Real-world Outcomes of PCIT for Children at Risk of Autism or Developmental Delay

Abstract

Disruptive behaviors in children with Autism Spectrum Disorder (ASD) or developmental delay are common, persistent and cause distress to families. Parent–Child Interaction Therapy (PCIT) may be an effective intervention with emerging evidence to support its use for children with at-risk development. We aimed to investigate the effectiveness of standard PCIT for young children (2–4 years) with disruptive behaviors and signs of ASD and/or developmental delay, treated in a real-world clinical setting. We hypothesized that there would be a reduction in disruptive behaviors and for parents, a reduction in depressive symptoms. This was a retrospective file-review study of 236 referrals to a toddler clinic over a 17-month period (January 2016 to May 2017). Disruptive child behavior (EBCI Intensity scale and ECBI Problem scale) and maternal depression (EDS score) severity were analyzed across two time conditions (pre-treatment and post-treatment) using linear mixed models with repeated measures, including time, child ASD risk status and their interaction as main effects. An identical linear mixed models with repeated measures analysis was subsequently conducted using clinician identified concern about the child’s development as the between subjects factor. Disruptive child behavior for children at-risk of autism (high SCQ score) and for those with low SCQ scores, improved on average into the non-clinical range. Parental EDS scores reduced in the both groups, but reduced by a greater degree in the children at-risk of autism (high SCQ) group. This study suggests that children at-risk of autism and developmental delay should not be excluded from PCIT, an evidence-based intervention for disruptive behaviors, as there is potential benefit for both children and parents.