Coherence of Parental Representations Following Therapy for Autistic Children.
Nisha Vashi, Alaa Ibrahim, Ava Pouyandeh and 1 others
PMID 38281275WHAT IT FOUND
Parents of autistic children did not show improved overall coherence after a 10-week child CBT program, but they did report lower concern and higher acceptance.
Changes in coherence predicted better general behavioural symptoms in children, not specific internalizing or externalizing problems.
Key findings
01Overall parental coherence did not change significantly following the 10-week CBT intervention for the children.
02Parents showed significant reductions in 'concern' and increases in 'acceptance' subscale scores after the intervention.
03Improvements in parental coherence were associated with improvements in children's general behavioural symptoms, but not with specific internalizing or externalizing problems.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was highly selected: no children had intellectual disabilities (IQ < 79 excluded), and children with aggressive or self-injurious behaviours were excluded, limiting generalizability to more complex clinical presentations. The study was not a randomized trial of the coherence outcome; it combined data from the treatment and waitlist arms of two separate RCTs, meaning all 81 dyads analyzed received the intervention. Attrition was significant: of the 129 eligible families, only 81 had complete pre- and post-intervention speech sample data. The coding scheme for coherence was stringent, and many participants were categorized as 'incoherent' at both timepoints, potentially masking subtle improvements. The study did not include a control group for the coherence analysis, so changes cannot be definitively attributed to the therapy rather than time or maturation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the reduction in parental 'concern' and increase in 'acceptance' as evidence that the therapy improved the parents' overall understanding or representation of their child. The primary measure, overall coherence, did not change significantly, and the study lacked a control group for this specific outcome.