|Title||Caregiver perspectives on interventions for behavior challenges in autistic children|
|Publication Type||Journal Article|
|Year of Publication||2021|
|Authors||Tschida, JE, Maddox, BB, Bertollo, JR, Kuschner, ES, Miller, JS, Ollendick, TH, Greene, RW, Yerys, BE|
|Journal||Research in Autism Spectrum Disorders|
|Keywords||Aggression, Autism, Intervention, Parent, School-age|
Background Children with an autism spectrum disorder (ASD) diagnosis have high rates of behaviors such as aggression, oppositional behaviors, and tantrums. Despite effectiveness of interventions for these behavior challenges in a considerable number of autistic children, there is little information on stakeholder perspectives about available interventions. The present study preliminarily characterized caregiver perspectives on intervention for behavior challenges in school-age autistic children. Method 321 caregivers of autistic children completed a survey about interventions used to address behavior challenges. Kruskal-Wallis rank-sum tests and subsequent pairwise comparisons using a Wilcoxon rank-sum test with False-Discovery Rate-adjusted p-values (q<0.05) were conducted for caregiver ratings of interventions. Thematic analysis was conducted for caregivers’ open-ended suggestions for improving interventions. Results Caregivers indicated limited approval of attempted interventions. For children with an IQ ≥ 70, the omnibus test was significant for caregiver ratings of intervention helpfulness (χ2(8) = 38.707, q<0.001, ε2 = 0.017) with medications and Collaborative & Proactive Solutions (CPS; Greene, 2010) therapy rated highest, and was significant for caregiver ratings of amount of improvement maintained over time (χ2(8) = 46.013, q<0.001, ε2 = 0.020) with medications, CPS, applied behavioral analysis (ABA), and “other interventions” rated highest. For children with an IQ < 70, pairwise tests revealed no significant differences. Caregivers suggested improvements at the systems, provider, caregiver/family, and child/intervention levels. Conclusions Caregivers’ limited approval of interventions used to address behavior challenges suggests the need for improved intervention options. While medications and ABA are standard-of-care interventions, CPS may be a caregiver-preferred and efficacious option that is underutilized among autistic children with an IQ ≥ 70.