This study examined the efficacy of the Child-Directed Interaction Training (CDIT) phase of Parent-Child Interaction Therapy for children with an Autism Spectrum Disorder (ASD). Thirty mother-child dyads with children ages 3-7 years with a diagnosis of ASD participated in this randomized controlled study. Following manualized CDIT, statistically significant and meaningful improvements in child disruptive behavior and social awareness as well as maternal distress associated with child disruptive behavior occurred. Across 8 sessions, mothers learned to provide positive attention to their children's appropriate social and play behaviors. Both child and parent changes were maintained at 6-week follow-up. A relatively brief, time-limited, and accessible intervention may be efficacious for improving child and parent behaviors in families of young children with ASD. By decreasing child disruptive behaviors, CDIT may also help to prepare children to benefit further from future interventions.

Differences in behavioral and cognitive profiles have been suggested to potentially impact the presentation of social and communication symptoms in females with autism spectrum disorder. This study examined gender differences in age of diagnosis, cognitive profiles, social communication symptomatology, and autism spectrum disorder symptom severity in a community-based sample of 566 males and 113 females with autism spectrum disorder ranging in age from 1 year, 9 months to 56 years, 4 months. Results suggest either very small or no gender differences in age at diagnosis, intelligence quotient, cognitive profiles, or autism spectrum disorder symptom severity. This is a departure from clinical lore that females with autism spectrum disorder are more likely to have lower intelligence quotient and more severe impairments. There is a slight difference in symptom severity with females having higher average total Childhood Autism Rating Scale scores, but this difference is likely of minimal clinical significance. In contrast, on the Autism Diagnostic Observation Schedule-Generic, females were found to receive lower scores than males particularly on modules 2 and 3. Across males and females, individuals with stronger verbal problem-solving skills were found to receive lower Autism Diagnostic Observation Schedule-Generic module 3 scores. Given the language demands of this module, additional attention may be warranted when evaluating older children and adolescents for autism spectrum disorder.

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.

This case demonstrates the feasibility of using PCIT with a child older than the recommended age range to address behavior problems associated with TBI.