Effect of Parent Training on Adaptive Behavior in Children With Autism Spectrum Disorder and Disruptive Behavior: Results of a Randomized Trial

Abstract

Objective: This study examined the impact of Parent Training on adaptive behavior in children with autism spectrum disorder (ASD) and disruptive behavior. Methods:This was a 24-week, six-site, randomized trial of parent training versus parent education in 180 children with ASD (age 3 to 7 years; 158 boys, 22 girls) and moderate or greater behavioral problems. Parent training included specific strategies to manage disruptive behavior over 11 to 13 sessions, 2 telephone boosters, and 2 home visits. Parent education provided useful information about autism, but no behavior management strategies over 12 core sessions and 1 home visit. In a previous report, we showed that parent training was superior to parent education in reducing disruptive behavior in young children with ASD. Here, we test whether parent training is superior to parent education in improving daily living skills as measured by the parent-rated Vineland Adaptive Behavior Scales II. The long-term impact of parent training on adaptive functioning is also presented. Conclusion:These results support the model that reduction in disruptive behavior can lead to improvement in activities of daily living. By contrast, the expected trajectory for adaptive behavior in children with ASD is often flat and predictably declines in children with intellectual disability. In the parent training group, higher-functioning children achieved significant gains in daily living skills. Children with intellectual disability kept pace with time.

A 6-year follow-up of children assessed for suspected autism spectrum disorder: parents’ experiences of society’s support

“…Research has suggested that parents’ knowledge is important for the child’s improvement in daily life 41. However, it should not have an impact on equal care and support from authorities to the families.…”

Adaptive behavior in autism: Minimal clinically important differences on the Vineland‐II

“…A recent Autism Speaks sponsored working group panel recommended the Vineland‐II as suitable (having adequate reliability, validity, and responsiveness) to quantify social communication deficits in clinical trials of ASD [Anagnostou et al, ; see also McConachie et al, ]. The Vineland‐II is also increasingly used in randomized trials targeting core ASD symptoms and/or adaptive behavior more broadly [e.g., Chugani et al, ; Dawson et al, ; Hardan et al, ; Scahill et al, ; Umbricht et al, ; Veenstra‐VanderWeele et al, ; Ventola et al, ], in part due to the relative lack of other reliable measures of change in these behaviors [Anagnostou et al, ]. This increasing use may also reflect the relatively broader scope of adaptive behaviors assessed by Vineland‐II, relative to the more circumscribed set of core ASD symptoms (McDougall et al, in press).…”

Point OutWords: protocol for a feasibility randomised controlled trial of a motor skills intervention to promote communicative development in non-verbal children with autism

“…The VABS [57] is a widely-used parent interview measuring adaptive behaviour, recommended as a test-retest measure in autism treatment studies [58] and normed for all ages [59]. Items are categorised into four primary domains: communication, daily living skills, socialisation, and motor skills, with maladaptive behaviour (internalising and externalising) also examined.…”