Evidence map›Paper›PMID 25898050›Full record

Trial reportJAMA2015

Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial.

Karen Bearss, Cynthia Johnson, Tristram Smith, Luc Lecavalier, Naomi Swiezy, Michael Aman, David B McAdam, Eric Butter, Charmaine Stillitano, Noha Minshawi and 11 more

Erratum issued 6 registry-linked trialsOpen access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 6 registered trials, which are not on this map. Cited by 189 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
189citing papers in PubMed, 13 pooled it
14.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01233414 nacompletednot on this map

Randomized Trial of Parent Training for Young Children With Autism

TypeinterventionalSponsorYale UniversityRan2010 to 2015Enrolled180ConditionsChild Development Disorders, PervasiveArmsParent Training, Psychoeducational Program
NCT04097457 naunknown statusnot on this mapstarted 2017, after this paper: background citation

A Community-implemented, Parent-mediated, Group Intervention for Children With Autism Spectrum Disorder (ASD) and Disruptive Behaviors.

TypeinterventionalSponsorHebrew University of JerusalemRan2017 to 2021Enrolled100ConditionsAutism Spectrum DisorderArms"Parent training for disruptive behaviors" manual (Bearss, Johnson, Handen, Butter, Lecavalier, Smith & Scahill, 2018)
NCT04204226 nacompletednot on this mapstarted 2019, after this paper: background citation

Assessing the Feasibility, Acceptability, and Preliminary Efficacy of an Adaptive Intervention Approach for Children With Autism and Disruptive Behavior: A Pilot Study

TypeinterventionalSponsorChildren's Hospital of PhiladelphiaRan2019 to 2021Enrolled42ConditionsASD, Child Behavior ProblemArmsSocial Worker, Autism Behavioral Health Navigation (ABHN), Social work + ABHN, Social work + ABHN + CAP
NCT04909658 nacompletednot on this mapstarted 2018, after this paper: background citation

The Effect of Acceptance and Commitment Therapy for Improving Psychological Well-being in Parents of Individuals With Autism Spectrum Disorder: a Randomized Controlled Trial

TypeinterventionalSponsorS.Anna Rehabilitation InstituteRan2018 to 2020Enrolled66ConditionsAutism, InfantileArmsACT Matrix, PT Protocol
NCT05750095 narecruitingnot on this mapstarted 2022, after this paper: background citation

Enabling Parents of Children With Autism Spectrum Disorders - a Randomized Controlled Trial of Parenting Programs

TypeinterventionalSponsorHaukeland University HospitalRan2022 to 2028Enrolled240ConditionsAutism Spectrum DisorderArmsIncredible Years Autism Spectrum and Language Delay Programme, First Aid for Parents
NCT07059364 narecruitingnot on this mapstarted 2025, after this paper: background citation

Empowering Caregivers to Promote Child Independence and Persistence With Activities

TypeinterventionalSponsorUniversity of NebraskaRan2025 to 2026Enrolled32ConditionsProfound AutismArmsCAST Treatment
3 · Its place in the literature

Who cites it

189 citing papers in PubMed, 13 syntheses or guidelines pooled it, 422 citations in OpenAlex.

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  12. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review.Journal of the American Academy of Child and Adolescent Psychiatry · 2016
    Pooled it
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  19. Using a Mobile App to Support Parents of Children with Behavior Problems.Research on child and adolescent psychopathology · 2025
    Trial
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129 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 9 institutions in 2 countries.

Karen BearssDepartment of Pediatrics, Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
Cynthia JohnsonDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania13Dr Johnson is now with the Department of Clinical and Health Psychology, University of Florida, Gainesville.
Tristram SmithDepartment of Pediatrics, University of Rochester, Rochester, New York.
Luc LecavalierDepartments of Psychology and Psychiatry, Nisonger Center, UCEDD, Ohio State University, Columbus.
Naomi SwiezyDepartment of Psychiatry, Indiana University, Indianapolis.
Michael AmanDepartments of Psychology and Psychiatry, Nisonger Center, UCEDD, Ohio State University, Columbus.
David B McAdamDepartment of Pediatrics, University of Rochester, Rochester, New York.
Eric ButterDepartment of Pediatrics, Ohio State University and Nationwide Children's Hospital, Columbus.
Charmaine StillitanoDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania.
Noha MinshawiDepartment of Psychiatry, Indiana University, Indianapolis.
Denis G SukhodolskyChild Study Center, Yale University, New Haven, Connecticut.
Daniel W MruzekDepartment of Pediatrics, University of Rochester, Rochester, New York.
Kylan TurnerDivision of Education Leadership and Innovation, Mary Lou Fulton Teachers College, Arizona State University, Tempe.
Tiffany NealDepartment of Psychiatry, Indiana University, Indianapolis.
Victoria HallettInstitute of Psychiatry, Psychology, and Neuroscience, King's College London, Department of Psychology, London, United Kingdom.
James A MulickDepartment of Pediatrics, Ohio State University and Nationwide Children's Hospital, Columbus.
Bryson GreenDepartment of Pediatrics, Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
Benjamin HandenDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
Yanhong DengSchool of Public Health, Yale University, New Haven, Connecticut.
James DziuraDepartment of Emergency Medicine, Yale University, New Haven, Connecticut.
Lawrence ScahillDepartment of Pediatrics, Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
Indiana University – Purdue University Indianapolis · USUniversity of Pittsburgh · USUniversity of Rochester · USYale University · USEmory University · USNationwide Children's Hospital · USArizona State University · USChildren's Healthcare of Atlanta · USKing's College London · GB

Funding

YALE UNIVERSITY CLINICAL AND TRANSLATIONAL SCIENCE AWARD PROGRAMUL1RR024139 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$56.8M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025008 · NCRR · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2007 to 2011
$29.0M
The University of Rochester's Clinical and Translational Science InstituteUL1TR000042 · NCATS · UNIVERSITY OF ROCHESTER · PI BENNETT, NANCY M, KIEBURTZ, KARL D. · 2012 to 2015
$14.4M
NEUROBIOLOGY OF FACIAL EXPRESSION IN AUTISMU54MH066397 · NIMH · UNIVERSITY OF ROCHESTER · PI KLORMAN, RAFAEL KLORMAN · 2003 to 2007
$7.1M
Yale University Clinical and Translational Science Award ProgramKL2RR024138 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$4.8M
1/5-Randomized Trial of Parent Training for Young Children with AutismR01MH081148 · NIMH · YALE UNIVERSITY · PI SCAHILL, LAWRENCE D. · 2010 to 2014
$1.8M
3/5-Randomized Trial of Parent Training for Young Children with AutismR01MH080906 · NIMH · UNIVERSITY OF ROCHESTER · PI SMITH, TRISTRAM H · 2010 to 2014
$1.2M
5/5-Randomized Trial of Parent Training for Young Children with AutismR01MH080965 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JOHNSON, CYNTHIA R · 2010 to 2014
$1.2M
4/5-Randomized Trial of Parent Training for Young Children with AutismR01MH081221 · NIMH · INDIANA UNIVERSITY INDIANAPOLIS · PI SWIEZY, NAOMI BETH · 2010 to 2014
$1.2M
2/5-Randomized Trial of Parent Training for Young Children with AutismR01MH081105 · NIMH · OHIO STATE UNIVERSITY · PI LECAVALIER, LUC · 2010 to 2014
$1.1M
Neurobiology of Behavior Therapy for Children with Tourette SyndromeK01MH079130 · NIMH · YALE UNIVERSITY · PI SUKHODOLSKY, DENIS G · 2008 to 2012
$833k
NCATS NIH HHS UL1 TR000042NCRR NIH HHS 5KL2RR024138NCRR NIH HHS KL2 RR024138NCRR NIH HHS UL1 RR024139NCRR NIH HHS UL1 RR025008NIMH NIH HHS K01 MH079130NIMH NIH HHS MH079130NIMH NIH HHS MH080906NIMH NIH HHS MH080965NIMH NIH HHS MH081105NIMH NIH HHS MH081148NIMH NIH HHS MH081221NIMH NIH HHS R01 MH080906NIMH NIH HHS R01 MH080965NIMH NIH HHS R01 MH081105NIMH NIH HHS R01 MH081148NIMH NIH HHS R01 MH081221NIMH NIH HHS U54 MH066397
6 · The paper itself

Abstract

importanceDisruptive behavior is common in children with autism spectrum disorder. Behavioral interventions are used to treat disruptive behavior but have not been evaluated in large-scale randomized trials.

objectiveTo evaluate the efficacy of parent training for children with autism spectrum disorder and disruptive behavior. DESIGN, SETTING, AND

participantsThis 24-week randomized trial compared parent training (n = 89) to parent education (n = 91) at 6 centers (Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester, Yale University). We screened 267 children; 180 children (aged 3-7 years) with autism spectrum disorder and disruptive behaviors were randomly assigned (86% white, 88% male) between September 2010 and February 2014.

interventionsParent training (11 core, 2 optional sessions; 2 telephone boosters; 2 home visits) provided specific strategies to manage disruptive behavior. Parent education (12 core sessions, 1 home visit) provided information about autism but no behavior management strategies. MAIN OUTCOMES AND MEASURES: Parents rated disruptive behavior and noncompliance on co-primary outcomes: the Aberrant Behavior Checklist-Irritability subscale (range, 0-45) and the Home Situations Questionnaire-Autism Spectrum Disorder (range, 0-9). On both measures, higher scores indicate greater severity and a 25% reduction indicates clinical improvement. A clinician blind to treatment assignment rated the Improvement scale of the Clinical Global Impression (range, 1-7), a secondary outcome, with a positive response less than 3.

resultsAt week 24, the Aberrant Behavior Checklist-Irritability subscale declined 47.7% in parent training (from 23.7 to 12.4) compared with 31.8% for parent education (23.9 to 16.3) (treatment effect, -3.9; 95% CI, -6.2 to -1.7; P < .001, standardized effect size = 0.62). The Home Situations Questionnaire-Autism Spectrum Disorder declined 55% (from 4.0 to 1.8) compared with 34.2% in parent education (3.8 to 2.5) (treatment effect, -0.7; 95% CI, -1.1 to -0.3; P < .001, standardized effect size = 0.45). Neither measure met the prespecified minimal clinically important difference. The proportions with a positive response on the Clinical Global Impression-Improvement scale were 68.5% for parent training vs 39.6% for parent education (P < .001). CONCLUSIONS AND RELEVANCE: For children with autism spectrum disorder, a 24-week parent training program was superior to parent education for reducing disruptive behavior on parent-reported outcomes, although the clinical significance of the improvement is unclear. The rate of positive response judged by a blinded clinician was greater for parent training vs parent education.

trial registrationclinicaltrials.gov Identifier: NCT01233414.

Indexed as

Health EducationBehavior TherapyChildChild Behavior DisordersChild Development Disorders, PervasiveFemaleHumansMaleParentsSingle-Blind Method

Identifiers

PMID25898050
PMCPMC9078140
OpenAlexW2162520210

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.