Yale joins in parenting study

New parenting methods developed by Yale researchers could help reduce extreme behaviors in children with autism or related disorders, according to the December issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Yale School of Nursing professor Lawrence Scahill, Ohio State University professor Michael Aman and Indiana University professor Christopher McDougle gave 124 children the drug risperidone, which reduced behavioral issues by 50 percent. Parents who underwent training were able to reduce their children’s behaviors by an additional 15 to 20 percent, Scahill said.

Additionally, children whose parents underwent training also ended up using about 14 percent less medication, Aman said.

The 24-week study was conducted at Yale, the Ohio State University and Indiana University. The researchers selected children between the ages of four and 13 who scored highly on a checklist that measures serious behavior problems. About one-third of children with autism or related disorders exhibit behavior ranging from tantrums to hair-pulling, biting other people and head-banging, Scahill said. These behaviors, he added, typically began around the ages of 6 to 9.

The researchers prepared a comprehensive manual to guide training sessions with parents, Aman said. During the study, parents learned to use a variety of methods, such as watching videos with their children, to point out the difference between good and bad behavior.

“It’s a form of behavior modification where one uses rewards and sometimes punishments to enhance the behaviors that we’re trying to encourage,” Aman said.

The researchers measured improvement in the children’s behavior with a questionnaire that asked how the child followed rules and instructions in various situations. For example, because autistic children have difficulties adjusting to unexpected transitions, Aman said, in one situation, the parent told his child to suddenly stop an activity.

Aman said behavioral treatment could have more lasting effects than medication because children who are taken off medication sometimes revert to past behaviors. In addition, risperidone is linked to weight gain, Aman said. On average, children in the study gained weight, going from below the 70th percentile to above the 80th percentile for their age, Aman said.

Scahill said Yale, Ohio State Unversity and Indiana University will work with the University of Rochester and the University of Pittsburgh to measure the effect of training alone on behavior improvement in a five-year study on autistic preschool children.

“Now that [the report] is published, one next step is to repeat this in the community and place this manual in the hands of everyday therapists,” Aman said.

The study was funded by a grant from the Research Units on Pediatric Psychopharmacology Autism Network of the National Institute of Mental Health.

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