Group Autism Parent-Training in a Low-Resource Community: A Randomized Controlled Trial of a Joint Engagement Intervention in Buenos Aires, Argentina

Background: Parent-implemented interventions for young children with ASD have been found to be associated with improvements in child social engagement (e.g. Casenhiser and Shanker. 2011; Kasari et al.2010; Patterson, Elder, Gulsrud and Kasari, 2013) language (Coolican et al. 2010; Vismara et al. 2009), imitation (Ingersoll and Gergans, 2007), and play (Gillett and LeBlanc 2007). In countries with relatively few trained autism professionals, such as Argentina, parent-implemented interventions may be the only services available for young children with ASD. However, traditional parent training models emphasizing individual coaching sessions are not scalable in countries such as Argentina and very little research has focused on group parent training which has the potential to make training more accessible to families (Minjarez, Williams, Mercier and Hardan, 2011; Ingersoll and Dvortcsak, 2007). This study is the first randomized controlled trial of a group-parent training program for ASD in Argentina.

Objectives: The study aimed to test the efficacy of the parent-training program translated into Spanish and delivered in a 2-day weekend workshop format.  

Methods: The parent-training program was originally developed for a multi-cultural, low-income, group in the Bronx, NY (Houghton and Lewis, 2012) and teaches parents research-based techniques for encouraging joint engagement embedded in everyday activities at home. 24 families, with children under 6 years of age with ASD, were randomly allocated to two groups. The primary dependent variable was parent interactive style, specifically Responsivity and Directiveness (Mahoney & Perales, 2003), as observed in a video recorded free play session with the child. Group 1 received the 2-day parent-training program first while Group 2 served as a control group. Then Group 2 received the training program, forming a secondary, multiple-baseline arm.

Results: Group 1 showed a significant increase in Responsivity and a significant decrease in Directiveness after the training program as compared to the control group. Group 2 showed the same pattern of change in interactive style as compared to the baseline period.

Conclusions: A brief, low-cost group parent-training program was shown to increase parent Responsivity and reduce Directiveness, an interactive style that has been shown to positively impact social-communication development in children with ASD.