Toward an exportable parent training program for disruptive behaviors in autism spectrum disorder

Abstract

Autism spectrum disorders (ASD) are chronic conditions of early childhood onset characterized by profound deficits in social interaction, impaired communication, and repetitive behavior. The prevalence of ASD is now estimated to be 1 in 88 children. As the number of identified cases of ASD has grown, so have the challenges of serving these children and their families. Unfortunately, the empirical foundation for many interventions for this population is not firmly established. Thus, there is a pressing need to conduct trials that will expand the evidence base and guide clinical treatment. Investigators from the Research Units in Pediatric Psychopharmacology (RUPP; Indiana University, Ohio State University, University of Pittsburgh, Yale University) followed a treatment development model outlined by an NIMH ad hoc committee to develop and test a parent training (PT) treatment manual for children with ASD accompanied by disruptive behavior problems. This article describes the process of manual development and cross-site therapist training, establishment and maintenance of treatment integrity, assessment of treatment acceptance by families as well as primary outcomes of three trials. Results suggest the structured PT program can be delivered with a high degree of fidelity within and across therapists, is acceptable to parents and can produce significant reductions in disruptive behaviors in children with ASD.

Parent Training in Autism Spectrum Disorder: What’s in a Name?

“…The Research Units in Pediatric Psychopharmacology (RUPP) Autism Network parent training program (Aman, et al, 2009; Bearss et al, 2013a; Bearss et al, 2013b; Johnson et al, 2007; RUPP, 2007; Scahill et al, 2012;) illustrates a Primary PMI program for the reduction in disruptive behavior and improvement in adaptive skills in young children with ASD. The program consists of 11 core and up to two optional focal-problem sessions (e.g., toileting or sleep problems) as well as two telephone booster calls and two home visits delivered over the course of six months.…”

“…The terms: “parent training” and “autism” identify articles where authors use labels such as “ parent training ” (Aman et al, 2009; Bearss et al, 2013b; Beaudoin, Sebire & Couture, 2014; Coolican, Smith, & Bryson, 2010; Drew et al, 2002; Ingersoll & Dvortcsak, 2006; Matson, Mahan, & Matson, 2009; Oosterling et al, 2010; Solomon, Necheles, Ferch, & Bruckman, 2007), “ parent education ” (Schultz, Schmidt & Stichter, 2011; Stahmer & Gist, 2001; Steiner, et al, 2012; Symon, 2001), “ parent-implemented ” (Ingersoll & Gergans, 2007; McConachie & Diggle, 2007; Nunes & Hanline, 2007; Reagon & Higbee, 2009; Tarbox, Schiff, & Najdowski, 2010), “ parent-mediated ” (Diggle, McConachie, & Randle, 2003; Green et al, 2020; Ingersoll & Wainer, 2013; Oono, Honey, & McConahie, 2013; Schertz & Odom, 2007; Siller, Hutman, & Sigman, 2013), and “ caregiver-mediated” (Kasari et al, 2010; Kasari et al, 2014). These programs represent a stunning range of intervention formats and treatment targets, including language skills, social skills, psychoeducation, and treatment of disruptive behaviors.…”

Behavioral parent training to address sleep disturbances in young children with autism spectrum disorder: a pilot trial

“…The BPT sleep program in our study was modeled after the Research Unit on Pediatric Psychopharmacology Autism Network Parent Training program [44,51-53]. The BPT program covered a range of strategies and procedures.…”

Cultivating Mind: Mindfulness Interventions for Children with Autism Spectrum Disorder and Problem Behaviours, and Their Mothers

“…Difficulties in the basic domains of social life, such as social-emotional reciprocity and the development and maintenance of relationships, appear to give rise to heightened anxiety and stress (Bluth et al 2013). This may help explain why individuals with ASD commonly present clinically significant problem behaviours (Bearss et al 2013) at a greater level than those with other types of developmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) (Goldin et al 2013) and intellectual disability (Estes et al 2009). The complex pattern of impairments, heightened anxiety and stress, and clinically significant problem behaviours together create a pronounced parenting challenge (Bearss et al 2013;Oono et al 2013).…”