TY - JOUR
T1 - A Novel Group Parenting Intervention for Emotional and Behavioral Difficulties in Young Autistic Children: Autism Spectrum Treatment and Resilience (ASTAR): A Randomized Controlled Trial
AU - Charman, Tony
AU - Palmer, Melanie
AU - Stringer, Dominic
AU - Hallett, Victoria
AU - Mueller, Joanne
AU - Romeo, Renee
AU - Tarver, Joanne
AU - Perez, Juan Paris
AU - Breese, Lauren
AU - Hollett, Megan
AU - Cawthorne, Thomas
AU - Boadu, Janet
AU - Salazar, Fernando
AU - O'Leary, Mark
AU - Beresford, Bryony
AU - Knapp, Martin
AU - Slonims, Vicky
AU - Pickles, Andrew
AU - Scott, Stephen
AU - Simonoff, Emily
N1 - © 2021 American Academy of Child and Adolescent Psychiatry.Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license
PY - 2021/11
Y1 - 2021/11
N2 - Objective: To examine the feasibility and preliminary efficacy of a group behavioral parenting intervention for emotional and behavioral problems (EBPs) in young autistic children. Method: This was a feasibility pilot randomized controlled trial comparing a 12-week group behavioral parenting intervention (Predictive Parenting) to an attention control (Psychoeducation). Parents of 62 autistic children 4 to 8 years of age were randomized to Predictive Parenting (n = 31) or Psychoeducation (n = 31). The primary outcome was a blinded observational measure of child behaviors that challenge. Secondary outcomes were observed child compliance and parenting behaviors; parent- and teacher-reported child EBPs; self-reported parenting practices, stress, self-efficacy, and well-being. Cost-effectiveness was also 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) favored Predictive Parenting. There were no differences on other measures. Predictive Parenting was more expensive than Psychoeducation, with a 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; in addition, 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/; 91411078.
AB - Objective: To examine the feasibility and preliminary efficacy of a group behavioral parenting intervention for emotional and behavioral problems (EBPs) in young autistic children. Method: This was a feasibility pilot randomized controlled trial comparing a 12-week group behavioral parenting intervention (Predictive Parenting) to an attention control (Psychoeducation). Parents of 62 autistic children 4 to 8 years of age were randomized to Predictive Parenting (n = 31) or Psychoeducation (n = 31). The primary outcome was a blinded observational measure of child behaviors that challenge. Secondary outcomes were observed child compliance and parenting behaviors; parent- and teacher-reported child EBPs; self-reported parenting practices, stress, self-efficacy, and well-being. Cost-effectiveness was also 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) favored Predictive Parenting. There were no differences on other measures. Predictive Parenting was more expensive than Psychoeducation, with a 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; in addition, 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/; 91411078.
KW - autism
KW - emotional and behavioral problems
KW - feasibility
KW - parenting
KW - randomized controlled trial
UR - https://www.sciencedirect.com/science/article/pii/S0890856721002987
UR - http://www.scopus.com/inward/record.url?scp=85109433971&partnerID=8YFLogxK
U2 - 10.1016/j.jaac.2021.03.024
DO - 10.1016/j.jaac.2021.03.024
M3 - Article
VL - 60
SP - 1404
EP - 1418
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
SN - 0890-8567
IS - 11
ER -