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Thompson EL, Gillespie-Smith K, Mair APA, Obsuth I. Exploring Emotional Dysregulation and Avoidance with Caregivers as the Mechanisms Linking Social Communication Understanding and Aggressive Behaviours. J Autism Dev Disord 2024:10.1007/s10803-024-06276-8. [PMID: 38714626 DOI: 10.1007/s10803-024-06276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 05/10/2024]
Abstract
Many autistic adolescents and young adults present with aggressive behaviours, which can be challenging for caregivers. The present study aimed to explore the underlying mechanisms between social communication understanding and aggressive behaviours in autistic and non-autistic adolescents, specifically the role of emotional dysregulation and its impact on avoidance with caregivers. Caregivers of autistic (n = 275) and non-autistic adolescents (n = 123) completed standardised caregiver-report questionnaires measuring social communication understanding, emotional dysregulation, avoidance between the adolescent and caregiver and aggressive behaviours. A serial mediation analysis indicated that levels of social communication understanding were indirectly associated with aggressive behaviours. This occurred through increased emotional dysregulation, which may have led to increased avoidance between the autistic and non-autistic adolescents and their caregivers. These findings support a sequential process by which adolescents with low social communication understanding are more likely to behave aggressively through being emotionally dysregulated and the impact of this on the increased avoidance within the caregiver-adolescent dyad. This process was found within autistic and non-autistic adolescents, suggesting a mechanism across individuals with aggression. These findings indicate that interventions based on improving emotion regulation ability and responses between adolescents and their caregivers may aid in reducing aggressive behaviours in adolescents and young adults with lower social communication understanding.
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Affiliation(s)
- Emma Louise Thompson
- School of Health and Social Science, University of Edinburgh, Edinburgh, EH8 9AG, UK.
- Department of Psychological Service & Research, NHS Dumfries & Galloway, Dumfries, DG1 4AP, UK.
| | - Karri Gillespie-Smith
- School of Health and Social Science, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Ally Pax Arcari Mair
- School of Health and Social Science, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Ingrid Obsuth
- School of Health and Social Science, University of Edinburgh, Edinburgh, EH8 9AG, UK
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2
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Quetsch LB, Bradley RS, Theodorou L, Newton K, McNeil CB. Community-based Agency Delivery of Parent-Child Interaction Therapy: Comparing Outcomes for Children with and Without Autism Spectrum Disorder and/or Developmental Delays. J Autism Dev Disord 2024; 54:33-45. [PMID: 36323995 DOI: 10.1007/s10803-022-05755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
While externalizing behaviors are common among children with autism spectrum disorder (ASD), there is a shortage of specialist community-based clinicians to provide treatment. Parent-Child Interaction Therapy (PCIT), an intervention designed to reduce child disruptive behaviors, may be effective for families of children with ASD but has rarely been studied outside of university-based research settings. We examined the effectiveness of PCIT delivered for children with (N = 109) and without (N = 2,324) ASD/developmental delays (DD) across community-based agencies in Oregon. Findings revealed significant reductions in disruptive behavior and positive changes in the parent-child relationship in both groups. These findings support PCIT as an efficacious intervention for children with ASD/DD and demonstrate PCIT's promise in community-based agencies with non-specialized clinicians.
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Affiliation(s)
| | | | | | | | - Cheryl B McNeil
- West Virginia University, Morgantown, WV, United States
- University of Florida, Gainesville, FL, United States
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3
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Ros-DeMarize R, Klein J, Carpenter LA. Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder. Behav Ther 2023; 54:892-901. [PMID: 37597965 DOI: 10.1016/j.beth.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/29/2022] [Accepted: 03/23/2023] [Indexed: 08/21/2023]
Abstract
The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2-6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.
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4
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Campbell SM, Hawes T, Swan K, Thomas R, Zimmer-Gembeck MJ. Evidence-Based Treatment in Practice: PCIT Research on Addressing Individual Differences and Diversity Through the Lens of 20 Years of Service. Psychol Res Behav Manag 2023; 16:2599-2617. [PMID: 37465048 PMCID: PMC10350409 DOI: 10.2147/prbm.s360302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
Parent-Child Interaction Therapy (PCIT) is an intensive parent support program for caregivers and their children who exhibit difficult-to-manage disruptive behaviors. After more than four decades of research supporting its efficacy for reducing children's disruptive behaviors and improving parent-child relationships, PCIT has become one of the most popular and widely disseminated parenting support programs in the world. The evidence for the efficacy of PCIT can be found in many reviews of randomized clinical trials and other rigorous studies. To add to those reviews, our aim was to provide practical guidance on how PCIT can be part of an evidence-based program for families that depends on practitioner expertise, as well as attention to families' diverse needs. To do this, we describe the evolution of PCIT as practiced in a university-community partnership that has continued for over 20 years, alongside a narrative description of selected and recent findings on PCIT and its use in specific client presentations across four themes. These themes include studies of 1) whether the standard manualized form of PCIT is efficacious across a selection of diverse family situations and child diagnoses, 2) the mechanisms of change that explain why some parents and some children might benefit more or less from PCIT, 3) whether treatment content modifications make PCIT more feasible to implement or acceptable to some families, at the same time as achieving the same or better outcomes, and 4) whether PCIT with structural modifications to the delivery, such as online or intensive delivery, yields similar outcomes as standard PCIT. Finally, we discuss how these directions in research have influenced research and practice, and end with a summary of how the growing attention on parent and child emotion regulation and parents' responses to (and coaching of) their children's emotions has become important to PCIT theory and our practice.
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Affiliation(s)
- Shawna M Campbell
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Tanya Hawes
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Kellie Swan
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Rae Thomas
- Tropical Australian Academic Health Centre, Townsville, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Melanie J Zimmer-Gembeck
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
- Griffith Centre for Mental Health, Griffith University, Gold Coast, QLD, Australia
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5
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Ros-DeMarize R, Boan A, Bradley C, Klein J, Carpenter L. Tele-PCIT: Initial Examination of Internet Delivered PCIT for Young Children with Autism. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01539-4. [PMID: 37171780 DOI: 10.1007/s10578-023-01539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Parent-Child Interaction Therapy (PCIT) is an empirically supported behavioral parenting program for disruptive behavior and has been shown to also be effective for children with autism spectrum disorder (ASD). Telehealth delivery of PCIT (Tele-PCIT) is also supported, but no trials have focused on children with ASD. The purpose of the study was to examine the initial efficacy of a time limited version of Tele-PCIT within an ASD sample. METHODS Participants included parents of 20 children (ages 2-6) with ASD who received 10 sessions of Tele-PCIT. Parents reported on their parenting stress, parenting practices, and child behavior. A play observation was coded for parent use of treatment skills and for child compliance. RESULTS 80% of participants completed treatment (n = 16) and results revealed significant improvements across parenting and child outcomes. Parents reported decreases in parenting stress from pre-to-post-treatment, which were maintained at a 3-month follow-up, along with decreases in negative parenting practices (i.e., Laxness and Overactivity) from pre-to-post treatment that were also maintained at follow-up. Significant increases in parent use of positive parenting skills (i.e., "Do" Skills) during child-led play and decreases in negative parenting skills (i.e., "Don't" Skills) were observed. Results also revealed significant reductions in parent rated child externalizing behavior problems from pre-to-post-treatment that were also maintained at follow-up. CONCLUSIONS Results of the current study support the initial efficacy of Tele-PCIT for treating disruptive behavior in young children with ASD. Findings from this pilot will inform larger examinations of Tele-PCIT for youth with ASD.
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Affiliation(s)
- Rosmary Ros-DeMarize
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
| | - Andrea Boan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Catherine Bradley
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Jordan Klein
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Carpenter
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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Ulaş S, Seçer İ, Victory EJ, McNeil CB. Scientific collaborations and research trends in Parent-Child Interaction Therapy: a bibliometric analysis. Front Psychol 2023; 14:1167937. [PMID: 37251036 PMCID: PMC10213549 DOI: 10.3389/fpsyg.2023.1167937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Parent-child interaction therapy (PCIT) is considered to be an effective intervention for children aged 2-7 years with conduct problems. PCIT research has been conducted for approximately 50 years; however, an analysis of general research patterns has not been published. In this context, the present study outlines a bibliometric analysis of scientific collaborations, prevalence across locations on the basis of countries and organizations, leading researchers, and trends within PCIT research. Findings demonstrate that PCIT is an area in which international scientific collaborations are intense and current, and collaborations continue to be formed around the world. Additionally, results indicate that dissemination of intercultural PCIT adaptations are continuous.
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Affiliation(s)
- Sümeyye Ulaş
- Laboratory Department of Psychological Counseling and Guidance, Atatürk University, Erzurum, Türkiye
| | - İsmail Seçer
- Laboratory Department of Psychological Counseling and Guidance, Atatürk University, Erzurum, Türkiye
| | - Erinn J. Victory
- Department of Psychology, West Virginia University, Morgantown, WV, United States
| | - Cheryl B. McNeil
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
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7
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Reyes-Martín J, Simó-Pinatella D, Font-Roura J. Assessment of Challenging Behavior Exhibited by People with Intellectual and Developmental Disabilities: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148701. [PMID: 35886552 PMCID: PMC9324269 DOI: 10.3390/ijerph19148701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022]
Abstract
The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention programs. This review aimed to identify and analyze the standardized instruments that exclusively focus on the assessment of challenging behavior. We identified and organized 141 articles into four categories: original instrument studies, validation studies, relational studies, and intervention studies. The results identified 24 instruments that generally show high-quality psychometric properties and other utilities beyond the observation of the presence of challenging behavior and diagnostic categorization. Age, level of adaptive behavior, disability, presence of autism spectrum disorder, and medication are some of the variables that were found to be possibly related to the occurrence of challenging behavior. Additionally, the results suggest that interventions focused on supporting positive behavior or providing training on behavior to professionals and caregivers significantly reduced the occurrence of these behaviors. Instruments that help us to understand and measure the challenging behavior exhibited by people with intellectual and developmental disabilities are essential for the design of effective evaluation and intervention protocols.
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Affiliation(s)
- Juliana Reyes-Martín
- Facultat de Psicologia, Ciències de l’Educació i de l’Esport, Blanquerna, Ramon Llull University, 08022 Barcelona, Spain;
- Fundació Vallparadís, Mutua Terrassa, 08221 Barcelona, Spain
- Correspondence:
| | - David Simó-Pinatella
- Facultat de Psicologia, Ciències de l’Educació i de l’Esport, Blanquerna, Ramon Llull University, 08022 Barcelona, Spain;
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8
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Ma M, Wang X, Qi P, Wang T. Affect, Behaviors of Children With Intellectual Disabilities and Parents' Coping Strategies During the COVID-19 Pandemic. Front Psychiatry 2022; 13:822908. [PMID: 35669262 PMCID: PMC9163408 DOI: 10.3389/fpsyt.2022.822908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background In early 2020, the COVID-19 pandemic emerged. To prevent the spread of the virus, China implemented restrictions on going out and ensured that people stayed at home. This study aims to investigate the affect and behaviors of children with intellectual disabilities (ID) during the lockdown. The informal coping strategies adopted by parents and their effects were further evaluated. Methods In this study, a total of 457 parents of children (mean age: 14.82 years ± 1.96) with ID in 12 provincial administrative regions across China were surveyed online using the Positive and Negative Affect Scale and our own questionnaire on daily behaviors, problem behaviors and informal coping strategies. Results During the COVID-19 pandemic, the positive affect (PA) score was significantly higher than that of negative affect (NA) (p < 0.001). Some children experienced mostly positive changes in sleep (16.63%), communication (14.66%), and diet (5.69%). However, more than one-third (39.39%) exhibited problem behaviors such as hyperactivity. A significant correlation was found between affect and behavior. The informal coping measures adopted by parents were generally effective among affect and the relationship with problem behaviors. Conclusions The affect of the children with ID at home was mainly positive. The overall behaviors (diet, sleep, and communication) were good, but there were problem behaviors. Effective coping strategies are associated with higher PA, lower NA, and fewer problem behaviors. The greater the number of effective coping strategies, the lesser the problem behaviors.
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Affiliation(s)
- Minjie Ma
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
- Xi'an Mangya School, Xi'an, China
| | - Xiao Wang
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
- Xi'an Mangya School, Xi'an, China
| | - Peiyu Qi
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
- School of Education and Psychology, Hainan Normal University, Haikou, China
| | - Tingzhao Wang
- Department of Special Education, School of Education, Shaanxi Normal University, Xi'an, China
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9
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Vess SF, Campbell JM. Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221140707. [PMID: 36506281 PMCID: PMC9726853 DOI: 10.1177/23969415221140707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIMS Parent-child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent-child interaction patterns to improve child behavior and enhance the quality of parent-child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties. METHODS This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old (M = 40 months) over a 4-month period. RESULTS PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement. CONCLUSIONS Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent-child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT. IMPLICATIONS The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.
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Affiliation(s)
- Sarah F. Vess
- Sarah F. Vess, Developmental Behavioral Pediatrics, Brenner Children's Hospital, Atrium Health Wake Forest Baptist, Wake Forest School of Medicine, 3325 Silas Creek Parkway, Winston Salem, NC 27103, USA.
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Comparative Effectiveness of Parent-Child Interaction Therapy for Children with and Without Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:2041-2052. [PMID: 30864057 DOI: 10.1007/s10803-019-03960-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Youth with autism spectrum disorder (ASD) often display disruptive behavior and noncompliance. Disruptive behavior in youth with ASD may limit their participation in educational and therapeutic activities and impact family functioning. Several evidence-based interventions are available for typically developing children, such as Parent-Child Interaction Therapy (PCIT). The current study examined the comparative effectiveness of PCIT for youth with ASD and without ASD. Results indicate that PCIT significantly improves parent-reported disruptive behavior in children with ASD at levels comparable to children without ASD. Additionally, improvements in ASD-related symptoms were noted for youth with ASD. These findings support the use of PCIT for children with ASD and provide clinicians with an evidence-based tool to address disruptive behavior in a wide spectrum of presenting children.
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11
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Parenting Strategies Used by Parents of Children with ASD: Differential Links with Child Problem Behaviour. J Autism Dev Disord 2019; 50:386-401. [PMID: 31676915 PMCID: PMC6994498 DOI: 10.1007/s10803-019-04219-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Here, we explored the structure of the 'Parenting Strategies Questionnaire', a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: Accommodation, Reinforcement Approaches and Reducing Uncertainty. Both Accommodation and Reducing Uncertainty were linked to child problem behaviour. Child factors explained up to 29% of the variance in Accommodation, with Socially Inflexible Non-compliance the strongest predictor, and up to 24% of the variance in Reducing Uncertainty, with Intolerance of Uncertainty the strongest predictor. Child factors were not related to Reinforcement Approaches. Longitudinal studies investigating these relationships are needed.
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Parladé MV, Weinstein A, Garcia D, Rowley AM, Ginn NC, Jent JF. Parent–Child Interaction Therapy for children with autism spectrum disorder and a matched case-control sample. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:160-176. [DOI: 10.1177/1362361319855851] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Parent–Child Interaction Therapy is an empirically based, behavioral parent training program for young children exhibiting disruptive behaviors. Parent–Child Interaction Therapy shows promise for treating disruptive behaviors in children with autism spectrum disorder. Treatment processes (i.e. treatment length and homework compliance), parenting skills, parenting stress, and behavioral outcomes (i.e. disruptive and externalizing behaviors and executive functioning) were compared in 16 children with autism spectrum disorder and 16 children without autism spectrum disorder matched on gender, age, and initial intensity of disruptive behaviors. Samples were statistically similar in terms of child receptive language, child race and ethnicity, parent age, gender and education, and number of two-parent families in treatment. Families received standard, mastery-based Parent–Child Interaction Therapy. Both groups demonstrated significant and clinically meaningful improvements in child disruptive and externalizing behavior and executive functioning, parenting skills, and parenting stress. Length of treatment, homework compliance, and parent and child outcomes did not differ significantly between groups. A subset of children with autism spectrum disorder also showed significant improvements in social responsiveness, adaptive skills, and restricted/repetitive behaviors. This study replicates and extends prior research by demonstrating that children with and without autism spectrum disorder experience similar benefits following Parent–Child Interaction Therapy. Findings may expand the availability and dissemination of time-limited, evidence-based interventions for autism spectrum disorder and comorbid disruptive behaviors.
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Affiliation(s)
| | | | | | | | - Nicole C Ginn
- The University of North Carolina at Chapel Hill, USA
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13
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Cambric M, Agazzi H. A Case Study of Parent–Child Interaction Therapy for the Treatment of High-Functioning Autism Spectrum Disorder. Clin Case Stud 2019. [DOI: 10.1177/1534650119843591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Youth with autism spectrum disorder (ASD) may have difficulties with compliance, impulsivity, and attention, which can affect daily adaptive functioning leading to disruptions in family social interactions, communication skills, academic achievement, and engagement in the community. Although previous research has identified behavioral treatments such as applied behavior analysis (ABA) therapy for youth with ASD, it is important to explore more interventions that can be effective in decreasing problematic behaviors while also building positive social skill development. This case study illustrates the effectiveness of Parent–Child Interaction Therapy (PCIT) to address behavioral problems in a 7-year-old boy with high-functioning ASD (HF-ASD) and comorbid ADHD. Overall, the results demonstrated a decrease in child challenging behaviors and an increase in child compliance. In addition, the child’s mother increased her use of positive parenting skills and effective commands. This study provides additional support for PCIT for children with ASD, but was not without challenges. These challenges, characteristic of families affected by ASD, and treatment implications for clinicians working with this population are discussed.
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14
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O'Nions E, Viding E, Floyd C, Quinlan E, Pidgeon C, Gould J, Happé F. Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/'pathological' demand avoidance. Child Adolesc Ment Health 2018; 23:220-227. [PMID: 32677301 DOI: 10.1111/camh.12242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND A subset of individuals with autism spectrum disorder (ASD) resemble descriptions of extreme/'pathological' demand avoidance, displaying obsessive avoidance of everyday demands and requests, strategic or 'socially manipulative' behaviour and sudden changes in mood. Investigating challenging presentations using dimensional description may prove preferable to identifying subgroups. However, there remains an imperative to explore which behavioural traits appear most problematic to inform quantitative investigation. This study provides an in-depth exploration of parent perspectives on maladaptive behaviour in children reported to have an autism spectrum diagnosis and features of extreme/'pathological' demand avoidance. METHOD Parents completed a tailored semistructured interview about their child's behaviour, focusing on difficulties relevant to descriptions of extreme/'pathological' demand avoidance. The 26 interviews rated as scoring above threshold for 'substantial' features of extreme/'pathological' demand avoidance on relevant indicators were analysed qualitatively using a general inductive approach. RESULTS New themes that emerged from these data included attempts by the child to control situations and others' activities. Avoidance behaviours in this sample could be described as 'strategic' rather than 'manipulative'. A range of factors, including a negative emotional response to demands, but also phobias, novelty, and uncertainty, were perceived to play a role in triggering extreme behaviour. CONCLUSIONS These descriptions highlight the importance of systematically measuring noncompliance, attempts to control situations and others' activities, and extreme mood variability in individuals with ASD. These dimensions represent important targets for intervention, given their considerable impact on daily life.
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Affiliation(s)
- Elizabeth O'Nions
- Parenting & Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Leuven Autism Research (LAuRes), University of Leuven (KU Leuven), Leuven, Belgium.,Developmental Risk & Resilience Unit, Clinical, Educational, and Health Psychology Research Department, Division of Psychology and Language Sciences, University College London, London, UK.,MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Essi Viding
- Developmental Risk & Resilience Unit, Clinical, Educational, and Health Psychology Research Department, Division of Psychology and Language Sciences, University College London, London, UK
| | - Caroline Floyd
- Central North West London NHS, Pembroke Centre, London, UK
| | - Emma Quinlan
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Connie Pidgeon
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Judith Gould
- The NAS Lorna Wing Centre for Autism, Bromley, Kent, UK
| | - Francesca Happé
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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15
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O'Nions E, Happé F, Evers K, Boonen H, Noens I. How do Parents Manage Irritability, Challenging Behaviour, Non-Compliance and Anxiety in Children with Autism Spectrum Disorders? A Meta-Synthesis. J Autism Dev Disord 2018; 48:1272-1286. [PMID: 29222612 PMCID: PMC5861158 DOI: 10.1007/s10803-017-3361-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD.
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Affiliation(s)
- Elizabeth O'Nions
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leopold Vanderkelenstraat 32, P. O. Box 3765, 3000, Leuven, Belgium.
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Division of Psychology and Language Sciences, Department of Clinical, Educational & Health Psychology, University College London, London, UK.
| | - Francesca Happé
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kris Evers
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leopold Vanderkelenstraat 32, P. O. Box 3765, 3000, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
- Department of Child Psychiatry UPC, KU Leuven, Leuven, Belgium
| | - Hannah Boonen
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leopold Vanderkelenstraat 32, P. O. Box 3765, 3000, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Ilse Noens
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leopold Vanderkelenstraat 32, P. O. Box 3765, 3000, Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
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16
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Monahan M, Agazzi H, Jordan-Arthur B. The Implementation of Parent–Child Interaction Therapy for the Treatment of Tourette Syndrome and Disruptive Behavior. Clin Case Stud 2017. [DOI: 10.1177/1534650117745356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A diagnosis of Tourette syndrome (TS) can confer a plethora of negative outcomes including impaired psychosocial functioning, academic difficulties, disruptive behavior, and mood dysregulation. Further, children diagnosed with TS can engender immense amounts of burden and stress experienced by their caregivers which can put strain and tension on the parent–child relationship. Uncovering efficacious treatments for improving the quality of life for children diagnosed with TS and their families represents both a great challenge as well as a chief concern for professionals working with this population. The present case study describes the provision of parent–child interaction therapy for addressing behavioral problems in a 5-year-old boy diagnosed with TS. Results suggest improvements in child compliance, decreases in disruptive behaviors, and decreases in certain symptomatology associated with TS. Treatment implications for working with youth with TS are described in detail.
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Affiliation(s)
| | - Heather Agazzi
- University of South Florida, Tampa, FL, USA
- Rothman Center for Pediatric Neuropsychiatry, Saint Petersburg, FL, USA
| | - Brittany Jordan-Arthur
- University of South Florida, Tampa, FL, USA
- Kennedy Krieger Institute, Baltimore, MD, USA
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17
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Jeter K, Zlomke K, Shawler P, Sullivan M. Comprehensive Psychometric Analysis of the Eyberg Child Behavior Inventory in Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:1354-1368. [PMID: 28197750 DOI: 10.1007/s10803-017-3048-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Many assessment measures have only been validated for one specific diagnostic population, which is costly and reduces the clinical utility of assessments. The Eyberg Child Behavior Inventory (ECBI) is one popular measure designed to assess disruptive behavior problems in youth. The ECBI has sound psychometric properties in typically developing youth, but the factor structure has never been examined in children with autism spectrum disorder (ASD). Therefore, the current study conducted a comprehensive psychometric analysis of the ECBI in children with ASD. Retrospective data from a nationally representative sample was collected from 335 children with ASD ages 2-12 years old. A four factor solution was identified for this sample. Implications of these findings and directions for future research are discussed.
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Affiliation(s)
- Kathryn Jeter
- Department of Psychology, University of South Alabama, 307 University Blvd N, UCOM 1000, Mobile, AL, 36688, USA. .,University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12400, Oklahoma City, OK, 73104, USA.
| | - Kimberly Zlomke
- Department of Psychology, University of South Alabama, 307 University Blvd N, UCOM 1000, Mobile, AL, 36688, USA
| | - Paul Shawler
- Department of Communication Sciences and Disorders, Oklahoma State University, 026B Murray Hall, Stillwater, OK, 74078, USA
| | - Maureen Sullivan
- Department of Communication Sciences and Disorders, Oklahoma State University, 026B Murray Hall, Stillwater, OK, 74078, USA
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