Parent-Training Improves Behavioral Problems In Children With Autism

MedicalResearch.com Interview with:
Lawrence Scahill, MSN, PhD and Karen Bearss, PhD
Department of Pediatrics, Marcus Autism Center
Children’s Healthcare of Atlanta and Emory University
Atlanta, Georgia

Medical Research: What is the background for this study? What are the main findings?

Response: Autism spectrum disorder (ASD) affects an estimated 0.6 to 1% of children worldwide.

In young children with ASD (e.g. 3 to 7 years of age) up to 50% also have disruptive
behaviors such as tantrums, aggression, self-injury and noncompliance. When present,
these disruptive behaviors interfere with the child’s readiness to make use of educational and other supportive services. The presence of disruptive behaviors also hinders the acquisition of routine daily living skills.

Parent Training has been shown to be effective for young children with disruptive behaviors who do not have Autism spectrum disorder – but it has not be well-studied in children with ASD.

The current multisite study shows that parent training is effective in reducing serious behavioral problems in young children with ASD. This is the largest randomized trial of a behavioral intervention in children with ASD.  180 children were randomly assigned to parent training or parent education. Both treatments were delivered individually to parents over 24 weeks.

Serious behavioral problems were reduced by almost 50% in the parent-training group compared to about 30% for parent education. A clinician who was blind to treatment assignment rated positive response in 69% of children in the parent training group compared to 40% for parent education. In addition, 79% of children who showed a positive response to parent training at the end of the 24-week trial maintained benefit at 6 months post treatment.

Parent training provided parents with specific strategies on how to manage tantrums, aggression, self-injury and noncompliance in children with autism spectrum disorder. Parent education provided up-to-date and useful information about ASD, but no instruction on how to address behavioral problems. Parents were engaged in the study treatments as evidenced by the low drop-out rate of 10% .

Medical Research: What should clinicians and patients take away from your report?

Response: Both treatments resulted in improvement – but parent training was clearly better.

The parent training program consists of 11 core sessions, 2 optional sessions, 2 telephone boosters, and 2 home visits. Our parent training program is relatively brief and can be implemented in a wide range of settings. With training, it can delivered by a wide range of practitioners.

Persistent disruptive behavior often promotes uncertainty for parents about how to deal with these behaviors.

By providing practical tools, parent training fosters parental confidence and promotes success in everyday life for the child and family.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Over the past decade our multisite group has developed and now tested a structured parent training program designed to teach parents how to address behavioral problems in young children with ASD.  The intervention is acceptable to parents and it can be reliably delivered by therapists trained in the manual.

This multi-site randomized trial showed that parent training is effective in reducing behavioral problems in young children with Autism spectrum disorder.  Parent training is ready for wider implementation.

The study was conducted by the Research Units on Behavioral Intervention (RUBI) Autism Network (Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester and Yale University).

The study was funded by the National Institute of Mental Health with addition support from Marcus Foundation and the JB Whitehead Foundation.

Citation:

Bearss K, Johnson C, Smith T, et al. Effect of Parent Training vs Parent Education on Behavioral Problems in Children With Autism Spectrum Disorder: A Randomized Clinical Trial. JAMA. 2015;313(15):1524-1533. doi:10.1001/jama.2015.3150.

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MedicalResearch.com Interview with: Lawrence Scahill, MSN, PhD and Karen Bearss, PhD (2015). Parent-Training Improves Behavioral Problems In Children With Autism 

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