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A Systematic Review and Meta-analysis of Parent Training for Disruptive Behavior in Children with Autism Spectrum Disorder

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Abstract

Parent training (PT) has emerged as a promising treatment for disruptive behavior in children with autism spectrum disorder (ASD). This review summarizes the essential elements of PT for disruptive behavior in children with ASD and evaluates the available evidence for PT using both descriptive and meta-analytic procedures. We searched Medline, PsycINFO, and PubMed databases (1980–2016) in peer-reviewed journals for randomized controlled trials (RCTs) of PT for disruptive behavior in children with ASD. The systematic search of 2023 publications yielded eight RCTs involving a total of 653 participants. We calculated effect sizes using either raw post-treatment means and standard deviations for each treatment group (PT and control) or group mean differences with associated 95% confidence intervals (CIs). Differences in post-treatment means were converted to a standardized difference in means (SMD) for each primary outcome. Results support the efficacy of PT for disruptive behavior in children with ASD, with a SMD of −0.59 [95% CI (−0.88, −0.30); p < 0.001]. Across these eight studies, there was significant heterogeneity in the effect of PT on disruptive behavior. This variability is likely due to differences in sample size, number of treatment sessions, study duration, and control condition employed. Current findings provide solid support for the efficacy of PT for disruptive behavior in children with ASD. Future studies should focus on effectiveness trials to promote wider implementation of PT in clinical settings.

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Acknowledgements

The authors thank Gabrielle Leah Bloch for her help with data collection.

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Authors and Affiliations

  1. Department of Pediatrics, Emory University School of Medicine, 1920 Briarcliff Road NE, Atlanta, GA, USA

    Valentina Postorino, William G. Sharp, Courtney E. McCracken, T. Lindsey Burrell, A. Nichole Evans & Lawrence Scahill

  2. Marcus Autism Center, 1920 Briarcliff Road NE, Atlanta, GA, USA

    Valentina Postorino, William G. Sharp, T. Lindsey Burrell, A. Nichole Evans & Lawrence Scahill

  3. Department of Psychiatry and Behavioral Sciences, Seattle Children’s Autism Center, University of Washington, 4909 25th Ave NE, Seattle, WA, USA

    Karen Bearss

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  1. Valentina Postorino
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  2. William G. Sharp
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  3. Courtney E. McCracken
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  4. Karen Bearss
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  7. Lawrence Scahill
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Correspondence to Lawrence Scahill.

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Conflict of interest

Dr. Scahill has served as a consultant to Neuren, Roche, Supernus, Shire. He receives book royalties from Oxford and Guilford.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee.

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Postorino, V., Sharp, W.G., McCracken, C.E. et al. A Systematic Review and Meta-analysis of Parent Training for Disruptive Behavior in Children with Autism Spectrum Disorder. Clin Child Fam Psychol Rev 20, 391–402 (2017). https://doi.org/10.1007/s10567-017-0237-2

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