

35 (53.8)

30 (54.6)

> 35

20 (30.8)

12 (21.8)

Father’s age at delivery (years)

20 - 29

3 (4.6)

2 (3.6)

0.95*

30 - 35

31 (47.7)

28 (50.9)

> 35

31 (47.7)

25 (45.5)

Mother’s education

High school certificate

1 (1.5)

0.921*

Intermediate

Graduate

32 (49.2)

29 (52.7)

Post graduate

32 (49.2)

26 (47.3)

Father’s education

High school certificate

1 (1.5)

0.874*

Intermediate

1 (1.8)

Graduate

40 (61.5)

33 (60)

Post graduate

24 (36.9)

21 (38.2)

Kuppuswamy’s socioeconomic scale

Lower middle

3 (4.61)

4 (7.27)

0.723*

Upper middle

47 (72.30)

41 (74.54)

Upper

15 (23.07)

10 (18.18)

Family structure

Nuclear

38 (58.5)

26 (47.3)

0.221

Joint

27 (41.5)

29 (52.7)

Birth order

47 (72.3)

43 (78.2)

0.139*

18 (27.7)

10 (18.2)

2 (3.6)

**Table 2.** Comparison of Pre- and Post-Intervention BSID III (Cognition, Language, Motor) Composite and CARS 2 Scores in Offline and Online Groups
Intervention	N	BSID III composite scores	CARS 2 scores
BSID III: Bayley Scale of Infant Development, third edition; CARS 2: Childhood Autism Rating Scale, second edition; SD: standard deviation.
Offline
Pre	65	65	65.08 (7.31)	< 0.001	50	52.17 (7.97)	< 0.001	73	73.60 (6.69)	< 0.001	36	35.93 (1.94)	< 0.001
Post	65	70	71.08 (8.36)		59	61.05 (11.29)		76	77.45 (7.21)		35.5	33.63 (2.35)
Online
Pre	55	60	62.09 (5.58)	< 0.001	50	51.75 (7.29)	< 0.001	70	72.24 (7.75)	0.012	36	35.96 (1.93)	< 0.001
Post	55	65	67.24 (6.19)		53	57.09 (9.11)		73	74.42 (6.45)		34	34.16 (1.72)

Table 2. Comparison of Pre- and Post-Intervention BSID III (Cognition, Language, Motor) Composite and CARS 2 Scores in Offline and Online Groups

Intervention

BSID III composite scores

CARS 2 scores

Cognitive

Language

Motor

Median

Mean (SD)

P value

Median

Mean (SD)

P value

Median

Mean (SD)

P value

Median

Mean (SD)

P value

BSID III: Bayley Scale of Infant Development, third edition; CARS 2: Childhood Autism Rating Scale, second edition; SD: standard deviation.

Offline

Pre

65.08 (7.31)

< 0.001

52.17 (7.97)

< 0.001

73.60 (6.69)

< 0.001

35.93 (1.94)

< 0.001

Post

71.08 (8.36)

61.05 (11.29)

77.45 (7.21)

35.5

33.63 (2.35)

Online

Pre

62.09 (5.58)

< 0.001

51.75 (7.29)

< 0.001

72.24 (7.75)

0.012

35.96 (1.93)

< 0.001

Post

67.24 (6.19)

57.09 (9.11)

74.42 (6.45)

34.16 (1.72)

**Table 3.** Comparison of Change in Mean Pre- and Post-Intervention BSID III Cognitive, Language, and Motor Composite Scores and CARS 2 Score Between Offline and Online Groups
Scores	Change in mean score after intervention
BSID III: Bayley Scale of Infant Development, third edition; CARS 2: Childhood Autism Rating Scale, second edition; SD: standard deviation.
BSID III cognitive	6.00 (4.25)	5.15 (3.73)	0.244
BSID III language	8.88 (8.38)	5.34 (6.42)	0.012
BSID III motor	3.85 (5.49)	2.18 (6.20)	0.122
CARS 2	2.31 (1.44)	1.80 (1.07)	0.034

Table 3. Comparison of Change in Mean Pre- and Post-Intervention BSID III Cognitive, Language, and Motor Composite Scores and CARS 2 Score Between Offline and Online Groups

Scores

Change in mean score after intervention

Offline intervention (SD)

Online intervention (SD)

P-value

BSID III: Bayley Scale of Infant Development, third edition; CARS 2: Childhood Autism Rating Scale, second edition; SD: standard deviation.

BSID III cognitive

6.00 (4.25)

5.15 (3.73)

0.244

BSID III language

8.88 (8.38)

5.34 (6.42)

0.012

BSID III motor

3.85 (5.49)

2.18 (6.20)

0.122

CARS 2

2.31 (1.44)

1.80 (1.07)

0.034

**Table 4.** Comparison of ASD Children Based on Pre- and Post-Intervention CARS 2 Severity Scores Between the Offline and Online Groups
CARS 2 severity	Offline intervention	Online intervention
ASD: autism spectrum disorder; CARS 2: Childhood Autism Rating Scale, second edition.
Mild to moderate	52 (80.0%)	62 (95.4%)	0.002	40 (72.7%)	52 (94.5%)	< 0.001
Severe	13 (20.0%)	3 (4.6%)		15 (27.3%)	3(5.5%)
Total (N)	65	65		55	55

Table 4. Comparison of ASD Children Based on Pre- and Post-Intervention CARS 2 Severity Scores Between the Offline and Online Groups

CARS 2 severity

Offline intervention

Online intervention

Pre, n (%)

Post, n (%)

P-value

Pre, n (%)

Post, n (%)

P-value

ASD: autism spectrum disorder; CARS 2: Childhood Autism Rating Scale, second edition.

Mild to moderate

52 (80.0%)

62 (95.4%)

0.002

40 (72.7%)

52 (94.5%)

< 0.001

Severe

13 (20.0%)

3 (4.6%)

15 (27.3%)

3(5.5%)

Total (N)

**Table 5.** Likert Scale Response to Gauge Satisfaction With Either Intervention
Likert scale	2 (%)	3 (%)	4 (%)	5 (%)	Total	P-value
Offline group	2 (3.1)	5 (7.7)	50 (76.9)	8 (12.3)	65	0.001
Online group	4 (7.3)	20 (36.4)	27 (49.1)	4 (7.3)	55
Total	6 (5)	25 (20.8)	77 (64.1)	12 (10)	120

Table 5. Likert Scale Response to Gauge Satisfaction With Either Intervention

Likert scale

2 (%)

3 (%)

4 (%)

5 (%)

Total

P-value

Offline group

2 (3.1)

5 (7.7)

50 (76.9)

8 (12.3)

0.001

Online group

4 (7.3)

20 (36.4)

27 (49.1)

4 (7.3)

Total

6 (5)

25 (20.8)

77 (64.1)

12 (10)

120