Therapies for Children With Autism Spectrum Disorders

course of parent training intervention. Irritability and Hyperactivity/Noncompliance measured on
the ABC showed improvement over time. Fifty-three percent of children were reported as very
much improved on the CGI-I, and thirty percent were reported to show minimal improvement.
Finally, with regard to adaptive behavior, improvement in daily living skills and increase in
adaptive skills were also shown over the course of treatment. The correlation between improved
compliance and improved adaptive behavior also strengthened over the course of treatment.
Following the initial feasibility study, 172 Aman et al. 177 conducted an RCT assessing whether
risperidone treatment combined with parent training in behavior management was superior to
risperidone treatment alone; this study was conducted as part of the RUPP Autism Network.
Parents of children ages 4 to 13 years with ASDs and significant tantrums, self-injury, and
aggression who were randomly assigned to the combined treatment group received parent
training with a behavior therapist according to a RUPP manual. As noted, the manual specified
11 core treatment sessions, three optional sessions, and up to three booster sessions of 60-90
minutes in length.
On average, parents in the combined condition participated in 10.82 sessions. As in the
feasibility study, outcome was assessed on the Home Situations Questionnaire and ABC; the
Children’s Yale-Brown Obsessive Compulsive Scale–PDD version was also administered both
pre- and post-intervention. After 24 weeks of treatment, HSQ scores for 71 percent of children
assigned to the combined treatment group and 60 percent of children assigned to the medicationonly
treatment group declined (i.e., decreased severity), which represents a significant difference
between groups over time. In addition, the ABC irritability, stereotypic behaviors, and
hyperactivity/noncompliance subscales all showed significant group differences over time, with
children of parents who received the parent training showing less severe symptoms in each of the
domains.
One case series of a teacher training procedure in reducing challenging behaviors (e.g.,
aggression, noncompliance, off-task behavior) 173 reported a significant reduction in the rate of
the target behavior following classroom instruction (45 hours) and practical application, training,
and supervision (45 hours) in applied behavior analysis.
Other Behavioral Interventions
Additional behavioral interventions include techniques such as neurofeedback and sleep
hygiene education. Neurofeedback, or electroencephalogram (EEG) biofeedback, aims to
remediate abnormal brainwave activity associated with disorders such as anxiety, ADHD, and
ASDs through training individuals to control brain activity patterns. Neurofeedback involves the
placement of electrodes to monitor brain activity while participants interact with specially
designed computer games or other modalities designed to promote attention or other skills. 179
Behavioral treatments for sleep problems may attempt to affect the timing of sleep, sleep-wake
cycle disorders, or promote efficacious sleep behaviors like bedtime routines and positive
reinforcement. 180
Content of the literature. Three studies 181-183 of additional behavioral interventions met our
inclusion criteria. Participant ages ranged from three to fourteen years across the studies, and all
three occurred in a clinic setting. Jarusiewicz 181 and Coben et al. 182 used neurofeedback with
children directly while the Reed et al. sleep workshops were aimed at parents using a group
approach. 183 Table 10 includes additional study details. All three studies in this section were
considered poor quality.
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