5,6 The nature of caregiver involvement varies across programs, with some programs focusing on providing education to caregivers about the child’s symptoms and other programs focusing on teaching caregivers specific technique that can be used in the natural environment.7 While both approaches have been successful, in order for treatment effects to be maintained, the intervention program needs to be compatible with the family’s daily routines.8 Traditional caregiver-mediated interventions designed to reduce behavior problems Inhibitors,research,lifescience,medical in

children without ASD are typically geared toward treating noncompliance.9,10 In these interventions, caregivers are taught to facilitate appropriate behavior by using rewards, and to decrease noncompliance by using consequences including ignoring and time out. Little Inhibitors,research,lifescience,medical Protein Tyrosine Kinase inhibitor research has been conducted to determine whether these traditional behavior management strategies are effective at treating problem behaviors in children with ASD. Because it is often an underlying symptom of ASD rather than noncompliance that leads to challenging behaviors Inhibitors,research,lifescience,medical in these children, a traditional behavior management approach focused on noncompliance may not

be effective. There have been several case studies reporting the effectiveness of using a traditional parent-mediated behavioral intervention, Parent Child Interaction Therapy9 (POT), to decrease challenging behaviors in children Inhibitors,research,lifescience,medical with ASD.11 These studies suggest that POT may be effective in reducing challenging behaviors, particularly when used with high-functioning children with ASD and when adaptations are made to target social skills. However, the use of ignoring is not recommended when targeting repetitive and self-stimulatory behaviors as the lack of social attention may actually provide increased opportunity to engage in these behaviors. Solomon and colleagues12 conducted the only study to date that compared the

effectiveness of a traditional caregiver-mediated behavioral Inhibitors,research,lifescience,medical intervention (POT) in a group of children with ASD and a waitlist control group. They found increased shared positive affect in parent-child dyads but no changes in parent stress or parent report of challenging behaviors compared with the comparison group. They noted the importance of building a parent-child relationship for children with ASD. Thus, for caregiver-mediated interventions targeting challenging behaviors for children with ASD have not been consistently found to reduce challenging behaviors and may need to be adapted to meet the specific needs of this population. In a comparison of the caregiver-mediated intervention literature for children with ASD and children with disruptive behavior disorders (DBD), Brookman-Frazee and colleagues13 reported striking differences in intervention techniques.