Use of a Direct Observational Measure in a Trial of Risperidone and Parent Training in Children with Pervasive Developmental Disorders

Abstract

A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N=49) versus risperidone plus parent training (COMB; n=75) (ages 4–13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (p=.0002) and 12 % increase in compliance to parental requests (p=.004) for the two treatment conditions combined. Parents displayed 64 % greater use of positive reinforcement (p=.001) and fewer repeated requests for compliance (p<.0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement (p=.01) and fewer restrictive statements (p<.05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures.

Effect of Parent Training vs Parent Education on Behavioral Problems in Children With Autism Spectrum Disorder

“…Since development of the protocol, questions have been raised about the ecological validity of the SOAP and whether it is representative of a child's behavior. 25 The SOAP will be presented in a separate report.…”

Toward an exportable parent training program for disruptive behaviors in autism spectrum disorder

“…All three trials included a Standardized Observation Analogue Procedure (SOAP), which study investigators developed as a means to capture change in parent and child behaviors from baseline to Week 24 across a series of 4 standardized behavior observation conditions (Johnson et al, 2009; Handen et al, in press). While the SOAP captured changes in child and parent behavior from Baseline to Week 24 in the RUPP-PT trial, the observation generally failed to consistently capture the disruptive and noncompliant behaviors that were the target of intervention.…”

Development of the Observation Schedule for Children with Autism–Anxiety, Behaviour and Parenting (OSCA–ABP): A New Measure of Child and Parenting Behavior for Use with Young Autistic Children

“…parent or teacher) a small-to-medium effect (SMD = 0.40) was found (Sonuga-Barke et al 2013). Other sources of bias in parental reports include broader rater effects, such as mood or stress, or misinterpretation of questionnaire items (Handen et al 2013). These biases are likely to present across different intervention arms and possibly be influenced by intervention, reducing measurement precision.…”

“…Where observational measures have been used, floor effects have been reported. Using the Structured Observational Analog Procedure-a parent-child interaction measure consisting of a series of four 10-min conditions (free play, social attention, demand, tangible restriction)-autistic children who were screened in on elevated levels of EBPs displayed unexpectedly high levels of compliance during the clinic-based assessment at baseline, limiting scope for change on this measure (Bearss et al 2015a;Handen et al 2013). High rates of compliance at baseline have also been reported on the DPICS, which consists of child-and parent-led play conditions and a clean up (Scudder et al 2019).…”