Primary Care Stepping Stones Triple P for Children With Autism

The purpose of this study is to determine the effectiveness of Primary Care Stepping Stones Triple P (PC-SS Triple P), an empirically supported parent mediated intervention, to improve the behavioral functioning of children newly diagnosed with Autism (aged 2-12 years), increase parental resilience and decrease parental stress.

Research literature exists on best practices for screening and diagnosing children with Autism. However, less is known about how to intervene with the child's parent. Across studies, relative to parents of children without disabilities, parents of children with Autism have reported higher levels of stress and lower levels of parenting competence. Such stress places children at risk for adverse developmental outcomes The proposed study aims to determine the effectiveness of Primary Care Stepping Stones Triple P (PC-SS Triple P), an empirically supported parent mediated intervention, to improve the behavioral functioning of children newly diagnosed with Autism (aged 2-12 years), increase parental resilience and decrease parental stress. The specific hypotheses include: Children whose parents receive PC-SS Triple P will demonstrate significantly greater improvements in their behavioral functioning than children of parents receiving Wait-list Control (WLC) at service closure. At service closure, parents receiving the PC-SS Triple P intervention will be more resilient and demonstrate lower levels of stress than parents in the Wait-List Control (WLC) condition. Parenting resilience and levels of parental stress will be positively associated with improvements in child behavior. Seventy-six parents of children newly diagnosed with Autism will be randomized into one of two conditions: a) PC-SS Triple P (N=38) or b) Wait List Control (WLC; N=38). Study data will be collected with the assistance of a data collector appropriately trained in human subject rights protections. It is anticipated that the present project will assist in the development and use of evidence-based practices for working with parents of children newly diagnosed with Autism within pediatric settings.

Parental Resilience, Parental Stress, Family Adaptation, Autistic Disorder, Behavior, Child Behavior, Child Development Disorders, Pervasive Developmental Disabilities, Caregivers, Parents, Parenting, Primary Health Care

Primary Care Stepping Stones Triple P program (PC-SS Triple P) - a parenting and family support strategy that aims to prevent and treat behavioral problems in children by enhancing parental resilience.

Wait List Control - Participants who will have access to treatment as usual services during the 4 weeks between baseline and 4 week assessment time points and then will have the opportunity to receive PC-SS Triple P.

Postive Parenting Program, Triple P, Stepping Stones Triple P, Stepping Stones Positive Parenting Program

PC-SS Triple P is a parenting and family support strategy that aims to prevent and treat behavioral problems in children by enhancing parental resilience.

General scale of resilience in adult populations with a bias towards coping with stress and adversity.

Sources and different types of stress that every parent can experience. Provides information in 4 specific domains of parenting stress: Parental Distress, Parent-Child Dysfunctional Interaction, Difficult Child, and Total Stress.

Assesses family functioning on six different dimensions: Problem Solving (ability to resolve problems), Communication (exchange of clear and direct verbal information), Roles (division of responsibility for completing family tasks), Affective Responsiveness (ability to respond with appropriate emotion), Affective Involvement (degree to which family members are involved and interested in one another), and Behavior Control (manner used to express and maintain standards of behavior).

Assesses behavior problems in individuals with developmental disabilities across 5 domains: Irritability and Agitation (15 items) Lethargy and Social Withdrawal (16 items) Stereotypic Behavior (7 items) Hyperactivity and Noncompliance (16 items) and Inappropriate Speech (4 items).

Measures dysfunctional discipline styles in parents by asking about the probability with which the parent uses particular discipline strategies. It yields four scores: Total score, Laxness (permissive, inconsistent discipline); Over-reactivity (harsh, emotional, authoritarian discipline and irritability); and Verbosity/Hostility (use of verbal or physical force).

Measures parents' sense of confidence and satisfaction with their parenting and their self-efficacy in the parenting role.

Inclusion Criteria: Parent inclusion criteria: being at least 18 years of age Index child inclusion criteria: receives a Diagnostic and Statistical Manual V (DSM-V) diagnosis of Autism with mild or moderate severity within 12 months of study onset. age is > or equal to 24 months (2 years, 0 months) and < or equal to 155 months old (12 years, 11 months). Exclusion Criteria: Parent exclusion criteria: inability to provide informed consent. being non-English speaking. Index child exclusion criteria: being a ward of the State of Missouri. being a sibling of another study participant.

Saint Louis University School of Medicine, Department of Pediatrics, Division of Developmental Pediatrics

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