Real-world Outcomes of PCIT for Children at Risk of Autism or Developmental Delay

• Published in: Journal of child and family studies Vol. 29; no. 6; pp. 1701 - 1711
• Main Authors: McInnis, Peter, Kohlhoff, Jane, Eapen, Valsamma
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2020; Springer; Springer Nature B.V
• Subjects: At risk populations; At risk youth; Autism; Autism Spectrum Disorders; Autistic children; Behavior; Behavior Problems; Behavioral Science and Psychology; Between-subjects design; Child and School Psychology; Child Behavior; Child development; Child psychopathology; Children; Children & youth; Depression, Mental; Developmental Delays; Developmentally delayed young children; Disruptive behaviour; Health aspects; Intervention; Maternal depression; Mental depression; Original Paper; Parent-Child interaction therapy; Parent-child relations; Parents; Parents & parenting; Psychological distress; Psychology; Referrals; Risk behavior; Risk factors; Social Sciences; Sociology; Special education; Young Children; Australia; Parent management training; Parenting; Developmental delay; Autism spectrum disorder; Parent–child interaction therapy
• ISSN: 1062-1024; 1573-2843
• DOI: 10.1007/s10826-020-01699-0

Objectives Disruptive behaviors in children with Autism Spectrum Disorder (ASD) or developmental delay are common, persistent and cause distress to families. Parent–Child Interaction Therapy (PCIT) may be an effective intervention with emerging evidence to support its use for children with at-risk development. We aimed to investigate the effectiveness of standard PCIT for young children (2–4 years) with disruptive behaviors and signs of ASD and/or developmental delay, treated in a real-world clinical setting. We hypothesized that there would be a reduction in disruptive behaviors and for parents, a reduction in depressive symptoms. Methods This was a retrospective file-review study of 236 referrals to a toddler clinic over a 17-month period (January 2016 to May 2017). Disruptive child behavior (EBCI Intensity scale and ECBI Problem scale) and maternal depression (EDS score) severity were analyzed across two time conditions (pre-treatment and post-treatment) using linear mixed models with repeated measures, including time, child ASD risk status and their interaction as main effects. An identical linear mixed models with repeated measures analysis was subsequently conducted using clinician identified concern about the child’s development as the between subjects factor. Results Disruptive child behavior for children at-risk of autism (high SCQ score) and for those with low SCQ scores, improved on average into the non-clinical range. Parental EDS scores reduced in the both groups, but reduced by a greater degree in the children at-risk of autism (high SCQ) group. Conclusions This study suggests that children at-risk of autism and developmental delay should not be excluded from PCIT, an evidence-based intervention for disruptive behaviors, as there is potential benefit for both children and parents. Highlights Standard PCIT reduced disruptive behavior for children at-risk of autism or developmental delay. Parental EDS scores reduced overall, by a greater degree for parents with a child at-risk of autism. PCIT may be effective for children at-risk of autism or developmental delay, and for their parents’ depressive symptoms.