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Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder : a randomized clinical trial . IMPORTANCE Disruptive behavior is common in children with autism spectrum disorder . Behavioral interventions are used to treat disruptive behavior but have not been evaluated in large-scale randomized trials . OBJECTIVE To evaluate the efficacy of parent training for children with autism spectrum disorder and disruptive behavior . DESIGN , SETTING , AND PARTICIPANTS This 24-week randomized trial compared parent training ( n = 89 ) to parent education ( n = 91 ) at 6 centers ( Emory University , Indiana University , Ohio State University , University of Pittsburgh , University of Rochester , Yale University ) . We screened 267 children ; 180 children ( aged 3-7 years ) with autism spectrum disorder and disruptive behaviors were randomly assigned ( 86 % white , 88 % male ) between September 2010 and February 2014 . INTERVENTIONS Parent training ( 11 core , 2 optional sessions ; 2 telephone boosters ; 2 home visits ) provided specific strategies to manage disruptive behavior . Parent education ( 12 core sessions , 1 home visit ) provided information about autism but no behavior management strategies . MAIN OUTCOMES AND MEASURES Parents rated disruptive behavior and noncompliance on co-primary outcomes : the Aberrant Behavior Checklist-Irritability subscale ( range , 0-45 ) and the Home Situations Questionnaire-Autism Spectrum Disorder ( range , 0-9 ) . On both measures , higher scores indicate greater severity and a 25 % reduction indicates clinical improvement . A clinician blind to treatment assignment rated the Improvement scale of the Clinical Global Impression ( range , 1-7 ) , a secondary outcome , with a positive response less than 3 . RESULTS At week 24 , the Aberrant Behavior Checklist-Irritability subscale declined 47.7 % in parent training ( from 23.7 to 12.4 ) compared with 31.8 % for parent education ( 23.9 to 16.3 ) ( treatment effect , -3.9 ; 95 % CI , -6.2 to -1.7 ; P < .001 , standardized effect size = 0.62 ) . The Home Situations Questionnaire-Autism Spectrum Disorder declined 55 % ( from 4.0 to 1.8 ) compared with 34.2 % in parent education ( 3.8 to 2.5 ) ( treatment effect , -0.7 ; 95 % CI , -1.1 to -0.3 ; P < .001 , standardized effect size = 0.45 ) . Neither measure met the prespecified minimal clinically important difference . The proportions with a positive response on the Clinical Global Impression-Improvement scale were 68.5 % for parent training vs 39.6 % for parent education ( P < .001 ) . CONCLUSIONS AND RELEVANCE For children with autism spectrum disorder , a 24-week parent training program was superior to parent education for reducing disruptive behavior on parent-reported outcomes , although the clinical significance of the improvement is unclear . The rate of positive response judged by a blinded clinician was greater for parent training vs parent education . TRIAL REGISTRATION clinicaltrials.gov Identifier : NCT01233414 .
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Intervention_Educational
parent training
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Intervention_Educational
parent education
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Intervention_Educational
parent training
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Participant_Condition
behavioral problems
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Participant_Age
children
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Participant_Condition
autism spectrum disorder
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Participant_Age
children
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Participant_Condition
autism spectrum disorder
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Participant_Condition
autism spectrum disorder
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Participant_Condition
disruptive behavior
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Participant_Age
parent
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Participant_Sample-size
n = 89 )
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Participant_Age
parent
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Participant_Sample-size
education ( n = 91
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Participant_Sample-size
267 children
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Participant_Sample-size
180 children
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Participant_Age
aged 3-7 years
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Participant_Condition
autism spectrum disorder
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Participant_Age
children