Project Description:
The overall aim of this 5-site consortium is to develop and test exportable psychosocial interventions for children with pervasive developmental disorders (Autistic Disorder, Pervasive Developmental Disorder, Not Otherwise Specified, & Aspergers Disorder). This multisite study will randomly assign 180 preschool children ( 3 to < 7 years of age) with pervasive developmental disorders (PDDs) to a structured, six-month Parent Training (PT) program or a six-month Parent Educational Program (PEP). PT provides a systematic presentation of specific techniques and supervised practice designed to reduce irritability (tantrums, aggression and self-injury), enhance compliance and promote adaptive skills. PEP provides current information for families of young children with PDD and will control
for attention and the passage of time. The primary outcomes of interest include a parentrated measure of irritability and noncompliance from multiple raters, a blinded rating of adaptive functioning and overall improvement. Blinded ratings will also be obtained from direct observation via assessment of video-recordings of a structured parent-child interaction. The impact of PT and PEP on parent nominated target problems, prosocial behavior and measures of parental stress will also be evaluated. Recent reviews indicate a steady increase in the number of preschool age children with PDD receiving special educational services (U.S. Government Accountability Office, 2005). These reviews also note that there is considerable variation in the intensity (hours per week) and content of these services (Hume, Bellini & Pratt, 2005). Parent training and parent education about autism may be missing or inadequate in many programs. To ensure generalizability of study results, children in both high (i.e., > 15 hours per week of specialized educational programming) and low intensity educational programs will be allowed to participate. Randomization and analytic procedures have been developed to examine the effects of concurrent treatment (high intensity versus low intensity) on outcome. The durability of PT will be monitored at 3 and 6 months post-treatment.
Strengths of this study include an investigator team with extensive experience in multisite studies in children with PDDs. The PIs also have expertise in the development and implementation of structured parent training in this population with established methods of therapist training and monitoring treatment fidelity as well as training independent evaluators for blinded outcome assessment. Finally, this study addresses an important public health problem. Children with autism are being identified earlier and in greater numbers. Thus, there is a pressing need for effective and exportable interventions to promote optimal development for these vulnerable children. Given the age group of the study and the likelihood that many children
