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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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“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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Metadata
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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