Use of a Direct Observational Measure in a Trial of Risperidone and Parent Training in Children with Pervasive Developmental Disorders

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Abstract

A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N = 49) versus risperidone plus parent training (COMB; n = 75) (ages 4–13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (p = .0002) and 12 % increase in compliance to parental requests (p = .004) for the two treatment conditions combined. Parents displayed 64 % greater use of positive reinforcement (p = .001) and fewer repeated requests for compliance (p < .0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement (p = .01) and fewer restrictive statements (p < .05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures.

Acknowledgement of funding

Supported by the following cooperative agreement grants from the National Institute of Mental Health (NIMH): U10MH66768 (P.I.: M. Aman), U10MH66766 (P.I.: C. McDougle), and U10MH66764 (P.I.: L. Scahill).

Trial Registration:

NCT00080145