Parent Training Leads to Dramatic Gains for Children with Autism

Tantrums, aggression, self-injury and other serious behavior problems are common in children with autism spectrum disorder (ASD). In the largest-ever clinical trial for autism, a multi-site study that included researchers at the University of Rochester Medical Center showed that a parent training program can help reduce these behaviors.

Results of the study, published in the April 21 edition of the Journal of the American Medical Association, showed that parent training decreased serious behavior problems by 47.7 percent. Researchers compared the parent training with an education program that also reduced serious behavior problems, but not as much.

Given the increased recognition of ASD in children — 1 in 68 children has been identified with ASD — there is a pressing need for effective and affordable treatments. The parent-training program in this study was designed to help meet this need. The program lasts 24 weeks and includes 11 core sessions in which a clinician works one-to-one with the primary caregiver for 1 - 1 ½ hours. There are also two home visits and up to four additional sessions.

“To provide this parent training, you need to be familiar with behavioral principles and children with autism, but you don’t need to be an autism specialist,” said Tristram Smith, Ph.D., a professor of Pediatrics at URMC who provides clinical services to children with ASD at UR Medicine’s Golisano Children’s Hospital.

The training program taught parents to identify environmental events that might contribute to behavior problems and presented strategies for preventing these problems. It also emphasized positive reinforcement for appropriate behavior and withholding reinforcement for inappropriate behavior.

”Parents often see their child’s behavior improve within a few weeks,” Smith said.

Smith was the lead investigator in Rochester. The other sites included Emory University, Indiana University, Ohio State University, University of Pittsburgh, and Yale University.

The study, funded by the National Institute of Mental Health, was the largest clinical trial conducted to date in children with autism spectrum disorder. It enrolled 180 children with autism spectrum disorder who were between 3 to 6 years old.

Smith and other researchers in Rochester are also in the midst of other studies that explore other ways that parent training can benefit children with autism spectrum disorder.