One of the biggest challenges that parents face with children with autism spectrum disorder is behavior and how to teach proper behavior to their children. According to a new study, parent training seems to be the key. Teaching parents specific tactics to deal with serious behavior problems appears to be the best way to reduce behavioral issues in young children with autism.
In the new study by researchers from the National Institute of Mental Health (NIMH), they found that children were more likely to respond positively to a 24-week structured parent training program than to a similar length program designed to educate parents.
The training of the parents helped to reduce disruptive or aggressive behavior for up to six months post intervention.
The study, published in the Journal of the American Medical Association, used parent training to provide parents with the specific strategies on how to manage serious behavior problems such as aggression, tantrums, noncompliance and even self-injury in children with autism. The parent education program, on the other hand, offered parents valuable information on autism, but did not provide guidance on how to manage serious behavioral problems.
"It's striking that children in both groups improved, but on measures of disruptive and noncompliant behavior, parent training was clearly better," said Karen Bearss, Ph.D., lead author of the study and an assistant professor of pediatrics at Marcus Autism Center and Emory University School of Medicine.
In young children, autism is often complicated by serious behavioral problems. These disruptive behaviors can be overwhelming for parents and foster profound uncertainty about how to deal with these problems. There are medications for these problems, but parents of young children are often hesitant to use them.
"This is the largest randomized trial of any behavioral intervention in children with autism spectrum disorder, and it shows that parent training works," said Lawrence Scahill, M.S.N., Ph.D., professor of pediatrics at Marcus and Emory School of Medicine, who directed the study.
For the study, the parents of 180 children age 3 to 7 years with ASD were randomly assigned to either 24 weeks of parent training or 24 weeks of parent education. Parents in both treatments attended over 90 percent of the sessions, suggesting the parents were highly engaged in the treatments. After 24 weeks of treatment, children in the parent-training group showed a 48 percent improvement on parent ratings of disruptive behavior compared to a 32 percent decline for parent education.
Overall progress was rated by a clinician who was blind to the treatment assignments. At week 24, 70 percent of children in the parent training group showed a positive response, compared to only 40 percent for the parent education group.
"This is a very important study for children and families with ASD. Parent training is known to be effective for children and adolescents with behavior problems, and is now demonstrated to be effective for children with ASD," said John Walkup, M.D., child psychiatrist and professor of psychiatry at Weill-Cornell Medical College and New York-Presbyterian Hospital.
Despite the increased recognition of autism in young children, rigorous testing and dissemination of evidence-based treatments has lagged for behind. The results of this study support the view that parent training is ready for widespread implementation and is a step forward in the move toward wider application of evidence based interventions.
