Managing Repetitive Behaviours in Young Children with Autism Spectrum Disorder (ASD): New Parent Group Intervention

 

Background: Repetitive behaviours (RBs) can interfere with a child’s ability to learn new skills and engage in daily living activities. Parents report that RBs interfere with family functioning and are among the most stressful behaviours to manage. However, not all RBs are problematic.  It is important to help parents understand RBs and learn how to manage them early, with the aim of reducing the impact for child and family. Most ASD-specific early intervention programmes focus on social communication. Parents rarely receive specific advice about their child’s RBs.

Objectives: This pilot randomised controlled trial (RCT) aimed to evaluate feasibility, acceptability and impact of a new 8-week group-based parent intervention which was developed in collaboration with parents of young children with ASD.

Methods: 45 families of children with ASD (3 to 8 years) were randomised to immediate or delayed intervention. The outcome measures include level of change in parent-chosen ‘target’ RB (independently rated); ‘blind’ researcher-coding of child and parent behaviours from video; parent questionnaires (RBQ2 and Self-Efficacy). Measures were taken at baseline, FU1 after 10 weeks, FU2 two months later, and FU3 two months later.

Results: At baseline, all children had high Autism severity (ADOS mean severity score 7.04; SRS total mean 120.13) and moderate-low adaptive functioning (VABS composite mean 68.76).

Parent attendance at groups was 96% overall. Parents who attended the group reported that they found the course helpful, and that that it increased their knowledge and confidence in managing RBs; e.g. “I feel more relaxed with dealing with RBs”, “I am more confident, have a bank of strategies I can use”.

A significant impact of intervention was found for RBQ2 factor 3 ‘preoccupation with restricted patterns of interest’ (FU1, p= .04, η_p²= .09; FU2, p= .02, η_p²= .12; i.e., moderate to large effect sizes), and for factor 4 ‘unusual sensory interest’ (p= .04, η_p²= .10). There was a significant main effect of group on parent Self Efficacy (p= .02, η_p²= .13); t-tests revealed that the immediate intervention group had higher self efficacy than the control group at FU1 and FU2. Analysis of observational measures of child RB and parent management strategies, rated level of improvement in parent–chosen target RB, and FU3 data will also be presented.

Conclusions:   The results of this pilot RCT suggest that a parent group intervention for managing RBs in young children with ASD has potential for beneficial impact. Parents were willing to be recruited and randomised, the format and content of the groups were feasible and acceptable, and the outcome measures were appropriate for use in a future fully powered trial.

This abstract describes independent research commissioned by the National Institute for Health Research (NIHR) under the Research for Patient Benefit programme (PB-PG-1010-23305). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.