Can Parent-Child Interaction Therapy Improve Core Features of Autism? Findings from a Comparison of PCIT for Children with and without Autism Spectrum Disorder

Abstract

Although there is a small yet growing body of evidence supporting Parent-Child Interaction Therapy (PCIT) as an effective treatment for disruptive behaviors among children with autism spectrum disorder (ASD; Scudder et al., 2019), further study is warranted, particularly with more robust methodology (e.g., larger sample sizes, comparison groups). Furthermore, preliminary studies have demonstrated improvements in symptoms of autism following the completion of PCIT, including improvements in frequency of child verbalizations (Hansen & Shillingsburg, 2016), caregiver report of social skills and social responsiveness (Zlomke et al., 2017), time spent in pretend toy play (Lieneman et al., 2019), and shared positive affect (Solomon et al., 2008). These studies, however, relied heavily on single case methodology or parent report of ASD symptoms. The current study explored the effectiveness of PCIT on core features of autism among children with and without an autism diagnosis referred to a private practice behavioral health clinic. A combination of caregiver report measures, an observer report measure, and behavioral coding systems were used to assess changes in verbalizations, play behavior, and joint engagement for both groups at pre- and post-treatment. Parent-child interactions were coded for child verbalizations and child behavior during play sessions. ANOVA and t-tests (or nonparametric alternatives) were conducted to examine pre-post changes in core features of autism and group differences between those with and without autism. Significant pre-post improvements in child disruptive behavior and compliance to parental commands were found in both groups, yet there were no significant pre-post improvements in child verbalizations, play behavior, or joint engagement. Limitations of the study (e.g., small sample size, methodological issues) and future directions are discussed.