Skip to main content

Clinical Application of Parent-Child Interaction Therapy to Promote Play and Vocalizations in Young Children with Autism Spectrum Disorder: A Case Study and Recommendations

  • Chapter
  • First Online:
Handbook of Parent-Child Interaction Therapy for Children on the Autism Spectrum

Abstract

Parent-Child Interaction Therapy (PCIT) is an empirically supported, manualized intervention for addressing disruptive behaviors in young children (Eyberg. Child and Family Behavior Therapy 10:33–46, 1988; Neary and Eyberg. Infants and Young Children 14:53–67, 2002). Recently, researchers have expanded the use of PCIT with diverse populations to include children with autism spectrum disorder (ASD; Hansen & Shillingsburg. Child and Family Behavior Therapy 38:318–330, 2016). Adaptations to the original PCIT protocol may be needed to address core characteristics of ASD that otherwise may limit treatment effectiveness with this population. Characteristics of ASD that should be considered include deficits in social communication and interactions, high levels of rigidity and stereotypic behavior, and circumscribed interests and preferences. This chapter will discuss how the characteristics of ASD may pose challenges to the standard PCIT approach and provide detailed recommendations for several adaptations including altering the mastery criteria and adding preference assessments, stimulus-stimulus pairing, mand training, instructional fading, errorless prompting, and three-step prompting. To provide guidance and suggestions to PCIT clinicians, the authors’ experiences working with parents of children with ASD in PCIT are discussed in addition to a case study (Hansen and Shillingsburg. Child and Family Behavior Therapy 38:318–330, 2016).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 429.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75(4), 594.

    Article  PubMed  Google Scholar 

  • Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33(3), 353–357. https://doi.org/10.1901/jaba.2000.33-353

    Article  PubMed  PubMed Central  Google Scholar 

  • Chevallier, C., Kohls, G., Troiani, V., Brodkin, E. S., & Schultz, R. T. (2012). The social motivation theory of autism. Trends in Cognitive Sciences, 16, 231–239. https://doi.org/10.1016/j.tics.2012.02.007

    Article  PubMed  PubMed Central  Google Scholar 

  • Dawson, G., Meltzoff, A. N., Osterling, J., Rinaldi, J., & Brown, E. (1998). Children with autism fail to orient to naturally occurring social stimuli. Journal of Autism and Developmental Disorders, 28(6), 479–485.

    Article  PubMed  Google Scholar 

  • Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., & Liaw, J. (2004). Early social attention impairments in autism: Social orienting, joint attention, and attention to distress. Developmental Psychology, 40(2), 271–283.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M. (1988). Parent–child interaction therapy: Integration of traditional and behavioral concerns. Child and Family Behavior Therapy, 10(1), 33–46.

    Article  Google Scholar 

  • Fisher, W. W., Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with systematic choice assessment to enhance reinforcer identification. American Journal of Mental Retardation, 101, 15–25.

    PubMed  Google Scholar 

  • Girolametto, L. E. (1988). Improving the social-conversational skills of developmentally disabled children: An intervention study. Journal of Speech and Hearing Disorders, 53(2), 156–167.

    Article  Google Scholar 

  • Greenwood, C. R., Thiemann-Bourque, K., Walker, D., Buzhardt, J., & Gilkerson, J. (2010). Assessing children’s home language environments using automatic speech recognition technology. Communication Disorders Quarterly, 32(2), 83–92.

    Article  Google Scholar 

  • Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36(2), 147–185. https://doi.org/10.1901/jaba.2003.36-147

    Article  PubMed  PubMed Central  Google Scholar 

  • Hansen, B., & Shillingsburg, M. A. (2016). Using a modified parent-child interaction therapy to increase vocalizations in children with autism. Child and Family Behavior Therapy, 38(4), 318–330. https://doi.org/10.1080/07317107.2016.1238692

    Article  Google Scholar 

  • Hart, B., & Risley, T. (1995). Meaningful differences in the everyday experience of young American children. Baltimore: Paul H. Brookes Publishing.

    Google Scholar 

  • Jaffe, J., Beebe, B., Feldstein, S., Crown, C. L., & Jasnow, M. D. (2001). Rhythms of dialogue in infancy. Monographs of the Society for Research in Child Development, 66(2), 1–149.

    Article  Google Scholar 

  • Leezenbaum, N. B., Campbell, S. B., Butler, D., & Iverson, J. M. (2014). Maternal verbal responses to communication of infants at low and heightened risk of autism. Autism, 18(6), 694–703.

    Article  PubMed  Google Scholar 

  • Lesack, R., Bearss, K., Celano, M., & Sharp, W. G. (2014). Parent–child interaction therapy and autism spectrum disorder: Adaptations with a child with severe developmental delays. Clinical Practice in Pediatric Psychology, 2, 68–82.

    Article  Google Scholar 

  • MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (2001). Prompts and prompt-fading strategies for people with autism. In C. Maurice, G. Green, & R. M. Foxx (Eds.), Making a difference: Behavioral intervention for autism (pp. 37–50). Austin, TX: Pro-Ed.

    Google Scholar 

  • McNeil, C. B., & Hembree-Kigin, T. L. (2011). Parent-child interaction therapy (2 nd ed.). New York, NY: Springer.

    Google Scholar 

  • Miltenberger, R. G. (2001). Behavior modification: Principles and procedures. Belmont, CA: Wadsworth/Thompson Learning.

    Google Scholar 

  • Neary, E. N., & Eyberg, S. M. (2002). Management of disruptive behavior in young children. Infants and Young Children, 14(4), 53–67. https://doi.org/10.1097/00001163-200204000-00007

    Article  Google Scholar 

  • Pace, G. M., Iwata, B. A., Cowdery, G. E., Andree, P. J., & McIntyre, T. (1993). Stimulus (instructional) fading during extinction of self-injurious escape behavior. Journal of Applied Behavior Analysis, 26(2), 205–212. https://doi.org/10.1901/jaba.1993.26-205

    Article  PubMed  PubMed Central  Google Scholar 

  • Patten, E., Belardi, K., Baranek, G. T., Watson, L. R., Labban, J. D., & Oller, D. K. (2014). Vocal patterns in infants with autism spectrum disorder: Canonical babbling status and vocalization frequency. Journal of Autism and Developmental Disorders, 44(10), 2413–2428.

    Article  PubMed  PubMed Central  Google Scholar 

  • Paul, R., Fuers, Y., Ramsay, G., Chawarska, K., & Klin, A. (2011). Out of the mouths of babes: Vocal production in infant siblings of children with ASD. Journal of Child Psychology and Psychiatry, 52, 588–598. https://doi.org/10.1111/j.1469-7610.2010.02332

    Article  PubMed  Google Scholar 

  • Paul, R., Orlovski, S. M., Marcinko, H. C., & Volkmar, F. (2009). Conversational behaviors in youth with high-functioning ASD and Asperger syndrome. Journal of Autism and Developmental Disorders, 39(1), 115–125. https://doi.org/10.1007/s10803-008-0607-1

    Article  PubMed  Google Scholar 

  • Pelaez, M., Ortega, J. V., & Gewirtz, J. L. (2011). Contingent and noncontingent reinforcement with maternal vocal imitation and motherese speech: Effects on infant vocalizations. European Journal of Behavior Analysis, 12, 277–287.

    Article  Google Scholar 

  • Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31(4), 605–620. https://doi.org/10.1901/jaba.1998.31-605

    Article  PubMed  PubMed Central  Google Scholar 

  • Sheinkopf, S. J., Mundy, P., Oller, D. K., & Steffens, M. (2000). Vocal atypicalities of preverbal autistic children. Journal of Autism and Developmental Disorders, 30, 345–354. https://doi.org/10.1023/A:1005531501155

    Article  PubMed  Google Scholar 

  • Shillingsburg, M. A. (2004). The use of establishing operation in parent-child interaction therapy. Child and Family Behavior Therapy, 26(4), 43–58. https://doi.org/10.1300/J019v26n04_03

    Article  Google Scholar 

  • Shillingsburg, M. A., Hansen, B., & Wright, M. (2018). Rapport building and instructional fading prior to instructional fading: Moving from child-led play to intensive teaching. Behavior Modification, 1–19. https://doi.org/10.1177/0145445517751436

    Article  PubMed  Google Scholar 

  • Skinner, B. F. (1957). Verbal Behavior. Englewood Cliffs, NJ: Prentice Hall.

    Book  Google Scholar 

  • Solomon, M., Ono, M., Timmer, S., & Goodlin-Jones, B. (2008). The effectiveness of parent-child interaction therapy for families of children on the autism spectrum. Journal of Autism and Developmental Disorders, 38, 1767–1776.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sundberg, M. L., Michael, J., Partington, J. W., & Sundberg, C. A. (1996). The role of automatic reinforcement in early language acquisition. The Analysis of Verbal Behavior, 13, 21–37.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tamis-LeMonda, C. S., Bornstein, M. H., & Baumwell, L. (2001). Maternal responsiveness and children’s achievement of language milestones. Child Development, 7(3), 748–767.

    Article  Google Scholar 

  • Tarbox, R. S. F., Wallace, M. D., Penrod, B., & Tarbox, J. (2007). Effects of three-step prompting on compliance with caregiver requests. Journal of Applied Behavior Analysis, 40(4), 703–706. https://doi.org/10.1901/jaba.2007.703-706

    Article  PubMed  PubMed Central  Google Scholar 

  • Warlaumont, A. S., Richards, J. A., Gilkerson, J., & Oller, D. K. (2014). A social feedback loop for speech development and its reduction in autism. Psychological Science, 25, 1314–1324. https://doi.org/10.1177/0956797614531023

    Article  PubMed  Google Scholar 

  • Warren, S., Gilkerson, J., Richards, J., Oller, D. K., Xu, D., Yapanel, U., & Gray, S. (2010). What automated vocal analysis reveals about the language learning environment of young children with autism. Journal of Autism and Developmental Disorders, 40, 555–569. https://doi.org/10.1007/s10803-009-0902-5

    Article  PubMed  Google Scholar 

  • Yoder, P. J., & Stone, W. L. (2006). A randomized comparison of the effects of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 49, 698–711. https://doi.org/10.1044/1092-4388(2006/051

    Article  PubMed  Google Scholar 

  • Yoder, P. J., & Warren, S. F. (1999). Maternal responsivity mediates the relationship between prelinguistic intentional communication and later language. Journal of Early Intervention, 22(2), 126–136.

    Article  Google Scholar 

  • Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23, 143–152. https://doi.org/10.1016/j.ijdevneu.2004.05.001

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Alice Shillingsburg .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shillingsburg, M.A., Hansen, B., Frampton, S. (2018). Clinical Application of Parent-Child Interaction Therapy to Promote Play and Vocalizations in Young Children with Autism Spectrum Disorder: A Case Study and Recommendations. In: McNeil, C., Quetsch, L., Anderson, C. (eds) Handbook of Parent-Child Interaction Therapy for Children on the Autism Spectrum. Springer, Cham. https://doi.org/10.1007/978-3-030-03213-5_26

Download citation

Publish with us

Policies and ethics