Skip to main content
Log in

Examining the Efficacy of Parent–Child Interaction Therapy with Children on the Autism Spectrum

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

Externalizing behaviors are a common component of the clinical presentation of autism spectrum disorders. Although traditionally used with typically-developing children, parent–child interaction therapy (PCIT) is one behaviorally-based parent training program that has demonstrated success in increasing child compliance, reducing problem behavior, and improving parent–child communication. The study examined the efficacy of PCIT as a treatment for children with autism spectrum disorders by employing a single subject, non-concurrent multiple baseline design across three subjects. Primary findings revealed increases in child compliance, reductions in child disruptive behavior, and improved parenting skills across participants. In addition, each caregiver reported high levels of satisfaction with the intervention. Results suggested that PCIT may be a treatment option for children on the autism spectrum with co-occurring behavioral difficulties. Although the non-concurrent nature of the multiple baseline design is a limitation, this study replicates and extends previous research investigating the efficacy of PCIT with children with autism and their parents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Agazzi, H., Tan, R., & Tan, S. Y. (2013). A case study of parent–child interaction therapy for the treatment of autism spectrum disorder. Clinical Case Studies, 12(6), 428–442.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • Bagner, D. M., & Eyberg, S. M. (2007). parent–child interaction therapy for disruptive behavior in children with mental retardation: A randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 36, 418–429.

    Article  PubMed  Google Scholar 

  • Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., & Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder. Journal of the American Medical Association, 313, 1524–1533.

    Article  PubMed  Google Scholar 

  • Bessmer, J., & Eyberg, S. (1993, November). Dyadic parentchild Interaction coding systemII (DPICS-II): Initial reliability and validity of the clinical version. Paper presented at the AABT preconference on social learning and the family, Atlanta, GA.

  • Boggs, S. R., Eyberg, S. M., & Reynolds, N. A. (1990). Concurrent validity of the Eyberg Child Behavior Inventory. Journal of Clinical Child Psychology, 19, 75–78.

    Article  Google Scholar 

  • Brestan, E. V., Jacobs, J. R., Rayfield, A. D., & Eyberg, S. M. (1999). A consumer satisfaction measure for parent–child treatments and its relation to measures of child behavior change. Behavior Therapy, 30, 17–30.

    Article  Google Scholar 

  • Brinkmeyer, M., & Eyberg, S. M. (2003). Parent–child interaction therapy for oppositional children. In A. E. Kazdin & J. R. Weiz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 204–223). New York: Guilford Press.

    Google Scholar 

  • Brookman-Frazee, L. I., Drahota, A., & Stadnick, N. (2012). Training community mental health therapists to deliver a package of evidence-based practice strategies for school-age children with autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 42(8), 1651–1661.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brookman-Frazee, L. I., Taylor, R., & Garland, A. F. (2010). Characterizing community-based mental health services for children with autism spectrum disorders and disruptive behavior problems. Journal of Autism and Developmental Disorders, 40, 1188–1201.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brumfield, B. D., & Roberts, M. W. (1998). A comparison of two measurements of child compliance with normal preschool children. Journal of Clinical Child Psychology, 27, 109–116.

    Article  PubMed  Google Scholar 

  • Burrell, T. L., & Borrego, J. (2012). Parent’s involvement in ASD treatment: What is their role? Cognitive and Behavioral Practice, 19, 423–432.

    Article  Google Scholar 

  • Butter, E. M., Wynn, J., & Mulick, J. A. (2003). Early intervention critical to autism treatment. Pediatric Annals, 32, 677–684.

    Article  PubMed  Google Scholar 

  • Center for Disease Control. (2012). Prevalence of autism spectrum disorders: Autism and developmental disabilities monitoring network, 14 sites, United States, 2008. MMWR Surveillance Summaries, 61(3), 1–19.

    Google Scholar 

  • DuBard, M. (2014). Alternatives to the holding chair: Commentary on Lesack. Clinical Practice in Pediatric Psychology, 2, 86–87.

    Article  Google Scholar 

  • Ducharme, J. M., & DiAdamo, C. (2005). An errorless approach to management of child noncompliance in a special education setting. School Psychology Review, 34, 107–115.

    Google Scholar 

  • Dunn, L. M., & Dunn, L. M. (1997). Peabody picture vocabulary test (3rd ed.). Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Eaves, R. C., & Milner, B. (1993). The criterion-related validity of the Childhood Autism Rating Scale and the Autism Behavior Checklist. Journal of Abnormal Child Psychology, 21(5), 481–491.

    Article  PubMed  Google Scholar 

  • Eisenstadt, T. H., Eyberg, S. M., McNeil, C. B., Newcomb, K., & Funderburk, B. (1993). Parent–child interaction therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome. Journal of Clinical Child Psychology, 22, 42–51.

    Article  Google Scholar 

  • Eyberg, S. M. (1993). Consumer satisfaction measures for assessing parent training programs. In L. VandeCreek, S. Knapp, & T. L. Jackson (Eds.), Innovations in clinical practice: A source book (Vol. 12). Sarasota, FL: Professional Resource Press.

    Google Scholar 

  • Eyberg, S. M. (2005). Tailoring and adapting parent–child interaction therapy for new populations. Education and Treatment of Children, 28, 197–201.

    Google Scholar 

  • Eyberg, S. M., Bessmer, J., Newcomb, K., Edwards, D., & Robinson, E. (1994). Dyadic parent–child interaction coding system-II: A manual. Social and Behavioral Sciences Documents (Ms. No. 2897).

  • Eyberg, S., Boggs, S., & Jaccard, J. (2014). Does maintenance treatment matter? Journal of Abnormal Child Psychology, 42(3), 355–366.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M., & Funderburk, B. (2011). Parent–child interaction therapy protocol. Gainesville: PCIT International.

    Google Scholar 

  • Eyberg, S. M., & Matarazzo, R. G. (1980). Training parents as therapists: A comparison between individual parent child interactions training and parent group didactic training. Journal of Clinical Psychology, 36, 492–499.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatment for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37(215), 237.

    Google Scholar 

  • Eyberg, S. M., Nelson, M. M., Duke, M., & Boggs, S. R. (2005). Manual for the dyadic parent–child interaction coding system (3rd ed.). Gainesville: University of Florida.

    Google Scholar 

  • Eyberg, S. M., & Pincus, D. (1999). Eyberg Child Behavior Inventory Sutter Student Behavior InventoryRevised professional manual. Lutz, FL: Psychological Assessment Resources.

    Google Scholar 

  • Eyberg, S. M., & Ross, A. W. (1978). Assessment of child behavior problems: The validation of a new inventory. Journal of Clinical Child Psychology, 7, 113–116.

    Article  Google Scholar 

  • Ghaziuddin, G., & Mountain-Kimchi, K. (2004). Defining the intellectual profile of Asperger syndrome: Comparison with high-functioning autism. Journal of Autism and Developmental Disorders, 34, 279–284.

    Article  PubMed  Google Scholar 

  • Ginn, N. C., Clionsky, L. N., Eyberg, S. M., Warner-Metzger, C., & Abner, J. P. (2015). Child-directed interaction training for young children with autism spectrum disorders: Parent and child outcomes. Journal of Clinical Child & Adolescent Psychology, 18, 1–9.

    Article  Google Scholar 

  • Greenspan, S. I., & Wieder, S. (2006). Engaging autism: Using the Floortime approach to help children relate, communicate, and think. Cambridge, MA: DaCapo Press.

    Google Scholar 

  • Gross, A. M., & Drabman, R. S. (1981). Behavioral contrast and behavior therapy. Behavior Therapy, 12, 231–246.

    Article  Google Scholar 

  • Hanf, C. (1969). A two-stage program for modifying maternal controlling during motherchild (MC) interaction. Paper presented at the meeting of the Western Psychological Association, Vancouver, British Columbia, Canada.

  • Hatamzadeh, A., Pouretemad, H., & Hassanabadi, H. (2010). The effectiveness of parent–child interaction therapy for children with high functioning autism. Procedia Social and Behavioral Sciences, 5, 994–997.

    Article  Google Scholar 

  • Herschell, A. D., Calzada, E. J., Eyberg, S. M., & McNeil, C. B. (2002). Parent–child interaction therapy: New directions in research. Cognitive and Behavioral Practice, 9, 6–16.

    Google Scholar 

  • Hood, K. K., & Eyberg, S. M. (2003). Outcomes of parent–child interaction therapy: Mothers’ reports of maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32, 419–429.

    Article  PubMed  Google Scholar 

  • Horner, R. H., Carr, E. G., Strain, P. S., Todd, A. W., & Reed, H. K. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism and Developmental Disorders, 32, 423–446.

    Article  PubMed  Google Scholar 

  • Hudson, A. M., Matthews, J. M., Gavidia-Payne, S. T., Cameron, C. A., Mildon, R. L., Radler, G. A., & Nankervis, K. L. (2003). Evaluation of an intervention system for parents of children with intellectual disability and challenging behavior. Journal of Intellectual Disability Research, 47, 238–249.

    Article  PubMed  Google Scholar 

  • Huynen, K. B., Lutzker, J. R., Bigelow, K. M., Touchette, P. E., & Campbell, R. V. (1996). Planned activities training for mothers of children with developmental delays. Behavior Modification, 20, 406–427.

    Article  PubMed  Google Scholar 

  • Ingersoll, B., & Dvortcsak, A. (2006). Including parent training in the early childhood special education curriculum for children with autism spectrum disorders. Journal of Positive Behavior Interventions, 8(2), 79–87.

    Article  Google Scholar 

  • Jamison, R. T. (2008). The effects of parent–child interaction therapy on problem behaviors in three children with autistic disorder. Dissertation Abstracts International: Section B: The Sciences and Engineering, 68(7-B), p. 4828.

  • Kaat, A. J., & Lecavalier, L. (2013). Disruptive behavior disorders in children and adolescents with autism spectrum disorders: A review of the prevalence, presentation, and treatment. Research in Autism Spectrum Disorders, 7, 1579–1594.

    Article  Google Scholar 

  • Klin, A., Volkmar, F. R., Sparrow, S. S., Cichetti, D. V., & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome. Journal of Child Psychology and Psychiatry, 36, 1127–1140.

    Article  PubMed  Google Scholar 

  • Koegel, R. L., Koegel, L. K., & Brookman, L. I. (2003). Empirically supported pivotal response interventions for children with autism. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 341–357). New York: Guilford Press.

    Google Scholar 

  • Krug, D. A., Arick, J. R., & Almond, P. J. (1980). Autism Behavior Checklist. Austin, TX: Pro-Ed.

    Google Scholar 

  • Lesack, R., Bearss, K., Celano, M., & Sharp, W. G. (2014). Parent–child interaction therapy and autism spectrum disorder: Adaptations with a child with severe developmental delays. Clinical Practice in Pediatric Psychology, 2(1), 68–82.

    Article  Google Scholar 

  • Masse, J., & McNeil, C. B. (2008). In-home parent–child interaction therapy: Clinical considerations. Child and Family Behavior Therapy, 30(2), 99–126.

    Article  Google Scholar 

  • Masse, J., McNeil, C. B., Wagner, S. M., & Chorney, D. B. (2007). Parent–child interaction therapy and high functioning autism: A conceptual overview. Journal of Early and Intensive Behavior Intervention, 4(4), 714–735.

    Article  Google Scholar 

  • McLeod, B., Wood, J. J., & Klebanoff, S. (2015). Advances in evidence-based intervention and assessment practices for youth with an autism spectrum disorder. Behavior Therapy, 46, 1–6.

    Article  PubMed  Google Scholar 

  • McNeil, C. B., Eyberg, S., Eisenstadt, T. H., Newcomb, K., & Funderburk, B. (1991). Parent–child interaction therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20, 140–151.

    Article  Google Scholar 

  • McNeil, C. B., & Hembree-Kigin, T. L. (2010). Parent–child interaction therapy. New York, NY: Springer.

    Book  Google Scholar 

  • Nixon, R. D. V., Sweeny, L., Erickson, D. B., & Touyz, S. W. (2003). Parent–child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Consulting and Clinical Psychology, 71, 251–260.

    Article  PubMed  Google Scholar 

  • Perry, A., Condillac, R. A., Freeman, N. L., Dunn-Geier, J., & Belair, J. (2005). Multi-site study of the Childhood Autism Rating Scale (CARS) in five clinical groups of young children. Journal of Autism and Developmental Disorders, 35, 625–634.

    Article  PubMed  Google Scholar 

  • Piazza, C. C., Bowman, L. G., Contrucci, S. A., Delia, M. D., Adelinis, J. D., & Goh, H. (1999). An evaluation of the properties of attention as reinforcement for destructive and appropriate behavior. Journal of Applied Behavior Analysis, 32, 437–449.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pincus, D. B., Santucci, L. C., Ehrenreich, J., & Eyberg, S. M. (2008). The implementation of modified parent–child interaction therapy for youth with separation anxiety disorder. Cognitive and Behavioral Practice, 15, 118–125.

    Article  Google Scholar 

  • Plant, K. M., & Sanders, M. R. (2007). Reducing problem behavior during care-giving in families of preschool-aged children with developmental disabilities. Research in Developmental Disabilities, 28, 362–385.

    Article  PubMed  Google Scholar 

  • Rayfield, A., & Sobel, A. (2000). Effectiveness of “in-room” coaching of parentchild interaction therapy. Paper presented at the first annual parent–child interaction therapy conference, Sacramento, CA.

  • Roberts, M. W., & Powers, S. W. (1988). The compliance test. Behavioral Assessment, 10, 375–398.

    Google Scholar 

  • Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37(1), 8–38.

    Article  Google Scholar 

  • Schopler, E., Reichler, R. J., & Renner, B. R. (1988). Child Autism Rating Scale. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Schuhmann, E. M., Foote, R. C., Eyberg, S. M., Boggs, S. R., & Algina, J. (1998). Efficacy of parent–child interaction therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27, 34–45.

    Article  PubMed  Google Scholar 

  • Smith, T. (2014). Safe utilization of a holding chair in short-term parent training to reduce high-risk behaviors: Commentary on Lesack. Clinical Practice in Pediatric Psychology, 2, 83–85.

    Article  Google Scholar 

  • Smith, T., & Iadarola, S. (2015). Evidence base update for autism spectrum disorder. Journal of Clinical Child & Adolescent Psychology, 44, 897–922.

    Article  Google Scholar 

  • Solomon, M., Ono, M., Timmer, S., & Goodlin-Jones, B. (2008). The effectiveness of parent–child interaction therapy for families of children on the autism spectrum. Journal of Autism and Developmental Disorders, 38, 1767–1776.

    Article  PubMed  Google Scholar 

  • Sturmey, P., Matson, J. L., & Sevin, J. A. (1992). Analysis of the internal consistency of three autism scales. Journal of Autism and Developmental Disorders, 22, 321–328.

    Article  PubMed  Google Scholar 

  • Tonge, B. J., Bull, K., Breteron, A., & Wilson, R. (2014). A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: The core components of effective programs, child-focused interventions and comprehensive treatment models. Current Opinion in Psychiatry, 27, 158–165.

    Article  PubMed  Google Scholar 

  • Wadden, N. P. K., Bryson, S. E., & Rodger, R. S. (1991). A closer look at the autism behavior checklist: Discriminant validity and factor structure. Journal of Autism and Developmental Disorders, 21, 529–541.

    Article  PubMed  Google Scholar 

  • Ware, L. M., McNeil, C. B., Masse, J. J., & Stevens, S. B. (2008). Efficacy of in-home parent–child interaction therapy. Child and Family Behavior Therapy, 30(2), 127–135.

    Article  Google Scholar 

  • Wechsler, D. (2002). Wechsler preschool and primary scale of intelligence (3rd ed.). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M. R. (2008). Stepping Stones Triple P: An RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology, 37, 469–480.

    Article  Google Scholar 

  • Zisser, A., & Eyberg, S. M. (2010). Parent-child interaction therapy and the treatment of disruptive behavior disorders. In J. Weisz & A. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 179–193). New York, NY: Guilford Press.

    Google Scholar 

Download references

Acknowledgments

Ashley Tempel Scudder, Paul Shawler.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joshua J. Masse.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Masse, J.J., McNeil, C.B., Wagner, S. et al. Examining the Efficacy of Parent–Child Interaction Therapy with Children on the Autism Spectrum. J Child Fam Stud 25, 2508–2525 (2016). https://doi.org/10.1007/s10826-016-0424-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-016-0424-7

Keywords

Navigation