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1.
J Am Acad Child Adolesc Psychiatry ; 60(11): 1404-1418, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-33965518

RESUMEN

OBJECTIVE: To examine the feasibility and preliminary efficacy of a group behavioral parenting intervention for emotional and behavioral problems (EBPs) in young autistic children. METHOD: This was a feasibility pilot randomized controlled trial comparing a 12-week group behavioral parenting intervention (Predictive Parenting) to an attention control (Psychoeducation). Parents of 62 autistic children 4 to 8 years of age were randomized to Predictive Parenting (n = 31) or Psychoeducation (n = 31). The primary outcome was a blinded observational measure of child behaviors that challenge. Secondary outcomes were observed child compliance and parenting behaviors; parent- and teacher-reported child EBPs; self-reported parenting practices, stress, self-efficacy, and well-being. Cost-effectiveness was also explored. RESULTS: Recruitment, retention, completion of measures, treatment fidelity, and parental satisfaction were high for both interventions. There was no group difference in primary outcome: mean log of rate 0.18 lower (d, 90% CI = -0.44 to 0.08) in Predictive Parenting. Differences in rates of child compliance (0.44, 90% CI = 0.11 to 0.77), facilitative parenting (0.63, 90% CI = 0.33 to 0.92) and parent-defined target symptom change (-0.59, 90% CI -0.17 to -1.00) favored Predictive Parenting. There were no differences on other measures. Predictive Parenting was more expensive than Psychoeducation, with a low probability of being more cost-effective. CONCLUSION: Feasibility was demonstrated. There was no evidence from this pilot trial that Predictive Parenting resulted in reductions in child EBPs beyond those seen following Psychoeducation; in addition, the effect size was small, and it was more expensive. However, it showed superiority for child compliance and facilitative parenting with moderate effect sizes. Future, definitive studies should evaluate whether augmented or extended intervention would lead to larger improvements. CLINICAL TRIAL REGISTRATION INFORMATION: Autism Spectrum Treatment and Resilience (ASTAR); https://www.isrctn.com/; 91411078.


Asunto(s)
Trastorno Autístico , Problema de Conducta , Niño , Emociones , Humanos , Responsabilidad Parental , Padres
2.
J Autism Dev Disord ; 51(1): 323-333, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32415533

RESUMEN

Parent-mediated interventions can reduce behavioral and emotional problems in children with ASD. This report discusses the development of the first group parent intervention targeting behaviors and anxiety in children with ASD, across the spectrum of cognitive and language ability. 'Predictive Parenting' was developed from the clinical observation (and emerging evidence base) that children with ASD struggle with 'prediction' and anticipating change. It integrates well-established parenting strategies within an ASD-specific framework. The concept was co-created with patient and public involvement panels of parents and adults with ASD. A feasibility study found the programme is acceptable and accessible. Qualitative feedback from participants was largely positive, and critiques were used to inform a larger, pilot randomized controlled trial of the intervention.


Asunto(s)
Síntomas Afectivos/psicología , Trastorno del Espectro Autista/psicología , Trastornos de la Conducta Infantil/psicología , Responsabilidad Parental/psicología , Padres/psicología , Adulto , Síntomas Afectivos/diagnóstico , Síntomas Afectivos/terapia , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/terapia , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/terapia , Preescolar , Estudios de Factibilidad , Femenino , Predicción , Humanos , Masculino
3.
BMJ Open ; 9(6): e029959, 2019 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-31248932

RESUMEN

INTRODUCTION: The majority of young autistic children display impairing emotional and behavioural difficulties that contribute to family stress. There is some evidence that behavioural parenting interventions are effective for reducing behavioural difficulties in autistic children, with less evidence assessing change in emotional difficulties. Previous trials have tended to use unblinded parent-report measures as primary outcomes and many do not employ an active control, limiting the conclusions that can be drawn. METHODS AND ANALYSIS: The Autism Spectrum Treatment and Resilience study is a pilot randomised controlled trial (RCT) testing the specific effect of a 12-week group parenting intervention (Predictive Parenting) on primary and secondary outcomes, in comparison to an attention control condition consisting of psychoeducation parent groups. Following a feasibility study to test research procedures and the interventions, the pilot RCT participants include 60 parents of autistic children aged 4-8 years who are randomised to Predictive Parenting versus the attention control. Measures are administered at baseline and post intervention to assess group differences in child and parent outcomes, costs and service use and adverse events. The primary outcome is an objective measure of child behaviours that challenge during interactions with their parent and a researcher. The trial aims to provide data on recruitment, retention, completion of measures and acceptability of the intervention and research protocol, in addition to providing a preliminary indication of potential efficacy and establishing an effect size that could be used to power a larger-scale efficacy trial. We will also provide preliminary estimates of the cost-effectiveness of the interventions. ETHICS AND DISSEMINATION: Ethical approval was granted from NHS Camden and Kings Cross Research Ethics Committee (ref: 16/LO/1769) along with NHS R&D approval from South London and Maudsley, Guy's and St Thomas', and Croydon Health Services NHS Trusts. The findings will be disseminated through publication in peer-reviewed journals and presentations at conferences. TRIAL REGISTRATION NUMBER: ISRCTN91411078.


Asunto(s)
Trastorno del Espectro Autista/terapia , Trastorno Autístico/terapia , Educación no Profesional/métodos , Trastorno del Espectro Autista/psicología , Trastorno Autístico/psicología , Niño , Preescolar , Femenino , Humanos , Masculino , Padres/educación , Padres/psicología , Proyectos Piloto
4.
J Appl Res Intellect Disabil ; 32(3): 533-542, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30656797

RESUMEN

BACKGROUND: A 2005 review by Beart, Hardy and Buchan, asking how people with intellectual disabilities view their social identities, has been widely cited, indicating this important topic needs an updated review. This review covers research on how people with intellectual disabilities view their ascribed label; to what extent they ascribe it to themselves; and whether they recognize it as devalued in society. METHOD: Rapid review methodology using PsycINFO, citation- and hand-searching identified relevant studies. RESULTS: The 16 studies identified indicate that the majority are aware of their ascribed label, or acknowledge they are "different". Others reject it, focusing on alternative attributes or roles. Most recognize others view the label negatively and express feelings of shame, anger and powerlessness. CONCLUSIONS: The review advances our understanding of social identity formation in people with intellectual disabilities, with implications for future research and practice to support construction of positive social identities and stigma resistance.


Asunto(s)
Discapacidad Intelectual/psicología , Identificación Social , Humanos
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