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Child Directed Interaction Training for Young Children with Autism Spectrum Disorders

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Material Information

Title:
Child Directed Interaction Training for Young Children with Autism Spectrum Disorders Parent Outcomes, Mediators, and Predictors of Treatment
Physical Description:
1 online resource (102 p.)
Language:
english
Creator:
Ginn, Nicole C
Publisher:
University of Florida
Place of Publication:
Gainesville, Fla.
Publication Date:

Thesis/Dissertation Information

Degree:
Doctorate ( Ph.D.)
Degree Grantor:
University of Florida
Degree Disciplines:
Psychology, Clinical and Health Psychology
Committee Chair:
Eyberg, Sheila M
Committee Co-Chair:
Boggs, Stephen R
Committee Members:
Rozensky, Ronald Howard
Bussing, Regina
Elder, Jennifer Harrison

Subjects

Subjects / Keywords:
autism -- parents -- pcit
Clinical and Health Psychology -- Dissertations, Academic -- UF
Genre:
Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract:
The prevalence of Autism Spectrum Disorders (ASDs) in young children continues to rise, underscoring the need for effective interventions for these children and their families. Intervention research with children with ASDs has shown less than optimal outcomes for nearly 50% of treated children. Parent outcomes in this population; have received less attention, although stress reduction following parent training programs has been reported. Parent-Child Interaction Therapy (PCIT) is a relatively available and inexpensive treatment with demonstrated effectiveness across a variety of child populations for improving child disruptive behaviors and positive parenting practices, as well as reducing parenting stress. The Child Directed Interaction Training (CDIT) phase of PCIT holds particular promise for children with ASDs due to its focus on improving the parent-child relationship in a naturalistic, child-led play situation. This study used a randomized controlled design to (a) evaluate CDIT outcomes for parenting skills and parenting stress and distress in the ASD population; (b) examine changes in parenting behaviors as a possible mediator of child disruptive behavior outcomes; and (c) explore parent and child predictors of child outcome following CDIT to identify characteristics that may determine optimal child outcome following treatment.   Thirty mother-child dyads with children between the ages of 3 to 7 years with a previous ASD diagnosis participated in this study. Results revealed that following manualized CDIT, mothers learned to provide positive attention to their children’s appropriate social and play behaviors and these skills were maintained at 6-week follow up. Mothers also showed significant reductions in parent distress associated with child disruptive behavior. Exploratory analyses also provided evidence for child IQ, child adaptive behavior, maternal stress associated with difficult child behaviors, and maternal distress as predictors of child outcomes following CDIT. These results provide preliminary evidence of the efficacy of CDIT for changing parent behaviors and reducing distress for mothers of young children with ASDs. It also suggests that outcomes following CDIT may be optimal for children with higher IQ and adaptive functioning and families with lower reported maternal stress and distress, but that outcomes may not differ across the 3-7 age range and differing ASD symptom severity.
General Note:
In the series University of Florida Digital Collections.
General Note:
Includes vita.
Bibliography:
Includes bibliographical references.
Source of Description:
Description based on online resource; title from PDF title page.
Source of Description:
This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility:
by Nicole C Ginn.
Thesis:
Thesis (Ph.D.)--University of Florida, 2013.
Local:
Adviser: Eyberg, Sheila M.
Local:
Co-adviser: Boggs, Stephen R.
Electronic Access:
RESTRICTED TO UF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE UNTIL 2015-08-31

Record Information

Source Institution:
UFRGP
Rights Management:
Applicable rights reserved.
Classification:
lcc - LD1780 2013
System ID:
UFE0044819:00001

MISSING IMAGE

Material Information

Title:
Child Directed Interaction Training for Young Children with Autism Spectrum Disorders Parent Outcomes, Mediators, and Predictors of Treatment
Physical Description:
1 online resource (102 p.)
Language:
english
Creator:
Ginn, Nicole C
Publisher:
University of Florida
Place of Publication:
Gainesville, Fla.
Publication Date:

Thesis/Dissertation Information

Degree:
Doctorate ( Ph.D.)
Degree Grantor:
University of Florida
Degree Disciplines:
Psychology, Clinical and Health Psychology
Committee Chair:
Eyberg, Sheila M
Committee Co-Chair:
Boggs, Stephen R
Committee Members:
Rozensky, Ronald Howard
Bussing, Regina
Elder, Jennifer Harrison

Subjects

Subjects / Keywords:
autism -- parents -- pcit
Clinical and Health Psychology -- Dissertations, Academic -- UF
Genre:
Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract:
The prevalence of Autism Spectrum Disorders (ASDs) in young children continues to rise, underscoring the need for effective interventions for these children and their families. Intervention research with children with ASDs has shown less than optimal outcomes for nearly 50% of treated children. Parent outcomes in this population; have received less attention, although stress reduction following parent training programs has been reported. Parent-Child Interaction Therapy (PCIT) is a relatively available and inexpensive treatment with demonstrated effectiveness across a variety of child populations for improving child disruptive behaviors and positive parenting practices, as well as reducing parenting stress. The Child Directed Interaction Training (CDIT) phase of PCIT holds particular promise for children with ASDs due to its focus on improving the parent-child relationship in a naturalistic, child-led play situation. This study used a randomized controlled design to (a) evaluate CDIT outcomes for parenting skills and parenting stress and distress in the ASD population; (b) examine changes in parenting behaviors as a possible mediator of child disruptive behavior outcomes; and (c) explore parent and child predictors of child outcome following CDIT to identify characteristics that may determine optimal child outcome following treatment.   Thirty mother-child dyads with children between the ages of 3 to 7 years with a previous ASD diagnosis participated in this study. Results revealed that following manualized CDIT, mothers learned to provide positive attention to their children’s appropriate social and play behaviors and these skills were maintained at 6-week follow up. Mothers also showed significant reductions in parent distress associated with child disruptive behavior. Exploratory analyses also provided evidence for child IQ, child adaptive behavior, maternal stress associated with difficult child behaviors, and maternal distress as predictors of child outcomes following CDIT. These results provide preliminary evidence of the efficacy of CDIT for changing parent behaviors and reducing distress for mothers of young children with ASDs. It also suggests that outcomes following CDIT may be optimal for children with higher IQ and adaptive functioning and families with lower reported maternal stress and distress, but that outcomes may not differ across the 3-7 age range and differing ASD symptom severity.
General Note:
In the series University of Florida Digital Collections.
General Note:
Includes vita.
Bibliography:
Includes bibliographical references.
Source of Description:
Description based on online resource; title from PDF title page.
Source of Description:
This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility:
by Nicole C Ginn.
Thesis:
Thesis (Ph.D.)--University of Florida, 2013.
Local:
Adviser: Eyberg, Sheila M.
Local:
Co-adviser: Boggs, Stephen R.
Electronic Access:
RESTRICTED TO UF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE UNTIL 2015-08-31

Record Information

Source Institution:
UFRGP
Rights Management:
Applicable rights reserved.
Classification:
lcc - LD1780 2013
System ID:
UFE0044819:00001


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Full Text

PAGE 8

p p

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Prevalence and Description of Autism Spectrum Diso rders (ASDs) Parents of Children with ASDs

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Treatments for Children with Autism Spectrum Disorders

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Parent Child Interaction Therapy

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Importance of Treatment Mediators and Predictors of Outcome

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Mediators

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Child Predictors of Outcome

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Parent Predictors of Outcome

PAGE 25

Study Aims and Hypotheses Hypothesis 1.1:

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Hypothe sis 1.2: Hypothesis 1.3: Aim 2: Hypothesis 2.1: Hypothesis 2.2: Hypothesis 2.3: Aim 3: Hypothesis 3.1:

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Aim 4: Aim 5:

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Participants

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SD SD n n n n

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n n

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Measures Family Demographic Questionnaire Semi structured Interview The Childhood Autism Rating Scale ).

PAGE 33

Differential Abilities Scale

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Peabody Picture Vocabulary Test Vineland Adaptive Behavior Scales

PAGE 35

Eyberg Child Behavior Inventory Dyadic Parent Child Interaction Coding System

PAGE 36

Social Responsiveness Scale

PAGE 37

Parenting Stress Index Short Form

PAGE 38

Adult Self Report for Ages 1859 not true very true often true Study Design and Procedure Experimental Design

PAGE 39

Phone Screening

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Study Assessments Informed Consent:

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Time 1 Assessment

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Time 2 and 3 Assessments

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Randomization

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Treatment

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Treatment Integrity

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Statistical Analysis

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t t

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X Y M

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M SD M a SD t X 2 p Note:

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M SD M a SD t X 2 p <0.05 Note: a b

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Phone Screened for eligibility ( n = 63) Completed Pre Treatment (Time 1) Assessment and Randomized ( n = 39) Excluded ( n = 24): n n n Completed Post Treatment (Time 2) Assessment ( n = 15) Completed Post Treatment (Time 2) Assessment ( n = 15) Assigne d to IT ( n = 19) n n n Assigned to WL ( n = 20) n n 6 Week Follow Up (Time 3) n n

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Observed Parent Child Interaction F p d F p d

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t t t d t d Parent Report of Stress and Distress

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F p d F p d Indirect Effects of Parent Behavior Change

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Child Predictors of Outcome

PAGE 57

Maternal Predictors of Outcome p F p p p

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F p F p p F p p

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Time 1 Time 2 Note. n n d Time 2 Time 3 Note. n Time 1 Time 3 Note. n d

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n M SD M SD F p d a Note: a d p p p

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p p p p p p

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p p p p Beta T p p Beta T p p

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p

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p

PAGE 65

Observed Parent Child Interaction

PAGE 66

Parent Report of Stress and Distress

PAGE 67

Indirect Effects of Parent Behavior Change

PAGE 68

Child and Maternal Predictors of Outcome

PAGE 70

Study Limitations and Future Directions

PAGE 75

Inclusion Criteria Exclusion Criteria

PAGE 76

Note.

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Week 1 Weeks 211 Week 12 Weeks 1317 Week 18 Week 1922 Week 23 IT No Tx No Tx WL No Tx Note.

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currently

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CDIT Phone Screener: This is calling from U of Fl, Im returning your call about possibly enrolling your child in CDIT for ASDs Id like to give you some info about the study and also ask some questions to see if it sounds like you and your child would be a good fit for our treatment. May I ask you a series of questions regarding your childs medical and psychiatric history? Your answers will be kept confidential and will be used only to help determine if you qualify for this research study. We will destroy any information provided if you do not participate in this study Confirm the following information: [childs name] Provide the following information about the study Ask parent to rate the child on the following behaviors:

PAGE 94

Parenting Stress Manual CDI: An effective brief inter vention for children with autism spectrum disorders? Manual for the ASEBA Adult Forms & Profiles Diagnostic and statistical manual of mental disorders (4th ed. text revision Journal of Clinical Child and Adolescent Psychology, 36 Journal of Positive Behavior Interventions, 9 Journal of Personality and Social Psychology, 51, Journal of Consulting and Clinical Psychology, 73 Journal of Autism and Developmental Disorders, 17 Jou rnal of Clinical Psychology, 46

PAGE 95

Autism encyclopedia: The complete guide to autism spectrum disorders Clinical Child and Family Ps ychology Review, 9 Cognitive and Behavioral Practice 18 Handbook of EvidenceBased Therapies for Children and Adolescents Prevalence of Autism Spectrum Disorders Journal of Consulting and Clinical Psychology, 72 Journal of Consulting and Clinical Psychology, 66 Journal of Developmental Behavioral Pediatrics, 21 Jou rnal of Intellectual Disability Research 54

PAGE 96

Journal of Autism and Developmental Disorders, 38 Development and Psychopathology, 2, & ( ). Clinical Psychology Review, Exceptionality, 2 Journal of Applied Behavior Analysis, 4, Examiners manual for the PPVT III: Peabody Picture Vocabulary Test Third Edition Journal of Clinical Child Psychology, 22 Child and Family Behavior T herapy Journal of Child and Family Studies Differential Ability Scales Second Edition Child & Family Behavior Therapy, 23,

PAGE 97

Manual for the Parent Child Interaction coding system (3rd ed.). ECBI & SESBI R: Eyberg Child Behavior Inventory and Sutter Eyberg Student Behavior Inventory, Revised, professional manual. Autism: The International Journal of Research and Practice, 5 Tailoring PCIT for Young Children with Autism Spectrum Disorders: Eight versus Twelve Weeks of Treat ment. Research in Autism Spectrum Disorders, 3 Engaging Autism: Using the Floortime approach to help children relate, communicate, and think Journal of Abnormal Child Psychology, 34, Journal of Autism and Developmental Disorders, 31 Communication Monographs, 76 Journal of Abnormal Child Psychology, 28 Journal of Clinical Child and Adolescent Psychology, 32 Journal of Consulting and Clinical Psychology, 68(3),

PAGE 98

Journal of Autism and Developmental Disorders, 37 Research in Autism Spectrum Disorders, 5 Journal of Abnormal Child Psychology, 36 Journal of Autism and Developmental Disorders, 27 Research in Autism Spectrum Disorders, 4 Journal of the Association for Persons with Severe Handicaps, 24 Journal of the Association for Persons with Severe Handicaps,24 Journal of Autism and Developmental Disorders, 22 Journal of Autism and Developmental Disorders, 22 Archives of General Psychiatry, 59 Journal of Intellectual Disability Research, 50,

PAGE 99

Journal of Autism and Developmental Disorders, 3 Journal of Consulting & Clinical Psychology, 55 In Kazdin & Wiesz (Eds.), EvidenceBased Psychotherapies for Children and Adolescents. Research in Autism Spectrum Disorders, 4 Journal of Early & Intensive Behavioral Intervention, 4 Behavioral intervention for young children with Autism: A manual for parents and professionals Journal of Evaluation in Clinical Practice, 13 Autism in children and adults: Etiology, assessment, and intervention Journal of Autism and Developmental Disorders, 38 Research in Autism Spectrum Disorders, 5 Jour nal of Applied Research in Intellectual Disabilities, 20

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Behavior Research Methods, Instruments and Computers, 36, Journal of Early Intervention, 15 Journal of Clinical Child and Adolescent Psychology, 37 A merican Journal of Mental Retardation, 110 Child and Family Behavior Therapy, 19 The Childhood Autism Rating Scale (CARS The Child Autism Rating Scale (CARS). The Child Autism Rating ScaleSecond Edition (CARS2) Journal of Clinical Child Psychology, 27 Journal of Consulting and Clinical Psychology, 73 American Journal on Mental Retardation 105 American Journal of Orthopsychiatry, 71

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Journal of Autism and Developmental Disorders, 38 Vineland Adaptive Behavior Scales (Vineland). Vineland Adaptive Behavior Scales, Second Edition (VinelandII) Journal of Autism and Developmental Disorders, 37 Predicting outcome in Parent Child Interaction Therapy: Success and attrition. Professional Psychology: Research and P ractice, 24 Journal of Developmental and Behavioral Pediatrics, 27(2). Journal of Autism and Developmental Diorders, Journal Of Child Psychology And Psychiatry51 Evidencebased psychotherapies for children and adolescents

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summa cum l aude