A Parent-Mediated Intervention That Targets Responsive Parental Behaviors Increases Attachment Behaviors in Children with ASD: Results from a Randomized Clinical Trial

Abstract

The current study is a randomized clinical trial evaluating the efficacy of Focused Playtime Intervention (FPI) in a sample of 70 children with Autism Spectrum Disorder. This parent-mediated intervention has previously been shown to significantly increase responsive parental communication (Siller et al. in J Autism Dev Disord 43:540–555, 2013a). The current analyses focus on children’s attachment related outcomes. Results revealed that children who were randomly assigned to FPI showed bigger increases in attachment-related behaviors, compared to children assigned to the control condition. Significant treatment effects of FPI were found for both an observational measure of attachment-related behaviors elicited during a brief separation-reunion episode and a questionnaire measure evaluating parental perceptions of child attachment. The theoretical and clinical implications of these findings are discussed.

A short-term longitudinal study of correlates and sequelae of attachment security in autism

“…Koren-Karie and colleagues (2009) reported that the relationship between maternal sensitivity and attachment security in autism holds after controlling for children’s level of developmental functioning and responsiveness to mother during a separate interaction. In the study perhaps most clearly corroborating this sensitivity–security link, Siller, Swanson, Gerber, Hutman, and Sigman (2014) reported that an intervention aimed at improving caregiver sensitivity with children with autism led (post-intervention) to an increase in attachment behaviors exhibited by the children during a modified separation and reunion procedure.…”

Late Positive Potential ERP Responses to Social and Nonsocial Stimuli in Youth with Autism Spectrum Disorder

“…Subsequent portions of the intervention may then include increasing the child's interest in their play-partner than the RI (Mahoney & MacDonald, 2007). This type of intervention has demonstrated positive parent and child outcomes, including in the context of Responsive Teaching (Karaaslan, Diken, & Mahoney, 2013; Mahoney & MacDonald, 2007; Mahoney & Perales, 2005), Adapted Responsive Teaching (Baranek et al, 2015); Focused Playtime Intervention (Kasari, 2014; Siller, Hutman, & Sigman, 2013; Siller, Swanson, Gerber, Hutman, & Sigman, 2014), and Hanen's More Than Words program (Carter et al, 2011; Venker, McDuffie, Ellis Weismer, & Abbeduto, 2012). The results of the current study support the potential utility of behavioral ASD interventions to leverage nonsocial interests to improve social-communication functioning in children with ASD by gradually expanding the child's interests to include new objects, actions, and people.…”

Evidence Base Update for Autism Spectrum Disorder

“…Two programs obtained similarly favorable results with targeted social-communication skills and more global outcomes (Kasari, Gulsrud, Wong, Kwon, & Locke, 2010;Siller, Hutman, & Sigman, 2013). A secondary analysis of Siller's intervention indicated that this program was also associated with gains in some attachment-related behaviors (Siller, Swanson, Gerber, Hutman, & Sigman, 2014). Other RCTs have generally reported more favorable results for communication and social engagement outcomes than in global outcomes (e.g., ASD symptoms).…”

“…The limited available evidence on parent training suggests that favorable response to treatment is moderated by baseline participant characteristics including object interest and more limited pretreatment communication skills (Siller, Swanson et al, 2014;Tonge et al, 2014). Other studies focused on predictors of outcome, such as the child's joint attention, involvement, enjoyment (Casenhiser et al, 2013), and age (Rogers et al, 2012); parent's intervention fidelity (Rogers et al, 2012) and quality of engagement (Kasari et al, 2010); and treatment ''dose'' (Rogers et al, 2012).…”