A Case Study of Parent-Child Interaction Therapy for a Young Child with Autism Spectrum Disorder: Behavioral and Developmental Considerations — Oak Academic Publishing
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A Case Study of Parent-Child Interaction Therapy for a Young Child with Autism Spectrum Disorder: Behavioral and Developmental Considerations
Department of Psychology, University of Crete, Gallos University Campus, Rethymno, Greece
1 Department of Psychology, University of Crete, Gallos University Campus, Rethymno, Greece
Externalizing behaviors and impairments in communication and adaptive functioning are the core defining features of the autism spectrum disorder (ASD). They are also the primary focus of interventions for children with ASD, as these conditions impact both the child’s adaptive behavior and parental mental health. This study examined the effectiveness of Parent-Child Interaction Therapy (PCIT) utilizing a case study of a 4-year-old boy diagnosed with ASD and comorbid disruptive behavior disorder. Behavioral observation data and psychometric tools with ecological validity were used across all assessments to evaluate intervention outcomes as assessed by the caregiver and the teacher. Results of both caregiver and teacher reports and observations indicated that 1) PCIT was effective in decreasing disruptive behaviors and improving parenting skills while reducing parental stress, and that 2) intervention gains had been maintained at the 3-month follow-up. Although the nature of this single case experimental study is a limitation, this article replicates and advances previous research examining PCIT success with children with autism and their parents while providing clinical implications for improving children’s adaptive behavior in a short time.
Abrahamse, M. E., Junger, M., van Wouwe, M. A., Boer, F., & Lindauer, R. J. (2016). Treating Child Disruptive Behavior in High-Risk Families: A Comparative Effectiveness Trial from a Community-Based Implementation. Journal of Child and Family Studies, 25, 1605-1622. https://doi.org/10.1007/s10826-015-0322-4
Achenbach, T. M., & Rescorla, L. A. (2002). Manual for the ASEBA Preschool Forms and Profiles. Burlington, VT: Research Center for Children, Youth, and Families, University of Vermont.
Achenbach, T. M., & Rescorla, L. A. (2009). Manual for the ASEBA Preschool Forms and Profiles (Adaptation—Standardization for the Greek Language by I. Tsaousis). Athens: Ellinika Grammata. (In Greek)
Agazzi, H., Tan, R., & Tan, S. Y. (2013). A Case Study of Parent-Child Interaction Therapy for the Treatment of Autism Spectrum Disorder. Clinical Case Studies, 12, 428-442. https://doi.org/10.1177/1534650113500067
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425596
Armstrong, K., & Kimonis, E. R. (2013). Parent-Child Interaction Therapy for the Treatment of Asperger’s Disorder in Early Childhood: A Case Study. Clinical Case Studies, 12, 60-72. https://doi.org/10.1177/1534650112463429
Bagner, D., & Eyeberg, S. (2007). Parent-Child Interaction Therapy for Disruptive Behavior in Children with Mental Retardation: A Randomized Control Trail. Journal of Clinical Child and Adolescent Psychology, 36, 418-429. https://doi.org/10.1080/15374410701448448
Baio, J., Wiggins, L., Christensen, D., Maenner, M., Daniels, J., Warren, Z., Kurzius-Spencer, M., Zahorodny, W., Robinson Rosenberg, C., White, T., Durkin, M. S., Imm, P., Nikolaou, L., Yeargin-Allsopp, M., Lee, L. C., Harrington, R., Lopez, M., Fitzgerald, R. T., Hewitt, A., Pettygrove, S., Constantino, J. N., Vehorn, A., Shenouda, J., Hall-Lande, J., Van Naarden Braun, K., & Dowling, N. F. (2018). Prevalence of Autism Spectrum Disorder among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States. Morbidity and Mortality Weekly Report. Surveillance Summaries, 67, 1-23. https://doi.org/10.15585/mmwr.ss6706a1
Bauminger, N., Solomon, M., & Rogers, S. J. (2010). Externalizing and Internalizing Behaviors in ASD. Autism Research, 3, 101-112. https://doi.org/10.1002/aur.131
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine, 25, 3186-3191. https://doi.org/10.1097/00007632-200012150-00014
Bjørseth, Å., & Wichstrøm, L. (2016). Effectiveness of Parent-Child Interaction Therapy (PCIT) in the Treatment of Young Children’s Behavior Problems. A Randomized Controlled Study. PLoS ONE, 11, e0159845. https://doi.org/10.1371/journal.pone.0159845
Bowlby, J. (1969). Attachment and Loss: Sadness and Depression. New York: Basic Books.
Brereton, A. V., Tonge, B. J., & Einfeld, S. L. (2006). Psychopathology in Children and Adolescents with Autism Compared to Young People with Intellectual Disability. Journal of Autism and Developmental Disabilities, 36, 863-870. https://doi.org/10.1007/s10803-006-0125-y
Budd, K. S., Hella, B., Bae, H., Mayerson, D. A., & Watkin, S. C. (2011). Delivering Parent-Child Interaction Therapy in an Urban Community Clinic. Cognitive and Behavior Therapy, 18, 502-514. https://doi.org/10.1016/j.cbpra.2010.12.002
Butter, E. M., Mulick, J. A., & Metz, B. (2006). Eight Case Reports of Learning Recovery in Children with Pervasive Developmental Disorders after Early Intervention. Behavioral Interventions, 21, 227-243. https://doi.org/10.1002/bin.225
Centers for Disease Control and Prevention (2014). Prevalence of Autism Spectrum Disorders among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010. Morbidity and Mortality Weekly Report. Surveillance Summaries, 63, 1-23. https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm
Dawson, G. (2008). Early Behavioral Intervention, Brain Plasticity, and the Prevention of Autism Spectrum Disorder. Development and Psychopathology, 20, 775-803. https://doi.org/10.1017/S0954579408000370
Duchan, E., & Patel, D. R. (2012). Epidemiology of Autism Spectrum Disorders. Pediatric Clinics, 59, 27-43. https://doi.org/10.1016/j.pcl.2011.10.003
Eyberg, S. M., & Funderburk, B. (2011). Parent-Child Interaction Therapy Protocol. Gainesville, FL: PCIT International.
Eyberg, S. M., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory: Professional Manual. Odesa, FL: Psychological Assessment Recourses.
Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-Based Psychosocial Treatment for Children and Adolescents with Disruptive Behavior. Journal of Clinical Child and Adolescent Psychology, 37, 215-237. https://doi.org/10.1080/15374410701820117
Eyberg, S. M., Nelson, M. M., Duke, M., & Boggs, S. R. (2005). Manual for the Parent-Child Interaction Coding System (3rd ed.). http://www.pcit.org
Ginn, N. C., Clionsky, L. N., Eyeberg, S. M., Warner-Metzger, C., & Abner, J. P. (2017). Child-Directed Interaction Training for Young Children with Autism Spectrum Disorders: Parents and Child Outcomes. Journal of Clinical Child and Adolescent Psychology, 46, 101-109. https://doi.org/10.1080/15374416.2015.1015135
Hartley, S. L., Sikora, D. M., & McCoy, R. (2008). Prevalence and Risk Factors of Maladaptive Behaviour in Young Children with Autistic Disorder. Journal of Intellectual Disability Research, 52, 819-829. https://doi.org/10.1111/j.1365-2788.2008.01065.x
Hosogane, N., Kodaira, M., Kihara, N., Saito, K., & Kamo, T. (2018). Parent-Child Interaction Therapy (PCIT) for Young Children with Attention-Deficit Hyperactivity Disorder (ADHD) in Japan. Annals of General Psychiatry, 17, Article No. 9. https://doi.org/10.1186/s12991-018-0180-8
Kaat, A. J., & Lecavalier, L. (2013). Disruptive Behavior Disorders in Children and Adolescents with Autism Spectrum Disorders: A Review of the Prevalence, Presentation, and Treatment. Research in Autism Spectrum Disorders, 7, 1579-1594. https://doi.org/10.1016/j.rasd.2013.08.012
Kanne, S. M., & Mazurek, M. O. (2011). Aggression in Children and Adolescents with ASD: Prevalence and Risk Factors. Journal of Autism and Developmental Disorders, 41, 926-937. https://doi.org/10.1007/s10803-010-1118-4
Leasack, R., Bearss, K., Celano, M., & Sharp, W. G. (2014). Parent-Child Interaction Therapy and Autism Spectrum Disorder: Adaptations with a Child with Severe Developmental Delays. Clinical Practice in Pediatric Psychology, 2, 68-82. https://doi.org/10.1037/cpp0000047
Lienaman, C. C., Brabson, L. A., Highlander, A., Wallance, N. M., & McNeil, C. B. (2017). Parent-Child Interaction Therapy: Current Perspectives. Psychology Research and Behavior Management, 10, 239-256. https://doi.org/10.2147/PRBM.S91200
Lindor, E., Sivarathan, C., May, T., Stefanac, N., Howells, K., & Rinehart, N. (2019). Problem Behavior in Autism Spectrum Disorder: Considering Core Symptom Severity and Accompanying Sleep Disturbance. Frontiers in Psychiatry, 10, 487. https://doi.org/10.3389/fpsyt.2019.00487
Mannion, A., & Leader, G. (2013). Comorbidity in Autism Spectrum Disorder: A Literature Review. Research in Autism Spectrum Disorders, 7, 1595-1616. https://doi.org/10.1016/j.rasd.2013.09.006
Masse, J. J., McNeil, C. B., Wagner, S., & Quetsch, L. B. (2016). Examining the Efficacy of Parent-Child Interaction Therapy with Children on the Autism Spectrum. Journal of Child and Families Studies, 25, 2508-2525. https://doi.org/10.1007/s10826-016-0424-7
McIntosh, D. E., Rizza, M. G., & Bliss, L. (2000). Implementing Empirically Supported Interventions: Teacher-Child Interaction Therapy. Psychology in the Schools, 37, 453-462. https://doi.org/10.1002/1520-6807(200009)37:5 3.0.CO;2-2
McKenzie, R., & Dallos, R. (2017). Autism and Attachment Difficulties: Overlap of Symptoms, Implications and Innovative Solutions. Journal of Clinical Child Psychology and Psychiatry, 22, 632-648. https://doi.org/10.1177/1359104517707323
McLeod, B. D., Wood, J. J., & Klebanoff, S. (2015). Advances in Evidence-Based Intervention and Assessment Practices for Youth with an Autism Spectrum Disorder. Behavior Therapy, 46, 1-6. https://doi.org/10.1016/j.beth.2014.07.004
McStay, R., Trembath, D., & Dissanayake, C. (2015). Raising a Child with Autism: A Developmental Perspective on Family Adaptation. Current Developmental Disorders Reports, 2, 65-83. https://doi.org/10.1007/s40474-014-0037-z
Papadopoulos, D. (2018). A General Overview of the Pragmatic Language-Social Skills and Interventions for Children with Autism Spectrum Disorders. Autism Open Access, 8. https://doi.org/10.4172/2165-7890.1000225
Scattone, D., Sarver, D. E., & Cox, A. D. (2018). Parent Child Interaction Therapy (PCIT): Autism Case Study #4. In C. B. McNeil, L. B. Quetsch, & C. M. Anderson, Handbook of Parent-Child Interaction Therapy on the Autism Spectrum (pp. 651-664). New York: Springer. https://doi.org/10.1007/978-3-030-03213-5_37
Schreibman, L., Dawson, G., Stahmer, A. G., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistical Developmental Behavior Interventions: Empirically Validated Treatments for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45, 2411-2428. https://doi.org/10.1007/s10803-015-2407-8
Scudder, A., Wong, C., Ober, N., Hoffman, M., Toscolani, J., & Handen, B.L. (2019). Parent-Child Interaction Therapy (PCIT) in Young Children with Autism Spectrum Disorder. Child & Family Behavior Therapy, 41, 201-220. https://doi.org/10.1080/07317107.2019.1659542
Smith, T., & Iadarola, S. (2015). Evidence Base Update for Autism Spectrum Disorder. Journal of Clinical Child & Adolescent Psychology, 44, 897-922. https://doi.org/10.1080/15374416.2015.1077448
Solomon, M., Ozonoff, S., Carter, C., & Caplan, R. (2008). Formal Thought Disorder and the Autism Spectrum: Relationship with Symptoms, Executive Control, and Anxiety. Journal of Autism and Developmental Disorders, 38, 1474-1484. https://doi.org/10.1007/s10803-007-0526-6
Teague, S. J., Gray, K. M., Tonge, B. J., & Newman, L. K. (2017). Attachment in Children with Autism Spectrum Disorder: A Systemic Review. Research in Autism Spectrum Disorders, 35, 35-50. https://doi.org/10.1016/j.rasd.2016.12.002
Tews, L. (2007). Early Intervention for Children with Autism: Methodologies Critique. Developmental Disabilities Bulletin, 35, 148-168.
Thomas, R., & Zimmer-Gembeck, M. J. (2007). Behavioral Outcomes of Parent-Child Interaction Therapy and Triple P—Positive Parenting Program: A Review and Meta-Analysis. Journal of Abnormal Child Psychology, 35, 475-495. https://doi.org/10.1007/s10802-007-9104-9
Thomas, R., & Zimmer-Gembeck, M. J. (2011). Ac in the Prevention of Parent-Child Interaction Therapy in the Prevention of Child Abuse. Child Development, 82, 177-192. https://doi.org/10.1111/j.1467-8624.2010.01548.x
Timmer, S. G., Ho, L. K., Urquiza, A. J., Zebell, N. M., Garcia, E. F., & Boys, D. (2011). The Effectiveness of Parent-Child Interaction Therapy with Depressive Mothers: The Changing Relationship as the Agent of Individual Change. Child Psychiatry and Human Development, 42, 406-423. https://doi.org/10.1007/s10578-011-0226-5
Timmer, S. G., Zebell, N. M., Culver, M. A., & Urquiza, A. J. (2010). Efficacy of Adjunct In-Home Coaching to Improve Outcomes in Parent-Child Interaction Therapy. Research on Social Work Practice, 20, 36-45. https://doi.org/10.1177/1049731509332842
Van Steensel, F., Bogels, S., & Perrin, S. (2011). Anxiety Disorders in Children and Adolescents with Autism Spectrum Disorders: A Meta-Analysis. Clinical Child and Family Psychology Review, 14, 302-317. https://doi.org/10.1007/s10567-011-0097-0
Ware, L. M., McNeil, C. B., Masse, J. J., & Stevens, S. B. (2008). Efficacy of In-Home Parent-Child Interaction Therapy. Child & Family Behavior Therapy, 30, 99-126. https://doi.org/10.1080/07317100802060302
Weisz, J. R., Doss, A. J., & Hawley K. M. (2005). Youth Psychotherapy Outcome Research: A Review and Critique of the Evidence Base. Annual Review of Psychology, 56, 337-363. https://doi.org/10.1146/annurev.psych.55.090902.141449
Wijnhoven, L., Creemers, D. H., Vermulst, A. A., & Granic, I. (2018). Prevalence and Risk Factors of Anxiety in a Clinical Dutch Sample of Children with an Autism Spectrum Disorder. Frontiers in Psychiatry, 9, 50. https://doi.org/10.3389/fpsyt.2018.00050
Wood, J. J., & Gadow, K. D. (2010). Exploring the Nature and Function of Anxiety in Youth with Autism Spectrum Disorders. Clinical Psychology: Science and Practice, 17, 281-292. https://doi.org/10.1111/j.1468-2850.2010.01220.x