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New research shows promising long-term improvements in autistic children’s behaviors and parenting stress

Washington D.C | May 18, 2023

The study documented results from a group-based parenting intervention co-developed by parents of autistic children and autistic adults

studyopens in new tab/window in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports  promising long-term improvements in autistic children’s behavior and parenting stress after receiving ‘Predictive Parenting’, a group-based behavioral parenting intervention.

Predictive Parenting, co-developed by parents of autistic children, autistic adults and researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and South London and Maudsley NHS Foundation Trust, provides parents active skills training to help them understand and manage anxiety and disruptive behavior often displayed by autistic children during early childhood.

The pilot trialopens in new tab/window, also published in JAACAP, was completed with 62 parents of autistic 4 to 8 year olds. Predictive Parenting was compared to group-based parent education about autism and results showed that parental satisfaction with Predictive Parenting was high. The findings were favorable towards improved behavioral outcomes for children in the Predictive Parenting group immediately after the intervention was completed, but was not statistically significant, rendering the original study a negative trial.

The authors re-contacted the families during the COVID-19 pandemic due to concerns about the potential adverse impacts of lockdowns on autistic children.

Dr Melanie Palmer, Research Associate at King’s and the study’s joint first author with Dr Virginia Carter Leno, said: “We wanted to see whether Predictive Parenting, which aimed to provide strategies for parents to promote predictability, was helpful two years later during these unprecedented stressful circumstances.” The findings from the follow-up studyopens in new tab/window suggest that Predictive Parenting may have a long-term positive impact on child behavior and parenting stress.

Professor Emily Simonoff, Director of the King’s Maudsley Partnership for Children and Young People’s Mental Health and senior author on the paper, said: “The findings are impressive as usually beneficial effects wear away over time but have increased here. The intervention focuses on common problems displayed by young autistic children. We found increasing benefits two years later. It may be that some families need more time to try out different strategies to reduce difficult behavior. We now need to conduct a large-scale clinical trial to confirm the pilot findings.”


Notes for editors

The article is "Effects of a Parenting Intervention for Emotional and Behavioral Problems in Young Autistic Children Under Conditions of Enhanced Uncertainty: Two-Year Follow-up of a Pilot Randomized Controlled Trial Cohort (ASTAR) During the United Kingdom COVID-19 Pandemic," by Melanie Palmer, PhD, Virginia Carter Leno, PhD, Victoria Hallett, PhD, DClinPsy, Joanne M. Mueller, DClinPsy, Lauren Breese, DClinPsy, Andrew Pickles, PhD, Vicky Slonims, PhD, Stephen Scott, PhD, FRCPsych, Tony Charman, PhD, Emily Simonoff, MD ( in new tab/window). It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 62, issue 5 (May 2023), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact  Melanie Palmer, PhD, at [email protected]


Journal of the American Academy of Child and Adolescent Psychiatryopens in new tab/window (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier

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We have supported the work of our research and healthcare communities for more than 140 years. Our 9,500 employees around the world, including 2,500 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 2,900 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy.

Together with the Elsevier Foundationopens in new tab/window, we work in partnership with the communities we serve to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

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