Use of a Direct Observational Measure in a Trial of Risperidone and Parent Training in Children with Pervasive Developmental Disorders.

A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; =49) versus risperidone plus parent training (COMB; =75) (ages 4-13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (=.0002) and 12 % increase in compliance to parental requests (=.004) for the two treatment conditions combined. Parents displayed 64 % greater use of positive reinforcement (=.001) and fewer repeated requests for compliance (<.0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement (=.01) and fewer restrictive statements (<.05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures.