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

Research output: Contribution to journalArticlepeer-review

Abstract

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/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

Bibliographical note

© 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

Keywords

  • autism
  • emotional and behavioral problems
  • feasibility
  • parenting
  • randomized controlled trial

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