Medication and Parent Training in Children With Pervasive Developmental Disorders and Serious Behavior Problems: Results From a Randomized Clinical Trial
Open accessAbstract
Objective Many children with pervasive developmental disorders (PDDs) have serious, functionally impairing behavioral problems. We tested whether combined treatment (COMB) with risperidone and parent training (PT) in behavior management is superior to medication alone (MED) in improving severe behavioral problems in children with PDDs.Method This 24-week, three-site, randomized, parallel-groups clinical trial enrolled 124 children, aged 4 through 13 years, with PDDs, accompanied by frequent tantrums, self-injury, and aggression. The children were randomized 3:2 to COMB (n = 75) or MED (n = 49). The participants received risperidone monotherapy from 0.5 to 3.5 mg/day (with switch to aripiprazole if risperidone was ineffective). Parents in the COMB group (n = 75; 60.5%) received a mean of 10.9 PT sessions. The primary measure of compliance was the Home Situations Questionnaire (HSQ) score.Results Primary: intent-to-treat random effects regression showed that COMB was superior to MED on HSQ (p = .006) [effect size at week 24 (d) = 0.34]. The HSQ score declined from 4.31 (± 1.67) to 1.23 (± 1.36) for COMB compared with 4.16 (± 1.47) to 1.68 (± 1.36) for MED. Secondary: groups did not differ on Clinical Global Impressions-Improvement scores at endpoint; compared with MED, COMB showed significant reductions on Aberrant Behavior Checklist Irritability (d = 0.48; p = .01), Stereotypic Behavior (d = 0.23; p = .04), and Hyperactivity/Noncompliance subscales (d = 0.55; p = .04). Final risperidone mean dose for MED was 2.26 mg/day (0.071 mg/kg), compared with 1.98 mg/day for COMB (0.066 mg/kg) (p = .04).Conclusions Medication plus PT resulted in greater reduction of serious maladaptive behavior than MED in children with PDDs, with a lower risperidone dose.
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In a risperidone-plus-parent-training trial, the combined group showed less aggression and larger hyperactivity decreases than the medication-only group.
“Results indicated that children who received parent training in addition to pharmacological treatment (i.e., risperidone) had lower rates of aggression and greater reductions in hyperactivity as compared to children who only received medication [63].”
From Treatment for Co-Occurring Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder (2012) · cites this paper as [63]
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Self-citation
- Authors
- Aman, M. G., Mcdougle, C. J., Scahill, L., Handen, B., Arnold, L. E., Johnson, C., Stigler, K. A., Bearss, K., Butter, E., Swiezy, N. B., Sukhodolsky, D. D., Ramadan, Y., Pozdol, S. L., Nikolov, R., Lecavalier, L., Kohn, A. E., Koenig, K., Hollway, J. A., Korzekwa, P., Gavaletz, A., Mulick, J. A., Hall, K. L., Dziura, J., Ritz, L., Trollinger, S., Yu, S., Vitiello, B., & Wagner, A.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Aman, Michael G.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 48
- Issue
- 12
- Pages
- 1143-1154
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3142923
- OpenAlex
- W2113512187
- Cited by
- 371
- References
- 51
- Citations by year
- 2026: 6 · 2025: 29 · 2024: 12 · 2023: 12 · 2022: 19 · 2021: 31 · 2020: 22 · 2019: 13 · 2018: 53 · 2017: 19 · 2016: 21 · 2015: 23 · 2014: 21 · 2013: 30 · 2012: 30
- FWCI
- 9.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- U.S. Public Health Service (ULRR025761)
- National Institute of Mental Health (U10MH066768, U10MH066764, U10MH66766, U10MH066766, U 10MH66764, U10MH66768)
- National Center for Research Resources (UL1RR025755, UL1RR024139)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- pervasive developmental disorders, autism spectrum disorder, risperidone, parent training, behavior management, combined psychotherapy and pharmacotherapy, tantrums, self-harm, aggression, irritability, stereotypy, hyperactivity, aripiprazole, Aberrant Behavior Checklist, medication adherence, antipsychotic adverse effects
- MeSH terms
- Adolescent, Behavior Therapy, Child, Child Behavior Disorders, Child Development Disorders, Pervasive, Child, Preschool, Combined Modality Therapy, Dose-Response Relationship, Drug, Double-Blind Method, Education, Female, Humans, Male, Personality Assessment, Psychometrics, Antipsychotic Agents, Risperidone
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