Autism Spectrum Disorder (ASD) is a neurological disorder characterized by major deficiencies in social interaction and communication. ASD occurs in 0.8-2.0% of school-age children, some of whom experience comorbidities.2018-05-01 Parent-child interaction therapy2 PCIT is an evidence-based treatment for disturbing behaviors in children 2 through 7 years of age and provides support to caregivers. Numerous clinical studies have reported positive results in the use of PCIT for children with ASD and their caregivers.3 The PCIT aims to strengthen the relationship between the caregiver and the child and to improve the child’s compliance. Clinical-oriented PCIT reduces children’s problem behaviors by directly training in caregiver-child interactions using a single-lens mirror with headphones and headphones. In Western countries, PCIT provides clinics in different areas, homes and hospitals (clinically based), but also online based on patient needs. When the clinic-based PCIT was launched in Japan about 10 years ago, the Internet-based PCIT (I-PCIT) was launched in the wake of the COVID-19 outbreak. Applied in 2020. To date, there has been only one case report on the effectiveness of I-PCIT in Japan.4 Therefore, further research is needed. This study compared the effectiveness of three, clinically-based PCIT cases and one I-PCIT case in children with ASD.
This study was approved by the Ethics Committee of the International University of Health and Safety. Three parent-child diodes were classified as clinical-oriented PCIT and one DID as I-PCIT. The four boys, aged 3 to 5 years (average 3.6 years, average 3.0 years) and based on DMS, were included in the study from the International University of Health and Safety (Nashusiobara, Tochigi, Japan). -5 Requirements. While clinic-based PCIT provides live parent training in the clinic, I-PCI uses a webcam to transmit parent-child communications from home in real time. PCIT is a treatment-focused treatment. Assessments were ordered and standardized questionnaires, before and after treatment, primarily by the Iberg Child Behavior Collection (ECB). ECBI was used to assess the behavior of children. The scale consists of 36 items and includes scale and problem scale. The strength scale measures the frequency of different characteristics on a 7-point scale and measures the problem behavior (yes or no). The Japanese version of the ECBI is standard in Kamo, with a cut-off score of 124 for a solid scale and 13 for a problem with Japan.5 The parents completed the ECBI each session. First, pre- and post-treatment ECBI strengths and problem outcomes were compared using a T-To verify the outcome of the entire PCIT treatment session consisting of two stages: -Child-based interaction (CDI) and parent-directed interaction (PDI) for all four cases (Figure 1a). Second, we compared clinical-based PCIT and I-PCIT (Fig. 1b) for improvement in ECBI strength-outcomes before and after each intervention.
Figure 1a shows the results of pre- and post-intervention. The ECBI strength score before treatment was 130.5 and postoperatively 66.0. The mean ECBI score before treatment was 16.0 and post-treatment 1.7. There were significant differences before and after total PCIT treatment for both clinically established and I-PCIT therapies (n = 4, ECBI Strength Results P = 0.0002, result rate (R.) = 0.97; Effects of ECBI problem P = 0.018, result rate (R.) = 0.90; Figure 1 a). Despite the limited number of subjects, Figure 1b shows both clinical-oriented PCIT and I-PCIT with strong efficacy in statistical validation. All DIDs showed improvement in ECBI strength and outcome, ranging from 36.8–54.8% (average 45.6, SD 7.3) to 78.5–91.3% (average 84.8, SD 5.2) for clinically based PCIT.n = 3) and for I-PCIT (respectively) were 62.6% and 100%, respectivelyn = 1; Figure 1b).
Regardless of the type of PCIT, PCIT was effective in improving behavioral problems in all cases. Using both types of PCIT efficiently, flawless PCIT treatment can be implemented during the COVID-19 era. According to our previous study,4 The current PCIT study can improve the ecological accuracy of treatment by encouraging in-home PCIT adoption, where therapists look for more challenging behaviors. In a clinically based PCIT, children are sometimes calmer and more obedient than at home, making it difficult for a therapist to intervene. However, advanced features such as I-PCIT, Wi-Fi and home video settings are required.
The authors do not discuss conflicts of interest.
MM and YM prepared the first manuscript and approved the last manuscript. MK developed the study and KK and TK support the implementation of PCIT treatment. All authors read and approved the final manuscript.