Improvements in Children’s Behavioral and Parasympathetic Regulation Following PCIT for Child Welfare Families

• In Event: 3-217 - Promoting the development of children’s autonomic regulation: The role of parents and the parent-child relationship

Integrative Statement

In this presentation, we report early efficacy findings from an RCT of Parent-Child Interaction Therapy (PCIT) on biobehavioral markers of self-regulation in young children exposed to maltreatment. Whereas sensitive parenting is known to foster development of executive functions in early childhood (e.g., Blair & Diamond, 2008), victims of child maltreatment (CM) experience significant problems with self-regulation (Bugental, 2009; DeBellis, 2005). Abnormal patterns of parasympathetic-linked cardiac control also are observed in CM-exposed children (Skowron et al., 2013), which mark deficiencies in central nervous system regulation of emotion and behavior (Beauchaine, 2015). However, no studies to date have examined whether PCIT can strengthen autonomic and behavioral markers of self-regulation in CM children.
Data from N = 74 child welfare families randomized to PCIT or the control condition were analyzed. Children averaged 4.73 years old (SD = 1.39, range 3 to 7), 56% boys, and 44% identified as ethnic minority. Primary caregivers and one child completed the 2-hour biobehavioral assessments at pre-, mid-, and post-intervention. Autonomic (i.e., respiratory sinus arrhythmia; RSA), measures of child regulation were collected at each time point during a 5’ resting baseline and a social interaction task comprised of two identical joint episodes (12’ each)—child with mother and child with unknown female researcher. For each joint episode, instructions on a computer screen prompted members of the dyad to count each other’s fingers, point to parts of each other’s faces, and whisper a story to each other (Fries et al., 2005). Child behavioral regulation measures included the Head-Toes-Knees-Shoulders (HTKS) task (McClelland et al., 2014) and parent-reported Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000). Parents reported on child disruptive behavior using the Eyberg Child Behavior Inventory (ECBI; Boggs, Eyberg, & Reynolds, 1990). Group differences in autonomic and behavioral change from pre- to post-intervention were tested using a series of repeated measures ANCOVAS that included child age and wave 1 measures of each variable.
Results showed statistically significant group differences in child disruptive behavior problems, with parents who completed PCIT reporting lower total child problem behavior scores (p =.001) and behavior intensity scores (p =.003). We observed marginal group differences across conditions in children’s psychophysiological function. Compared to controls, children receiving PCIT displayed task-average increases in post-treatment RSA (i.e, parasympathetic activation) approaching statistical significance at rest (p = .14), while interacting with their mother (p =.15), and with an unfamiliar adult (p =.26). Children in the intervention group were also reported to have near-statistically significantly fewer emotional control problems than controls (p =.10). No group differences were observed for children’s performance on the HTKS.
These preliminary results appear promising and suggest that PCIT parent training may confer benefits in child regulation, in addition to reducing disruptive behavior. Data collection is ongoing, and we anticipate analyzing data for N=120 children by March 2019. If confirmed and strengthened by our further analyses, the initial trends documented here may show that PCIT has the capacity to effect change in behavioral and peripheral biomarkers of self-regulation in children exposed to CM.

Authors

• Elizabeth A. Skowron, University of Oregon
  Presenting Author

• David DeGarmo, University of Oregon
  Non-Presenting Author

• Jessica Norman Wells, University of Oregon
  Non-Presenting Author

• Maria Lynn Schweer-Collins, University of Oregon
  Non-Presenting Author

• Carolyn M. Scholtes, University of Oregon
  Non-Presenting Author