Parent training boosts medication effect for autism

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Life with a child who has a pervasive developmental disorder such as autism or Asperger’s syndrome is often a storm of tantrums, irritability, impulsive behavior and obstinacy — a challenge that has child psychiatrists casting about for ways to help the stressed-out families of their patients, as well as the patients themselves.

The antipsychotic medication risperidone is approved for those with autism to reduce irritability, and many other medications are widely used to rein in the defiance and explosive behavior that often come with a PDD diagnosis. But a group of researchers, spurred by the National Institute of Mental Health, set out to see if parent training could help children already on medication to further temper their negative behaviors, and bring an added measure of peace to their families.

Compared with kids on medication alone, the behavior of children whose parents got a battery of training sessions improved more and by several measures. The success of the program prompted the authors of the study — researchers from Ohio State University, Indiana University, Yale University and the University of Pittsburgh as well as with NIMH — to declare they will make the parent-training manual, homework assignments and therapist scripts broadly available. Their study is published in the Journal of the American Academy of Child & Adolescent Psychiatry. [Updated 5:45 p.m. Nov. 24] (An earlier version of this article included an incorrect name for this publication. It now has the correct name.)

‘Because parents are the agents of change, parent training is less expensive than many other forms of psychosocial intervention,’ the researchers concluded. The growing population of kids with PDD, they added, makes the availability of ‘effective behavioral interventions’ an urgent need.

Over 24 weeks, the parents of children with pervasive developmental disorder attended as many as 17 sessions, 60 to 90 minutes long, aimed at teaching them to help the child acquire and consolidate self-management and communication skills and to be more flexible and compliant. Parents learned to use visual schedules to ease transitions, to use positive reinforcement effectively, to teach their kids how to communicate their needs and be more flexible. A behavior therapist came to the home twice and made two telephone calls to answer questions and give support.

— Melissa Healy