Caregiver perspectives on interventions for behavior challenges in autistic children
- Publisher:
- Elsevier BV
- Publication Type:
- Journal Article
- Citation:
- Research in Autism Spectrum Disorders, 2021, 81, pp. 101714
- Issue Date:
- 2021-03-01
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| 1-s2.0-S175094672030204X-main.pdf | Published version | 946.34 kB |
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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.
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