Is PCIT An Effective Treatment for ASD?

Background: Parent-Child Interaction Therapy (PCIT) is a behaviorally-based intervention package designed for preschool-age children that emphasizes changing parent-child interaction patterns in order to improve child behavior and enhance the quality of parent-child relationships. During PCIT, parents are taught specific skills to establish a secure, nurturing relationship with their child while simultaneously increasing their child’s prosocial behavior and decreasing their child’s negative behavior (Bell & Eyberg, 2002). Given that the goals of PCIT are to improve the parent-child attachment relationship along with the parent’s behavior management skills (Brinkmeyer & Eyberg, 2003), PCIT has garnered empirical support for treating a variety of clinical problems. Families with ASDs may benefit from PCIT by experiencing reduced parental stress, stronger parent-child bonds, improved parenting skills, decreased child disruptive behavior, and improved prosocial interactions.  Recent studies have garnered support for the use of PCIT with families of children with ASDs.  Solomon, Ono, Timmer, & Goodlin-Jones (2008) presented encouraging evidence regarding the efficacy of applying PCIT to the ASD population. Further, Vess and Campbell (2009) found that PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands in families of children with ASDs.  Parents reported greater confidence in their parenting abilities post-treatment. Significant improvement in core areas of autism symptomatology, including social approach behaviors and receptive-expressive language communication abilities, was reported by parents at post-treatment. Further, parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement.

Objectives:

The current study is designed to evaluate the efficacy of PCIT in reducing conduct problems and improving parent-child relationships for preschool children diagnosed with ASDs and provide support for continued investigation in this area.

Methods: PCIT was implemented according to manualized procedures (Eyberg & Child Study Lab, 1999). Children between the ages of 2 and 6 previously diagnosed with an ASD participated in the study with their primary caregiver.  Recruitment in the study is ongoing.  Five families have completed treatment to date.  At the time the paper is presented, it is anticipated that 20 families will have completed treatment.  
A pre-post intervention design was utilized. The Child Behavior Checklist for Ages 1 ½ - 5 (CBCL; Achenbach & Rescorla, 2000) was administered pre- and post-treatment.  Measures administered at each treatment session included the Eyberg Child Behavior Iventory (ECBI; Eyberg & Pincus, 1999) and the DPICS-III (Eyberg, McDiarmid-Nelson, Duke, & Boggs, 2005). Graduation from the PCIT program involved meeting individual CDI and PDI mastery requirements and an ECBI score of 114 or less.

Results:

Preliminary results demonstrate that PCIT is effective in changing parenting behaviors and increasing child compliance.  This paper will describe the intervention program along with specific changes in (a) parenting behavior, (b) child behavior problems, (c) child compliance, and (d) parent-child interactions post-treatment.

Conclusions: PCIT shows promise as an intervention for preschool children with autism.   This pilot research provides direction for therapists considering utilizing PCIT with this population and supports further research in this area.