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Eye Tracking Young Children with Autism
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Eye Tracking Young Children with Autism

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Direct observation in a large-scale randomized trial of parent training in children with autism spectrum disorder and

Naomi Swiezy1, Tristam Smith2, Cindy R Johnson3

  • 1Department of Psychiatry, HANDS in Autism® Interdisciplinary Training and Resource Center, Indiana University School of Medicine, Indianapolis, IN; HANDS in Autism®, Indiana University School of Medicine, 1002 Wishard Drive, Suite 1021, Indianapolis, IN 46202.

Research in Autism Spectrum Disorders
|December 24, 2021
PubMed

Insights

The Standardized Observation Analogue Procedure (SOAP) showed limited utility in a large autism spectrum disorder (ASD) trial. Baseline data did not align with parent reports, questioning its validity for measuring treatment effects in young children.

Area of Science:

  • Clinical Psychology
  • Developmental Psychology
  • Pediatric Psychiatry

Background:

  • Parenting interventions are crucial for managing disruptive behaviors in children with autism spectrum disorder (ASD).
  • Direct observation methods are often employed to objectively assess treatment efficacy.
  • The Standardized Observation Analogue Procedure (SOAP) is a tool for evaluating child behavior during parent-child interactions.

Purpose of the Study:

  • To evaluate the Standardized Observation Analogue Procedure (SOAP) as an outcome measure in a large-scale randomized trial.
  • To assess the SOAP's ability to detect differences between parent training (PT) and parent education (PE) for children with ASD and disruptive behaviors.
  • To examine the feasibility and practicality of using direct observation in large randomized trials.

Main Methods:

  • A modified 16-minute SOAP was administered during parent-child interactions in a clinical laboratory setting.
  • Participants included young children with ASD and moderate disruptive behaviors.
  • Data from 168 children with complete SOAP data at baseline were analyzed.

Main Results:

  • A significant majority (126/168) of children exhibited no disruptive behavior on the SOAP at baseline, contradicting study entry criteria.
  • Baseline SOAP data were inconsistent with parent ratings, limiting the measure's ability to show treatment-related improvements.
  • The SOAP proved challenging, time-consuming, and resource-intensive for a large-scale trial.

Conclusions:

  • The SOAP's validity as an outcome measure in large randomized trials for ASD with disruptive behavior is questionable due to baseline data inconsistencies.
  • The feasibility and practicality of using direct observation methods as primary outcome measures in large-scale studies require careful consideration.
  • Alternative or supplementary outcome measures may be necessary for robust evaluation of interventions for children with ASD.

Keywords:
AssessmentAutism spectrum disorder (ASD)BehavioralRandomized Control Trial (RCT)behavioral interventiondirect observationparent and caregiver training

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