Parent-Child Interaction Therapy: A Literature Review on Its Effectiveness for Children with Autism Spectrum Disorder (Asd) (original) (raw)
Related papers
2018
Children diagnosed with autism spectrum disorder (ASD) experience difficulties with social communication and restrictive, repetitive, and stereotyped behavior patterns that place them at an increased risk for developing challenging behaviors that warrant early intervention (American Psychiatric Association, 2013). These problems are unlikely to decrease without intervention. Research indicates that parents' involvement in behaviorally based interventions improves the functioning of children with ASD (Horner, Carr, Strain, Todd, & Reid, 2002).. Parent-Child Interaction Therapy (Eyberg & Funderburk, 2011) is an empirically supported intervention for young children with disruptive behaviors. PCIT shares similarities with numerous proven ASD treatments including caregiver involvement, structure and predictable schedule, and the use of behavioral strategies (e.g., positive reinforcement, differential attention). As such, children with ASD are increasingly referred to PCIT. Researchers and clinicians have started to address the use of PCIT for targeting child compliance and social responsiveness in children with ASD. However, there is a need for research on the feasibility of PCIT for children with ASD and barriers to treatment participation for these families. The present study utilized a non-concurrent multiple baseline design with three parent-child dyads enrolled in PCIT to examine the degree of stability and immediacy of effect in caregivers parenting skill use and in patterns of challenging behaviors, ASD symptoms, and expressive communication exhibited by young children with ASD. Due to a significant attrition rate in the study, barriers to treatment participation were also examined. Findings suggested that PCIT improved children's challenging behaviors and parent's use of labeled praises. Chapter One: Introduction Statement of the Problem Recent estimates suggest that ASD affects approximately one million individuals in the United States and costs society over $35-90 billion per year (Ganz, 2007). Children with ASD often experience deficits in social communication and development, placing them at a high risk for the development of challenging behaviors. The presence of these challenging behaviors directly correlates with fewer adaptive behaviors for children with ASD such as social skills and self-help behaviors (Matson, Mahan, Hess, Fodstad, & Neal, 2010). Challenging behaviors are often severely intense and may pose physical safety risks to the child and those around them (Matson, Wilkins, & Macken, 2009). As a result, children with ASD may experience limited access to educational and/or community opportunities (Matson et al., 2009; Sigafoos, Arthur, & O'Reilly, 2003). These challenging behaviors often negatively impact the quality of life of children with ASD and their families. As such, parents often classify their chid's challenging behaviors as the primary reason for referral to intervention services (Matson & Minshawi, 2006; Matson et al., 2009). Furthermore, if left untreated, these challenging behaviors are more likely to persist into adulthood and increase in severity as the child physically matures (Murphy, Beadle-Brown, Wing, Gould, Shah, & Homes, 2005). Research on interventions for children with ASD heavily focuses on the provision of early intervention. Early intervention services often involve the application of behavioral strategies and emphasize generalization across settings (Simon, 2016). Children with ASD often participate in several different therapy activities that take up a tremendous amount of the Definition of Key Terms Parent-Child Interaction Therapy (PCIT). Parent-Child Interaction Therapy (Eyberg, 1988) is an evidence-based parent-training intervention used for young children between ages 2 and 7 with emotional and behavioral disorders. This therapy As a result, PCIT decreases children's challenging behaviors and increases children's pro-social behaviors. Autism spectrum disorder (ASD). Autism spectrum disorder refers to a complex developmental disorder. Symptoms of ASD include impairments in social communication and interaction across multiple contexts, as well as restricted, repetitive patterns of behavior, interests, or activities. These symptoms must be evident in early childhood and cause impairments in daily functioning (APA, 2013). These symptoms place children with ASD at an increased risk for the development of challenging behaviors. Challenging behaviors. Children with ASD experience symptoms including impaired social communication and interaction as well as restricted, repetitive patterns of behaviors, interests, or activities. These symptoms often lead to the development of challenging behaviors. For the purpose of the present study, challenging behaviors will include those that cause significant problems for the parent and/or child. Examples of challenging behaviors include disruptive behaviors (e.g., tantrums, aggression towards self or others, noncompliance, property destruction), as well as repetitive and stereotypical behaviors (e.g., hand flapping, echolalia). Positive parenting skills. Parenting behaviors refer to the behaviors coded with the Dyadic Parent-Child Interaction Coding System-Fourth Edition (DPICS-IV; Eyberg, Nelson, Ginn, Bhuiyan & Boggs, 2013). The DPICS-IV is a five-minute coding observation used during PCIT in order to measure multiple parent and child behaviors. During the CDI and PDI phase of PCIT, the DPICS-IV assesses the frequency of parents' use of three positive parenting behaviors. These three "Do" skills include labeled praises (e.g., "I love it when you use your inside voice!"), reflections (e.g., "Yes, that's a red truck."), and behavior descriptions (e.g., "You're driving the train on the track."). Parents' "Don't" skills during CDI are also recorded including questions (e.g., "What are you building?"), direct commands (e.g., "Sit down next to me."), and indirect commands (e.g., "Would you like to sit down?"), and negative talk (e.g., "Stop doing that!") during the session. Parents' neutral talk (e.g., "I'm playing with the train.") and unlabeled praises (e.g., "Good job.") are also recorded. During the PDI phase, the DPICS-IV measures child compliance and non-compliance with their parent's commands, in addition to the continued assessment of parents' CDI skills. Specifically, parents are assessed on their ability to give direct commands with the appropriate follow-through sequence and children's compliance or noncompliance with direct commands is recorded.
2015
The present study examined the effectiveness of Parent-Child Interaction Therapy in improving the behavioral outcomes in young children with autism spectrum disorder. Using a non-concurrent multiple baseline design with four mother-child dyads, the study determined the impact of PCIT on the frequency and severity of young children's challenging behaviors, mothers' positive parenting practices, and mothers' satisfaction with treatment. Outcome measures included the Eyberg Child Behavior Inventory, Child Behavior Checklist, Dyadic Parent-Child Interaction Coding System, and Therapy Attitude Inventory. Results from visual analysis and hierarchical linear modeling indicated a treatment effect for mothers' use of labeled praises (b = 14.79, p = 0.01), reflections (b = 9.93, p < .0001), and behavior descriptions (b = 13.13, p = 0.01). Mothers conveyed high levels of satisfaction with PCIT and reported improvements in their relationship with their child, as well as in their child's major behavior problems and compliance. Children's challenging behaviors declined in frequency and severity; however, these decreases were not statistically significant. The findings of this study indicate that PCIT improves mothers' parenting practices and is a highly satisfactory treatment for mothers of children with ASD. Future studies should incorporate measures specific to ASD symptoms and measures of challenging behaviors from multiple caregivers, such as teachers. Studies should also employ more rigorous statistical methods to determine the average length of treatment required to reduce challenging behaviors in children with ASD. Chapter One: Children with ASD may also exhibit ODD symptoms, such as hostility and defiance (Gadow, DeVincent, Pomeroy, & Azizian, 2004). Once these behavioral problems become part of the child and parents' established routine, they are not likely to decrease without intervention (Horner et al., 2002). It is essential to intervene as early as possible because early intervention may reduce behavioral problems associated with ASD (Wilkinson, 2014). Currently, there is not a cure for ASD but there are many treatments that target the core symptoms and comorbidities associated with ASD (Ospina et al., 2008; Wilkinson, 2014). Early comprehensive behavioral interventions have been shown to increase IQ, communication skills, educational placements, and adaptive skills, while also decreasing problem behaviors and other symptoms of ASD (Beauchaine & Hinshaw, 2013). Interventions derived from principles of applied behavior analysis (ABA) have the strongest research support for use with young children with ASD. Behaviorally based interventions that build upon a child's interests, use a series of simple steps to teach tasks, engage a child's attention, and regularly reinforce prosocial skills are effective for improving the functioning of children with ASD, especially when parents and teachers are involved (Horner et al., 2002). Research indicates that interventions are more effective when there is a strong family involvement component included in the treatment package, as opposed to the specialist being solely responsible for delivering the intervention (Horner et al., 2002). Parents have great expertise regarding the strengths and needs of their child with ASD (Danya International & Organization for Autism Research, 2004; National Autism Center, 2009). They are able to provide important information relevant to assessment, diagnosis, and educational background. Additionally, they can provide assistance in planning and setting goals for their children. Furthermore, research indicates that parents can be effective interventionists of their child's
Parent-Child Interaction Therapy with Children on the Autism Spectrum: A Narrative Review
Handbook of Parent-Child Interaction Therapy for Children on the Autism Spectrum, 2018
This chapter reviews, in detail, all Parent-Child Interaction Therapy (PCIT) studies for children diagnosed with autism spectrum disorder (ASD) and provides information to improve clinical expertise and inform effective practice. Even though PCIT was originally developed to treat children with externalizing behaviors, there has been increased interest in using this evidencebased treatment (EBT) with children on the spectrum. Two theoretical articles, seven nonexperimental studies, and four quasi-experimental and experimental studies comprise the entire literature of PCIT for children with ASD (PCIT-ASD). These studies lay the groundwork necessary to inform future researchers and clinicians interested in PCIT-ASD.
The Open Family Studies Journal, 2020
This research briefly promotes the inclusion of Parent-Child Interaction Therapy (PCIT) for children with Autism Spectrum Disorder (ASD) in a continuum of empirically-supported ASD treatments. PCIT is a manualized, short-term intervention that improves child compliance and the caregiver-child bond, and is an empirically-supported treatment backed by over 40 years of research. Caregivers are often unprepared to handle the needs of children with ASD presenting with comorbid behavioral problems. As a result, families frequently require mental health services for their children on the autism spectrum; however, access to empirically supported treatments for these families is limited. Furthermore, many mental health providers feel unequipped to treat this special population. Families with children on the autism spectrum are in desperate need of quality, time-limited, evidence-based treatments targeting disruptive behaviors. PCIT is a well-established treatment for disruptive behaviors that represents a promising treatment for complementing other evidenced-based ASD services. Research shows that after PCIT, children with ASD demonstrate improvements in disruptive behavior, social awareness, adaptability, and positive affect. Currently, the PCIT-ASD literature provides a case for conducting PCIT with preschool children who are in the higher functioning range of the autism spectrum (Levels 1 and 2) and display comorbid behavioral problems. Providing PCIT clinicians with training about the special needs of children with ASD could lead to improved access to services for this population. This paper accomplishes the following objectives: 1) Provides an overview of PCIT, 2) Summarizes the PCIT-ASD research, 3) Reviews PCIT-ASD clinical considerations and training requirements, and 3) Suggests future directions for PCIT-ASD research.
Journal of Autism and Developmental Disorders, 2008
We report the results of a pilot trial of an evidence-based treatment—Parent–Child Interaction Therapy (PCIT; Eyberg et al. Psychopharmacology Bulletin, 31(1), 83–91, 1995) for boys aged 5–12 with high functioning autism spectrum disorders and clinically significant behavioral problems. The study also included an investigation of the role of shared positive affect during the course of therapy on child and parent outcomes. The intervention group showed reductions in parent perceptions of child problem behaviors and child atypicality, as well as an increase in child adaptability. Shared positive affect in parent child dyads and parent positive affect increased between the initial and final phases of the therapy. Parent positive affect after the first phase was related to perceptions of improvement in problem behaviors and adaptive functioning.
Parent-Child Interaction Therapy for Children With Special Needs
2015
Parent-Child Interaction Therapy (PCIT) is an evidence-based method for reducing disruptive behavior in children and improving parent management of behavior. PCIT is a form of behavioral intervention that can be used in clinical, home and school settings. Although initially designed for intervention related to oppositional defiant disorder and conduct disorder, PCIT has been found to be a promising intervention for addressing behavioral issues among children with special needs. We present methods, research-based instructions and a case example of PCIT with a child diagnosed with autism. This article is intended to assist professional counselors in designing appropriate interventions for both children and parents.Keywords: autism, parent-child interaction therapy, special needs, behavioral intervention, case exampleCounseling techniques for children stem from a myriad of theoretical perspectives, and professional counselors are often in the unique position to provide systems interven...
International Journal of Academic Research in Progressive Education and Development
Two basic characteristics characterize autism spectrum disorder: a difficulty in social communication and the prevalence of repetitive activities and/or restricted interests. The most frequently cited explanation for insufficient social contact or skill development is a lack of social cognition. Numerous interventions have been utilized to help children with this issue, including social storytelling, scheduled physical exercise programs, and peer-mediated intervention. Typically, interventions are performed in a clinical setting by experts such as occupational therapists. However, research indicates that parents' involvement has a significant contribution to helping children to improve their children's social interactions and skills, particularly those with an autistic spectrum disorder. Thus, this study emphasizes social interaction intervention, its benefits, and the involvement of parents in social interaction intervention with autistic children. According to the previous research, early learning experiences through early intervention with the social contract approach significantly enhance development progress among ASD Children. Autistic children's behavior may improve with parental involvement in the intervention, and it may also reduce parenting stress because of improved behavior.
Parent‐mediated early intervention for young children with autism spectrum disorders (ASD)
Evidence-Based Child Health: A Cochrane Review Journal, 2013
BackgroundYoung children with autism spectrum disorders (ASD) have impairments in the areas of communication and social interaction and often display repetitive or non‐compliant behaviour. This early pattern of difficulties is a challenge for parents. Therefore, approaches that help parents develop strategies for interaction and management of behaviour are an obvious route for early intervention in ASD. This review updates a Cochrane review first published in 2002 but is based on a new protocol.ObjectivesTo assess the effectiveness of parent‐mediated early interventions in terms of the benefits for both children with ASD and their parents and to explore some potential moderators of treatment effect.Search methodsWe searched a range of psychological, educational and biomedical databases including CENTRAL, MEDLINE, Embase, PsycINFO and ERIC in August 2012. As this is an update of a previous review, we limited the search to the period following the original searches in 2002. Bibliograp...
Autism Severity and Qualities of Parent–Child Relations
Journal of Autism and Developmental Disorders, 2012
Relationship Development Intervention (RDI™) is a cost-effective research-guided intervention approach for remediating autism spectrum disorders. The program uses a parent-training model to help children learn skills like joint attention, social referencing, theory of mind, social reciprocity, and communication for experience sharing purposes. It is an evidence-based practice approach that makes use of a combination of the best available research and clinical expertise in treatment decisions (Twachtman-Cullen, 2009). The following are peer-reviewed published articles document evidence of its efficacy for children with ASD.
European Child & Adolescent Psychiatry, 2019
Parent-mediated intervention is widely used for pre-schoolers with autism spectrum disorder (ASD). Previous studies indicate small-to-moderate effects on social communication skills, but with a wide heterogeneity that requires further research. In this randomized controlled trial (RCT), cooperative parent-mediated therapy (CPMT) an individual parent coaching program for young children with ASD was administered to preschool children with ASD. All children received the same low-intensity psychosocial intervention (LPI) delivered in community settings, to evaluate the potential additional benefit of CPMT. Thirty-four participants with ASD (7 females; 27 males; aged 2, 6, 11 years) and their parents were included in the trial. The primary blinded outcome was social communication skills, assessed using the ADOS-G social communication algorithm score (ADOS-G SC). Secondary outcomes included ASD symptom severity, parent-rated language abilities and emotional/behavioral problems, and self-reported caregiver stress. Evaluations were made at baseline and post-treatment (at 6 months) by an independent multidisciplinary team. Results documented that CPMT showed an additional benefit on LPI with significant improvements of the primary blinded outcome, socio-communication skills, and of some secondary outcomes such as ASD symptom severity, emotional problems and parental stress related to parent-child dysfunctional interaction. No additional benefit was found for language abilities. Findings of our RCT show that CPMT provide an additional significant short-term treatment benefit on ASD core symptoms, when compared with active control group receiving only LPI.