A Novel Group Parenting Intervention for Emotional and Behavioral Difficulties in Young Autistic Children: Autism Spectrum Treatment and Resilience (ASTAR): A Randomized Controlled Trial

Tony Charman, Melanie Palmer, Dominic Stringer, Victoria Hallett, Joanne Mueller, Renee Romeo, Joanne Tarver, Juan Paris Perez, Lauren Breese, Megan Hollett, Thomas Cawthorne, Janet Boadu, Fernando Salazar, Mark O'Leary, Bryony Beresford, Martin Knapp, Vicky Slonims, Andrew Pickles, Stephen Scott, Emily Simonoff

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Abstract

Objective To examine feasibility and preliminary efficacy of a group behavioural parenting intervention for emotional and behavioural problems (EBPs) in young autistic children. Method Feasibility pilot randomized controlled trial comparing a 12-week group behavioural parenting intervention (Predictive Parenting) to an attention control (Psychoeducation). Parents of sixty-two 4-8-year-old autistic children were randomized to Predictive Parenting (n=31) or Psychoeducation (n=31). Primary outcome: Blinded observational measure of child behaviours that challenge. Secondary outcomes: Observed child compliance and parenting behaviours; parent- and teacher-reported child EBPs; self-reported parenting practices, stress, self-efficacy and wellbeing. Cost-effectiveness was explored. Results Recruitment, retention, completion of measures, treatment fidelity and parental satisfaction were high for both interventions. There was no group difference in primary outcome: mean log of rate 0.18 lower (d, 90% CI, -0.44 to 0.08) in Predictive Parenting. Differences in rates of child compliance (0.44, 90% CI 0.11 to 0.77), facilitative parenting (0.63, 90% CI 0.33 to 0.92) and parent-defined target symptom change (-0.59, 90% CI -0.17 to -1.00) favoured Predictive Parenting. No differences on other measures. Predictive Parenting was more expensive than Psychoeducation with low probability of being more cost-effective. Conclusion Feasibility was demonstrated. There was no evidence from this pilot trial that Predictive Parenting resulted in reductions in child EBPs beyond those seen following Psychoeducation, the effect size was small, and it was more expensive. However, it showed superiority for child compliance and facilitative parenting with moderate effect sizes. Future, definitive studies should evaluate whether augmented or extended intervention would lead to larger improvements. Clinical trial registration information Autism Spectrum Treatment and Resilience (ASTAR); https://www.isrctn.com/; ISRCTN91411078.
Original languageEnglish
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Early online date6 May 2021
DOIs
Publication statusE-pub ahead of print - 6 May 2021

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