Use of a Direct Observational Measure in a Trial of Risperidone and Parent Training in Children with Pervasive Developmental Disorders

摘要

A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N = 49) versus risperidone plus parent training (COMB; n = 75) (ages 4-13 years). At 24-weeks, there was 28 reduction in child inappropriate behavior during a Demand Condition (p =.0002) and 12 increase in compliance to parental requests (p =.004) for the two treatment conditions combined. Parents displayed 64 greater use of positive reinforcement (p =.001) and fewer repeated requests for compliance (p < .0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement (p =.01) and fewer restrictive statements (p < .05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures.