5 - (IOP 18) Results from a Randomized Trial of Tele-pcit for Disruptive Behavior in Autism

Introduction: Behavioral parenting interventions are highly effective in targeting disruptive behavior problems in young children with and without autism spectrum disorder (ASD). Parent Child Interaction Therapy (PCIT) is an evidence based behavioral parenting program that uses live coaching to increase positive parenting skills and reduce disruptive behaviors problems. However, challenges include high attrition and limited accessibility. Delivering PCIT through telehealth in a time-limited format has the potential to overcome treatment engagement barriers, particularly for underserved populations. The current study included a randomized controlled trial to examine the efficacy of time-limited, telehealth delivery of PCIT (Tele-PCIT) across parent and child outcomes for children with ASD from underserved backgrounds.

Method: Participants included 79 parent-child dyads randomized to a 10-session version of Tele-PCIT (n = 40) or Treatment as Usual (TAU; n = 39). All children (Mage = 4.72) had a diagnosis of ASD, elevated disruptive behavior problems, and a verbal age of at least 24 months, and 95% of families had primary Medicaid. Parents completed the Parenting Scale and Eyberg Child Behavior Inventory at baseline (Time 1) and 12-weeks after randomization (Time 2). Parent use of PCIT “Do” and “Don’t” Skills and child compliance were also coded during a play observation.

Results: Of the 40 families randomized to Tele-PCIT, 5 dropped out after randomization before beginning treatment. Of the 35 that began therapy, 25 completed all 10 sessions and reported high levels of satisfaction. Parents in the Tele-PCIT group exhibited significantly more effective discipline strategies, as measured by reported decreased levels of Laxness (F = 10.27, p < .001), and Overreactivity (F = 11.75, p < .001) as well as improvements in observed parenting skills (“Do/”Don’t skills” Fs =19.55 & 19.40, ps <.001) when compared with the TAU group. Children in the Tele-PCIT group exhibited significantly greater reductions in parent reported behavior problems (F = 37.78, p < .001) and increases in observed compliance (F = 6.17, p < .05). Three-month follow-up outcomes are currently being collected (n = 44 complete) and preliminary analyses show maintenance of effects.

Discussion: Results highlight PCIT as an efficacious transdiagnostic treatment for disruptive behavior within a particularly high-risk group of young children with ASD from underserved backgrounds. This study addresses a critical barrier to progress in the field for an underserved population by providing evidence for an intervention that is empirically based, feasible, accessible, and cost-effective. Future analyses will examine long term maintenance, along with parent and child characteristics that predict outcomes.