Up to 6 out of 1,000 children worldwide may be on the spectrum of an autistic disorder (ASD) and 50 percent of those kids demonstrate serious and disruptive behavior, including tantrums, aggression, self-injury and noncompliance. For children with ASD, serious disruptive behavior interrupts daily functioning and social skills development, limits their ability to benefit from education and speech therapy, can increase social isolation and intensify caregiver stress.
Luc Lecavalier and colleagues from The Ohio State University Wexner Medical Center conducted a 24-week parent training study designed to effectively reduce serious behavioral problems in young children with ASD.
The study, the largest randomized, multi-center trial to evaluate behavioral interventions for ASD, appeared in the Journal of the American Medical Association.
"The results are overwhelmingly in favor of parent training when it comes to managing disruptive and noncompliant behavior in young children with ASD. We thought the outcomes would send a clear message, but we didn't expect the tremendous number of parents who responded so positively," said Lecavalier, professor of psychology and psychiatry and principal investigator at Ohio State's Nisonger Center.
Researchers randomly assigned 180 children (ages 3-7) with ASD to parent training or parent education programs. Programming included 11 sessions of one-on-one therapy, brief coaching and intervention and homework.
Parent education was designed to control for time and therapist attention and provided useful information about ASD without providing specific techniques to reduce the disruptive behaviors. While parent ratings of child behavior improved in both groups, the parent training program showed behavior problems were reduced by almost half, compared to roughly 30 percent for those in the parent education group.
In addition, a clinician who was blind to treatment assignment reported 70 percent of children with ASD in the parent training group showed a positive response, compared to 40 percent for parent education. Also, 79 percent of children who showed positive response to parent training intervention at week 24 maintained improvement six months post treatment.
Lecavalier said parent training is an exportable treatment for young children with ASD that could be implemented across a wide range of settings, such as clinics and schools. He believes results of the study may inform policy discussions.
"Parents of young children with ASD face many unknowns and we're hopeful that our study's results will empower other parents to seek efficient methods to manage serious disruptive behavior," Lecavalier said.