Predictive parenting behavioural interventions could help parents better understand and therefore better support young autistic children with difficult emotions and behaviour.
The research from the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London shows that ‘Predictive Parenting’, a group-based behavioural parenting intervention for parents of autistic children, reduces children’s emotional and behavioural difficulties as well as parenting stress in the long term.
The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, followed-up parents of autistic children in 2020 during the Covid-19 pandemic to investigate the longer-term effects of the intervention that was first delivered pre-pandemic.
Predictive Parenting consisted of 12 weekly, two-hour groups that extended parents’ understanding of autism and difficult emotions and behaviour, and that included techniques to help parents anticipate, prevent, and respond to the child’s anxiety.
It was developed from the clinical observation that autistic children struggle with unpredictability and anticipating change, and it integrates well-established behavioral parenting strategies within an autism-specific framework.
Researchers conducted follow-up questionnaires and interviews with 49 parents of autistic children who participated in the Autism Spectrum Treatment and Resilience (ASTAR) pilot trial in 2017-18. Parents were randomly assigned to receive either the Predictive Parenting intervention or Psychoeducation (information about autism and signposting to resources without specific guidance on managing emotions or behaviour).
Parents who received Predictive Parenting reported a significant reduction in child irritability and parenting stress during the Covid-19 pandemic, two years after the intervention. In contrast, child irritability and parenting stress reported by those who received Psychoeducation had returned to pre-intervention levels two years later.
Dr Melanie Palmer, Research Associate at King’s IoPPN and the study’s joint first author, said: “The Covid-19 pandemic and ensuing lockdowns provided uniquely disruptive conditions to see how families with autistic children were adapting to a change in their routines. We re-contacted parents who took part in our pre-pandemic pilot trial to assess the longer-term impact of the Predictive Parenting intervention and to see how these families were coping during the pandemic.
“Our study shows that Predictive Parenting provided families with useful tools that were effective two years later during the unprecedented circumstances of the pandemic.”
In the follow-up questionnaires and interviews, parents shared positive feedback on both interventions and reported utilising strategies from Predictive Parenting during the Covid-19 lockdowns.
The study was led by researchers at the IoPPN and involved clinicians from South London and Maudsley NHS Foundation Trust and the Newcomen Centre at the Evelina Children’s Hospital. It was funded by the National Institute for Health and Care Research (NIHR) with additional support from the Maudsley Charity. Professor Emily Simonoff and Professor Andrew Pickles (another co-author) are supported by the NIHR Maudsley Biomedical Research Centre and are NIHR Senior Investigators.
