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Training Helps Parents Reduce Challenging Autism Behaviors

Intensive training program teaches parents techniques that improve communication and cooperative behavior in children with autism
April 21, 2015

A new study documents the effectiveness of a training program that teaches parents strategies for managing challenging behavior in young children with autism.

The report appears today in JAMA, the Journal of the American Medical Association.

The study enrolled 180 children with autism, ages 3 to 7 years, and their parents. Roughly half the parents received behavior intervention training. The training consisted of eleven 60- to 90-minute sessions with a therapist over 16 weeks. The therapist taught management strategies for challenging behaviors such as tantrums, aggression, self-injury and refusal to cooperate. This was followed by one home visit and two phone consultations over the following two months.

For comparison, the other half of the parents (91) received twelve “parent education” sessions and one home visit. During these educational sessions, the parents learned about autism and autism services, but received no training in behavior management.

Before and after the parent sessions, specialists evaluated all the children for challenging behaviors using standardized checklists. All the children showed improvements.

However, the children whose parents received the behavioral training showed greater improvements: a 48 percent vs 32 percent improvement on the Aberrant Behavior Checklist-Irritability subscale; and a 55 percent vs 34 percent improvement on the Home Situations Questionnaire-Autism Spectrum Disorder.

Parent behavioral training also surpassed parent education on a rating of the children’s overall improvement (69 percent vs 40 percent), as judged by a specialist who didn’t know which sessions each child’s parents had received.

“This is a huge step,” comments Kara Reagon, Autism Speaks Associate Director for Dissemination Science. “It’s telling us that simply educating parents about autism isn’t enough. They really need help in the home and community, and there’s a need for more effective parent training.” (Dr. Reagon wasn’t involved in the study.)

By way of example, Dr. Reagon notes the importance of teaching parents to consider what happened immediately before a child acts out in a disruptive or harmful way.

“Sometimes children with autism don’t have verbal skills to say what they want,” she explains. “By looking at what happened before the behavior started and afterward, we can often identify what’s causing it.” The next step is to help the child replace the problem behavior with a better alternative such as pointing to what he wants instead of crying, screaming or grabbing in frustration.