Feasibility of Group Parent Training for Children with Autism Spectrum Disorder and Disruptive Behavior: A Demonstration
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ORIGINAL PAPER
Feasibility of Group Parent Training for Children with Autism Spectrum Disorder and Disruptive Behavior: A Demonstration Pilot T. Lindsey Burrell1,2 · Valentina Postorino3 · Lawrence Scahill1,2 · Hannah M. Rea4 · Scott Gillespie1 · A. Nichole Evans1 · Karen Bearss5,6
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Delivery of interventions in a group format is a potential solution to limited access to specialized services for children with autism spectrum disorder (ASD). We conducted an open feasibility trial of group-based RUBI parent training in 18 children (mean age 6.12 ± 1.95 years) with ASD and disruptive behaviors. Parents participated in one of five groups (3 to 4 parents per group). Eighty-three percent of participants completed the 24-week trial. Session attendance was moderate (74.2%). All parents indicated that they would recommend the treatment. Therapists demonstrated 98.8% fidelity to the manual. Eleven of 18 (64.7%) participants were rated as much/very much improved by an independent evaluator at Week 24. Preliminary efficacy findings justify further study. Keywords Autism spectrum disorder · Group intervention · Parent training · Disruptive behaviors · Feasibility
Introduction Twenty-five to 50% of children with Autism Spectrum Disorder (ASD) exhibit behavior problems including tantrums, noncompliance, aggression and self-injury (Hartley et al. 2008; Hill et al. 2014; Mazurek et al. 2013). These behavior problems amplify caregiver stress (Hayes and Watson 2013; Lecavalier 2006; Postorino et al. 2019) and promote * T. Lindsey Burrell [email protected] 1
Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30329, USA
2
Marcus Autism Center, 1920 Briarcliff Road NE, Atlanta, GA 30329, USA
3
JFK Partners School of Medicine, University of Colorado Denver, 13121 E. 17th Avenue, C234, Aurora, CO 80045, USA
4
Department of Psychology, University of Georgia, 125 Baldwin Drive, Athens, GA 30602, USA
5
Seattle Children’s Autism Center and Research Institute, 4909 25th Avenue Northeast, Seattle, WA 98105, USA
6
Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
uncertainty regarding how to manage these problems (Iadarola et al. 2018). Serious behavior problems may lead to restrictive school placements (Horner et al. 2002; Mazefsky et al. 2013; Mazurek et al. 2013) as well as social isolation and stigma for parents (Gray 2009; Waltz 2002). Furthermore, heightened parenting stress due to serious behavior problems in children may take a toll on parental mental and physical health and undermine family functioning (Mancil et al. 2009; Tehee et al. 2009; Postorino et al. 2019). Heightened parental stress may perpetuate and worsen the child’s maladaptive behaviors (Karst and Van Hecke 2012). Economic impacts include lower household incomes compared to families of children without ASD, due, at least in part, to cost
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