Skip to main content
SpringerLink
Log in

Introducing ‘Predictive Parenting’: A Feasibility Study of a New Group Parenting Intervention Targeting Emotional and Behavioral Difficulties in Children with Autism Spectrum Disorder

  • Brief Report
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Parent-mediated interventions can reduce behavioral and emotional problems in children with ASD. This report discusses the development of the first group parent intervention targeting behaviors and anxiety in children with ASD, across the spectrum of cognitive and language ability. ‘Predictive Parenting’ was developed from the clinical observation (and emerging evidence base) that children with ASD struggle with ‘prediction’ and anticipating change. It integrates well-established parenting strategies within an ASD-specific framework. The concept was co-created with patient and public involvement panels of parents and adults with ASD. A feasibility study found the programme is acceptable and accessible. Qualitative feedback from participants was largely positive, and critiques were used to inform a larger, pilot randomized controlled trial of the intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Attwood, T. (2004). Exploring feelings: Cognitive behavior therapy to manage anxiety. Alrington, TX: Future Horizons.

    Google Scholar 

  • Bearss, K., Johnson, C., Handen, B., Butter, E., Lecavalier, L., Smith, T., et al. (2018). Parent training for disruptive behavior : The RUBI autism network [Clinician Manual]. New York: Oxford University Press.

    Book  Google Scholar 

  • Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., et al. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. JAMA-Journal of the American Medical Association, 313(15), 1524–1533. https://doi.org/10.1001/jama.2015.3150.

    Article  Google Scholar 

  • Beavers, G. A., Iwata, B. A., & Lerman, D. C. (2013). Thirty years of research on the functional analysis of problem behavior. Journal of Applied Behavioral Analysis, 46, 1–21.

    Article  Google Scholar 

  • Bogels, S., & Restifo, K. (2014). Mindful parenting :A guide for mental health practitioners. New York: Springer.

    Book  Google Scholar 

  • Boulter, C., Freeston, M., South, M., & Rodgers, J. (2014). Intolerance of uncertainty as a framework for understanding anxiety in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(6), 1391–1402. https://doi.org/10.1007/s10803-013-2001-x.

    Article  PubMed  Google Scholar 

  • Buck, T. R., Viskochil, J., Farley, M., Coon, H., McMahon, W. M., Morgan, J., et al. (2014). Psychiatric comorbidity and medication use in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-014-2170-2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness, stress and well-being in parents of children with autism spectrum disorder: A systematic review. Journal of Child and Family Studies, 25(1), 1–14. https://doi.org/10.1007/s10826-015-0193-8.

    Article  Google Scholar 

  • Cartwright-Hatton, S., McNally, D., Field, A. P., Rust, S., Laskey, B., Dixon, C., et al. (2011). A new parenting-based group intervention for young anxious children: Results of a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 50(3), 242–251e246. https://doi.org/10.1016/j.jaac.2010.12.015.

    Article  PubMed  Google Scholar 

  • Cook, J. M., Donovan, C. L., & Garnett, M. S. (2017). A parent-mediated, cognitive behavioral therapy group treatment for young children with high-functioning autism spectrum disorder and comorbid anxiety: Development and case illustration of the fun with feelings program. Journal of Cognitive Psychotherapy, 31(3), 204–224. https://doi.org/10.1891/0889-8391.31.3.204.

    Article  PubMed  Google Scholar 

  • Fletcher-Watson, S., Adams, J., Brook, K., Charman, T., Crane, L., Cusack, J., et al. (2018). Making the future together: Shaping autism research through meaningful participation. Autism. https://doi.org/10.1177/1362361318786721.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gomot, M., & Wicker, B. (2012). A challenging, unpredictable world for people with autism spectrum disorder. International Journal of Psychophysiology, 83(2), 240–247. https://doi.org/10.1016/j.ijpsycho.2011.09.017.

    Article  PubMed  Google Scholar 

  • Gray, C. (2000). The new social story book (Illustrated ed.). Arlington: Gray.

    Google Scholar 

  • Hartley, S. L., Sikora, D. M., & McCoy, R. (2008). Prevalence and risk factors of maladaptive behaviour in young children with Autistic disorder. Journal of Intellectual Disability Research, 52(10), 819–829. https://doi.org/10.1111/j.1365-2788.2008.01065.x.

    Article  PubMed  Google Scholar 

  • Hill, A. P., Zuckerman, K. E., Hagen, A. D., Kriz, D. J., Duvall, S. W., van Santen, J., et al. (2014). Aggressive behavior problems in children with autism spectrum disorders: Prevalence and correlates in a large clinical sample. Research in Autism Spectrum Disorders, 8(9), 1121–1133. https://doi.org/10.1016/j.rasd.2014.05.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • Knight, V., Sartini, E., & Spriggs, A. D. (2015). Evaluating visual activity schedules as evidence-based practice for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(1), 157–178. https://doi.org/10.1007/s10803-014-2201-z.

    Article  PubMed  Google Scholar 

  • Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research. https://doi.org/10.1111/j.1365-2788.2005.00732.x.

    Article  PubMed  Google Scholar 

  • Lecavalier, L., Wood, J. J., Halladay, A. K., Jones, N. E., Aman, M. G., Cook, E. H., et al. (2014). Measuring anxiety as a treatment endpoint in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(5), 1128–1143. https://doi.org/10.1007/s10803-013-1974-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Maskey, M., Warnell, F., Parr, J. R., Le Couteur, A., & McConachie, H. (2013). Emotional and behavioural problems in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(4), 851–859. https://doi.org/10.1007/s10803-012-1622-9.

    Article  PubMed  Google Scholar 

  • McLarty, M. (1997). Putting objects of reference in context. European Journal of Special Needs Education, 12(1), 12–20. https://doi.org/10.1080/0885625970120102.

    Article  Google Scholar 

  • McNally Keehn, R., Lincoln, A., Brown, M., & Chavira, D. (2013). The coping cat program for children with anxiety and autism spectrum disorder: A pilot randomized controlled trial. Journal of Autism and Developmental Disorders, 43, 57–67. https://doi.org/10.1007/s10803-012-1541-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Monga, S., Rosenbloom, B. N., Tanha, A., Owens, M., & Young, A. (2015). Comparison of child-parent and parent-only cognitive-behavioral therapy programs for anxious children aged 5 to 7 years: Short- and long-term outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 54(2), 138–146. https://doi.org/10.1016/j.jaac.2014.10.008.

    Article  PubMed  Google Scholar 

  • O'Nions, E., Happe, F., Evers, K., Boonen, H., & Noens, I. (2018). How do parents manage irritability, challenging behaviour, non-compliance and anxiety in children with autism spectrum disorders? a meta-synthesis. Journal of Autism and Developmental Disorders, 48(4), 1272–1286. https://doi.org/10.1007/s10803-017-3361-4.

    Article  PubMed  Google Scholar 

  • Palmer, M. L., Tarver, J., Perez, J. P., Cawthorne, T., Romeo, R., Stringer, D., et al. (2019). A novel group parenting intervention to reduce emotional and behavioural problems in young autistic children. Protocol for the Autism Spectrum Treatment and Resilience (ASTAR) feasibility and pilot randomised control trial. British Medical Journal Open, 9(6), e029959.

    Google Scholar 

  • Pellicano, E., & Burr, D. (2012). When the world becomes 'too real': A Bayesian explanation of autistic perception. Trends in Cognitive Sciences, 16(10), 504–510. https://doi.org/10.1016/j.tics.2012.08.009.

    Article  PubMed  Google Scholar 

  • Pickles, A., Starr, E., Kazak, S., Bolton, P., Papanikolaou, K., Bailey, A., et al. (2000). Variable expression of the autism broader phenotype: Findings from extended pedigrees. Journal of Child Psychology and Psychiatry, 41(4), 491–502.

    Article  Google Scholar 

  • Postorino, V., Sharp, W. G., McCracken, C. E., Bearss, K., Burrell, T. L., Evans, A. N., et al. (2017). A systematic review and meta-analysis of parent training for disruptive behavior in children with autism spectrum disorder. Clinical Child and Family Psychology Review. https://doi.org/10.1007/s10567-017-0237-2.

    Article  PubMed  Google Scholar 

  • Qi, C. H., Barton, E. E., Collier, M., Lin, Y. L., & Montoya, C. (2018). A systematic review of effects of social stories interventions for individuals with autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 33(1), 25–34. https://doi.org/10.1177/1088357615613516.

    Article  Google Scholar 

  • Rodgers, J., Hodgson, A., Shields, K., Wright, C., Honey, E., & Freeston, M. (2017). Towards a treatment for intolerance of uncertainty in young people with autism spectrum disorder: Development of the coping with uncertainty in everyday situations (CUES(c)) programme. Journal of Autism and Developmental Disorders, 47(12), 3959–3966. https://doi.org/10.1007/s10803-016-2924-0.

    Article  PubMed  Google Scholar 

  • Rzepecka, H., McKenzie, K., McClure, I., & Murphy, S. (2011). Sleep, anxiety and challenging behaviour in children with intellectual disability and/or autism spectrum disorder. Research in Developmental Disabilities, 32(6), 2758–2766. https://doi.org/10.1016/j.ridd.2011.05.034.

    Article  PubMed  Google Scholar 

  • Schaaf, R. C., Toth-Cohen, S., Johnson, S. L., Outten, G., & Benevides, T. W. (2011). The everyday routines of families of children with autism examining the impact of sensory processing difficulties on the family. Autism, 15(3), 373–389. https://doi.org/10.1177/1362361310386505.

    Article  PubMed  Google Scholar 

  • Scudder, A., Wong, C., Ober, N., Hoffman, M., Toscolani, J., & Handen, B. (2019). Parent–child interaction therapy (PCIT) in young children with autism spectrum disorder. Child and Family Behavior Therapy, 41(4), 201–220. https://doi.org/10.1080/07317107.2019.1659542.

    Article  Google Scholar 

  • Simonoff, E., Jones, C. R., Baird, G., Pickles, A., Happe, F., & Charman, T. (2013). The persistence and stability of psychiatric problems in adolescents with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 54(2), 186–194. https://doi.org/10.1111/j.1469-7610.2012.02606.x.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. https://doi.org/10.1097/CHI.0b013e318179964f.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Fisher, B. C., Wahler, R. G., McAleavey, K., et al. (2006). Mindful parenting decreases aggression, noncompliance, and self-injury in children with autism. Journal of Emotional and Behavioral Disorders, 14(3), 169–177. https://doi.org/10.1177/10634266060140030401.

    Article  Google Scholar 

  • Sinha, P., Kjelgaard, M. M., Gandhi, T. K., Tsourides, K., Cardinaux, A. L., Pantazis, D., et al. (2014). Autism as a disorder of prediction. Proceedings of the National Academy of Sciences of the United States of America, 111(42), 15220–15225. https://doi.org/10.1073/pnas.1416797111.

    Article  PubMed  PubMed Central  Google Scholar 

  • Storch, E. A., Arnold, E. B., Jones, A. M., Ale, C. M., Wood, J. J., Ehrenreich-May, J., et al. (2012). The role of co-occurring disruptive behavior in the clinical presentation of children and adolescents with anxiety in the context of autism spectrum disorders. Child Psychiatry and Human Development, 43(5), 743–746.

    Article  Google Scholar 

  • Tarver, J., Palmer, M., Webb, S., Scott, S., Slonims, V., Simonoff, E., et al. (2019). Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis. Autism. https://doi.org/10.1177/1362361319830042.

    Article  PubMed  Google Scholar 

  • Tellegen, C. L., & Sanders, M. R. (2014). A randomized controlled trial evaluating a brief parenting program with children with autism spectrum disorders. Journal of Consulting and Clinical Psychology, 82(6), 1193–1200. https://doi.org/10.1037/a0037246.

    Article  PubMed  Google Scholar 

  • Thirlwall, K., Cooper, P. J., Karalus, J., Voysey, M., Willetts, L., & Creswell, C. (2013). Treatment of child anxiety disorders via guided parent-delivered cognitive behavioural therapy: Randomised controlled trial. British Journal of Psychiatry, 203(6), 436–444. https://doi.org/10.1192/bjp.bp.113.126698.

    Article  Google Scholar 

  • Ung, D., Selles, R., Small, B. J., & Storch, E. A. (2015). A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry and Human Development, 46(4), 533–547. https://doi.org/10.1007/s10578-014-0494-y.

    Article  PubMed  Google Scholar 

  • Cruys, S., Evers, K., Van der Hallen, R., Van Eylen, L., Boets, B., de-Wit, L., et al. (2014). Precise minds in uncertain worlds: Predictive coding in autism. Psychological Review, 121(4), 649–675. https://doi.org/10.1037/a0037665.

    Article  PubMed  Google Scholar 

  • Van Steensel, F. J. A., Bogels, S. M., & de Bruin, E. I. (2013). Psychiatric comorbidity in children with autism spectrum disorders: A comparison with children with ADHD. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-012-9587-z.

    Article  PubMed  Google Scholar 

  • VERBIsoftware. (2016). MAXQDA analytics pro. Berlin, Germany: VERBI.

  • Webster-Stratton, C., & Reid, M. (2010). The Incredible Years parents, teachers and children training series: A multifaceted treatment approach for young children with conduct problems. In J. Weisz & A. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed.). New York: Guildford Press.

    Google Scholar 

  • Weiss, J. A., Thomson, K., Burnham Riosa, P., Albaum, C., Chan, V., Maughan, A., et al. (2018). A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism. Journal of Child Psychology and Psychiatry, 59(11), 1180–1191. https://doi.org/10.1111/jcpp.12915.

    Article  PubMed  Google Scholar 

  • White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229.

    Article  Google Scholar 

  • Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M. R. (2009a). Behavioural Family Intervention with parents of children with ASD: What do they find useful in the parenting program Stepping Stones Triple P? Research in Autism Spectrum Disorders, 3(3), 702–713. https://doi.org/10.1016/j.rasd.2009.01.009.

    Article  Google Scholar 

  • Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M. R. (2009b). Stepping stones triple P: An RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology, 37(4), 469–480. https://doi.org/10.1007/s10802-008-9285-x.

    Article  PubMed  Google Scholar 

  • Williams, M. E., Hastings, R., Charles, J. M., Evans, S., & Hutchings, J. (2017). Parenting for autism, language, and communication evaluation study (PALACES): Protocol for a pilot randomised controlled trial. British Medical Journal Open, 7(2), e014524. https://doi.org/10.1136/bmjopen-2016-014524.

    Article  Google Scholar 

  • Winnicott, D. W. (1987). The child, the family, and the outside world. Reading, Mass.: Addison-Wesley Pub. Co.

    Google Scholar 

  • Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of Child Psychology and Psychiatry, 50(3), 224–234. https://doi.org/10.1111/j.1469-7610.2008.01948.x.

    Article  PubMed  Google Scholar 

  • Zand, D. H., Bultas, M. W., McMillin, S. E., Halloran, D., White, T., McNamara, D., et al. (2017). A pilot of a brief positive parenting program on children newly diagnosed with autism spectrum disorder. Family Process. https://doi.org/10.1111/famp.12334.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to all parents who participated in the current study and to the parents and autistic adults who took part in our PPI panels. We acknowledge the valuable contribution of the ASTAR research team, including Dr. Melanie Palmer, Dr. Joanne Tarver and Dr. Juan Perez for the recruitment and assessment of ASTAR participants. Local clinicians supported significantly with recruitment and offering space for the groups, including Dr. Fernando Salazar, Dr. Susanna Cole, Dr. Sue Goode, Dr. Shade Alu, Dr. Mark O’Leary, Dr. Narad Methura, Marion Drennan, Jackie Sutherland and Sarran Bond. Our thanks go to staff at Drumbeat school, particularly Marie Neave and Hannah Robinson.

Funding

This research was funded by National Institute for Health Research (NIHR) under its Program Grants for Applied Research program (RP-PG-1211-20016). ES and AP additionally receive support from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley Foundation Trust (IS-BRC-1215-20018) and the NIHR through Senior Investigator Awards (NF-SI-0514-10073; NF-SI-0617-10120). The views expressed in this presentation are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Additional funding for intervention materials was received from the Maudsley Charity (1157).

Author information

Author notes

  1. Victoria Hallett and Joanne Mueller have contributed equally.

Authors and Affiliations

  1. South London and Maudsley NHS Foundation Trust, London, UK

    Victoria Hallett, Joanne Mueller, Lauren Breese, Megan Hollett, Stephen Scott, Tony Charman & Emily Simonoff

  2. Social Policy Research Unit, University of York, York, UK

    Bryony Beresford & Annie Irvine

  3. Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK

    Andrew Pickles, Stephen Scott, Tony Charman & Emily Simonoff

  4. Newcomen Neurodevelopmental Centre, Children’s Neurosciences, Evelina Children’s Hospital, Guy’s and St Thomas NHS Foundation, London, UK

    Vicky Slonims

Authors
  1. Victoria Hallett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanne Mueller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lauren Breese
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Megan Hollett
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bryony Beresford
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Annie Irvine
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andrew Pickles
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vicky Slonims
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stephen Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tony Charman
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Emily Simonoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the conception and design of the feasibility study and/or the Predictive Parenting programme. Funding for the project was obtained by ES, TC, AP, BB, SS and VS. The therapy team (VH, JM, LB, MH) took a lead in the development of the group materials and group facilitation. The first draft of the manuscript was written by Dr Victoria Hallett, Dr Joanne Mueller and Dr Lauren Breese. All authors commented on early versions of the manuscript and read and approved the final submission.

Corresponding author

Correspondence to Victoria Hallett.

Ethics declarations

Conflicts of interest

AP declares that he receives royalties from WPS for the Social Communication Questionnaire.

Ethical Approval

Ethical approval was granted from NHS Camden and Kings Cross Research Ethics Committee (ref: 16/LO/1769) along with NHS R&D permission from South London and Maudsley, Guy's and St Thomas', and Croydon Health Services NHS Trusts. The findings will be disseminated through publication in peer-reviewed journals and presentations at conferences.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hallett, V., Mueller, J., Breese, L. et al. Introducing ‘Predictive Parenting’: A Feasibility Study of a New Group Parenting Intervention Targeting Emotional and Behavioral Difficulties in Children with Autism Spectrum Disorder. J Autism Dev Disord 51, 323–333 (2021). https://doi.org/10.1007/s10803-020-04442-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-020-04442-2

Keywords

Search

Navigation