Parent Training, Meds Combo Improves Behavior in PDD

Modest extra benefit for children with pervasive developmental disorders, behavioral problems

FRIDAY, March 2 (HealthDay News) -- Children with pervasive developmental disorders (PDD) and serious behavioral problems respond better to medication combined with parent training than just medication, according to a study published in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

Lawrence Scahill, M.S.N., Ph.D., of Yale University in New Haven, Conn., and colleagues conducted a 24-week trial in which 124 children (aged 4 to 13 years) with PDD and serious behavioral problems were randomized to medication alone (MED; risperidone, or aripiprazole if risperidone was ineffective) or a combination of medication plus parent training (PT) (COMB). Parents of children in the COMB group participated in an average of 11.4 PT sessions. Vineland Adaptive Behavior Scales were used to assess improvement.

The researchers found that both groups showed improvement over the trial period on all Vineland domains. Greater improvement was seen in Vineland Socialization and Adaptive Composite Standard scores in the COMB group versus the MED group (P = 0.01 and 0.05, respectively). Socialization and Communication domains showed greater improvement in the COMB group versus the MED group on Age Equivalent scores (P = 0.03 and 0.05, respectively). Compared with the MED group, children in the COMB group were twice as likely to make a gain of at least six months in the Vineland Communication Age Equivalent score, but the difference was no longer significant after controlling for IQ.

"Reduction of serious maladaptive behavior promotes improvement in adaptive behavior. Medication plus PT shows modest additional benefit over medication alone," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies.

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