Internet parent-child interaction therapy (I-PCIT) in medically ill child: A case report
Valeria Melo1, Michael Zaccariello2, Emma Girard3
1Mayo Clinic Alix School of Medicine, Mayo Clinic Rochester, MN.
Insights
Internet-parent-child interaction therapy (I-PCIT) effectively treated behavioral issues in a child with medical conditions. Home-based I-PCIT improved disruptive behaviors, demonstrating its feasibility and benefits.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Behavioral Therapy
Background:
- Behavioral problems in medically ill children pose significant challenges.
- The COVID-19 pandemic necessitated adaptations in therapeutic service delivery.
- Internet-parent-child interaction therapy (I-PCIT) offers a potential solution for home-based treatment.
Observation:
- A 5-year-old girl with electrical status epilepticus in sleep, frontal lobe executive function deficit, and ADHD presented with severe behavioral issues.
- These issues included inattentiveness, aggression towards siblings, and difficulties at daycare.
- The patient also experienced sleep disturbances.
Findings:
- Home-based I-PCIT was successfully implemented for the patient.
- The intervention significantly improved the child's disruptive behaviors.
- A combination of I-PCIT and methylphenidate contributed to the child's success at home and school.
Implications:
- Home-based I-PCIT is a feasible and beneficial treatment for behavior problems in medically ill children.
- I-PCIT adaptations, including home-based and internet-based models, warrant further research for pediatric populations.
- Investigating combined treatment protocols for medically ill children is crucial.
Introduction:
This case illustrates the feasibility, benefit, and putative enhanced ecological validity of performing internet-parent-child interaction therapy (I-PCIT) in the parent-child dyad's home for the treatment of behavior problems in medically ill children in the context of a global pandemic.
Patient Concerns:
Parents of a 5-year-old girl initially presented with concerns regarding inattentiveness, physical and verbal fighting with her siblings, and getting kicked out of daycare for hitting another child. Patient also had difficulties sleeping at night.
Diagnoses:
Patient was diagnosed with electrical status epilepticus in sleep, frontal lobe executive function deficit, and attention deficit hyperactivity disorder.
Interventions:
Patient received a course of I-PCIT. Equipment included a cell phone with video capabilities connected to a videotelephony software program and set-up in the child's home by the parents. The treatment course included 8, 1-hour, weekly teaching/coaching sessions (7 of which were performed using I-PCIT) plus 1 follow-up booster session 6 months later.
Outcomes:
Home-based I-PCIT implementation greatly improved disruptive behaviors in a young child with electrical status epilepticus in sleep and attention deficit hyperactivity disorder.
Conclusion:
A combination of I-PCIT and methylphenidate allowed her to be successful at home and in a school setting. More research is needed on PCIT adaptations, such as home-based and internet-based PCIT, for medically ill children as well as treatment protocols for combined therapies.
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