Lawrence Scahill1, Karen Bearss2, Luc Lecavalier3, Tristram Smith4, Naomi Swiezy5, Michael G Aman3, Denis G Sukhodolsky6, Courtney McCracken7, Noha Minshawi5, Kylan Turner8, Lynne Levato4, Celine Saulnier2, James Dziura9, Cynthia Johnson10. 1. Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta. Electronic address: lawrence.scahill@emory.edu. 2. Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta. 3. Nisonger Center, UCEDD, Ohio State University, Columbus. 4. University of Rochester, Rochester, NY. 5. Indiana University, Indianapolis. 6. Child Study Center, Yale University, New Haven, CT. 7. Emory University School of Medicine. 8. Division of Education Leadership and Innovation, Mary Lou Fulton Teachers College, Arizona State University, Tempe. 9. Yale University. 10. University of Florida, Gainesville.
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, 6-site, randomized trial of parent training versus parent education in 180 children with ASD (aged 3-7 years; 158 boys and 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. RESULTS: At week 24, the parent training group showed a 5.7-point improvement from baseline on the Daily Living domain compared to no change in parent education (p = .004; effect size = 0.36). On the Socialization domain, there was a 5.9-point improvement in parent training versus a 3.1-point improvement in parent education (p = .11; effect size = 0.29). Gains in the Communication domain were similar across treatment groups. The gain in Daily Living was greater in children with IQ of >70. However, the interaction of treatment-by-IQ was not significant. Gains in Daily Living at week 24 were maintained upon re-evaluation at 24 weeks posttreatment. 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. Clinical trial registration information-Randomized Trial of Parent Training for Young Children With Autism (RUBI); http://clinicaltrials.gov/; NCT01233414.
RCT Entities:
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, 6-site, randomized trial of parent training versus parent education in 180 children with ASD (aged 3-7 years; 158 boys and 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. RESULTS: At week 24, the parent training group showed a 5.7-point improvement from baseline on the Daily Living domain compared to no change in parent education (p = .004; effect size = 0.36). On the Socialization domain, there was a 5.9-point improvement in parent training versus a 3.1-point improvement in parent education (p = .11; effect size = 0.29). Gains in the Communication domain were similar across treatment groups. The gain in Daily Living was greater in children with IQ of >70. However, the interaction of treatment-by-IQ was not significant. Gains in Daily Living at week 24 were maintained upon re-evaluation at 24 weeks posttreatment. 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. Clinical trial registration information-Randomized Trial of Parent Training for Young Children With Autism (RUBI); http://clinicaltrials.gov/; NCT01233414.
Authors: Karen Bearss; T Lindsey Burrell; Saankari A Challa; Valentina Postorino; Scott E Gillespie; Courtney Crooks; Lawrence Scahill Journal: J Autism Dev Disord Date: 2018-04
Authors: C H Chatham; K I Taylor; T Charman; X Liogier D'ardhuy; E Eule; A Fedele; A Y Hardan; E Loth; L Murtagh; M Del Valle Rubido; A San Jose Caceres; J Sevigny; L Sikich; L Snyder; J E Tillmann; P E Ventola; K L Walton-Bowen; P P Wang; T Willgoss; F Bolognani Journal: Autism Res Date: 2017-09-21 Impact factor: 5.216
Authors: Cynthia R Johnson; Tristram Smith; Alexandra DeMand; Luc Lecavalier; Victoria Evans; Matthew Gurka; Naomi Swiezy; Karen Bearss; Lawrence Scahill Journal: Sleep Med Date: 2018-02-01 Impact factor: 3.492
Authors: Terry Katz; Amy M Shui; Cynthia R Johnson; Amanda L Richdale; Ann M Reynolds; Lawrence Scahill; Beth A Malow Journal: J Autism Dev Disord Date: 2018-08