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URL: http://jams.arakmu.ac.ir/article-1-6142-en.html
2- Department of Cognitive Psychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran. ,
3- Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran.
4- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
1. Introduction
xtra-role behaviors are the problems of children with Autism Spectrum Disorder (ASD). They are behaviors that are resistant to many educational-rehabilitation programs. These behaviors have significant adverse effects on the performance of the child’s orthodoxy and his educational environment [7] and the psychological health of parents [12, 13].
Some pharmacological and non-pharmacological therapies are applied to manage these behaviors [17, 18]. Among these therapies, it seems that parents play an essential role in treating children with autism. The child spends most of his time with his parents, which can be an excellent opportunity to teach appropriate behavior to children and manage extra-role behaviors in them [23]. Therefore, parent-mediated behavioral intervention seems to be an effective way to overcome these problems. However, these methods have not been adequately introduced yet. This study aims to systematically review these studies and their primary and secondary outcomes, analyze the components of parent-mediated behavioral therapy, and examine the need to expand these Iranian families’ programs.
2. Materials and Methods
The current study is a systematic review; the statistical population includes useful articles of national databases including Sid and Magiran in 2006-2007 and international databases including Medline, PubMed, Springer, Science Direct, Online library, PsycINFOT in 2000-2017 to review studies of parent-mediated behavioral interventions on autism-related behaviors. At the first stage, to achieve tasks related to the subject, the researchers selected the related keywords in internal databases. Next, the researchers examined the external databases, including Medline, PubMed, Springer, Science Direct, Online Library, and PsycINFOT.
We obtained 3557 articles at this stage. Next, we deleted duplicate studies and retrieved 2705 papers from foreign databases; no documents were obtained from Persian databases. In the second stage, unrelated items were removed, and 84 articles remained. Then, according to the including and excluding criteria, the abstract and the quality of the articles’ methodology (based on the exact definition of the target group, type of study, sampling method, sample size, and validity and reliability of data collection tools) were reviewed. Finally, 9 articles with inclusion criteria were selected.
3. Results
Based on the study methodology results, 7 studies were randomized experimental studies, and 2 were quasi-experimental studies. All treatment programs were based on a behavioral approach. Three studies used the structure of group meetings, 5 studies used the design of individual sessions, and 1 study used a combination of group and individual sessions. The studies’ results showed a positive effect of parent-mediated behavioral therapy on extra-role behavior such as repetitive behaviors, habituation (mood swings, aggression, self-harm), echo, and destructive behaviors (preliminary results).
Regarding parents’ psychological functions, these interventions have increased parental self-efficacy, increased positive parenting style, increased parental knowledge about managing aggressive behaviors, and reduced psychological problems (anxiety and depression). In addition, consequently, the reduction of extra-role behaviors has led to an increase in adaptive behaviors [33, 34] and social skills [29] in children with autism (secondary results).
The conceptual and practical basis of all parent education programs is behavioral management education. Components of treatment plans included a variety of outcome-oriented interventions (such as stopping response and re-guidance), earlier interventions A (such as daily program design), and earlier interventions B (such as enriching the game environment). Four studies reported the results of treatment loyalty assessment, and six studies reported treatment follow-up. Three studies had moderate evidence of certainty, and six studies had strong evidence of confidence.
4. Discussion and Conclusion
The results of this study showed that parent-mediated behavioral intervention is effective in extra-role behaviors. In general, according to the results of this study, it seems that in many countries, parent-centered therapies, especially those focusing on addictive behaviors, are gaining more and more attention, and efforts have begun to adapt autism treatment to the family system [50, 51].
The importance of this change can be seen in the high cost of treatment [52] and parents’ efforts in learning the behavior of children with autism and generalizing the better effects of treatment [53] because parents are always with children and can cause fundamental changes in the autistic syndrome by fundamentally changing the child’s lifestyle. Therefore, it seems that such a move (changing tissue therapy from clinic to home) should be made in different countries, especially in Iran. Of course, the critical point when designing programs based on empirical evidence is to pay attention to culture. These programs should be in harmony with the culture of families in each country. The values and beliefs of the family should be considered in the treatment program.
It seems that to increase the effectiveness of parent-mediated behavioral intervention, it is necessary to use a variety of outcome-based and antecedent-based interventions so that with integrated therapy, these interventions can be more effective in reducing extra-role behaviors in children with autism. Since the children with autism have different severity of symptoms and also due to the lack of therapists and autism centers and the increasing prevalence of this disorder, it is necessary to change the treatment of ASD from center- mediated to family-mediated; this highlights the importance of developing family-mediated treatment programs in the country.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Biological Research of Shahid Beheshti University (Code: IR.SBU.ICBS.97/1013).
Funding
This article is extracted from a PhD. dissertation of first author, Department of Psychology, Faculty of Educational Science and Psychology, Shahid Beheshti University.
Authors' contributions
All authors met the standard writing criteria based on the recommendations of the International Committee of Medical Journal Publishers (ICMJE) and all contributed equally to the writing of the work.
Conflicts of interest
References
1.Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, et al. Prevalence of Autism Spectrum Disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ. 2018; 67(6):1-23. [DOI:10.15585/mmwr.ss6706a1] [PMID] [PMCID]
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing; 2013. [DOI:10.1176/appi.books.9780890425596]
3.Lancaster BM. Assessment and treatment of autism. Indian J Pediatr. 2005; 72(1):45-52. [DOI:10.1007/BF02760580] [PMID]
4.Baird G, Simonoff E, Pickles A, Chandler S, Loucas T, Meldrum D, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: The Special Needs and Autism Project (SNAP). Lancet. 2006; 368(9531):210-5. [DOI:10.1016/S0140-6736(06)69041-7]
5.Leekam SR, Prior MR, Uljarevic M. Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychol Bull. 2011; 137(4):562-93. [DOI:10.1037/a0023341] [PMID]
6.Rhode G, Jenson WR, Reavis HK. The tough kid book: Practical classroom management strategies. Sopris West; 1992. https://books.google.com/books?id
7.Sigafoos J, Arthur-Kelly M, O’Reilly MF. Challenging behavior and developmental disability. New Jersey: Wiley; 2003. https://www.amazon.com/Challenging-Behaviour-Developmental-Disability-Sigafoos/dp/1861563787
8.Loftin RL, Odom SL, Lantz JF. Social Interaction and Repetitive Motor Behaviors. J Autism Dev Disord. 2008; 38(6):1124-35. [DOI:10.1007/s10803-007-0499-5] [PMID]
9.Dunst CJ, Trivette CM, Masiello T. Exploratory investigation of the effects of interest-based learning on the development of young children with autism. Autism. 2011; 15(3):295-305. [DOI:10.1177/1362361310370971] [PMID]
10.Matson JL, Mahan S, LoVullo SV. Parent training: A review of methods for children with developmental disabilities. Res Dev Disabil. 2009; 30(5):961-8. [DOI:10.1016/j.ridd.2009.01.009] [PMID]
11.Matson JL, Smiroldo BB, Bamburg JW. The relationship of social skills to psychopathology for individuals with severe or profound mental retardation. J Intellect Dev Disabil. 1998; 23(2):137-45. [DOI:10.1080/13668259800033641]
12.Shiri E, Pouretemad, H, Fathabadi J, Narimani M. [Impacts of autistic behavioral excesses on child, parent, and their interaction: A qualitative study (Persian)]. Journal of Family Research. 2019; 15(2):267-82.
13.Giallo R, Wood CE, Jellett R, Porter R. Fatigue, wellbeing and parental self-efficacy in mothers of children with an Autism Spectrum Disorder. Autism. 2013; 17(4):465-80. [DOI:10.1177/1362361311416830] [PMID]
14.Greenberg JS, Seltzer MM, Krauss MW, Chou RJ-A, Hong J. The effect of quality of the relationship between mothers and adult children with schizophrenia, autism, or down syndrome on maternal well-being: the mediating role of optimism. Am J Orthopsychiatry. 2004; 74(1):14-25. [DOI:10.1037/0002-9432.74.1.14] [PMID] [PMCID]
15.Huang CY, Yen HC, Tseng MH, Tung LC, Chen YD, Chen KL. Impacts of autistic behaviors, emotional and behavioral problems on parenting stress in caregivers of children with Autism. J Autism Dev Disord. 2014; 44(6):1383-90. [DOI:10.1007/s10803-013-2000-y] [PMID]
16.Mihaila I, Hartley SL. Parental sleep quality and behavior problems of children with autism. Autism. 2018; 22(3):236-44. [DOI:10.1177/1362361316673570] [PMID] [PMCID]
17.Matin Sadr N, Haghgoo H, Samadi SA, Rassafiani M, Bakhshi E. [Impact of air seat cushions and ball chairs on classroom behavior of students with Autism spectrum disorder (Persian)]. J Rehabil. 2016; 17(2):136-47. [DOI:10.21859/jrehab-1702136]
18.Mamaghanieh M, Pouretemad HR, Ahmadi F, Khoushabi K. [The Effectiveness of picture exchange communication system on behavioral problems of children with Autism (Persian)]. J Rehabil. 2011; 12(1):19-26. http://rehabilitationj.uswr.ac.ir/article-1-875-en.html
19.Crowe BHA, Salt AT. Autism: The management and support of children and young people on the autism spectrum (NICE Clinical Guideline 170). Arch Dis Child Educ Pract Ed. 2015; 100(1):20-3. [DOI: 10.1136/archdischild-2013-305468] [PMCID]
20.Leskovec TJ, Rowles BM, Findling RL. Pharmacological treatment options for Autism spectrum disorders in children and adolescents. Harv Rev Psychiatry. 2008; 16(2):97-112. [DOI:10.1080/10673220802075852] [PMID]
21.Tonge B, Brereton A, Kiomall M, Mackinnon A, Rinehart NJ. A randomised group comparison controlled trial of ‘preschoolers with autism’: A parent education and skills training intervention for young children with autistic disorder. Autism. 2014; 18(2):166-77. [DOI:10.1177/1362361312458186] [PMID]
22.Bello-Mojeed M, Ani C, Lagunju I, Omigbodun O. Feasibility of parent-mediated behavioural intervention for behavioural problems in children with Autism spectrum disorder in Nigeria: A pilot study. Child Adolesc Psychiatry Ment Health. 2016; 10(1):28. [DOI:10.1186/s13034-016-0117-4] [PMID] [PMCID]
23.Buschbacher P, Fox L, Clarke S. Recapturing desired family routines: A parent-professional behavioral collaboration. Res Pract Pers with Sev Disabil. 2004; 29(1):25-39. [DOI:10.2511/rpsd.29.1.25]
24.Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with Autism Spectrum Disorders (ASD). Cochrane Database Syst Rev. 2013; (4):CD009774. [DOI:10.1002/14651858.CD009774.pub2] [PMID]
25.Nock MK, Kazdin AE. Randomized controlled trial of a brief intervention for increasing participation in parent management training. J Consult Clin Psychol. 2005; 73(5):872-9. [DOI:10.1037/0022-006X.73.5.872] [PMID]
26.Boyd BA, McDonough SG, Bodfish JW. Evidence-based behavioral interventions for repetitive behaviors in Autism. J Autism Dev Disord. 2012; 42(6):1236-48. [DOI:10.1007/s10803-011-1284-z] [PMID] [PMCID]
27.Rogers SJ, Vismara LA. Evidence-based comprehensive treatments for early autism. J Clin Child Adolesc Psychol. 2008; 37(1):8-38. [DOI:10.1080/15374410701817808] [PMID] [PMCID]
28.Khosroshahi SB, Pouretemad HR, Khooshabi K. The effect of little bird program in decreasing problem behaviors of autistic children. Procedia - Soc Behav Sci. 2010; 5:1166-70. [DOI:10.1016/j.sbspro.2010.07.254]
29.Sofronoff K, Leslie A, Brown W. Parent management training and Asperger syndrome: A randomized controlled trial to evaluate a parent based intervention. Autism. 2004; 8(3):301-17. [DOI:10.1177/1362361304045215] [PMID]
30.Whittingham K, Sofronoff K, Sheffield J, Sanders MR. Stepping stones triple P: An RCT of a parenting program with parents of a child diagnosed with an Autism spectrum disorder. J Abnorm Child Psychol. 2009; 37(4):469-80. [DOI:10.1007/s10802-008-9285-x] [PMID]
31.Bearss K, Johnson C, Smith T, Lecavalier L, Swiezy N, Aman M, et al. Effect of parent training vs parent education on behavioral problems in children with Autism spectrum disorder: A randomized clinical trial. JAMA. 2015; 313(15):1524-33. [DOI:10.1001/jama.2015.3150] [PMID]
32.Grahame V, Brett D, Dixon L, McConachie H, Lowry J, Rodgers J, et al. Managing repetitive behaviours in young children with Autism Spectrum Disorder (ASD): Pilot randomised controlled trial of a new parent group intervention. J Autism Dev Disord. 2015; 45(10):3168-82. [DOI:10.1007/s10803-015-2474-x] [PMID]
33.Reitzel J, Summers J, Lorv B, Szatmari P, Zwaigenbaum L, Georgiades S, et al. Pilot randomized controlled trial of a Functional Behavior Skills Training program for young children with Autism Spectrum Disorder who have significant early learning skill impairments and their families. Res Autism Spectr Disord. 2013; 7(11):1418-32. [DOI:10.1016/j.rasd.2013.07.025]
34.Bearss K, Johnson C, Handen B, Smith T, Scahill L. A pilot study of parent training in young children with Autism spectrum disorders and disruptive behavior. J Autism Dev Disord. 2013; 43(4):829-40. [DOI:10.1007/s10803-012-1624-7] [PMID]
35.Tellegen CL, Sanders MR. A randomized controlled trial evaluating a brief parenting program with children with Autism spectrum disorders. J Consult Clin Psychol. 2014; 82(6):1193-200. [DOI:10.1037/a0037246] [PMID]
36.Aman MG, McDougle CJ, Scahill L, Handen B, Arnold LE, Johnson C, et al. Medication and parent training in children with pervasive developmental disorders and serious behavior problems: Results from a randomized clinical trial. J Am Acad Child Adolesc Psychiatry. 2009; 48(12):1143-54. [DOI:10.1097/CHI.0b013e3181bfd669] [PMID] [PMCID]
37.Beavers GA, Iwata BA, Lerman DC. Thirty years of research on the functional analysis of problem behavior. J Appl Behav Anal. 2013; 46(1):1-21. [DOI:10.1002/jaba.30] [PMID]
38.Wong C, Odom SL, Hume KA, Cox AW, Fettig A, Kucharczyk S, et al. Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. J Autism Dev Disord. 2015; 45(7):1951-66. [DOI:10.1007/s10803-014-2351-z] [PMID]
39.Whittemore R, Knafl K. The integrative review: Updated methodology. J Adv Nurs. 2005; 52(5):546-53. [DOI:10.1111/j.1365-2648.2005.03621.x] [PMID]
40.Patel MR, Carr JE, Kim C, Robles A, Eastridge D. Functional analysis of aberrant behavior maintained by automatic reinforcement: Assessments of specific sensory reinforcers. Res Dev Disabil. 2000; 21(5):393-407. [DOI:10.1016/S0891-4222(00)00051-2]
41.Kodak T, Miltenberger RG, Romaniuk C. The effects of differential negative reinforcement of other behavior and noncontingent escape on compliance. J Appl Behav Anal. 2003; 36(3):379-82. [DOI:10.1901/jaba.2003.36-379] [PMID] [PMCID]
42.Wacker DP, Harding JW, Berg WK, Lee JF, Schieltz KM, Padilla YC, et al. An evaluation of persistence of treatment effects during long-term treatment of destructive behavior. J Exp Anal Behav. 2011; 96(2):261-82. [DOI:10.1901/jeab.2011.96-261] [PMID] [PMCID]
43.Derby KM, Wacker DP, Sasso G, Steege M, Northup J, Cigrand K, et al. Brief functional assessment techniques to evaluate aberrant behavior in an outpatient setting: A summary of 79 cases. J Appl Behav Anal. 1992; 25(3):713-21. [DOI:10.1901/jaba.1992.25-713] [PMID] [PMCID]
44.Rapp JT, Vollmer TR. Stereotypy I: A review of behavioral assessment and treatment. Res Dev Disabil. 2005; 26(6):527-47. [DOI:10.1016/j.ridd.2004.11.005] [PMID]
45.Reese RM, Richman DM, Belmont JM, Morse P. Functional characteristics of disruptive behavior in developmentally disabled children with and without Autism. J Autism Dev Disord. 2005; 35(4):419-28. [DOI:10.1007/s10803-005-5032-0] [PMID]
46.Lewis MH, Tanimura Y, Lee LW, Bodfish JW. Animal models of restricted repetitive behavior in autism. Behav Brain Res. 2007; 176(1):66-74. [DOI:10.1016/j.bbr.2006.08.023] [PMID] [PMCID]
47.Berkson G, Tupa M. Early development of stereotyped and self-injurious behaviors. J Early Interv. 2000; 23(1):1-19. [DOI:10.1177/10538151000230010401]
48.Rickards AL, Walstab JE, Wright-Rossi RA, Simpson J, Reddihough DS. One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families. Child Care Health Dev. 2009; 35(5):593-602. [DOI:10.1111/j.1365-2214.2009.00953.x] [PMID]
49.Bodfish JW, Symons FJ, Parker DE, Lewis MH. Varieties of repetitive behavior in Autism: Comparisons to mental retardation. J Autism Dev Disord. 2000; 30(3):237-43. [DOI:10.1023/A:1005596502855] [PMID]
50.Buescher AVS, Cidav Z, Knapp M, Mandell DS. Costs of Autism Spectrum Disorders in the United Kingdom and the United States. JAMA Pediatr. 2014; 168(8):721-8. [DOI:10.1001/jamapediatrics.2014.210] [PMID]
51.Chimeh N, Tahmasian K, Pouretemad HR, Ofoghi H, Ahmadabadi Z. Development of the psycho-educational program of “living adjusted with Autism” and its effectiveness on limiting the autistic symptoms in children and their mothers’ life quality. J Except Child. 2013; 13(2):22-31. http://joec.ir/article-1-135-en.html
52.Sanders MR, Kirby JN. Consumer engagement and the development, evaluation, and dissemination of evidence-based parenting programs. Behav Ther. 2012; 43(2):236-50. [DOI:10.1016/j.beth.2011.01.005] [PMID] [PMCID]
53.Perera H, Jeewandara KC, Seneviratne S, Guruge C. Outcome of home-based early intervention for Autism in Srilanka: Follow-up of a cohort and comparison with a nonintervention group. Biomed Res Int. 2016; 2016:3284087. [DOI:10.1155/2016/3284087] [PMID] [PMCID]
54.Shiri E, Pouretemad H, Fathabadi J, Narimani M. A pilot study of family-based management of behavioral excesses in young Iranian children with autism spectrum disorder. Asian J Psychiatr. 2020; 47:101845. [DOI:10.1016/j.ajp.2019.101845] [PMID]
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