Predictors of Improvement in Functional Language and Social Communication among Children with Autism Spectrum Disorder Using Brief Parent-Mediated Intervention

Background: Brief parent-mediated intervention (PMI) may improve communication outcomes in autism spectrum disorder (ASD); however, evidence from Zambia is limited. This study examined the predictors of improvement in functional language and social communication among children with ASD who received brief PMI. Methods: In this quasi-experimental pre–post study, 60 children with ASD aged 3–18 years were recruited from two special schools in Lusaka, Zambia. The caregivers received brief PMI training over 12 weeks. Child outcomes were assessed at baseline and post-intervention using the Childhood Autism Rating Scale. Logistic regression was used to identify the predictors of improvement. Results: Functional language and social communication improved significantly after PMI (p = 0.0001), whereas the overall ASD severity did not change significantly. Improvement was independently associated with older child age (AOR 2.23, 95% CI 1.92–2.59), greater session attendance (AOR 3.74, 95% CI 1.97–7.10), and higher parent fidelity, including understanding and correct use of intervention strategies during follow-up visits. Conclusion: Brief PMI was associated with meaningful gains in functional language and social communication. Child age, caregiver attendance, and parent fidelity predicted better outcomes, supporting the integration of structured PMI into routine ASD care in low-resource settings.