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

autism emotional and behavioral problems feasibility parenting randomized controlled trial

Journal

Journal of the American Academy of Child and Adolescent Psychiatry
ISSN: 1527-5418
Titre abrégé: J Am Acad Child Adolesc Psychiatry
Pays: United States
ID NLM: 8704565

Informations de publication

Date de publication:
11 2021
Historique:
received: 22 06 2020
revised: 08 02 2021
accepted: 28 04 2021
pubmed: 10 5 2021
medline: 15 12 2021
entrez: 9 5 2021
Statut: ppublish

Résumé

To examine the feasibility and preliminary efficacy of a group behavioral parenting intervention for emotional and behavioral problems (EBPs) in young autistic children. 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. 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. 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. Autism Spectrum Treatment and Resilience (ASTAR); https://www.isrctn.com/; 91411078.

Identifiants

pubmed: 33965518
pii: S0890-8567(21)00298-7
doi: 10.1016/j.jaac.2021.03.024
pii:
doi:

Banques de données

ISRCTN
['ISRCTN91411078']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1404-1418

Subventions

Organisme : Department of Health
ID : RP-PG-1211-20016
Pays : United Kingdom
Organisme : Department of Health
ID : NF-SI-0617-10120
Pays : United Kingdom
Organisme : Department of Health
ID : NF-SI-0514-10073
Pays : United Kingdom
Organisme : Department of Health
ID : IS-BRC-1215-20018
Pays : United Kingdom

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Tony Charman (T)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom. Electronic address: tony.charman@kcl.ac.uk.

Melanie Palmer (M)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Dominic Stringer (D)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Victoria Hallett (V)

South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Joanne Mueller (J)

South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Renee Romeo (R)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Joanne Tarver (J)

School of Life and Health Sciences, Aston University, Birmingham, United Kingdom.

Juan Paris Perez (J)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Lauren Breese (L)

South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Megan Hollett (M)

South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Thomas Cawthorne (T)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Janet Boadu (J)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Fernando Salazar (F)

South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Mark O'Leary (M)

Bromley Healthcare CIC Ltd, London, United Kingdom.

Bryony Beresford (B)

Social Policy Research Unit, University of York, York, United Kingdom.

Martin Knapp (M)

Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom.

Vicky Slonims (V)

Newcomen Neurodevelopmental Centre, Children's Neurosciences, Evelina Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom.

Andrew Pickles (A)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.

Stephen Scott (S)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Emily Simonoff (E)

Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.

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