Does Parent Education Improve Compliance in Children and Adolescents with Autism

Spectrum Disorder?
Natasha Arastehmanesh, OTS & Evelyn Babaroudi, OTS
Touro University Nevada, School of Occupational Therapy

ackground & Clinical Scenario

Prevalence of Autism spectrum disorder (ASD) has
increased within the recent years from 1 in 88 births in
2008 to 1 in 68 births in 2010 (Center for Disease
Control and Prevention, 2014).
ASD is characterized by persistent deficits in social
communication, social interaction, and restricted,
repetitive patterns of behaviors, interests and activities
(American Physiological Association, 2013).
Deficits in social interaction and communication can
impede a childs ability to interact effectively with their
surroundings thereby limiting cognition and adaptive
functioning (American Physiological Association, 2013).
Majority of children with ASD develop behavioral and
emotional problems such as, tantrums, aggression,
noncompliance, property destruction, self-injury, and
recklessness and hyperactivity (Bearss, Johnson,
Handen, Smith, & Scahill, 2013).
Emotional and behavioral problems can increase
parental stress, as is commonly reported in parents of
children with ASD (Bearss, Johnson, Handen, Smith, &
Scahill, 2013).
Parent education has emerged as an effective tool in
educating parents of children with ASD about proper
techniques for facilitating interaction with their child
(Sofronoff, Leslie, & Brown, 2004).

Summary of Key Findings

Methods
Inclusion Criteria:
Children and adolescents (0-19 years old) with ASD
Intervention or treatment program implemented by an
occupational therapist, or any professional qualified
such as psychologist or trained therapist

Increased compliance

Child may present with similar features to ASD but may

not have diagnosis (social interaction, verbal
communication, restrictive repetitive behavior)

Improved parenting confidence

Comorbid disabilities
Exclusion Criteria:
Studies not available in English
Articles published before the year of 2004
Adults with ASD or any population other than children
and adolescents
Studies not available in full text
Databases Searched:
Google Scholar, EBSCO, CINHAL, PubMed
Key Search Terms:
Autism spectrum disorder, parent education, parent
training, compliance

Evidence Table
Level of
Evidence

Reductions in aggressive behaviors

Increased parent involvement

Number of Articles Selected

Systematic reviews, meta-analysis, randomized controlled trials

II

Two groups, nonrandomized studies (e.g., cohort, case-control)

III

One group, nonrandomized (e.g., before and after, pretest, and

posttest)

IV

Descriptive studies that include analysis of outcomes (single subject

design, case series)

Case reports and expert opinion, which include narrative literature

reviews and consensus statements

Qualitative Studies

Improvement in short term cognitive and

adaptive functioning
The results of an RCT suggest that combined
treatment (parent training and
pharmacotherapy) is superior to medication
alone, and no measured baseline
characteristics (family income, mothers
education, child IQ) predicted or moderated this
effect (Farmer et al., 2012, Level I).
A week long parent education program taught
parents pivotal response training techniques to
embed in daily routines. Results indicate that
parents successfully learned the PRT
techniques and generalized them into their
interactions with their children at home.
Childrens social communication and behaviors
improved during interactions with both parents
and the significant caregivers (Symon, 2005,
Level IV).

Study Design/Methodology of Selected Articles

Other

TOTAL:

Contact Information:
Ot16.Natasha.Arastehmanesh@nv.touro.edu
Ot16.Evelyn.Babaroudi@nv.touro.edu

Improved social communication skills

Increased positive social interaction with

siblings

References (Partial List)

Anan, R. M., Warner, L. J., McGillivary, J. E., Chong, I. M., &
Hines, S. J. (2008). Group intensive family training (GIFT) for
preschoolers with autism spectrum disorders. Behavioral
Interventions, 23(3), 165-180.doi: 10.1002/bin.262
Bearss, K., Johnson, C., Handen, B., Smith, T., & Scahill, L.
(2013). A pilot study of parent training in young children with
autism spectrum disorders and disruptive behavior. Journal of
autism and developmental disorders, 43(4), 829- 840. doi:
10.1007/s10803-012-1624-7
Farmer, C., Lecavalier, L., Yu, S., Arnold, L. E., McDougle, C. J.,
Scahill, L., ... & Aman, M. G. (2012). Predictors and
moderators of parent training efficacy in a sample of children
with autism spectrum disorders and serious behavioral
problems. Journal of autism and developmental disorders,
42(6), 1037-1044. doi: 10.1007/s10803-011- 1338-2
McConachie, H., Randle, V., Hammal, D., & Le Couteur, A.
(2005). A controlled trial of a training course for parents of
children with suspected autism spectrum disorder. The Journal
of pediatrics,147(3), 335-340. doi: 10.1016/j.jpeds.2005.03.056

The articles demonstrated positive results associated

with the following themes:

10

Retrieved from:
http://www.bestforautism.com/images/Slideshow-homepage/5.jpg

Implications for OT
The clinical and community-based practice of OT:
The constraints of time and money can steer
parents away from participating in a parent
education program.
Brief and low cost parent training programs,
implemented in clinical and community-based
settings, can allow therapists to actively engage
parents in the delivery of treatment.
Program development:
Many parents do not have the available resources
and time to partake in a program that is extensive
in nature.
Implementing parent training programs that are
short, cost-effective, and readily available will
address these shortcomings.
Societal needs:
Short term and cost-effective programs will help
address societal needs (i.e. finances and time
constraints).
The use of parent training may shorten the
amount of visits the child will need on a weekly
basis and therefore meet societal needs.
Healthcare delivery and policy:
Educating primary health care professionals on
the effects of parent training programs in helping
parents deal with disruptive behaviors will be of
beneficial value.
Pediatricians, and psychologist/psychiatrists can
play a key role in promoting child health by
encouraging parents to complete a parent training
program.
Education and training of OT students:
Educating and training OT students on how to
structure and lead a parent training workshop
should be implemented in the curriculum.
Refinement, revision, and advancement of factual
knowledge or theory:
Efficacy of parent training can be advanced
through more research such as randomized
control trials including large sample sizes.
Studies should examine the effect of parent
education on children with varying symptoms from
mild to severe.