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Moderators of Parent Training for Disruptive Behaviors in Young Children with Autism Spectrum Disorder

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Abstract

We conducted a 6 month, randomized trial of parent training (PT) versus a parent education program (PEP) in 180 young children (158 boys, 22 girls), ages 3–7 years, with autism spectrum disorder (ASD). PT was superior to PEP in decreasing disruptive and noncompliant behaviors. In the current study, we assess moderators of treatment response in this trial. Thirteen clinical and demographic variables were evaluated as potential moderators of three outcome variables: the Aberrant Behavior Checklist-Irritability subscale (ABC-I), Home Situations Questionnaire (HSQ), and Clinical Global Impressions-Improvement Scale (CGI-I). We used an intent-to-treat model and random effects regression. Neither IQ nor ASD severity moderated outcome on the selected outcome measures. Severity of Attention Deficit Hyperactivity Disorder (ADHD) and anxiety moderated outcomes on the ABC-I and HSQ. For instance, there was a 6.6 point difference on the ABC-I between high and low ADHD groups (p = .05) and a 5.3 point difference between high and low Anxiety groups (p = .04). Oppositional defiant disorder symptoms and household income moderated outcomes on the HSQ. None of the baseline variables moderated outcome on the CGI-I. That IQ and ASD symptom severity did not moderate outcome suggests that PT is likely to benefit a wide range of children with ASD and disruptive behavior.

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Acknowledgements

We thank the families who participated in this study. We thank Jill Pritchett for assistance with manuscript preparation. We also thank the Data and Safety Monitoring Board: Gerald Golden, MD (retired pediatric neurologist), Christopher Young, MD (Medical Director of Wellmore Behavioral Health, Waterbury, CT) and Martin Schwartzman father of a child with autism).

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Authors and Affiliations

  1. Nisonger Center and Department of Psychology, Ohio State University, 371D McCampbell Hall, 1581 Dodd Dr., Columbus, OH, 43210, USA

    Luc Lecavalier

  2. University of Rochester Medical Center School of Medicine and Dentistry, 601 Elmwood Ave, Box 671, Rochester, NY, 14642, USA

    Tristram Smith

  3. Department of Clinical and Health Psychology, 1225 Center Dr., Room 3130, PO Box 100165, Gainesville, FL, 32610-0165, USA

    Cynthia Johnson

  4. Department of Psychiatry and Behavioral Sciences, 4909 25th Ave NE, Seattle, WA, 98105, USA

    Karen Bearss

  5. Indiana University Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA

    Naomi Swiezy

  6. Ohio State University, 1581 Dodd Dr., Columbus, OH, 43210, USA

    Michael G. Aman

  7. Yale Child Study Center, 230 South Frontage Road, PO Box 207900, New Haven, CT, 06520-7900, USA

    Denis G. Sukhodolsky

  8. Yale Center for Analytical Sciences, 300 George Street Suite 555, New Haven, CT, 06511, USA

    Yanhong Deng & James Dziura

  9. Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA, 30329-4010, USA

    Lawrence Scahill

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  1. Luc Lecavalier
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  2. Tristram Smith
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  3. Cynthia Johnson
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  10. Lawrence Scahill
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Correspondence to Luc Lecavalier.

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Conflict of Interest

This work was funded by the National Institute of Mental Health by the following grants: Yale University/Emory University MH081148 (principal investigator: L Scahill); University of Pittsburgh/University of Florida MH080965 (principal investigator: C Johnson); Ohio State University MH081105 (principal investigator: L Lecavalier); Indiana University MH081221 (principal investigator: N Swiezy); University of Rochester MH080906 (principal investigator: T Smith). The project described in this publication also was supported by MH079130 (principal investigator: D Sukhodolsky), the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1 TR000454 (Emory University), UL1 TR000042 (University of Rochester), UL1 RR024139 (Yale University) and the Marcus Foundation. Author (d) serves as a consultant for The Autism Foundation. Author (j) serves as a consultant for the following research organizations: Neuren, Coronado, Roche and Supurnus Pharmaceuticals. Additionally, author (j) receives royalties from Oxford and Guilford Press and receives research funds from The Marcus Foundation. Author (f) has received a research grant from The Autism Treatment Network (#UA3MC11054). Author (f) served as a consultant, served on the advisory board and participated in investigator training for: Cogstate, Inc., Confluence Pharmaceutica; Cogstate Clinical Trials, Ltd., Coronado Biosciences, Forest Research, Hoffman-La Roche, Lumos Pharma, Medavante, Inc., Novarti’s, Pfizer, Prophase LLC and Supernus Pharmaceuticals. Author (b) has received research grants from HRSA, NIH, NIMH, Autism Speaks, U.S. Department of Education, NIH/UCLA and AIR-B/HRSA. All other authors have declared that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Trial Registration: Clinicaltrials.gov #NCT01233414 http://clinicaltrials.gov/show/NCT01233414

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Lecavalier, L., Smith, T., Johnson, C. et al. Moderators of Parent Training for Disruptive Behaviors in Young Children with Autism Spectrum Disorder. J Abnorm Child Psychol 45, 1235–1245 (2017). https://doi.org/10.1007/s10802-016-0233-x

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