Change Trajectories During Parent-Child Interaction Therapy for Autistic Children and Their Caregivers.
Catherine A Burrows, William Andrew Rothenberg, Dainelys Garcia and 5 others
Disruptive behavior decreased across the first phase of PCIT for 98 autistic children, including those with lower cognitive scores.
Higher parenting stress slowed the decline, and early homework practice helped caregivers build positive skills faster.
Key findings
1Disruptive behavior (ECBI Intensity) showed a significant linear decline across CDI sessions, and children with lower cognitive scores (DAS-II GCA) experienced more rapid declines until session 11.
2Higher parenting stress (PSI-4) predicted both a slower decrease in child disruptive behavior and slower acquisition of caregiver Do-skills over the course of treatment.
3Homework completion during the first three CDI sessions predicted faster growth in caregiver Do-skills, but did not predict any change in child disruptive behavior.
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How it was doneWhat they found
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What it does not show
Only the CDI phase was examined; the PDI phase and full treatment course are not represented. 91% of children were male and 85% of caregivers were female, limiting generalizability to autistic girls and male caregivers. Missing data was substantial for ADOS-2 (46.9%) and cognitive level (61.2%), reducing the power of those predictor analyses. No control or comparison group, so the study shows what happened during PCIT but cannot rule out that behavior would have improved without it. Quadratic trajectories reverse direction around session 11 to 13, so a 'faster decline' in one group may become a slower decline or increase in later sessions. The study examined one intervention (PCIT) delivered by trained therapists, so the contribution of any single component (coaching, structure, homework) cannot be separated.
Declared interests
The authors declare no conflicts of interest. Funding came from The Children's Trust of Miami, Florida (Grant 2310-7571) and NIH Grant K23HD112507. Treatment was free to participating families.
The easy way to misread this
Do not read the homework finding as evidence that home practice drives the child's behavior change. The paper states homework completion predicted faster caregiver Do-skill growth but did not predict any change in child disruptive behavior.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →