key: cord-0873060-4wmcxhkg
authors: Matano, Miyuki; Monden, Yukifumi; Kurane, Koyuru; Kawasaki, Masako; Kamo, Toshiko
title: Potential of internet‐delivered PCIT for ASD in the COVID‐19 era: A pilot study
date: 2021-09-07
journal: Pediatr Int
DOI: 10.1111/ped.14699
sha: 1c70fa1c79b84b735497b1c2217b7894b9346fad
doc_id: 873060
cord_uid: 4wmcxhkg

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were conducted before and after treatment using observation and standardized questionnaires, mainly the Eyberg Child Behavior Inventory (ECBI). The ECBI was used to assess the children's problematic behaviors. The scale includes 36 items and comprises an intensity scale and a problem scale. The intensity scale measures the frequency of various behaviors on a 7-point scale and the problem scale classifies behavior as either problematic or not (yes or no). The Japanese version of the ECBI was standardized by Kamo and the cutoff scores are 124 for the intensity scale and 13 for the problem scale in Japan. 5 The parents completed the ECBI at each session. Initially, pre-and posttreatment ECBI intensity and problem scores were compared using a t-test to verify the effect of the whole PCIT treatment session, which included two phases: child-directed interaction (CDI) and parent-directed interaction (PDI) for all four cases (Fig. 1a) . Second, we compared the rate of improvement in ECBI intensity-scores before and after each intervention for clinical-based PCIT and I-PCIT (Fig. 1b) . Figure 1a shows the pre-and postintervention scores. The average of the ECBI intensity scores before treatment was 130.5 and after treatment was 66.0. The average of ECBI problem scores before treatment was 16.0 and after treatment was 1.7. There were significant differences before and after the entire course of PCIT treatment for both clinic-based and I-PCIT treatments (n = 4, ECBI intensity scores: P = 0.0002, effect size(r) = 0.97; ECBI problem scores: P = 0.018, effect size(r) = 0.90; Fig. 1a ). Although the number of subjects was limited, Fig. 1b shows that both clinic-based PCIT and I-PCIT exhibited robust effectiveness in statistical validation. All dyads showed improvement in ECBI intensity and problem scores which ranged from 36.8-54.8% (mean 45.6, SD 7.3) to 78.5-91.3% (mean 84.8, SD 5.2), respectively, for clinicbased PCIT (n = 3) and were 62.6 % and 100%, respectively for I-PCIT (n = 1; Fig. 1b) .

PCIT was effective in improving behavioral problems in all cases, regardless of the PCIT type. Using either type of PCIT effectively, seamless PCIT treatment is feasible in the COVID-19 era. As our previous study, 4 the current PCIT study may improve the ecological validity of treatment by encouraging the adoption of PCIT at home where therapists can observe the most problematic behaviors. In clinic-based PCIT, children are sometimes calm and obedient compared to when they are at home, making it difficult for the therapist to intervene. However, for I-PCIT, advanced preparation, such as Wi-Fi and video settings in the home, is required. Fig. 1 (a) The average of the Eyberg Child Behavior Inventory (ECBI) intensity scores before and after treatment were 130.5 and 66.0. The average of the ECBI problem scores before and after treatment were 16.0 and 1.75. Pre-and posttreatment ECBI intensity scores were compared using a t-test to verify the effect of the whole Parent-Child Interaction Therapy (PCIT) treatment session. There were significant differences before and after treatment for both clinic-based PCIT and Internet delivered PCIT treatments (I-PCIT) (n= 4, P = 0.0002, effect size(r) = 0.97; ECBI problem scores: P = 0.018, effect size(r) = 0.90). (b) Comparison between the rate of improvement in the ECBI intensity and problem scores before and after each intervention for clinical-based PCIT and I-PCIT. All dyads showed improvement in ECBI intensity and problem scores, which ranged from 36.8% to 54.8% (mean 45.6, SD 7.3) and 78.5-91.3% (mean 84.8, SD 5.2), respectively, for clinic-based PCIT (n = 3), and 62.6% and 100%, respectively, for I-PCIT (n = 1).

Prevalence of autism spectrum disorder among children aged 8 years -autism and developmental disabilities monitoring network, 11 sites

Parent-child interaction therapy for children with autism spectrum disorder: research, training, and clinical considerations

Internet-delivered parent-child interaction therapy (I-PCIT) in Japan: case report of application to a maltreating parent-child dyad

Eyberg Child Behavior Inventory Japanese Edition

The authors declare no conflicts of interest.

M.M. and Y.M. drafted the initial manuscript and approved the final manuscript. M.K. conceptualized the study and K.K. and T.K. supported the implementation of the PCIT therapy. All authors read and approved the final manuscript.