A Pragmatic, Pilot Randomised Controlled Trial of the Incredible Years Autism Spectrum and Language Delays Programme

Introduction: Many children with Autism Spectrum Disorder (ASD) have co-occurring mental health difficulties such as anxiety, hyperactivity, and conduct problems. These co-occurring problems can be very challenging for parents and can often cause more distress than the core ASD traits. The Incredible Years^®Autism Spectrum and Language Delays (IY-ASLD) programme was recently developed to target the needs and concerns of parents of children with ASD. The 12-week programme is designed for initial support to parents following diagnosis and targets the parent-child relationship as well as broad developmental outcomes including language and communication, adaptive skills, and social skills. The main aims of this study were to examine the feasibility of delivering this programme within child health services (including programme attendance and satisfaction) and to provide initial evidence of effectiveness.

Methods: A pilot randomised controlled trial was conducted in four specialist children services to compare the IY-ASLD programme with a control condition. A total of 58 parents of children with ASD (aged 3-8 years) were randomly allocated to receive the IY-ASLD immediately or after six months. Data were collected before randomisation and six months later. Measures included child behaviour, parental stress, parenting behaviour, parental depression, child social communication, and a 10-minute parent-child play observation. Parents in the intervention condition also completed a satisfaction questionnaire and a qualitative interview on their views of the programme.

Results: Attendance on the programme was high with 72% of parents attending eight or more sessions. Satisfaction with the programme was also high with over 90% of the parents rating the content, teaching, group discussions, role play, and home activities as helpful or very helpful. A medium effect size was found for observed parental praise (d= 0.62) indicating that parents in the intervention condition significantly increased their use of praise with their children compared to control parents. Small effect sizes were found for other observed parental behaviours, child externalising behaviour, parental distress, parental depression, and negative parenting skills.

Conclusions: The IY-ASLD programme was successfully delivered by existing staff in four specialist children services. It was well-received by parents who reported good levels of satisfaction and high rates of attendance. Initial evidence of effectiveness suggests positive effects for parenting behaviour, child behaviour, and parental mental health. The results are promising however the study was not powered to find significant effects therefore a larger study would need to be conducted to further examine the programme’s effectiveness.