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Effectiveness of Parent-Mediated Intervention Combined With Positive Behavioral Support on Challenging Behaviors and Parenting Stress Among Children With Autism.

29. april 2026 opdateret af: Khizra Iqbal, Islamia University of Bahawalpur

Effectiveness of Parent-Mediated Intervention Combined With Positive Behavioral Support on Challenging Behaviors and Parenting Stress Among Children With Autism in South Punjab: A Quasi-Experimental Study

This study aims to evaluate the effectiveness of a parent-mediated intervention combined with Positive Behavioral Support (PBS) in reducing challenging behaviors among children with autism and decreasing parenting stress in South Punjab, Pakistan. By equipping parents with PBS techniques, the intervention seeks to identify and manage behavioral triggers, thereby improving child behavior and reducing caregiver strain.

There is a growing need for culturally adapted intervention programs in local languages such as Urdu and Seraiki, tailored to the socio-cultural context of Pakistani families. This study addresses this gap by providing indigenous evidence on a dual-component intervention (Parent-Mediated Intervention + PBS) designed specifically for the family structure and caregiving practices in South Punjab.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This quasi-experimental study is designed to examine the effectiveness of a combined Parent-Mediated Intervention (PMI) and Positive Behavioral Support (PBS) program in managing challenging behaviors among children diagnosed with autism spectrum disorder and reducing parenting stress among their caregivers in South Punjab, Pakistan.

Children with autism often exhibit challenging behaviors such as aggression, self-injury, and non-compliance, which significantly increase caregiver burden and negatively impact family functioning. In low-resource settings like South Punjab, access to structured behavioral interventions is limited, and most available programs are not culturally or linguistically adapted.

The intervention program in this study integrates parent training (PMI) with evidence-based behavioral strategies (PBS). Parents will be trained to identify antecedents and consequences of challenging behaviors, implement behavior modification techniques, and reinforce adaptive behaviors in natural home settings. The intervention will be delivered in local languages (Urdu and Seraiki) to enhance accessibility and comprehension.

Participants will be divided into intervention and control groups. The intervention group will receive the combined PMI + PBS program, while the control group will receive treatment as usual. Standardized measures will be used to assess changes in child behavior and parenting stress before and after the intervention.

The findings of this study are expected to provide culturally relevant evidence for scalable, family-based interventions in Pakistan and contribute to improving the quality of life of children with autism and their caregivers.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

80

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Pakistan
      • Multiple Locations, Pakistan, 60000
        • The Islamia University of Bahawalpur

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria: Children aged 3 to 12 years with a confirmed diagnosis of ASD (based on DSM-5 criteria).

Presence of at least two moderate-to-severe "challenging behaviors" as reported by parents.

Parents/caregivers who are the primary providers of daily care. Residents of South Punjab for the past 12 months.

Exclusion Criteria: Children with severe comorbid physical disabilities (e.g., total blindness or deafness) that prevent participation in standard PBS activities.

Parents currently enrolled in other intensive behavioral training programs.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Parent-Mediated Intervention + Positive Behavioral Support (PMI + PBS)

Participants in this arm will receive a structured parent-mediated intervention combined with Positive Behavioral Support (PBS). Parents will be trained to identify antecedents and consequences of challenging behaviors, implement behavior modification strategies, and reinforce adaptive behaviors in their children.

The intervention will be delivered through weekly structured sessions over a period of 12 weeks. Each session will include psychoeducation, skills training, modeling, and guided practice. Parents will also be assigned home-based tasks to apply learned strategies in natural settings. The intervention will be delivered in local languages (Urdu and Seraiki) to ensure cultural relevance and comprehension.
Adfærdsmæssigt: Parent-Mediated Intervention + Positive Behavioral Support (PMI + PBS)

Duration: 8-10 weeks intervention, 2 sessions per week (total 16-20 sessions)

  1. Parent-Mediated Intervention (PMI) included

    Training parents in:

    Communication strategies Positive reinforcement Managing child behavior

  2. Positive Behavioral Support (PBS) Functional behavior assessment Identifying triggers of behavior

Teaching:

Replacement behaviors Reinforcement techniques Behavior management plans

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Aberrant Behavior Checklist (ABC)
Tidsramme: From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
The Aberrant Behavior Checklist (ABC) is a standardized caregiver-reported scale used to assess problem behaviors in children with developmental disorders. It includes 58 items across five domains: irritability, lethargy/social withdrawal, stereotypic behavior, hyperactivity, and inappropriate speech. Each item is rated on a 4-point scale (0-3), with total scores ranging from 0 to 174. Higher scores indicate greater severity of challenging behaviors, reflecting a worse outcome.
From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
Parenting Stress Index (PSI)
Tidsramme: From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
The Parenting Stress Index (PSI) is a standardized self-report measure assessing stress experienced by parents in relation to child-rearing. It includes domains such as parental distress, parent-child dysfunctional interaction, and difficult child characteristics. Scores typically range from 36 to 180 (short form). Higher scores indicate greater parenting stress, reflecting a worse outcome.
From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Adaptive functioning (VABS)
Tidsramme: From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
The Vineland Adaptive Behavior Scales (VABS) is a standardized instrument used to assess adaptive functioning, including communication, daily living skills, socialization, and motor skills. Scores are reported as standard scores with a mean of 100 and a standard deviation of 15, typically ranging from approximately 20 to 160. Higher scores indicate better adaptive functioning, reflecting a better outcome.
From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
Treatment Adherence
Tidsramme: From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks
Treatment adherence will be measured as the percentage of intervention sessions attended by parents out of the total number of scheduled sessions. Adherence will be calculated as a percentage ranging from 0% to 100%. Higher percentages indicate greater adherence to the intervention protocol, reflecting a better outcome.
From baseline (week 0), mid-intervention assessment (week 6), to post-intervention assessment at 12 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Islamia University of Bahawalpur

Efterforskere

  • Ledende efterforsker: Khizra Iqbal, The Islamia University Bahawalpur, Punjab Pakistan

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2026

Primær færdiggørelse (Anslået)

1. maj 2026

Studieafslutning (Anslået)

1. juli 2026

Datoer for studieregistrering

Først indsendt

22. april 2026

Først indsendt, der opfyldte QC-kriterier

29. april 2026

Først opslået (Faktiske)

6. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ECSFLLSDU2025-10.

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