The greater part of this thesis concerns the development and testing of an interaction-focused intervention: ‘Video feedback Intervention to promote Positive Parenting adapted to Autism’ (VIPP-AUTI). VIPP-AUTI is a manualised program of a five-session home training, using video-taped fragments of the individual parent-child dyad during play and mealtime interactions. The video feedback has been provided to the primary caregiver of the child (mother or father) and targeted at enhancing parental sensitivity to their child’s signals, taken its ASD-characteristics into account. In a randomized controlled trial we tested effectiveness of VIPP-AUTI with primary caregivers of 78 children with ASD. Alongside the studies concerning VIPP-AUTI, we explored coping-related competences of parents with respect to their child’s ASD diagnosis, using a brief, semi-structured interview. We also focused on neurobiological mechanisms related to early parent-child interactions. In a placebo-controlled, double-blind, within-subject experiment, we investigated the influence of oxytocin, a neuropeptide and attachment-related hormone, on father-child play-interaction.
The parent-mediated program VIPP-AUTI demonstrated effectiveness on parents’ sensitivity to stimulate their child with ASD adequately as well as on their increased self-efficacy in child rearing. A secondary therapeutic effect of VIPP-AUTI was found on increased child initiating joint attention skills. Parents of children with ASD showed high levels of acceptance and active adaptation to the recent diagnosis of their child. Intranasally oxytocin administration to fathers of children with and without ASD elevated the quality of paternal sensitive play interaction with the child.
Implementation of the VIPP-AUTI program in clinical practice is supported by its effectiveness, short-term duration, home-based intervening, detailed manual, relatively brief training of interveners and client satisfaction.
Identification of parental reaction to child’s ASD-diagnosis is important to tailor parent-mediated interventions.
Further research is needed to explore a potential contribution of oxytocin administration to parents within the field of interventions to promote adequate parent-child interactions.