Effects of Risperidone and Parent Training on Adaptive Functioning in Children with Pervasive Developmental Disorders and Serious Behavioral Problems

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Autor/inn/en	Scahill, Lawrence; McDougle, Christopher J.; Aman, Michael G.; Johnson, Cynthia; Handen, Benjamin; Bearss, Karen; Dziura, James; Butter, Eric; Swiezy, Naomi G.; Arnold, L. Eugene; Stigler, Kimberly A.; Sukhodolsky, Denis D.; Lecavalier, Luc; Pozdol, Stacie L.; Nikolov, Roumen; Hollway, Jill A.; Korzekwa, Patricia; Gavaletz, Allison; Kohn, Arlene E.; Koenig, Kathleen; Grinnon, Stacie; Mulick, James A.; Yu, Sunkyung; Vitiello, Benedetto
Titel	Effects of Risperidone and Parent Training on Adaptive Functioning in Children with Pervasive Developmental Disorders and Serious Behavioral Problems
Quelle	In: Journal of the American Academy of Child & Adolescent Psychiatry, 51 (2012) 2, S.136-146 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-8567
DOI	10.1016/j.jaac.2011.11.010
Schlagwörter	Socialization; Autism; Interpersonal Relationship; Interaction; Effect Size; Drug Therapy; Parent Education; Adjustment (to Environment); Pervasive Developmental Disorders; Behavior Disorders; Children; Early Adolescents; Comparative Analysis; Interpersonal Communication; Intelligence Quotient; Behavior Modification; Vineland Adaptive Behavior Scales + Suchen Sie Ihr Suchwort? Socialisation; Sozialisation; Autismus; Interpersonal relation; Interpersonal relations; Interpersonelle Beziehung; Zwischenmenschliche Beziehung; Interaktion; Parents education; Elternbildung; Elternschule; Child; Kind; Kinder; Interpersonale Kommunikation; Intelligenzquotient; Behaviour modification; Verhaltensänderung
Abstract	Objective: Children with Pervasive Developmental Disorders (PDDs) have social interaction deficits, delayed communication, and repetitive behaviors as well as impairments in adaptive functioning. Many children actually show a decline in adaptive skills compared with age mates over time. Method: This 24-week, three-site, controlled clinical trial randomized 124 children (4 through 13 years of age) with PDDs and serious behavioral problems to medication alone (MED; n = 49; risperidone 0.5 to 3.5 mg/day; if ineffective, switch to aripiprazole was permitted) or a combination of medication plus parent training (PT) (COMB; n = 75). Parents of children in COMB received an average of 11.4 PT sessions. Standard scores and Age-Equivalent scores on Vineland Adaptive Behavior Scales were the outcome measures of primary interest. Results: Seventeen subjects did not have a post-randomization Vineland assessment. Thus, we used a mixed model with outcome conditioned on the baseline Vineland scores. Both groups showed improvement over the 24-week trial on all Vineland domains. Compared with MED, Vineland Socialization and Adaptive Composite Standard scores showed greater improvement in the COMB group (p = 0.01 and 0.05, and effect sizes = 0.35 and 0.22, respectively). On Age Equivalent scores, Socialization and Communication domains showed greater improvement in COMB versus MED (p = 0.03 and 0.05, and effect sizes = 0.33 and 0.14, respectively). Using logistic regression, children in the COMB group were twice as likely to make at least 6 months' gain (equal to the passage of time) in the Vineland Communication Age Equivalent score compared with MED (p = 0.02). After controlling for IQ, this difference was no longer significant. Conclusion: Reduction of serious maladaptive behavior promotes improvement in adaptive behavior. Medication plus PT shows modest additional benefit over medication alone. Clinical trial registration information--RUPP PI PDD: Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders; http://www.clinicaltrials.gov; NCT00080145. (Contains 4 tables.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10