|
| Parent Child Interaction Therapy (PCIT) as Early Intervention for Young Children with Behavioral and Developmental Disorders |
| Tuesday, August 14, 2007 |
| 2:30 PM–3:50 PM |
| L4 Room 1 |
| Area: CBM/AUT; Domain: Applied Behavior Analysis |
| Chair: Sheila Eyberg (University of Florida) |
| Discussant: Sheila Eyberg (University of Florida) |
| CE Instructor: Trevor F. Stokes, Ph.D. |
| Abstract: Parent Child Interaction Therapy (PCIT) is an empirically-supported treatment for conduct-disordered young children that emphasizes changing parent-child interaction patterns to increase childrens prosocial behavior and decrease negative behavior. This treatment focuses on two basic interactions. In Child Directed Interaction (CDI), parents engage their child in a play situation with the goal of strengthening the parent-child attachment through differential social attention. In Parent Directed Interaction (PDI), parents learn to use specific behavioral analysis and therapy techniques to direct their childs behavior and follow through effectively. PCIT outcome research has demonstrated statistically and clinically significant improvements in the conduct-disordered behavior of young children. These effects were superior to waitlist controls and to parent group didactic training. This symposium will provide an overview of PCIT and present recent data on PCIT efficacy with conduct-disordered children as well as effectiveness data with low income urban families and with families of children with autism. |
| |
| An Overview of the Efficacy of PCIT. |
| STEPHEN R. BOGGS (University Of Florida), Melanie M. Nelson (University of Oklahoma ), Sheila Eyberg (University of Florida) |
| Abstract: This study evaluated the efficacy of Parent-Child Interaction Therapy (PCIT) with 100 families of 3- through 6-year old children with Oppositional Defiant Disorder. Families were randomly assigned to an immediate treatment (IT) or a wait-list control (WL) condition. Four months after pretreatment assessment, families in both conditions were seen for a second assessment. Assessments included direct observations of parent-child interactions, parent report of child behavior problems, and measures of parent adjustment.
The primary analyses comparing families in IT and WL conditions were analyses of covariance with pretreatment scores on the respective measures used as covariates. Direct observation measures indicated that parents in the IT condition interacted more positively with their children, gave fewer commands, and were less likely to engage in negative behavior (e.g., criticism, smart talk) than parents in the WL condition. Children in the IT condition were observed to be significantly more compliant to parent commands and less likely to engage in inappropriate behavior. In addition, parents in IT reported clinically significant improvements in their child’s behavior following PCIT and also reported decreased parenting stress. All families that received treatment reported high levels of satisfaction with both the process and outcome of PCIT. |
| |
| Disseminating PCIT in an Urban Community Mental Health Center. |
| KAREN S. BUDD (DePaul University), Aaron Lyon (DePaul University), Steven Behling (DePaul University), Rachel Gershenson (DePaul University) |
| Abstract: Transporting PCIT from research settings, where its efficacy has been established, to the community entails changes at many levels, including the organization (e.g., constituent priorities, funding, and delivery sites), staff (e.g., clinician level and responsibilities), and participants (e.g., referral and demographics). This paper summarizes findings of the first two years of dissemination of PCIT in the DePaul University Community Mental Health Center, which serves predominantly ethnic minority, low-income, urban families in a public mental health context. Although PCIT efficacy studies have included diverse and economically disadvantaged participants, their numbers have been too few to establish that PCIT is a beneficial treatment for these families. Our findings show that PCIT leads to substantial positive changes for families who participate consistently; however, one-half of families terminated PCIT prematurely, often following major stressors (e.g., hotline calls, child’s dismissal from preschool, or parent unemployment). We present outcome data on the families served and describe adaptations to engage and retain families (e.g., scheduling sessions at a local daycare center, temporarily suspending PCIT sessions until family conditions stabilize). Based on our preliminary findings, we propose directions for enhancing treatment effectiveness of PCIT in community settings. |
| |
| Applying PCIT to Parents and Siblings of Children with Autism. |
| TREVOR F. STOKES (University of South Florida), Amy Green (University of South Florida), Jessica Lynn Curley Ross (University of South Florida), Idia Binitie (University of South Florida), Sheri Jacobs (University of South Florida) |
| Abstract: Applying Parent Child Interaction Therapy (PCIT) to different diagnostic populations of children and families has increased in recent years as PCIT has been shown to be an efficacious intervention for children with disorders of behavior. This paper summarizes the adaptation of PCIT to families of children with autism. Specifically, both parents and siblings of children with autism were coached concurrently in the procedures of Child Directed Interaction (CDI), which are pivotal skills of powerful differential attention treatment interventions. Techniques involved the management of interactions though reduction in less functional repertoires of asking questions, giving commands, and using negative talk, while increasing behavioral descriptions, reflections, labeled praise and positive touch. Two clusters of CDI skills were introduced within a multiple baseline design across behaviors. Treatment occurred within ongoing clinical sessions at a university-based psychological services center. Consistent with an approved IRB protocol, videotapes of casework sessions were reviewed and analyzed post-hoc to document behavior changes and establish the reliability of observation within four single case experimental designs. |
|
| |