(PS2-45) ADHD Symptom Improvement Within an Autism Sample Receiving Tele-pcit

Abstract Text: Children with Autism Spectrum Disorder (ASD) often present with elevated rates of disruptive behavior problems such as aggression and oppositionality which can cause significant impairment across settings. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common co-occurring diagnoses in children with ASD with rates ranging from 30 to 70%. While Parent-Child Interaction Therapy (PCIT) is an evidence-based caregiver training program for young children with disruptive behaviors, less is known about its impact on ADHD symptomatology in children with ASD. This study aims to examine the prevalence of ADHD diagnoses in an autism sample referred for PCIT and examine the impact of Tele-PCIT on children’s ADHD symptoms (i.e. hyperactivity, inattention) across parent and teacher ratings. Participants included 79 children (Mage = 4.73, SD = 1.13) with ASD, elevated disruptive behaviors, and minimum verbal age equivalent of 24 months. Participants were randomized to a 10-session telehealth adaptation of PCIT (Tele-PCIT; n = 40) or a treatment as usual condition (TAU; n = 39). Participants completed a post assessment 12-weeks after their intake and a 3-month follow-up. Caregivers reported on their child’s ADHD symptoms using the Disruptive Behavior Disorder Rating Scale (DBD). A subset of this sample also completed teacher ratings (n = 14), including the Behavior Assessment System for Children, Third Edition (BASC-3), at pre and post assessment. Of the 79 child participants, 24 (30%) had a co-occurring diagnosis of ADHD. Symptoms of hyperactivity significantly decreased from pre (M = 1.99, SE = .16) to post (M = 1.55, SE = .18) for children in the Tele-PCIT group F(1,52) = 11.85, p < 0.001, but not for the TAU group F(1,52) = .51, p = .48. Inattentive symptoms also decreased significantly from pre (M = 2.19, SE = .23) to post (M = 1.45, SE = .22) for children in the Tele-PCIT group F(1,52) = 9.33, p = 0.004, but not for the TAU group F(1,52) = 1.87, p = .18. Improvements in hyperactivity (post-follow-up p = .78) and inattention (post-follow-up p = .67), were maintained for the Tele-PCIT group at 3-month follow-up. Of those with completed teacher ratings, no significant differences were found for inattention. However, teachers rated significant decreases in hyperactivity for children in the tele-PCIT group F(1,10) = 17.73, p < 0.01, compared to significant increases in hyperactivity for children in the TAU group F(1,10) = 10.63, p < 0.01. Co-occurring ADHD diagnoses and symptoms were common in this sample of preschool aged children with ASD. Although child behavior problems are the primary target in PCIT, results support the utility of Tele-PCIT in improving symptoms associated with ADHD, with gains were maintained at follow-up. While our power to detect teacher rated improvements was limited by a small sample size, preliminary data suggests improvements in ADHD symptoms in the classroom for children receiving Tele-PCIT. Additional work is needed to understand if this treatment may delay the need for medication management of ADHD symptoms in this population.