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02-07-2021

Using Parent Target Problem Narratives to Evaluate Outcomes in Children with Autism Spectrum Disorder

Auteurs: Elisabeth Sheridan, Scott Gillespie, Cynthia R. Johnson, Luc Lecavalier, Tristram Smith, Naomi Swiezy, Kylan Turner, Jill Pritchett, Daniel W. Mruzek, Andrea N. Evans, Karen Bearss, Lawrence Scahill

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 11/2021

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Abstract

This paper examines the reliability and validity of parent target problems (PTPs) in a multi-site randomized controlled trial of parent training (PT) versus psychoeducation (PEP) in children (150 boys, 19 girls; mean age 4.7 ± 1.2 years) with autism spectrum disorder (ASD) and disruptive behavior. At baseline, treatment blind, independent evaluators asked parents to nominate the child’s top two problems. Each problem was documented in a brief narrative. Narratives were reviewed and revised at follow-up visits during the six-month trial. When the trial was completed, five judges, blind to treatment condition, independently rated change from baseline on a 9-point scale (1 = normal; 2 = markedly improved; 3 = definitely improved; 4 = equivocally improved; 5 = no change; 6 = possibly worse; 7 = definitely worse; 8 = markedly worse; 9 = disastrously worse) at Weeks 8, 12, 16, and 24 (inter-rater intraclass correlation = 0.78). PTP scores for the two target problems were averaged across the five raters, yielding a mean score for each child at each time point. Mean PTP scores showed improvement in both treatment groups over the 24-week study. Compared to PEP, PTP ratings showed a steeper decline in PT based on significant interaction of group and time (t(df) = 2.14(155.9), p = 0.034; Week 24 effect size = 0.75). In categorical analysis, we compared cutoffs mean PTP scores of 3.0 (definitely improved), 3.25, and 3.5 with the positive response rate on the Clinical Global Impressions-Improvement scale from the original study. Sensitivities ranged from 52–78%. PTP narratives offer a systematic, reliable, and valid way to track child-specific outcomes in clinical trials and clinical practice.
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Metagegevens
Titel
Using Parent Target Problem Narratives to Evaluate Outcomes in Children with Autism Spectrum Disorder
Auteurs
Elisabeth Sheridan
Scott Gillespie
Cynthia R. Johnson
Luc Lecavalier
Tristram Smith
Naomi Swiezy
Kylan Turner
Jill Pritchett
Daniel W. Mruzek
Andrea N. Evans
Karen Bearss
Lawrence Scahill
Publicatiedatum
02-07-2021
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 11/2021
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-021-00843-8