The overarching aims of this PhD project were to describe the field of parent-mediated interventions (PMIs) for children with autism and as-sess both the positive and adverse effects of these interventions. Ad-ditionally, an aim was to examine the impact of attachment in families with children with autism as well as possible associations with the ef-fects of the Paediatric Autism Communication Therapy (PACT) inter-vention.

A systematic review with meta-analysis and Trial Sequential Analysis identified and accumulated evidence of the effects of the PMIs. A qualitative interview study was additionally conducted with parents who had participated in a feasibility study of the PACT intervention. Finally, a cross-sectional study exploring representations of attach-ment and shame in parents of children with autism was performed.

The PhD project indicates that PACT is both a feasible and beneficial intervention in Denmark. Our findings show how parents struggle both emotionally and practically to adjust to everyday life with their child with autism. Attachment insecurity is common in parents of chil-dren with autism. Strategies applied through the PACT intervention may support parents in more sensitive caregiving, which may also improve attachment security in the children. Findings suggest that more qualitative and quantitative research is needed to understand and assess the effects of PMIs such as PACT.