Journal article
Using Parent Target Problem Narratives to Evaluate Outcomes in Children with Autism Spectrum Disorder
Research on child and adolescent psychopathology, v 49(11), pp 1527-1535
Nov 2021
PMID: 34213717
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
This paper examines the reliability and validity of parent target problems (PTPs) in a multi-site randomized controlled trial of parent training (PT) versus psychoeducation (PEP) in children (150 boys, 19 girls; mean age 4.7 ± 1.2 years) with autism spectrum disorder (ASD) and disruptive behavior. At baseline, treatment blind, independent evaluators asked parents to nominate the child's top two problems. Each problem was documented in a brief narrative. Narratives were reviewed and revised at follow-up visits during the six-month trial. When the trial was completed, five judges, blind to treatment condition, independently rated change from baseline on a 9-point scale (1 = normal; 2 = markedly improved; 3 = definitely improved; 4 = equivocally improved; 5 = no change; 6 = possibly worse; 7 = definitely worse; 8 = markedly worse; 9 = disastrously worse) at Weeks 8, 12, 16, and 24 (inter-rater intraclass correlation = 0.78). PTP scores for the two target problems were averaged across the five raters, yielding a mean score for each child at each time point. Mean PTP scores showed improvement in both treatment groups over the 24-week study. Compared to PEP, PTP ratings showed a steeper decline in PT based on significant interaction of group and time (t(df) = 2.14(155.9), p = 0.034; Week 24 effect size = 0.75). In categorical analysis, we compared cutoffs mean PTP scores of 3.0 (definitely improved), 3.25, and 3.5 with the positive response rate on the Clinical Global Impressions-Improvement scale from the original study. Sensitivities ranged from 52-78%. PTP narratives offer a systematic, reliable, and valid way to track child-specific outcomes in clinical trials and clinical practice.
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Details
- Title
- Using Parent Target Problem Narratives to Evaluate Outcomes in Children with Autism Spectrum Disorder
- Creators
- Elisabeth Sheridan - Drexel UniversityScott Gillespie - Emory UniversityCynthia R Johnson - Cleveland Clinic Lerner College of MedicineLuc Lecavalier - The Ohio State UniversityTristram Smith - University of Rochester Medical CenterNaomi Swiezy - Riley Hospital for ChildrenKylan Turner - Simmons UniversityJill Pritchett - The Ohio State UniversityDaniel W Mruzek - University of Rochester Medical CenterAndrea N Evans - Emory UniversityKaren Bearss - Department of Psychiatry and Behavioral Sciences, Seattle Children's Autism Center, University of Washington, 4909 25th Ave NE, Seattle, WA, USA.Lawrence Scahill - Emory University
- Publication Details
- Research on child and adolescent psychopathology, v 49(11), pp 1527-1535
- Publisher
- Springer Nature
- Grant note
- R01 MH080906 / NIMH NIH HHS R01 MH080965 / NIMH NIH HHS R01 MH081105 / NIMH NIH HHS R01 MH081221 / NIMH NIH HHS R01 MH081148 / NIMH NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000669172400001
- Scopus ID
- 2-s2.0-85109316112
- Other Identifier
- 991019168424504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychology, Clinical
- Psychology, Developmental