Parent Training for Disruptive Behaviors in Referred Children with Autism Spectrum Disorder: A Randomized Controlled Trial
Face-to-face behavioral parent training beats waitlist for disruptive behaviors in 4-young learners with ASD, but blended online formats fizzle.
01Research in Context
What this study did
Breider and her team ran a three-arm randomized trial in two U.S. community clinics. They enrolled the children with ASD and disruptive behaviors like noncompliance and tantrums.
Parents were assigned to face-to-face behavioral parent training, blended online-plus-therapist training, or a waitlist. Both active groups met over the study periodly sessions.
What they found
Six months later, the in-person group beat the waitlist on parent-rated noncompliance and irritability. The blended group looked no better than waitlist on any measure.
Gains held steady at six-month follow-up, but only for families who got the live coach in the room.
How this fits with other research
Sofronoff et al. (2004) showed parent-management training works for Asperger syndrome, but they saw no difference between workshop and individual formats. Breider’s 2024 data now say format does matter—online blending fizzles.
SVerberg et al. (2022) used standard PCIT with autistic preschoolers and also saw big compliance gains. Together the studies line up: real-time coaching in the room cuts disruptive behavior across ages.
Bello-Mojeed et al. (2016) ran a five-session group in Nigeria and still reduced aggression. Breider’s longer program keeps the positive streak alive and sets a higher dose benchmark for low-resource sites.
Farmer et al. (2012) added antipsychotic medication and still saw extra benefit from parent training. Breider proves the parent part alone can work, so you don’t need meds as a prerequisite.
Why it matters
If you run a clinic, schedule live parent groups first. The blended arm saved travel time but failed to help kids, so keep online modules as homework boosters, not the main course. Use Breider’s 11-session protocol when insurance asks for an evidence-based dose. And show families these data—parents who know face-to-face works may skip the app and show up ready to engage.
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02At a glance
03Original abstract
The purpose of this study was to investigate whether face-to-face and therapist-assisted online (i.e., blended) behavioral parent training are effective on reducing disruptive behaviors in children with autism spectrum disorder (ASD) in routine mental health care. Ninety-seven children with ASD (4–13 years; 76 boys) were randomized to face-to-face parent training, blended parent training, or a waitlist control condition. We assessed treatment effects on parent-rated child noncompliance (primary outcome) and irritability (secondary outcome). This involved comparing both formats separately to the control condition using linear regression models. Child behaviors at 6 months follow-up were also examined. Children in the face-to-face parent training condition improved significantly more on noncompliance and irritability than children in the waitlist condition and improvements sustained to 6 months follow-up. Children in the blended condition did not improve more than children in the waitlist condition and attrition was high. Our results extend findings from efficacy studies to routine mental health care and advocate the use of face-to-face parent training for disruptive behaviors in children with ASD. More research into blended parent training programs for children with ASD and disruptive behaviors in routine mental health care should be conducted to draw more definite conclusions about the value of blended parent training for these children. Trial registration number NL4712; date of registration 22–10–2014. The online version contains supplementary material available at 10.1007/s10803-024-06567-0.
Journal of Autism and Developmental Disorders, 2024 · doi:10.1007/s10803-024-06567-0