Researchers find training superior to education program for parents of children with autism

Compared with a parent education program, a 24-week parent training program resulted in better behavioral outcomes in children with autism spectrum disorder, according to new study findings.

Behavioral interventions used to treat disruptive behaviors in children with autism spectrum disorders have not been assessed in large, randomized trials. For this reason, Karen Bearrs, PhD, of the Marcus Autism Center, Children’s Healthcare of Atlanta and Emory University, and colleagues sought to evaluate and compare a training program vs. an education program for parents of children with autism spectrum disorders.

The study took place across six centers at Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester and Yale University.

The researchers enrolled 180 children aged between 3 and 7 years with autism spectrum disorders and disruptive behaviors; 86% were white and 88% were boys.

Parents of children were randomly assigned to either a parent training program which provided specific strategies for managing disruptive behavior or to an education program which provided parents with information about autism but without behavior management strategies.

Results at 24 weeks indicated that when compared with a decrease of 47.7% in the Aberrant Behavior Checklist-Irritability subscale for the parent training arm, there was a 31.8% decrease in the subscale for the parent education arm (95% CI, 95% CI, – 6.2 to – 1.7).

In addition, parent training resulted in a decrease of 55% for the Home Situations Questionnaire-Autism Spectrum Disorder compared with the 34.2% decrease with parent education (95% CI, –1.1 to – 0.3; P < .001).

Although neither program met the prespecified minimal clinically important difference, according to the researchers, positive responses were achieved in 68.5% with parent training vs. 39.6% with parent education (P < .001) for the Clinical Global Impression-Improvement scale.

In an accompanying editorial, Bryan H. King, MD, MBA, of the University of Washington and Seattle Children’s Hospital, wrote: “Although specific behavioral training was superior, both groups reported considerable improvement over baseline, suggesting that even regular intensive education about autism provided value to parents and translated to perceived behavioral improvements in their children. Some challenges for the future include what can be learned about the children who did not respond to behavioral intervention and why some children of parents who were not educated about behavioral principles also improved. Autism is a diverse condition, and a better understanding of how psychosocial interventions work will be critical for determining how to personalize treatment.”

Disclosure: The researchers report receiving contract positions, consulting relationships, and advisory board positions with Biomarin Pharmaceuticals, Bristol-Myers Squibb, Confluence Pharmaceuticals, Cog State Clinical Trials, Coronado Biosciences, Curemark, Eli Lilly, Forest Research, Hoffman La Roche, Johnson and Johnson, Med Avante, Neuren, Novartis, Pfizer, ProPhase, Roche, Shire Pharmaceuticals and Supernus Pharmaceuticals.