(PS10-B33) Leveraging Brief Evidenced-based Telehealth Therapy to Improve Parent and Child Outcomes Among Underserved Youth with Neurodevelopmental Disorders

Background: Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for disruptive behavior that has been shown to be effective for children with neurodevelopmental disorders (ND), such as autism spectrum disorder, attention-deficit hyperactivity disorder, and developmental delays. While rigorous trials have demonstrated the efficacy of telehealth for children with and without ND, less work has focused on briefer, more cost-effective versions of PCIT for families from underserved backgrounds (i.e., low income) who may face increased barriers.

Objectives: The purpose of this study was to examine the efficacy of a time limited, 10 session version of PCIT delivered via telehealth (Tele-PCIT) within a sample of children with ND from low-income backgrounds.

Method: Participants included parents of 27 children (2-6 years old, M_age = 5.15) with ND, co-occurring disruptive behavior problems, and verbal skills above a 24-month age equivalent. Parents reported on their parenting stress on the Parenting Stress Index, parenting practices on the Parenting Scale, and child behavior on the Eyberg Child Behavior Inventory at pre-and-post-treatment.

Results: Among treatment completers (n = 21, 78%), 95% of parents reported high levels of satisfaction with Tele-PCIT (M = 4.76 out of 5) and 76% reported that telehealth delivery enhanced their experience (M = 4.43 out of 5). Parents reported decreases in parenting stress from pre-to-post-treatment, F (1, 20) = 34.32, p < .001, d = -.65. Parents also reported improvement in positive parenting practices, including decreases in Laxness (tendency to give in or provide positive consequences for misbehavior), F (1, 20) = 23.94, p < .001, d = -1.22, and Overreactivity (displays of anger or irritability) F (1, 20) = 21.85, p < .001, d = -1.22. Results also revealed significant reductions in parent rated child externalizing behavior problems from pre-to-post-treatment, F (1, 20) = 38.85, p < .001, d = -1.37. Of those with available 3-month follow-up data (n = 10), improvements in behavior were maintained at follow-up as behavior problems remained significantly lower as compared with pre-treatment levels (d = -2.07, p < .001) and comparable to post-treatment levels (d = -.02, p > .99). Decreases in parenting stress were maintained at follow-up as parent ratings remained significantly lower compared with pre-treatment (d = -1.39, p < .01) and comparable to post-treatment (d = -.53, p > .25). Similarly, decreases in Laxness and Overreactivity were maintained at follow up (pre-to-follow up d = -1.66, d = -2.22, respectively).

Conclusions: Preliminary study results suggest that time limited Tele-PCIT can be feasibly completed with high engagement rates and high levels of satisfaction, and is effective in improving positive parenting practices, reducing child behavioral challenges, and reducing parenting stress in a population of underserved youth. Findings from this pilot will inform larger examinations of Tele-PCIT for improving access within underserved ND populations.

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