Effectiveness of a Parent-Child Developmental Behavioral Training Program in a Community-Based Clinic

Background:  There has been increasing support for the efficacy of parent-mediated interventions to improve social communication in young children with Autism Spectrum Disorder (ASD)(Kasari et al., 2010).  An initial efficacy trial for a specific model of parent-child developmental behavioral training (PCDBT) demonstrated an increase in child language associated with increased parent use of intervention techniques (Ingersoll & Dvortcsak, 2010).  There continues to be a need for studies of effectiveness of interventions when implemented in diverse community settings (e.g., National Advisory Mental Health Council, 2001; National Research Council, 2001; Rogers, 1998).  Thus, this study examines the effectiveness of PCDBT implemented in an ethnically diverse community-based clinic.

Objectives: To investigate 1) treatment outcomes in a community clinic parent training therapy program, and 2) child characteristics that may moderate treatment outcomes.

Methods:  Preliminary data are drawn from a comprehensive baseline assessment of an ongoing R01 study conducted in a community clinic parent training therapy program.  Parents completed the Autism Impact Measure (AIM; Kanne et al., 2014), Social Responsiveness Scale, 2^nd edition (SRS-2; Constantino & Gruber, 2012) and demographic forms.  The Autism Diagnostic Observation Schedule, 2^nd edition (ADOS-2; Lord et al., 2012) and Vineland Adaptive Behavior Scales, 2^nd edition (Vineland-II; Sparrow, Cicchetti & Balla, 2005) were administrated by trained, research reliable project staff.  This sample includes 34 children (82% male) ages 2-9 years (M = 4.4 years; SD = 2.2) and their primary caregivers. All children had a diagnosis of Autism Spectrum Disorder (all cases validated by positive ADOS-2), and 63% identified as racial or ethnic minority. Paired sample t-tests were conducted to examine treatment outcomes on selected measures. Hierarchical blocked regressions were conducted to identify predictors for treatment outcomes.

Results:  There was significant improvement post treatment as measured by the ADOS-2 Social Affect subscale, the ADOS-2 overall score, the AIM frequency total score, the AIM impact total score, and the Vineland-II Communication domain (see Table 1 for results). Other measures of social functioning and behavior did not capture significant change.  Additionally, age, minority status, and IQ were tested as potential predictors of treatment outcome.  None of these variables were significant predictors after controlling for baseline functioning (Age: β=-0.08, p=0.63; Minority: β=0.08, p=0.62; IQ: β=-0.29, p=0.14).

Conclusions:  Findings demonstrate that parent-child developmental behavioral training offered in a community clinic results in moderate improvements in social functioning and communication.  This finding is consistent with the literature demonstrating effectiveness of parent training programs targeting social communication in community settings (e.g., Baker-Ericzén, Stahmer, & Burns, 2007).  Further, the treatment outcomes are consistent with efficacy trials of other parent-mediated training programs (Oono, Honey, & McConachie, 2013).  It is also important to note that individual characteristics, such as age, minority status, and IQ, did not moderate treatment outcomes in this diverse community sample.  A current limitation of this study is the small sample size; the sample will be doubled by the submission of the poster.