Parent training reduces serious behavioral problems in children with autism

Young children with autism spectrum disorder, who also have serious behavioral problems, showed improved behavior when their parents were trained with specific, structured strategies to manage tantrums, aggression, self-injury, and non-compliance.

The findings from this parent training study by Yale and Emory University researchers were published recently in the Journal of the American Medical Association (JAMA).

Autism spectrum disorder (ASD) is a chronic condition beginning in early childhood and defined by impaired social communication and repetitive behavior. ASD affects 0.6 to 1% of children worldwide. In young children, ASD is often complicated by moderate or severe behavioral problems.

This 24-week, multisite, randomized trial was conducted by the Research Units on Behavioral Intervention (RUBI) Autism Network, a six-site National Institute of Mental Health-funded consortium dedicated to developing and testing behavioral treatments for children with ASD.

Denis Sukhodolsky, assistant professor at Yale Child Study Center, provided oversight for the study at the Yale site. Sukhodolsky and other investigators at Yale played a central role in data management, statistical analysis, and study monitoring.

“Parent training has been well studied in children with disruptive behavior disorder,” said Sukhodolsky. “Our study shows that parent training is also helpful for improving behavioral problems such as irritability and non-compliance in young children with ASD.”

RUBI investigators randomly assigned 180 children between the ages of 3 and 7 with ASD and behavioral problems to either a 24-week parent training program, or a 24-week parent education program. Parent education provided up-to-date and useful information about ASD, but no instruction on how to manage behavioral problems.

“Parent education was an active control condition,” said James Dziura, associate professor in the Department of Emergency Medicine at Yale, who, along with Cindy Brandt, M.D., led the data management and statistical analysis for the study. “Both groups showed improvement, but parent training was superior on measures of disruptive and noncompliant behavior.”

In addition to Yale and Emory University, which is the lead site, the RUBI Autism Network includes Indiana University, Ohio State University, University of Pittsburgh, and University of Rochester.

Other authors on the study include Karen Bearss, Cynthia Johnson, Tristram Smith, Luc Lecavalier, Naomi Swiezy, Michael Aman, David B. McAdam, Eric Butter, Charmaine Stillitano, Noha Minshawi, Daniel W. Mruzek, Kylan Turner, Tiffany Neal, Victoria Hallett, James A. Mulick, Bryson Green, Benjamin Handen, Yanhong Deng, and Lawrence Scahill.


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