Restricted accessResearch articleFirst published online 2015-2
Combining Parent–Child Interaction Therapy and Visual Supports for the Treatment of Challenging Behavior in a Child With Autism and Intellectual Disabilities and Comorbid Epilepsy
About one in six children has one or more developmental disabilities, which include autism spectrum disorder (ASD) and intellectual disabilities (ID). Individuals with both ASD and ID are at higher risk of epilepsy, and those with younger onset of seizures are at higher risk of both developmental and behavioral disorders. Young children presenting with developmental and behavioral challenges are often very difficult for caregivers to manage, and challenging behavior results in reduced learning opportunities. Finding effective and efficient interventions to address behavioral issues remains a clinical priority to improve overall outcomes for all children and especially those with developmental disabilities. This case study presents the treatment of a 5-year-old girl diagnosed with ASD, ID, and comorbid epilepsy using Parent–Child Interaction Therapy (PCIT) combined with visual supports (VS). Findings from this case report documented (a) an improvement in behavioral functioning in home, school, and community settings; (b) evidence for the effectiveness of parent-mediated intervention; and (c) support for collaboration and care coordination to improve intervention outcomes.
AchenbachT. M.RescorlaL. A. (2000). Manual for the ASEBA Preschool forms & profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families.
2.
AgazziH.TanR.TanS. (2013). A case study of Parent Child Interaction Therapy for the treatment of autism spectrum disorder. Clinical Case Studies, 12, 428-442.
3.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
4.
ArmstrongK.HangauerJ.AgazziH. (2013). Intellectual and developmental disabilities and other low-incidence disorders. In ReddyL. A.WeissmanA. S.HaleJ. B. (Eds.), Neuropsychological assessment and intervention for youth (pp. 227-246). Washington, DC: American Psychological Association.
5.
ArmstrongK.KimonisE. R. (2012). Parent–Child Interaction Therapy for the treatment of Asperger’s disorder in early childhood: A case study. Clinical Case Studies, 11, 234-252.
6.
BagnerD.EybergS. (2007). Parent–Child Interaction Therapy for disruptive behavior in children with mental retardation: A randomized control trial. Journal of Clinical Child & Adolescent Psychology, 36, 418-429.
7.
BergA. T. (2011). Epilepsy, cognition, and behavior: The clinical picture. Epilepsia, 52(Suppl. 1), 7-12.
8.
BergA. T.LangfittJ. T.TestaF. M.LevyS. R.DiMarioF.WesterveldM.KulasJ. (2008). Global cognitive function in children with epilepsy: A community-based study. Epilepsia, 49, 608-614.
9.
BergA. T.PlioplysS.TuchmanR. (2011). Risk and correlates of autism spectrum disorder in children with epilepsy: A community-based study. Journal of Child Neurology, 26, 540-547.
10.
BreretonA. V.TongeB. J.EinfeldS. L. (2006). Psychopathology in children and adolescents with autism compared to young people with intellectual disability. Journal of Autism and Developmental Disorders, 36, 863-870.
11.
BrinkmeyerM.EybergS. (2003). Parent–Child Interaction Therapy for oppositional children. In KazdinA. E.WeissJ. R. (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 204-223). New York, NY: Guilford Press.
12.
ButterE. M.MulickJ. A.MetzB. (2006). Eight case reports of learning recovery in children with pervasive developmental disorders after early intervention. Behavioral Interventions, 21, 227-243.
13.
CanitanoR. (2007). Epilepsy in autism spectrum disorders. European Child Adolescent Psychiatry, 16, 61-66.
14.
CanitanoR.LuchettiA.ZapellaM. (2005). Epilepsy, electrocephalographic abnormalities, and regression in children with autism. Journal of Child Neurology, 20, 27-31.
ChaflantA. M.RapeeR.CarrollL. (2007). Treating anxiety disorders in children with high functioning autism spectrum disorders: A controlled trial. Journal of Autism and Developmental Disorders, 37, 1842-1857.
17.
CohenH.Amerine-DickensM.SmithT. (2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Developmental & Behavioral Pediatrics, 27, 145-155.
18.
DauphinM.KinneyE. M.StromerR. (2004). Using video-enhanced activity schedules and matrix training to teach sociodramatic play to a child with autism. Journal of Positive Behavior Interventions, 6, 238-250.
19.
De bildtA.SytemaS.KetelaarsD.KraijerD. (2003). Measuring pervasive developmental disorders in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 33, 595-605.
EybergS. M.NelsonM.BoggsS. (2008). Evidence-based Psychosocial Treatments for children and adolescents with disruptive behavior disorders. Journal of Clinical Child & Adolescent Psychology, 37, 215-237.
22.
EybergS. M.NelsonM. M.DukeM.BoggsS. R. (2004). Manual for the Parent–Child Interaction Coding System (3rd ed.). Available from http://www.pcit.org
23.
EybergS. M.PincusD. (1999). Eyberg Child Behavior Inventory and Sutter–Eyberg Student Behavior Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.
24.
FombonneE. (2005). Past and future perspectives on autism epidemiology. In MoldinS. O.RubensteinJ. L. (Eds.), Understanding autism: From basic neuroscience to treatment (pp. 25-48). Boca Raton, FL: CRC Press Taylor & Francis.
25.
GadowK. D.DeVincentC. J.PomeroyJ.AzizianA. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34, 379-393.
26.
GoldsteinS.NaglieriJ. (2010). Autism Spectrum Rating Scale. New York, NY: Multi-Health Systems.
27.
GrayC. A.GarlandJ. D. (1993). Social Stories: Improving responses of students with autism with accurate social information. Focus on Autistic Behavior, 8, 1-10.
28.
HornerR. H.CarrE. G.StrainP. S.ToddA. W.ReedH. J. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism and Developmental Disorders, 32, 339-351.
29.
HowardJ. S.SparkmanC. R.CohenH. G.GreenG.StanislawH. (2005). A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, 26, 359-383.
30.
JohnsonC. P.MyersS. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 2007-2361.
31.
JohnstonS.NelsonC.EvansJ.PalazoloK. (2003). The use of visual supports in teaching young children with autism spectrum disorder to initiate interactions. AAC: Augmentative and Alternative Communication, 19, 86-104.
32.
LovaasI.SmithT. (1989). Behavioral treatment and normal educational training and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.
33.
MasseJ. J.McNeilC. B.WagnerS. M.ChorneyD. B. (2008). Parent–Child Interaction Therapy and high functioning autism: A conceptual overview. Journal of Early & Intensive Behavior Intervention, 4, 714-735.
34.
National Autism Center. (2009). National Standards Project: Addressing the need for evidence-based practice guidelines for autism spectrum disorder. Randolph, MA: Author.
PierceK. L.SchreibmanL. (1994). Teaching daily living skills to children with autism in unsupervised settings through pictorial self-management. Journal of Applied Behavior Analysis, 27, 471-481.
37.
ReidM. J.WalterA. L.O’LearyS. G. (1999). Treatment of young children’s bedtime refusal and nighttime wakings: A comparison of standard and graduated ignoring procedures. Journal of Abnormal Child Psychology, 27, 5-16.
38.
ReynhoutG.CarterM. (2007). Social stories for children with disabilities. Journal of Autism and Developmental Disorders, 22, 173-182.
39.
SmithT.EikesethS.KlevstrandM.LovaasO. I. (1997). Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. American Journal on Mental Retardation, 105, 269-285.
40.
SolomonM.OnoM.TimmerS.Goodlin-JonesB. (2008). The effectiveness of Parent–Child Interaction Therapy for families of children on the autism spectrum. Journal Autism Developmental Disorders, 38, 1767-1776.
41.
StraussK.ManciniF.FavaL. (2013). Parent inclusion in early intensive behavior interventions for young children with ASD: A synthesis of meta-analyses from 2009-2011. Research in Developmental Disabilities, 34, 2967-2985.
42.
Van SteenselF.BogelsS.PerrinS. (2011). Anxiety disorders in children and adolescents with autism spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14, 302-317.
43.
VismaraL. A.RogersS. J. (2010). Behavioral treatments in autism spectrum disorders: What do we know. Annual Review Clinical Psychology, 6, 447-468.
44.
WeiskopS.RichdaleA.MatthewsJ. (2005). Behavioral treatment to reduce sleep problems in children with autism or fragile X syndrome. Developmental Medicine & Child Neurology, 47, 94-104.
45.
WolfM.RisleyT.MeesH. (1964). Application of operant conditioning procedures to the behavior problems of an autistic child. Behavior Research and Therapy, 1, 305-312.
